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Tuesday, 28 August 2007
Terminator 2
The previous posting on how the therapy relationship ends raised some ideas in the comments. One was by Karen who notes that the ending of counselling is a difficult transition without any guidance. This of course raises the question of how does a client end the counselling relationship, and indeed how the therapist ends it as well. What is the formula for doing such a thing?
Unfortunately such a formula does not exist. There is no clear answer but a whole variety of opinions. Of course each therapy is related to a different theory and thus there are many different definitions on what constitutes psychological ‘cure’. It can be assumed that the point at which one is meant to end therapy is when the client is cured.
There are always different approaches
“Cure” is a very unclear thing or at least a thing on which there is very little agreement throughout the profession of psychotherapy. There are many differing definitions of it.
Something humans continually seek but it often remains quite elusive.
So all I can do is offer my ideas or thoughts on the formula or offer some form of guidance as to what can indeed be a difficult transition from client to non-client.
The first part of the formula for me is the underlying principles on which the relationship between the client and therapist are based. My thoughts are that the relationship is largely obligation free. Or there is one out of four obligations required.
1. The client has no obligation to see a particular therapist
2. The therapist has no obligation to see a particular client
3. A client has no obligation to explain to a therapist why they wish to end therapy.
4. If the client requests it, a therapist has an obligation to explain to the client why they wish to end therapy.
The Pitts. Human relationships and obligation.
In the next step of the formula one must distinguish between two types of counselling. Sometimes people seek counselling with a specific short term goal. In such instances terminating counselling is fairly easy. I recently was visited by a parent and her 12 year old daughter. The daughter was having some difficulty socialising at school. So the counselling was to discuss strategies with the parent on how to deal with the girl in this difficult time. Also to work with the girl on her thoughts and feelings about herself and her peers. To establish a few strategies with the girl to cope better with her peers. I saw them for 5 sessions and she was starting to cope better and so the counselling ended.
Where more of a problem exists is when a client enters into a longer term treatment contract with a therapist, (months or years). When this happens the client is working at a deeper level than the short term therapy solution. Of course when a client sees a counsellor for some time then the client and therapist develop some kind of attachment and bond. As I have mentioned before breaking that bond can be quite difficult especially when the other person has been of some particular emotional significance to you, like a therapist is meant to be for a client.
John Bowlby.
The father of human attachment.
This is where my second part of the formula comes in. People tend to behave in patterns and that means their relationships will tend to have patterns. In their relationships they will have a tendency to do the same thing over and over again. The most important factor in the termination phase of counselling, is that the client does not leave the therapeutic relationship in the same old self defeating relationship patterns that they have.
For example if a client has a history of being rejected they may start to do a few things that will get the therapist angry or tired of them. They may start to not pay the bills, they may consistently keep attacking the therapist personally, they may all of a sudden appear at the therapist’s home one night because they just have to see them then and there. It is up to the therapist to identify and anticipate these relationship game manoeuvres by the client so that the therapeutic relationship does not end up in the same old way for the client.
On the other side the therapist will also form an attachment with the client to some degree. This is usually not a problem if the therapist can manage their attachment so they do not also get ‘locked’ into their own same old self defeating relationship patterns. Sometimes they do get locked in and then the whole process can get complicated indeed.
For example if in the therapist’s background they were undermined and put down by the parents then he/she can have some doubts about self. The therapist’s mother may have told her that she never did well enough at school and her sisters were always better than her at their studies. So with a particular client these feelings and memories start to come up for some reason in the therapist. The therapist may then feel quite threatened if a client starts to make noises about ending counselling. The counsellor may start to unconsciously think, “If this client leaves then mother was right I am no good”.
Perhaps if I do this then mummy will love me and tell me that I am good.
As I said in the previous post any time there is an attachment between two people then there is the potential for considerable difficulties. Attachments are not a easy thing to end for humans no matter what kind of relationship it is.
