George Kunz
Seattle
University
Seattle, WA
What makes therapy therapeutic?
Is it transference and counter transference? Is it the therapeutic
alliance? Is it unconditional positive regard? Yes! All these are
therapeutic. However, we need to ask deeper philosophical questions
about the nature of this relationship, this unique face-to-face
encounter between client and therapist. With careful reflection
on psychotherapy, I will make the extravagant claim that it is ethical
responsibility that makes therapy therapeutic.
We need to reflectively dig deeper
into this relationship to understand what makes therapy therapeutic.
While ethical responsibility may not be sufficient, it is
necessary for healing. More than ethical responsibility is needed
for therapy, but without it, therapy won't work. Furthermore, I
will claim that simplicity, humility, and patience
are the expressions of ethical responsibility. Simplicity, humility,
and patience are the ethical conditions that make psychotherapy
therapeutic. I will eventually claim that this relationship is sacred,
and could be called religious.
When I claim that simplicity,
humility, and patience are therapeutic, I don't mean
they are the necessary skills of the therapist. They are not qualities
that can be developed for use as techniques. A therapist can't practice
the skill of simplicity, or train herself in humility, or develop
the proper habit of patience. They are conditions of this unique
relationship between client and therapist that we call psychotherapy.
They begin in the appeal of the client asking the therapist to not
harm and to help her with problems. They are fulfilled by the therapist's
response to that appeal.
Simplicity, humility, and patience
are gifts. I don't mean gifts as talents or special sensitivity
of the therapist. They are gifts in the sense that they are the
freely given condition between the client and therapist in this
unique relationship. The client gives her gift by appealing to the
therapist to transcend his role as a therapist, to transcend even
himself, in order to be responsible. In return, the therapist gives
his gift by responsibly responding to the client, and by appealing
to her to transcend her role as a client, to transcend even herself,
to be responsible toward others.
The Germanic word gift is
close to the Latin word gratus. Gratus is the etymological
root for the words gratuitous, and gratitude, and
gracious. Psychotherapy ought to be understood within the
mode of gift-giving rather than in the business model of economic
exchange that grounds much of the field of counseling. As gift,
therapy is closer to the notion of grace than to the notion of contract.
Grace is the unexplainable and unmerited gratuity of a good relationship
Briefly, simplicity is the
gift when the therapist, in his effort to understand the client,
is asked by her uniqueness to not reduce her to one of his convenient
psychological labels; and then he responds with respect to this
request. Humility is the unmerited gift when the therapist, having
the skill and opportunity to change the client's behavior, is asked
by the client's vulnerability to not manipulate her; and then he
does not apply a technique on her. Patience is the gratuitous gift
when the client's suffering asks the therapist's compassion to not
suffer her suffering, but to suffer her. Suffering her is therapeutic.
Let's conduct a phenomenological
analysis of the straightforward face-to-face encounter in the therapeutic
relationship. When we do a phenomenological analysis, we hold back
any interpretation or explanation and describe as carefully as possible
what shows itself. When the client reveals herself in pain, she
wants to be understood; she does not want some explanatory interpretation
Let's describe these three gifts
of simplicity, humility, and patience in order to understand how
they each make therapy therapeutic. At the cognitive level, simplicity
can be understood from a phenomenological description of what it
means to know another person. At the behavioral level, humility
can be understood from a phenomenological description of what acting
for the good of another really is. At the feeling level, patience
can be understood from a phenomenological description of suffering
another.
Our phenomenological reflections
will respond to the following three questions. The first question
asks about knowing another. What does it mean for a therapist psychologically
knowledgeable about pathology, to acknowledge that he does not know
the client; that he cannot reduce her to a category and make clinical
judgments about her; that he cannot ethically assign a pathological
label to her distinctive behavior? What is therapeutic about this
paradoxical condition of knowing, and yet not knowing? What makes
simplicity therapeutic?
