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6/12/2015

Off to See the Wizard?

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The perceived authority of psychotherapists is a curious phenomenon that seems to evoke wonder and dread in many people, especially if they think they might need to go see one. For therapists are often thought of as stern judges whose theories of human psychology are always ready to hand to identify any hidden pathology that could make someone the helpless victim of his own foibles. Moreover, every gesture and vocal hitch, to say nothing of the content of a person's speech, appears liable to become damning evidence for a merciless investigation that will reveal the darkest, most shameful secrets of a subject's personality. No wonder that when I tell people that I am a therapist they often become self conscious and diffident, as if I am in danger of turning my cold analytical gaze into the depths of their being. Perhaps the only reason anybody would ever consider submitting to the humiliation that therapy imposes is an acute need to find freedom or release from a psychological affliction that feels intolerable. The terrifying prestige of the therapist reminds me of the movie The Wizard of Oz, in which the lost and bewildered Dorothy, desperate to find her way home, goes on the Yellow Brick Road to see the Wizard of Oz so that he can help her get back to Kansas. When she is eventually given an audience with the Wizard, she enters a vast hall and finds a terrifying presence whose enormous sun-like head is wreathed in flames as he speaks in thunderous pronouncements. To Dorothy's disappointment, he refuses to help her unless she completes the dangerous, impossible task of stealing the broom off of the terrifying Wicked Witch of the West. As we all know, although she succeeds in her heroic quest, as soon as she tries to cash in her success the Wizard demurs from helping her right away, Fortunately, her dog, Toto, reveals him to be a rather bumbling old fraud who admits that he's not really much of a wizard at all. In fact, he has nothing to do with her getting back to Kansas. But then as the Good Witch Glinda helps Dorothy realise, she never needed his help in the first place. 

The idea of a psychotherapist appearing like the Wizard of Oz might seem like a playful caricature, but like all caricatures the picture it presents has enough resemblance to the truth to be immediately recognisable. Many people do regard psychotherapists with suspicion and fear. And some therapists do occupy their positions with a certain stern authority that may seem like an attempt to appear oracular. Certainly, earlier generations of psychotherapists, particularly psychoanalysts, were careful to establish strict boundaries and protocols that were obviously intended to keep clients/patients in their place. Moreover, the assumption of most therapists was that the client couldn't really have a legitimate perspective on his own experience, but could only act out of his psychological condition with scant insight into his true motivations. Some therapists even felt they had the authority to make diagnoses that were more like dreadful prophesies than psychological assessments. Years before he became Baba Ram Dass, for example, Richard Alpert was told by his psychoanalyst that he was "too sick to love". Spoken with all the authority that his psychoanalytic training was supposed to have conferred on him, that analyst must have seemed just as terrifying as the Wizard of Oz appeared to Dorothy. But now that Ram Dass seems like nothing less than an avatar of divine love, it's hard not to regard his analyst as anything but a ridiculous old fraud. We might even hope that he had followed the Wizard's example and admitted the fact. 

But there is another aspect to this matter that also deserves attention. The stern authority of the therapist can sometimes be desired by the client, even though experiencing the disapproval of the therapist is something the client typically dreads. Freud himself was wise enough to understand that the patient's desire for the analyst to be authoritative indicated the patient's strong feelings of parental transference. He also saw no hope of disabusing patients of their misplaced feelings and instead made transference into a vital feature of the analytical process. As a gambit this was quite masterful, but as Freud realised, it did bring some attendant dangers. Perhaps foremost among these dangers was that the analyst would reciprocate the patient's feelings of childish dependence by developing a counter-transference and embracing the role of parental authority that was projected on to him. Still, Freud maintained that by successfully negotiating the tricky dynamics of transference and counter-transference a psychoanalyst could help bring about self insight and lasting change in the patient. Nowadays, however, few psychotherapists outside of the psychoanalytic fold would feel comfortable wearing the heavy mantle of authority that Freud believed was essential for therapy. Although most therapists realise that clients will still continue to have transferences for their therapists no matter how much the therapist tries to resist them, they also know that it is when both parties are able to emerge from the duet of transference and counter-transference that real insight can take place in the client. The question then, is how?

This brings us back to Jeff Harrison's necessary question: what is therapeutic? More specifically here, though, what is it that the therapist does that is therapeutic? In fact, this is a question that many, if not most therapists have entertained with considerable anxiety at some point or another in their work. I remember once seeing a client whose problems seemed so overwhelming and so far beyond my ability to deal with them that I nearly blurted out:"You need to see a therapist!" Although I maintained my composure and kept silent, my true, unexpressed response could have been: "You need to go see a wizard". But knowing that I was no wizard, I relied on my training and began to listen attentively and sympathetically to my client without trying to convince either him or myself that I had all the answers. This proved to be the right thing to do as I was able to form a strong alliance with him which enabled us both to deal with his issues constructively. But my listening was the key that enabled him to explore his self experience in depth. Such attentive, sympathetic listening is, I believe, one of the most therapeutic things that a therapist can do. And though it certainly entails the loss of a certain forbidding authority for the therapist, it also earns him respect based in mutual trust. 

The authority of the therapist is no illusion then, though it should be based on something other than the projected hopes and fears of the client. It should be an authority that develops from the therapist's demonstrated concern and sound judgement, as well as the client's commitment to psychotherapy. Although it may not be wizardly, it can certainly be effective in helping the client come to terms with his experience.

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    Bob Chisholm is a counsellor and psychotherapist with a particular interest in Buddhist psychology

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