Do Not Heal Your Neighbor. Some Reflections On Psychological Help For Friends And Family

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

A dual relationship in psychotherapy is a situation where the therapist acts in relation to his client in any other role. (relative, friend, lover, employer, boss, subordinate, consumer or other service provider, etc.). The prohibition of double relationships is spelled out in the codes of ethics of very many, if not all, psychological communities. In countries where psychological activity is licensed, violation of this prohibition can result in loss of practice.

However, there are people who either have never heard of such a rule, or do not understand its meaning. I also want to talk about the meaning. Many working therapists have to deny clients in relationships outside the office, as well as explain to friends and family why there is no opportunity to work with them "as a psychologist." But general words about professional ethics, as a rule, do not explain anything.

The psychologist's refusal is most easily explained by the unwillingness to work for free. But don't we have a tradition of selflessly helping our neighbors? Why a psychologist, accepting disinterested help in fixing a computer from his friend, cannot repay him in kind, "fixing" his psyche a little? And why does he refuse acquaintances such a service even for money?

I must say right away: I see no problems in sharing professional knowledge. To give explanations on the topic, make diagnostic assumptions and even "test" some technique on friends - all this can be offered completely free of charge and to complete mutual pleasure.

Not to mention, to comfort, listen, support - all this is part of normal relations with people, and psychologists do it in the same way as everyone else. Psychology permeates people's lives, and each is a little psychologist for his fellow men. To varying degrees and at different levels, and this is perfectly normal.

But professional psychotherapy is not only knowledge, advice and support. And where we are talking about the danger of double relationships - it is important to pay attention to the word "relationship". Psychotherapy is a specially organized, very specific and, I'm not afraid of the word, unnatural relationship. There are no analogues in real life. They are limited to a given framework and are created for specific purposes.

If a person comes to a psychologist, he is dissatisfied with the quality of his life and begins to suspect that the reason is somewhere in himself. The client can tell the therapist about his life outside the office, and the therapist will willingly support him, but at the same time - he will observe how the client builds relationships directly here. With him, with a therapist.

Whatever correct concepts a person is initially guided by, as the relationship with the therapist deepens, he will certainly try to repeat his model of relationship with the world and act out the traumas that were once inflicted on him by the most important people in his life. And he will habitually try to defend himself - by avoiding contact, devaluation, reciprocal aggression. He will project his inner model onto real relationships. Just as he does in life. This is his world, he sees it that way. And the world most often confirms his view. Because people are sufficiently reactive and also tend to defend themselves.

Unlike people in life, the therapist, firstly, will not go anywhere from the contact, and secondly, he will try to build a different modality of relations with the client. Such that the client, firstly, understands how what is happening to him is related to what he is doing, secondly, he can experience all the difficult feelings associated with this, and thirdly, he tries the relationship in a different model to then transfer this experience into your real life.

How this happens is a separate big topic for another article. Here, however, it is important to simply understand the principle in order to answer the question: why did I call the client-therapeutic relationship unnatural? Is this not possible, if desired and with the proper skill, to do it for your loved ones?

Probably, you can try, but here the problem of balance in relationships arises in full growth. And the accompanying question - why should I? Or him?

All of us in relationships with people want to both give and receive. And so it happens. This is an exchange at the level of relationships and feelings, often understood intuitively and without specially stipulated conditions. People can turn their needs and expectations to each other, feel disappointed if the needs are not met, correct or not correct their behavior, negotiate, draw conclusions. In other words, people in real relationships exchange expectations and actions.

How is a therapeutic relationship different? The fact that the therapist in this relationship does not have any personal needs addressed to the client. The therapist's expectations are completely removed from the context of the client-therapeutic relationship. This is called a therapeutic position.

The therapist does not need the client to be something - for him, for the therapist. Everything the therapist does in this relationship is for the client. During deep work, the therapist, as a rule, evokes strong (and very different, not always positive) feelings in the client: the intimate is shared with the therapist, the therapeutic situation actualizes the trauma of attachment, the therapist receives intense transferences, etc.

Significance means power. The therapist has a lot of power, the use of which in his own interests is unacceptable, and is limited to therapeutic ethics. That is why any business, friendship, sexual and other relationship with the therapist outside the office is the use of the client … Even if the client himself wanted and offered it himself, it doesn't matter. The client in this relationship is too biased to take full responsibility for their decisions.

How is the balance restored in these relations? It's very simple - money. Payment in therapy is an important factor that "nullifies" any tension in a relationship. This does not mean that the feelings in the relationship are not real, including the therapist's feelings for the client.

It is important to understand that the conventionality of these relationships is not equal to pretense. The client-therapy relationship is a sincere and deep relationship. Their convention is that symmetry in relationships is restored not by mutual satisfaction of personal needs, but by means of symbolic action. Payment is a guarantee of disinterestedness and purity of the therapist's intentions: he does not expect anything from the client except money for work:)

So, in therapy, a special kind of relationship is created in which the therapist works FOR the client, and does not require return from him in the form of gratitude, feelings, care, help, in general, any expected actions. And payment is used as compensation.

Now let's get back to therapeutic work with friends and family. It already seems to me that this paragraph can not be written, the conclusions are so obvious. There is no doubt that in life the therapist is just as much a living person, and in relationships with people, oddly enough, he also expects something from them.

What happens when a person is at the same time a partner, lover or friend to whom I turn my expectations, as well as a client - to whom there can be no expectations? What is happening is what the term "double relationship" reflects - a split of needs and goals. I sincerely wish my loved one happiness and the realization of his needs - but at the same time I expect that his happiness and his needs will not contradict mine, since our lives are connected.

How and in whose favor will I resolve this contradiction? How will I use my therapeutic power? How do I share - what I am doing in the relationship for the client, and what - for myself in the relationship with him? And how will the client decide for himself the analogous contradiction between therapeutic work and concern for maintaining the relationship? Or is it assumed that such a contradiction with loved ones will never arise? But this is also an expectation, moreover, very naive. I will add that even with a high level of consciousness, expectations can be unconscious. Yes, the therapist also has an unconscious.

Rest assured that what is not compensated by payment in a therapeutic relationship will certainly be compensated for by something else. But what, in what form and how voluntary is a big question.

I believe that the desire to "disinterestedly" heal their loved ones is strongly tied to the desire for self-affirmation and power. But even if we assume that the therapist is so disinterested and aware that he can control all this and will act only in the interests of a loved one, this means that he simply transfers this duality inside himself.

That is, it creates for itself an intrapersonal splitting, and spends all its strength and resources on maintaining this splitting. Instead of simply referring the other person to another good therapist, if the other has such a need.