The second question asks about
acting for the good of another. What does it mean for a skilled
practitioner trained in the techniques of therapy to recognize that
the vulnerability of the client asks him to not act on her, to not
apply his technical skills to manipulate her behavior? What is therapeutic
about this paradoxical condition of acting, and yet not acting as
the agent of her change? What makes humility therapeutic?
The third question asks about suffering
for another. What does it mean when an empathic and caring counselor
faces the suffering of a client, to know that he must not be drawn
into feeling the same emotional suffering the client feels, but
must, however, suffer her? What is therapeutic about this paradoxical
condition of not suffering and yet suffering? What makes patience
therapeutic?
Let's begin with a phenomenological
description at the cognitive level, at the level of knowledge. What
is known, and what is not known in the therapeutic encounter? At
this point, we are not concerned with the content of their discussion,
what is spoken about during therapy, but what meanings are expressed
to each other simply by their facing each other. "Speaking in psychotherapy
is primarily speaking to another, and secondarily speaking about
something."
I call this a phenomenology of
the faces of the client and therapist facing each other, speaking
to each other.
The client's face says to the therapist,
"here I am."
This message, "here I am," is the
most powerful expression of human existence. Even before my client
opens her mouth, her face facing me says, "I am here." Before she
speaks about her situation, her face says, "I am the one before
you. I am here and others are not here. I am here, and this suffering
I suffer, these problems I will tell you about are unique." Her
face does not say, "I'm here to represent that group of people called
depressives." She does not say, "My suffering is just like the suffering
of others." The face of the client says, "It's me. You see me here.
You do not see a client in pain. You see me in pain. I am the only
one here, and I'm here in pain."
The face of the good therapist
says in response, "Here I am. I'm not only here with you. I am here
for you."
The client's face says more, "I
am more than just here. I am here and I am vulnerable. I am more
vulnerable here than when I'm out on the street. In here I tell
you my story. I'm opening up my life to you. I lay bare my suffering.
In here I lower my defenses. I trust you will not abuse me. I have
no one here to protect me. I am more vulnerable than you. This is
not an equal situation. You're secure. I'm vulnerable."
The face of the good therapist
responds to her fear, "I will not harm you."
The face of the client goes on
to say, "I am here bearing my own witness to my own suffering. No
one is here but me to tell you that my story of pain is real, that
I'm not lying to you. No one is here but me to tell you that I and
my story have dignity and worth simply because I exist."
Even if the client tells the therapist
that she does not have any value, that her mother always told her
that she was worthless, that her father beat her because she was
stupid and ugly, her face says to me, "Here I am; I am good; I do
have dignity."
The good therapist's gift to her
conflict is, "I see you and I witness your goodness and dignity."
The client's face goes on to say,
"I see you seeing me before you. I see you witnessing me as the
one before you, witnessing that I am the only one telling you about
my suffering. As I speak about my suffering, I see you as the one
here hearing my problems. I want to believe your face when it expresses
back to me, 'I am here. Yes, I hear you. I'm not only with you but
for you.'" Her face says, "I want to see your face expressing to
me that you will not harm me, you will not reduce me to one of your
categories. You will not use me simply to practice becoming a skilled
therapist, not use me to feel good about yourself." This appeal
by the client, and the responsible witness by the therapist to the
client's witness of herself is what makes this ethical and what
makes it therapeutic.
With this phenomenological description
of the cognitive condition of the therapeutic event, let's look
again at the first question: What is simplicity? What does it mean
for a therapist to both know and not know a client's pathology?
What does it mean to see her behavior and hear her story about problems,
but not reduce them to symptoms? How does one not know when one
knows? How is this paradoxical simplicity therapeutic?
