About Love And Pity - The Value Of Honesty In Psychotherapy: A Case From Practice

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

P., a young girl of 25 years old, working as a civil servant, not married, no children. She turned with complaints about conflicts that arise in her work and with loved ones. Despite the fact that she needed care, attention, warmth, in life she felt a pronounced deficit of them

P.'s physical defect in the form of an amputated arm was striking, but she did not say anything about it. At the first meeting, P. looked a little scared, alarmed. In the course of the conversation, I inquired about what had happened to the hand, however, P. quite sharply threw to me that “she didn’t want and wasn’t going to talk about it”. I was surprised by such a harsh response to my curiosity, but respecting the borders of P., I chose not to intrude into them prematurely. Nonetheless, this reaction kept and even increased my curiosity about the underlying story.

P.'s relations with others developed in a rather typical way - as long as they remained formal and distant, P. did not experience any anxiety, however, over time, as a result of rapprochement with someone, P.'s anxiety grew. As a rule, soon the relationship ended in some kind of scandal or was significantly aggravated as a result of any conflict. Being an educated, well-read and erudite person in the field of psychology, P. assumed the presence of some kind of contribution to this process, which, in fact, wanted to understand in the process of therapy.

During therapy, we discussed with P. many aspects of the process of building her relationships with other people. But the topic of her disability was invariably taboo. P.'s message sounded like this: "Talk about anything, just do not ask me about the amputated arm!" This state of affairs aroused in me a mixture of curiosity, pity for P., as well as growing irritation towards her, connected with the fact that such her message deprived me of my freedom in relations with her. At the next session, I decided to tell her about this, which caused her anger. She shouted that I was "invading her privacy in the most perfidious way."

I felt rejected and confused and even a little scared of a reaction of such intensity and intensity. Nevertheless, I decided not to leave this topic blocking our relationship and not to ignore what happened. I placed the experiences I described in contact with P., as well as the desire to stay in a relationship with her and still talk about this topic, despite her strong negative reaction. P. with tears in her eyes asked not to touch her. At that moment, I experienced some fear in response to her words and said that I would not want to ignore what was happening. Continuing, I said that I suppose she had every reason to ignore her experience with her amputated arm, but that this seemed to be having a significant negative impact on her life. P. said that she was the same person as everyone else. Her reaction surprised me a little - the image of her inferiority never appeared in our contact. Moreover, her words, seemingly quite obvious, sounded very nervous, in the background of intense anxiety, and were more similar to the content of auto-training or self-hypnosis, rather than statements in which P. believes.

I asked P. to repeat these words again, having said them to me personally. Starting to speak, P. burst into tears, didn’t say anything in sobs for a while, and then shouted through her tears: “I am nothing! I am disabled! Nobody needs me!"

These words "pierced right through me" with a sharp pain that got stuck in a large lump in my throat.

I told P. about this and asked her not to stop in this process of the emerging experience and to maintain contact with me at the same time. Through tears P.began to talk excitedly about her feelings and thoughts that were associated with her disability, as well as that others "taught her not to talk about her defect." As it turned out, the surrounding were P.'s “parents”, who brought her up in the spirit of “patience and fortitude,” which meant ignoring not only her physical defect, but also any other of her weaknesses.

I thought that in this way you can only help a person become disabled, and not support him in adapting to the existing fact of reality. Moreover, the deformed process of P.'s experience, ironically, formed her ideas about herself as a disabled person. During these reflections, I experienced pity and sympathy for P., which I tried to place in my relationship with her. In response, I faced a negative reaction to myself and a demand "not to humiliate with your pity."

I said that I could not control my feelings and wanted to be more or less truthful in my relationship, and I respect P. too much to allow myself to be hypocritical with her. P. seemed surprised at my words and looked confused. After a few minutes of silence, she said: "What do you care about me ?!" Now it's time to surprise me.

I said that I perceive our therapeutic relationship not as a game of therapy, but as a space, although created specifically for therapeutic purposes, but where I invest with all my heart and experience. And since she is a person who is not indifferent to me, therefore her experiences are very important to me. P. said that she did not remember anyone seriously interested in her concerns about her amputated arm. Answering her, I suggested that, with such an attitude of her own ignoring of the problem, she may well ignore the interest of the people around her. And not every person, due to fear of her anger, will risk taking an interest in this. P. looked impressed. Further, some time of therapy was devoted to P.'s story about her experience of the fact of disability. I asked P. to stay in contact with me with my experience and listen to the desires that arise in this process. A minute later, P. said that it was extremely important for her to meet my desire to take care of her. And after that she said: "Thank you."

The described session turned out to be a turning point in the process of P.'s therapy. She initiated progress in P.'s restoration of freedom in relations with other people, as a result of which she began to develop close and long-term relationships. After a while, she told me that she was getting married, to a man who took care of her and "understood at a glance." Returning to the events illustrated by this vignette, it is worth paying attention to the fact that my intervention, which focuses attention on P.'s experience related to the fact of his physical defect, simultaneously contained aspects of both frustration and support.

Frustration related to P.'s attempts to ignore the need to relate to this fact, and support was related to the actual process of experiencing the phenomena arising in this process as a new way of organizing contact. Moreover, I believe that by supporting new ways of organizing contact with the client, it is impossible not to frustrate the old chronic self-patterns.