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Good Practice, Good Care for Professional Psychotherapists: Are Interpretations a Sign of Annoyance? (or the Fine Line Between Understanding and Critisizing)

Wednesday, May 6, 2009

Are Interpretations a Sign of Annoyance? (or the Fine Line Between Understanding and Critisizing)

At lunch with a group of colleagues today, one of us was telling a very detailed story of some trouble he had gotten himself into, and his emotional pain over it. About ten minutes along in his tale of woe, the others, who appeared to be listening intently, began to interrupt him with interpretations. Now imagine how much fun this could be for a group of therapists, a few of whom are analytically trained, to want to jump in and interpret the problem for our troubled fellow. And each of us did have the idea that we understood something, more than something about this guy's problem, about his life circumstances, even his repetitions and defenses. We knew he had money troubles, and women troubles. A forceful, but slightly absent father. We knew he never felt very effective in business and struggled under the shadow of a talented and much accomplished brother.

We were sympathetic to him, though. We wanted to help. We wanted to be helpful. We wanted to help him understand something about himself, and about how he interacts with the world. And with us. And about how he may be inviting the world to interact with him. It was going to be, quite possibly, a good time for all.

Until one of us spoke up and ruined it. She put a big hand up and halted the help party just out of the start gate, and before it could reach a satisfying gallop. Before we could tell him things about himself, and the people he was in trouble with. The halt began with a question. "Is everyone transfixed by Sam's story?" We all nodded. "Is anyone feeling anything?" We stopped. We said no. We just want to help. And then....well, one of us said, yes. He was annoyed, a little, maybe. And another said, she was angry. And another said she was jealous. Sam seemed to have such colorful problems.

And so then, we departed from Sam's story a bit, and went to discuss why some therapists offer up analyses and other's don't. And what is helpful and what is not, and how to know.

One of us said that, come to think of it, when her own therapist gives her an interpretation, or an analysis, she feels criticized. She said that she thought she would feel understood, known, but that, in fact, the bulls eye evaluation of her defenses, her psyche, her emotional operations,was actually too keen, too accusatory, too unsettling. Instead of feeling understood, she felt undressed.

So, things to ponder. Sometimes telling someone something about themselves, or about who or how they are is akin to saying, "You know what your problem is, you...." And we would most likely not, with our therapist's hat on, do that. So we may have to be aware that sometimes interpretations to clients are simply a costumed way of delivering a punch. And the temptation to do so is a red flag that we, the therapist, may be experiencing a feeling that may seem intolerable to us.

True too of the impulse to be helpful. So what to do? We are suppose to be helpful right? So my friend who stopped us mid track admits that she does have her interpretive guesses about clients, but that she usually keeps them to herself. Or she wraps them into a question. That way the client can say yes or no. Or can consider it, and if it rings true, they can take to it, and if not, of its too unsettling and not supportive of needed defenses, they can reject it without shame or fear, or worry of hurting the analyst.

Sometimes, our job, I suppose, is to keep quiet. To study what's going on in the room. In ourselves. And not come forward with our ideas too fast. We may be missing out. Or having an impact that we are not aware of.

Our guy Sam, he was glad for the turn in conversation. He learned something about himself after all, and in a way that felt useful to him. Turns out that he learned something about how reality is not what it appears to be, and that when we slow down a bit, and ask questions, we can save ourselves a lot of heartache, and do much better work.

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