To get started, there are a few
embarrassing difficulties. Good therapists hold two cognitive dissonant
bits of knowledge. They know that their academic education about
pathology helps them as therapists. They also know that equally
good therapeutic healing can take place through the help of untrained
people, for example, relatives and friends, even strangers. People
without trained knowledge about the signs of pathology often give
more help than do therapists. On the one hand, therapists know that
their own expert knowledge helps them understand clients. But, on
the other hand, they are also haunted by the sense that something
beyond their knowledge of pathology, something transcending their
skills, ultimately brings healing. Good therapists know that there
is something within the face-to-face relationship itself, this speaking
to… is what heals.
Unlike other scientist practitioners, such as
a car mechanic or a cardiac specialist, the psychotherapist must
know that right here facing him is an individual whose singularity,
whose distinctive uniqueness questions his use of general knowledge
about pathology. The face of the client asks the therapist to place
his general knowledge in the background, and to place her in the
foreground.
Psychotherapy is unlike medical practice. For
example, I am very happy that my cardiac doctor relies primarily
on his expert knowledge of the structure, function, and operation
of the heart in order for him to examine and treat my particular
heart. While I am pleased that he treats me as an individual, it
is his general expert knowledge of human hearts that gives me the
confidence that he will do the right thing with me.
Unlike the medical doctor, the psychotherapist
is confronted by an individual whose psychological singularity is
unique in every way. The client's social and environmental conditions
may be like others, but they are unique. Her interpersonal relationships
may be analogous to others, but they are unique. Her suffering may
be like others, but it is quite unique. The therapist should not
say, "Oh, I know what you mean." He does not know what she means.
When he says, "I know what you mean," he is reducing her meaning
to a common meaning that he knows from himself and others. He is
not called to know what she means. He is called to understand (stand
under) her, but not know her meanings as she knows them. Her experiences
are singularly unique.
Let's proceed a little deeper with our philosophical
excavation of psychotherapy. This mental task of moving the client's
individuality into the foreground and the therapist's general knowledge
of pathology into the background is a philosophical maneuver. It's
an epistemological choice to attend to individuality rather than
commonality. Aristotle taught us this trick centuries ago. This
epistemological maneuver assumes, however, that the person is "nothing
more than"…a thing among things, a being among beings containing
both individual and general characteristics, and the knower can
choose to attend to the person's individuality or to her commonality,
depending on his particular interest. Psychotherapy, however, should
not involve an arbitrary philosophical exercise, an epistemological
strategy, a mind trick. Psychotherapy is a concrete, lived-out ethical
event based on the ultimate goodness of the client, and an ethical
obligation to that goodness by the therapist. He is called to understand
(stand under) the client. His face should say, "I am here, standing
under you, to be for you."
In psychotherapy, the face of the client does
not call into question the therapist's general knowledge, nor question
the therapist's skill in cognitively moving between knowing individuality
and knowing generality. The face of the client questions the therapist's
ethical judgment about reducing the client to fit a general category.
Therapy is an ethical event, not an epistemological event. The singularity
and uniqueness of the person does not threaten the therapist's general
understanding of pathology. Her singularity commands his ethical
behavior. Attending to this singular client appealing for singular
understanding and help is an ethical reality.
The meaning of the primordial first word, "Here
I am," expressed by both client and therapist facing each other
makes this ethical reality therapeutic.
The good therapist knows that it is the ethical
that makes therapy therapeutic. He experiences that her self-revelation,
"Here I am," makes her uniquely singular, and uniquely responsible
as the one telling and owning her story, and his hearing this revelation
makes him uniquely singular, and uniquely responsible as listening
and receiving that story. Not only was singular pain lived, and
a singular story about that pain told, and that story was told in
person by the person who lived that pain, and that story is owned
by that person, but also that story of pain is heard only by that
therapist, witnessing back to the client that he is alone in the
therapy situation hearing her unique story and testifying to her
that he hears her revealing her story. This witnessing of the client's
witnessing makes the therapist uniquely responsible. The therapist
does not disclose the client's meanings. The client reveals herself.