Some therapists become quite clinical and thus the attachment from the therapist to the client is kept to a minimum. The down side of this is you loose the considerable therapeutic power of the client - therapist relationship. If the therapist is going to allow himself or herself to develop some attachment to the client then one gains the advantages of the therapeutic relationship. However they also need to be aware of their own tendency to get into their old self defeating relationship patterns.
So that is the formula for me.
The terminator
"I'll be back"
Graffiti
21:45 Permalink | Comments (25) | Email this
Comments
Hi Graffiti,
This is going back to one of your earlier posts on how to run a good group.
I've been to a workshop today, on statistics of all things. Normally a very boring topic. Guess what, it wasn't!!
You know why, partly cause the presenter presented information that was totally relevant to his audience, but he also had FC in. We played games and when they were finished, he threw minites around the room at the winners and anyone else who could catch them.
So there's a new FC bit of play for groups - throw minties at your audience.
Posted by: Madeleine | Tuesday, 28 August 2007
I like Arnies direct and simple method of Terminating Graffiti, he is not that interested in his repetitive patterns it seems. One could call him a real "doer".
I am interested that you write...
"People tend to behave in patterns and that means their relationships will tend to have patterns. In their relationships they will have a tendency to do the same thing over and over again. The most important factor in the termination phase of counselling, is that the client does not leave the therapeutic relationship in the same old self defeating relationship patterns that they have."
Sometimes there is a fine line for a client activating these self defeating and repetitive patterns. They may move toward that line of leaving (therapy) but don't actually leave. There is a testing process going on. In some cases I believe that leaving therapy can be just as difficult as starting the whole process. Both these stages of therapy are extremely important in the "cycle" of attachments. There is much more learning for a person at starting and finishing stages of therapy in the way you describe attchments.
Sometimes I sense the client move towards that line of leaving and make a mental note of it. They could be making some important redecisions in that space. However at other times it is not so obvious that a client is actually setting up another pattern.
k
Posted by: kenoath | Tuesday, 28 August 2007
My favourite line is when Sarah Conor says
"You're terminated, fucker. "
*giggles*
"I'll be back" with a somewhat more serious comment when I have had tea!
:-)
Posted by: kahless | Wednesday, 29 August 2007
In terms of terminating therapy, I think for me, I could think:
1.Have I just got some sort of script pay-off by quitting therapy; and / or
2.Am I running away; and/or
3.Have I wasted the last year; and/or
4.Blah
5.blah
6.blah
7.endlessly!
But ultimately I think I am tending towards the following conclusion:
I have made a decision which I should respect,
it feels as comfortable as it ever was going to be,
not to worry or think too deeply about it.
Just wait until next week, when I see someone new, and talk to them about it (because it HAS affected me) and see what falls out of that.
i.e. Kahless you made a right decision for you and good for you!
:-)
Thanks for your series of thought provoking posts Graffiti.
Posted by: kahless | Wednesday, 29 August 2007
I must admit that I have called a few clients back over the years because of that very slipping back into the patterns. I don't believe its anything to do with my rejection issues, moreover the particular contract established with that client and my sense that if I do nothing I am actually reinforcing a pattern for the client in some way. In some isolated cases I see how it's better to “reach in” (to that client) knowing that is what I am doing at the time.
There have been a couple of clients that I have done this with and they have gone on to achieve what they were after in therapy. They were very thankful that I thought they were important enough to check in with them.
I am always wary when I receive a text message cancelling an appointment that says "sorry". Why are they sorry?
Posted by: kenoath | Wednesday, 29 August 2007
Sometimes 'sorry' can be a polite gap filler Kenoath?
For me in this instance the last thing I want is my old counsellor to call me. That would be a stressor. But on the other hand I can see when it would be valid Kenoath.
I can see that if someone has reached out to me after some sort of 'termination', it would make me feel warm inside. That I was worth it. In some instances mind. I guess it is a fine line and a fine judgement.
mmm. Late, I'm rambling, better bolt....
Posted by: kahless | Wednesday, 29 August 2007
Yes you could be right there Kahless. A polite sorry around changing schedules etc. I may be thinking about a specific client here rather than over analyzing the sorry. A sorry is just a sorry perhaps.
k
Posted by: kenoath | Wednesday, 29 August 2007
For a short while, I liked that Donald Trump show
where they used two very effective words Kahless.
