Therapist's Path: From Fragility To Resilience

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

In his development, a "young", that is, a beginner, a psychotherapist goes a certain way. I think that students from different schools have their own nuances, tk. the direction and the professional community leave certain imprints. But the main points - first a fragile therapeutic identity, then a flexible and stable one - are available to professionals regardless of directions. That is, the therapist goes from the fragility of identity to its flexibility and stability.

I see the development and strengthening of professional identity this way, because:

a) it is the logic of general assignment of identity;

b) what I have read and heard from colleagues about the process of therapeutic development is going this way;

c) my development was like this - from fragility to flexibility and stability, and I still remember it well.

I'll tell you about this path. I think that for those who are in the exciting processes of working with the first clients, my text can be a support, while the rest will be just interested.

At first, the therapist is terrified of being a therapist. This can be compared with the schizoid-paranoid period of development according to Melanie Klein (1). I remember this period myself - yes, it's scary. It is scary to identify myself as a therapist, to give the first announcements, to tell friends and acquaintances that I am inviting clients. Then wait for a response and stay in the unknown when the first client will come. This horror is an expected part of development. It can be more bearable if you train regularly - work in a troika, in a supervisory group, go to an intensive therapist. For those who have a psychological education and work as a psychologist, in something even easier, the skill of diagnostic and counseling work is very supportive.

Then the first client comes and then another exciting period begins - shame. You have to work with the client somehow! The way Katerina Bai-Balaeva (2) described this period as a narcissistic vulnerability of the therapist speaks to me very much. That is, the first clients are the pain of the "narcissistic head" (according to the dynamic concept of personality). I would like to be a good therapist, but it is not yet clear how. In this period, there is a lot of fear of imposture.

In addition to everything, there is another fear that the client will come to the problem, to the pain of the therapist. Then it can be very difficult for the therapist. "This is because a novice therapist hurts everywhere, wherever you poke, it hurts" (3). At first I was outraged by this idea. There is personal therapy, you should not get sick everywhere, because a lot has already been mastered to yourself. But now I can agree with this thesis. Against the background of heightened fear and shame from the beginning of the practice, the young therapist can "get sick" everywhere, all client topics can respond to personal problems, no matter how much personal therapy was before. This is because consulting early clients raises the general level of anxiety dramatically. On top of that, clients, as a rule, contact in a state of crisis, that is, they are people in anxiety. And against the background of a general high anxiety in the field, against the background of the natural fear of discovering imposture, the fear of being an unhelpful therapist, which is natural for this period, it is very easy to lose the feeling of your body, to forget yourself, to merge with an incomprehensible figure and fall into passion. This is not the most pleasant period for the therapist, but it cannot be avoided. It is very supportive of dynamic supervision of one's work, reading articles on work (both about working with specific problems, and just thinking about therapy) and all the same - working in "training" conditions.

This is the period of painful fragility of the therapist. The therapist remains the therapist (the most important thing is to stay with the client (4)), endures and maintains difficult experiences, while he / she has a very difficult time: a lot of fear and shame. After losing the therapeutic position, you need to get ready, sometimes you need to get together as if from scratch. During this period, it is great to remind yourself of what has already been done - there is such and such experience, such and such skills. And it would be nice to find a collegial environment for this period, which will be supportive at first. After all, first you need to understand where you are and what your real size is, in order to grow later. That is, first to be in the zone of actual development, then to attend to saturation of the zone of proximal development.

And gradually, from this point of fragility of the therapeutic position, a reversal occurs. There are various points that can be “pathways” along which one can move towards a more stable and at the same time flexible therapeutic position.

I will outline some:

The first point is gaining experience. Regular training in a safe environment allows you to gain stability. It's simple: if the therapist trains more, he gains more skill. The more skill at work, the easier it is to return yourself to a therapeutic position if it has been lost, it is easier to restore your therapeutic self-esteem, it is easier to decide to be creative in therapy.

The second point is the recognition of your feelings as part of the field situation. There is a client, a therapist and a therapy situation. The feelings the therapist has are part of the therapy situation. You can not fight them ("I am ashamed that I am such an imperfect therapist, I miss something important from the session - I need to improve myself!"), But consider them as part of the situation: if these feelings arise in the field of work with this client, what do they say about your job? If the therapist is ashamed, then what can this say about the topics with which the client came, about the client's state? And if the therapist is afraid, why? These are all very curious things, because feelings can be the keys to avoidance patterns in a session.

The third point is recognizing your confusion as part of the inevitable. The work will add something new and challenging. And because this is how life works: it is not clear what will happen next - and because there is a gradual cognitive and emotional complication of the therapist. The more you know and are able to, the more questions. It seems to me that it is impossible to become a therapist who does not feel confusion, shame, doubts, a therapist who fully understands what therapy is. Understanding what therapy is, seems to me more of a procedural action. This is what you periodically reflect on and re-evaluate - what is my therapy.

The fourth point is collegial support. It is important to find "friends", for example, a sufficiently suitable supervisor, a sufficiently friendly and promoting collegial environment (both vertically and horizontally organized collegial connections), a good enough co-therapist to try to do workshops together, to show up at conferences (together it is not so scary) …

I don’t want to write about personal therapy, it’s something akin to the obvious - it’s useful.

As you master these "paths" the therapist becomes more confident and competent. These are important parts of a professional position that lead to a more flexible and sustainable professional position.

Then something like what happens to students: after having done a good job on the record-book, she starts working for you. That is, the emerging flexible and stable therapeutic identity works to develop and maintain sustainable practice.

The therapist becomes more attractive to clients because he looks like a "stable figure". It becomes clear from the person that you can turn to him / her with complex experiences, you can turn complex experiences on him / her, if that. The therapist will withstand, will not crumble, will not take revenge. As in the poem: "better slow down in daddy, daddy is soft, he will forgive" (5). The therapist, who has mastered his professional position, remains in the session with the client, without fading, without losing sensitivity to himself, his / her presence is more flexible. And it becomes easier for clients in difficult feelings themselves. After all, when you have a crisis, it’s good when you have someone you can slow down on.

To summarize this article. The path from a fragile therapist to just a reasonably well-performing and resilient therapist is a common road that can be mastered. It is important to have a good attitude towards oneself and the ability to build a suitable supportive and developmental professional environment for oneself. All this will contribute to the gradual accumulation of experience and stable professional growth, which will lead to the building of practice.

Something like a list of sources:

1) I heard this idea at a lecture by Maria Mikhailova at the MGI conference in Ramenskoye, 2017.

2) An article by Katerina Bai-Balaeva about supervision is available through search engines.

3) In my opinion, it was in one of Alexey Smirnov's lectures on the supervisory shuttle for therapists, 2016.

4) Elena Kaliteevskaya spoke about this in our basic course of gestalt therapy. Inaccurate quote: "The therapist is the person who remains the last in contact with the client's complex feelings. The people to whom they are addressed cannot be expressed. The therapist remains."

5) Grigory Oster "Bad advice".:)