Let's look at these two words, disclose and
reveal. When the therapist makes his detached diagnosis searching
for symptoms that will disclose the meanings of the client, he is
trying to make her fit his pre-established categories. Picture the
analogous miner with the head-lamp searching to disclose the ore.
He is not only looking for what is there, but his light is also
bringing the oar into light, out of darkness. In disclosing, consciousness
not only knows, it opens up the reality it wants to know. Picture
the therapist with his theoretical head-lamp illuminating what he
is looking for in order to disclose symptoms to fit his theory.
His consciousness not only knows the client, he also opens up for
himself the reality that he wants to know.
On the other hand, when the client reveals herself,
she is the one who bears witness about herself. To reveal has a
different meaning than to disclose. In contrast to the self-fulfilling
search of a therapist, the client's revelation of her story is more
like a prophetic manifestation, an epiphany. Her life is sacred.
Her revelation of her life with all its pain and confusion manifests
the sacred. This is a religious act.
The singularity of the client facing the therapist
makes him singularly responsible. There is no other person seated
before the client at this moment. The therapist cannot retreat from
his place before the client. He cannot escape from his own skin,
from his embodied presence before this client, here in this place
and now at this time, witnessing her presence as the one who is
revealing her suffering. The face of the client, her eyes looking
at the therapist, her ethical command to him as she reveals her
story says, "you cannot escape by acting as if you are only a representative
of the group called therapists." At this place and time before the
client the therapist is not a general therapist before a general
client. The simple statements from each to the other, "here I am;
there you are," are gifts of simplicity, gifts of therapy. The Greek
word Therapeutikos means "one who cares for by paying attention
to reality as it is given." Therapists must be phenomenologists
rather than scientists. They must pay attention to the person as
she or he gives herself or himself, rather than searching for evidence
to prove their hypotheses.
Let's do another phenomenological reflection
on what is often given. Clients lie. They tell therapist things
that are not true. Clients can believe something that is not true,
so when they tell the therapist this untruth, it is not really a
lie. A lie is when the truth is known and an alternative is spoken
to another. When the client tells a story that is not the reality
as it happened, she is still testifying that that story is her story.
She says without speaking, "This is my story. This is the way it
happened. This is how I felt." She may in some way believe her own
version of the situation, or believe that this is what the therapist
wants to hear and believe. The therapist may conclude that her lying,
or her false belief, is part of her pathology, and therefore the
truth of the story is not what is important, only that she believes
this story. The client's experience is what is important. It is
the client's reality, and the therapist must accept it as her reality.
This raises another reflective question: is
the therapist more like the reader of history whose desire is to
have truth disclosed as it happened, or is the therapist more like
the reader of fiction whose desire is to have truth disclosed as
if it happened? Both historian and story-teller disclose truth about
the human condition. The historian has a legitimate claim that his
truth is a truth beyond the truth of fictional themes. The fiction
writer has a legitimate claim that her truth is a truth beyond the
truth of factual history. Both can claim from their own perspective
their ethical responsibility to tell their truth about the human
condition.
To which truth should the therapist be committed?
The truth "as" it happened, or the truth "as if" it happened? Neither.
The truth to which the therapist must be committed should be neither
the truth of the historian nor the truth of the fictional storyteller.
He must be committed to the client herself as the truth. In psychotherapy
truth first and foremost comes from the most real of reality, the
concrete person before the therapist. There is nothing more real
than the existing person in her concrete presence, even when she
is lying. The real person's existence is more real than any spoken
reality. She is not only there; she is there with her own infinite
worth, simply because she exists as a human person. (Later we'll
discuss the ontological thereness of the client.) If her lies are
a part of her pathology, then the therapist must be interested in,
and open to, both the story as representative of an historical reality,
and also the story as if it happened, because he is committed to
this first reality, this first truth, the concrete person there
before him.
The therapist wants to understand how the client
believes reality happened. The therapist also wants to know how
the client distorts reality away from the way it actually happened.