"YOU'RE FIRED"
kenoath
Posted by: kenoath | Wednesday, 29 August 2007
Hi Madeleine,
Sounds like a good workshop that could have been very boring, and wasn't! Good for you.
I have actually done that at a presentation. Throwing lollies into the audience. It was the closing ceremony at the Singapore TA conference in about 1992. I began by getting everyone to turn to the person next to them and give a positive stroke, hug and so forth. As they did that I proceeded to throw marshmallows out into the audience. I did however get a bit concerned for a time there, as people then started throwing them at each other and I thought we were going to end up with this massive food fight!!
Graffiti
Posted by: Tony | Wednesday, 29 August 2007
Hello Kenoath,
There is much more learning for a person at starting and finishing stages of therapy in the way you describe attchments.
Good comment. Human attachment is a thing full of ignis fatuus. Always to be a topic for psychotherapist and client.
Graffiti
Posted by: Graffiti | Wednesday, 29 August 2007
Yes kahless this sounds good
i.e. Kahless you made a right decision for you and good for you!
It looks like that big bit of cake is getting yummier all the time.
Tony
Posted by: Tony | Wednesday, 29 August 2007
When you say this kenoath,
There have been a couple of clients that I have done this with and they have gone on to achieve what they were after in therapy. They were very thankful that I thought they were important enough to check in with them.
It sounds like you have done a good thing and that your motive behind the contact was from a caring position rather than from some other script position. Good to hear your other point of view. As I originally said to karen there is not a single view on this matter and I was just giving mine, and thanks for giving yours.
Yes it would seem that Arnie is a 'doer' and when he gets things done he gets them really done!!
Graffiti
Posted by: Graffiti | Wednesday, 29 August 2007
I like your comment about the 'fine line' Kahless, very apt.
To me it boils down to the motive of the counsellor in contacting the cleint and why they are asking 'why did you leave'.
But the fine line as you say the therapist may think they are doing it from a caring position when they unconsciously are doing it from a feeling rejected position. they are simply not aware they are. Fine line, yes
Tony
Posted by: Tony | Wednesday, 29 August 2007
"ignis fatuus"
Geez Graffiti I almost thought you swore at me then.
k
Posted by: kenoath | Wednesday, 29 August 2007
No, not a cussin' Kenoath,
Don't know where that one came from but just popped into my mind, probably learnt it at high school
graffiti
Posted by: Graffiti | Wednesday, 29 August 2007
I looked it up Graffiti. I learn something everyday reading around here. I'll be back.
kenoath
Posted by: kenoath | Wednesday, 29 August 2007
Just in case anyone else wondered as well and to save you looking it up...!!
ignis fatuus
n. (pl. ignes fatui ) 'foolish fire'; light produced over marshland; will-o'-the wisp; any misleading idea or thing.
Posted by: kahless | Thursday, 30 August 2007
Dropping in to say hello. Perhaps the blog Terminator 2 will go on to be Terminator 3, 4 and 5 Graffiti. Least its not a Bruce Willis film that has multiple numbers.
kenoath
Posted by: kenoath | Thursday, 30 August 2007
Geez! Thanks Kahless!
I think i just got some frown lines wondering what the???? But now i know. Thanks...
I texted someone once and told him that i was finished. He text back and asked me to come in for a meeting to work things out. I'd been in his kind of meetings before and didn't want to be... tricked or, made feel bad because i didn't behave in a way that he would see as 'acceptable' so i text back and said "no".
Now i think of it, i guess contact from some one after finalising something as regular as therapy, how the after-service call is recieved may depend on what the relationship or attachment was like in the first place. I wouldn't know and have only other things to go by but perhaps it may depend on who they've made you into for them to beable to accept you or accept what you say/help them? This man was evil. I actually liked him and accepted him but he was so totally evil.
I was wondering, but didn't ask yet...