The therapist must believe that if the client is to challenge her
own pathology she must come to a clearer understanding of what happened.
The therapist must believe that the client would serve herself better
were she to stop distorting reality. The therapist must believe
that the world of reality, as it gives itself, is a co-therapist,
or better, is the primary therapist. It is the real world that heals.
The real world must be allowed to heal in therapy, even when that
reality is the source of pain. Facing reality must in some way be
therapeutic. The therapist has an ethical obligation to help the
client face reality while also respecting the client's beliefs about
reality.
The therapist must use this hard reality precisely
because he values the client more than he values either the historical
truth or the fictional truth, simply because that real person is
the first and last truth. The therapist has an ethical obligation
to respect the client's story as one that, at this time, preserves
her dignity. Therefore, the therapist must be committed to the truth
both as it happened, and the truth as if it happened because the
client is the first truth. This is the therapist's paradoxical ethical
charge.
Let's consider the temporal progression of therapy.
At the beginning, before they have met, before the actual facing
takes place in therapy, the therapist does "know" the client as
if she were a member of a classification, as one member of a group
labeled depressive, or obsessive-compulsive, or whatever. The therapist
reads the file on the client; he reads her history. Someone else
at the intake session possibly wrote this history now on file. This
history is a disclosure of a person as a member of a classification
with her own particular characteristics. So the therapist, at the
beginning of the process, knows a disclosed client. While it is
a picture of the actual client (after all, it is her history), it
is, of course, not a picture of the actual client. Over time the
therapist comes to know both more and less of the client. As the
client reveals herself, she reveals that there is much more to her
than disclosed in her history. Even in the midst of therapy, what
she speaks about not only reveals, but also conceals. This is not
a deliberate concealment. Whatever reveals simultaneously and inevitably
conceals.
The front side of an object reveals that front
side and conceals the backside, which can be disclosed by turning
the object around. The narrative of a client both reveals what is
spoken and conceals what is left unspoken. While that which is hidden
can then be revealed, it in turn conceals more. The reality of the
client is infinitely more than can be revealed by any multiple turning
over the life of the client in an extended narrative. As the therapist
comes to know more of the client, he comes to know less. He comes
to know that there is always more of the client. The client is infinitely
more than what a therapist can know. The therapist knows there is
always the unknown. The therapist is always in the condition of
unknowing. This unknowing is therapeutic because it respects the
infinite privacy and solitude, the infinite Otherness, of the client.
Right within her revelation is the truth that the client cannot
be fully known. She is always more…
The gradual disclosure of an object is an epistemological
act. The gradual revelation of the infinite otherness and dignity
of the Other is an ethical event. The Other reveals not only unseen
sides, she reveals that she is infinitely sided, infinitely Other.
Her infinity is not just uncountable characteristics. Her infinity
is expressed in her existence as a human person, whose infinite
value is a first principle. Let me correct that: the value of a
person is a first principle that is not a principle. It is a concrete
fact. She is a person whose face says, "I am infinitely unknowable
and mysterious." And further says, "I have infinite value. Do not
do violence to me. Do not reduce me to a principle. Do not make
me into an idea of a client whom you think you can know."
Let me sum up this phenomenology of knowing
the client and her pathology. The gift of the client is her revelation
of her unique and sacred self, and her appeal to not be violated,
to not be reduced to pathology, but to be acknowledged as infinitely
worthy. "Do not do violence to me. Do not violate my integrity and
worth." The gift of the therapist is his response to her revelation
and appeal. "I will not reduce you." This situation of mutual simplicity
is therapeutic.
Here is my first charge to students. Study your
pathology. Know symptoms. Learn their etiology. But most importantly,
listen to your client as she or he says, "Here I am. Don't violate
me with your labels of pathology." Say back to the client, "I see
you. I am listening to you."
Let's discuss the second question, the one at
the level of behavior. What does it mean to work with a client,
and yet be asked to not use technical skills to manipulate the client?
What does it mean to act, and yet not act in a way that engineers
the client into predetermined outcomes?
Again therapists hold a cognitive dissonant
set of beliefs. They know that they can use methods to change the
client's behavior for the better. They also know that therapeutic
healing can take place with the help of untrained others without
the use of techniques? Healing can even happen without any intervention.
The therapist believes that his training in therapy can help clients
change behavior. He also recognizes that what is therapeutic is
beyond his skill as a therapist. He is haunted by the recognition
that healing transcends whatever he does. What takes place is bigger,
more profound. Her request, "be here," and, his response, "Here
I am," are prophetic revelations.
Let us again conduct a phenomenology of the
relationship between client and therapist. The first message from
the client's face says, "Do not violate my freedom." The second
message is, "serve my needs." She says by her presence, "Do not
violate me by manipulating me. Help me with my difficulties." Helping
without manipulating is humility. Humility is the service of another's
freedom. The client says, "Help me regain my freedom. My problems
keep me from acting freely. I am investing in you, therapist, the
freedom to help me with my lack of freedom." The client's previous
bad judgments and behavior have reduced her freedom. Her loss of
freedom asks for the therapist to use his freedom to help her regain
her freedom. The client's troubles and neediness says, "I've been
hurt. I've been sabotaged. I sabotage myself, and I cannot regain
freedom on my own. I'm investing in you the authority to help me
overcome my self-sabotage, in order to be free again." The therapist
is asked to help her regain health. The client does not say, "Help
me regain capricious freedom, help me with my self-centered freedom,
with that freedom I use to sabotage my freedom and health, and to
hurt others." Her face says, "Help me regain responsible freedom."
The therapist must be obedient to the freedom invested in him to
be used to serve the need of the client to regain her responsible
freedom.
Let me make another extravagant claim: the therapist
is responsible for the responsibility of the client. This claim
that one is responsible for the responsibility of another goes against
our precious individualism. We tend to understand the concept of
responsibility as belonging only to the individual. Our usual thinking
goes like this: If the therapist is responsible for the responsibility
of the client, then the client must no longer be responsible for
herself. Or, if the client is responsible for herself, then the
therapist must in no way be responsible for her. The therapist is
responsible only for himself. The client is responsible only for
herself. No one is responsible for another.
This isolating individualism of Western civilization
is pathogenic. And it sabotages the therapeutic of therapy. Accepting
the gift of responsibility for the client's needs is the therapeutic
humility of the therapist. The client's primary need is to be responsible
to others. Her pathology is, in some sense, her tendency to be egocentrically
needy and not responsible. Her therapy, therefore, is to become
more responsible. Certainly, the client has been abused by others.
She has been harmed. She has harmed herself. She has harmed others.
She turns to the therapist in her search for responsibility. The
therapist is responsible for the responsibility of the client.
Obviously this does not mean that the therapist
is to take away from the client her responsibility and take it on
himself. He is not responsible to make the client's choices and
act for her. He is responsible for the client's responsibility.
Just how the therapist fulfills that responsibility
to help his client become responsible is learned in practice and
good supervision. Analogous to the question about whether the therapist
is like a history or a fiction reader, we can ask if the therapist
is more like an engineer or a confessor. The engineer changes future
behavior toward a predetermined outcome. The confessor accepts and
forgives past behavior, and witnesses the restoration of love from
the community or God. The therapist is neither an engineer nor confessor.
He is responsible to the client's psychological health. If her health
depends on overcoming her egocentric needs and developing responsibility,
then the therapist is responsible for her responsibility.
Let me sum up this phenomenology at the behavioral
level about working with clients. Don't say, "I can change you."
The gift of the client is the revelation of herself and her appeal
for the therapist to not try to change her with techniques, but
to help her regain her responsible freedom. She says, "Respect my
freedom. Help me respect my freedom." The gift of the therapist
is to respond to this appeal. "Your responsible freedom is sacred."