Is it like... once a therapist, always a therapist or do you get to be normal sometimes? (What ever 'normal' is supposed to mean *giggles* ohh geez, i'm so good with this english /communication stuff!!)
I'm going to try and say that again ok? ... does it (being a therapist) become 'who you are' or are you able to make it 'something you do when your working', so that you're not working as a therapist unconsciously when you're not at work ie. out for the night, with your kids, at home eating dinner, chatting at a bbq etc...?
I don't know if that question even makes any sense. If it didn't and you need me to ask again just say. It's been itching my brain for some time. Hope you're smiling. I'm out to clean up all the 'output' from our canine friends. Eww! Ahhh the joys of pet caring...
Roses
Posted by: Roses | Thursday, 30 August 2007
Tony?
In terminator 2, didn't arnie come back as the good guy? They must have really good therapy where ever he's from... oh yeah... it's in the future when hardly anyone is alive anymore. Boy! What it takes huh? Ohh gosh! This ended up being a bit of a yucky comment. Sorry about that. It was suppose to be... oh never mind.
The yard is poo-less now. You should see what they've done to the pillows. It's like we've have grey snow over night. I wonder if they'll miss the pillows when it's rainy and cold and they have to sleep in their kennels with out them. Probably not. Ohh to be a pet. Actually, that's what my dad used to call me when i was little. Hmm, nice memory. Come to think of it, he had to clean up after me sometimes too. Cheers...
Roses
Posted by: Roses | Thursday, 30 August 2007
Hi Roses,
In T2 Arnie did come back as a good guy to protect Sarah Connor from an even more advanced terminator. In fact he gave his life in the end to save her.
I have 2 dogs called Ben and Holly. Its good being a dog owner isn't it. I love my doggies so much. I dont leave my dogs outside, they live inside. They wouldn't be able to bear the cold. They like their home comforts too much.
Interesting that you think therapists are 'normal' ...
:-) :-)
*tongue in cheek*
Posted by: kahless | Thursday, 30 August 2007
Hi Kahless,
We just had one dog. White fluffy (some people would say) pretend dog but a dog none-the-less. But untill we get the other yard built, we have 4; a fluffy white one, a little brown jack russel, a puppy but not too puppy umm, not doberman the other really big black ones (what ever) and the hound that i'm tempted to call 'tiny'.
Like Tony said, when it rains it usually pours. Ohh it's pouring alright, but such are the joys of life. I'm surprised at how not 'harrassed' i'm feeling about the whole thing. They must be extrodinary canines indeed!
When you were over home the other day, what did you mean about my post being interesting?
Ooo, maybe i should ask you that over there. Sorry about that. I don't know the polite etiquite type thingy's - if it's you, it's you where ever i see you isn't it? What ever...
I didn't say therapists are normal, i was just wondering whether they think they are, and if that's the way it really is. If they can actually put down their 'trade' at the end of the day or week. It seems like the kind of thing one could get really lost in. Just curious that's all.
Hi Tony,
Just pretend you didn't see this comment. Cheers...
Roses
Posted by: Roses | Thursday, 30 August 2007
Hi Roses,
In answer to your question, your post had the line
"There are moments in a person’s life that make life worth its price to be lived"
I commented 'interesting' as I read this line several times over and over and couldnt make my mind up wether I agreed or not.
Still cant.
So I thought what an interesting line that has made me read it over and over!
Cheers
Posted by: kahless | Thursday, 30 August 2007
Hey Kahless, perhaps your ex therapist might do well to read Heinz Kohut or even Michael Franz Basch. Kohut wondered why so many clients left his analysis prematurely and hence forth "invented" Self Psychotherpay. He discovered that when he let go of his own need for psychoanalytical interventions (interpretations) and decided to understand exclusively from the clients position (empathy attunement) the clients stopped being angry with him and continued to work-heal.
cheers
kenoath
Posted by: kenoath | Sunday, 02 September 2007
Hi Kenoath,
I have read your comment a few times and not sure I really understand (though I am sure you are right!)
:o)
cheers
kahless.
Posted by: kahless | Sunday, 02 September 2007