These mutual expressions make up the gift of humility. This humility
is ethically therapeutic.
Students, my charge to you is, become skilled!
Develop styles that help. But most importantly listen to your client
say, "Here I am. Don't manipulate me." Reveal back to the client,
"I am here for you. Your well-being and responsible freedom is what
is important from this encounter."
Finally, let's conduct a phenomenology at the
affective level, the feeling level, to respond to the third question:
What does it mean for a caring and empathetic therapist to suffer
the client but not suffer the suffering of the client? What does
it mean to emotionally respond to the client and yet not feel the
client's feeling?
Again the therapist holds dissonant beliefs
about his own emotions. He knows that his affective detachment from
the client helps him be therapeutic. He also knows that compassion
is needed. He also knows that healing can take place with the help
of emotionally involved others, such as family and friends. Those
emotionally involved family members know that only the client can
suffer her suffering. Their love for the client together with their
experience that they cannot suffer the client's suffering makes
them suffer. Healing can happen only if another suffers. The therapist
suffers because he values the infinite goodness of this suffering
person. She is good. Her suffering is not good. He suffers because
she suffers. The therapist cannot love the client as the family
loves her. But his concern for the client must be like their love
by wanting her to not suffer because she is good and her suffering
is not good, and he is willing to suffer her. His interest must
be a disinterested interest. He wants her to not suffer purely for
her goodness, not for some benefit back to himself. He must be committed
to the client without any need for reciprocal pay-back toward his
interest. Of course he enjoys and celebrates her relief from suffering.
But he is not motivated for this benefit to him. He is motivated
for her goodness.
The therapist suffers patience. Patience is
suffering the Other. It is not re-suffering the Other's suffering.
I should not say to the client, "I feel your pain; I have felt that
same pain you feel." When the therapist tells the client that he
has felt her pain, he disrespects her pain by making it a generalized
pain, one that can be shared, one the therapist and others have
felt. But the client's pain is distinct; it is unique; it is singular.
Only she feels this pain. The therapist may have suffered a pain
like the client's, but he cannot feel the client's pain; and he
cannot tell her that the pain she feels is common. That would be
a lie, because her pain is unique.
The client is not asking the therapist to suffer
her pain. The client is asking the therapist to suffer her. The
therapist must be patient, not compassionate by trying to suffer
her suffering. The therapist does not suffer empathy or sympathy
by trying to suffer her suffering. He does not suffer as the client
suffers or with the client. He suffers the client. The client asks
the therapist to be patient, to suffer her, to be responsible to
her pain. She is asking the therapist to suffer the responsibility
of being responsible for her. This request is her gift for the therapist
to be patient, to transcend his own feelings. This gift can be therapeutic
if received and suffered by the therapist. The client's suffering
asks, "be here, suffer because I suffer," and, his response, "Here
I am," is a sacrificial rite.
The face of the client and the story she tells
say, "Here I am. My suffering is unique. I cannot detach it from
myself in order to give it to you. As much as I would like to rid
myself of this pain by giving it away, only I can suffer my suffering."
The client does not explicitly ask the therapist to suffer. But
the client's suffering says, "I want you to suffer me. When I know
you suffer me, when you care enough to sacrifice me, when I experience
that your suffering is suffering me, then will I know your ethical
responsibility is authentic. When I experience you suffering me,
I know I am infinitely worthy. I know my existence, as disturbed
and troubled as it is, has a dignity worthy of your suffering."
The client, in the midst of her suffering, knows
that the therapist's suffering her is an ethical and noble suffering.
Feeling his love-like suffering, his suffering disinterested interest,
makes therapy therapeutic. Suffering others heals their suffering.
Let me sum up this phenomenology at the affective
level of suffering of both client and therapist. This gift of the
client appealing to the therapist to suffer her because she is infinitely
and uniquely worthy is the condition of patience. Suffering the
client's appeal for suffering without suffering the suffering of
the client is patience. Patience is ethically therapeutic.
Students, my third charge to you: suffer your
clients when they say, "Here I am. I am asking you to suffer me.
Your suffering will show me that I am worthy."
Let's do a little more philosophical reflection
on the ontological thereness of the client. It is the ethical condition
in any interpersonal relationship that establishes the ontological
status of the participants, answering the question: What kind of
reality do humans have while in relationship? What kind of beings
are these beings? First of all, they both exist as human persons,
not simply as beings among beings. Because each has consciousness
and freedom giving witness to and owning their own being there,
their reality is more real than the reality of things. Each is there
and expresses that he or she is there, "Here I am." This is the
kernel insight of existentialism. Human reality is pre-eminent reality.
Our thereness is doubly there. Let's call the reality of each person
"hyper-reality," "super-there."
In psychotherapy the client's thereness is more
than doubly there. She does not present herself as one whose reality
is based on her expressing some social position or title, or based
on her skills or talents. In therapy her reality is stripped of
these qualifications. She is not there behind the cover of a social
class or individual capability. She is there simply as the human
person she is. Her reality is bare or naked reality. It is a reality
that is truly pre-eminent reality. Her reality is not a reality
propped up by personal or social qualities. The naked reality of
the client makes her not less real, but more real. Her reality is
hyper-hyper reality, or triple reality, if you allow me to continue
to use these weird superlatives to describe the ethical and therefore
ontological condition of the client.
In psychotherapy the client's thereness is more
than triple reality. She not only is there naked without being clothed
by credentials or social position, but she is also there giving
witness that she hurts. Her vulnerability exposes her as if her
raw nerve endings were turned inside out, powerless, unprotected,
susceptible to pain. Hers is hyper-hyper-hyper reality. The more
she reveals herself in her suffering, the more she stands exposed
as raw reality. She is self-revealing. She is raw, naked without
honors. She is there as pain. Her thereness is infinitely there.
Correspondingly the therapist's ontological
existence is defined not only as the one who is there as responsible
for other persons, but also as the one whose bare and naked reality
without the props of personal or social status makes his thereness
hyper-hyper-hyper responsible. The pre-eminent existence of the
client as raw thereness gives the therapist his pre-eminent existence
as responsible thereness.
Summing up, therapy is therapeutic when client
and therapist offer to each other the gift of simple reality as
bare and naked before each other, without the complexity of social
status, or ideology, or psychological theory. They are two people
standing toward each other with nothing but themselves to present
their reality.
Therapy is therapeutic when each offers and
accepts the gift of humility. Neither has an agenda beyond helping
the client regain her responsible freedom. The therapist serves
this good without any disguise or deceit. He is simply there as
servant. The client's otherness and freedom is infinitely beyond
his manipulation. His freedom is invested in him by and for her,
and committed to her good.
Therapy is therapeutic when they offer and accept
the gift of patience. Each suffers her and his bare and naked existence.
Patient suffering is the infinite emotion that heals.
Finally, let me return to the word religion
to describe therapy. Religion is etymologically derived from the
Latin religare, which means to bind in obligation. Our ordinary
understanding of the notion of religion refers to denominations,
or to doctrines, or rituals. The more primitive meaning of the word
religion is from the prefix re- meaning again and again + -ligare,
meaning to bind. Religion means to continually transcend ourselves
and bind in obligation to others. The therapeutic relationship is
religious. When the word religion is understood as the ethical bond
toward others, an obligation which can be refused, but which is
freely chosen, and therefore an obligation to which one can fully
commit, then we can call the therapeutic encounter a religious bond.
Students, you are entering into a religious
profession, a sacred profession. Make it holy!!
*An address delivered at Orientation Retreat
for the
Graduate Program
in Counseling Psychology at
Trinity Western University
on September 14, 2002 |