Microsoft Word - 44C1C4EB-0A23-088E3C.doc

Sergio Rodriguez-Castillo

California Institute of Integral Studies

Integral Counseling Psychology

May, 2006

In order to use the mutual experience, one must have in one’s bones a theory of the emotional
development of the child and the relationship of the child to the environmental factors
D.W. Winnicott

One should always start out on the wrong foot.

Carl Whitaker

Contents

Foreword: ............................................................................................................................................... 3
I. The Client............................................................................................................................................ 3

It is all about the client.

..................................................................................................3

Learn about the client.

...................................................................................................3

Clients want to heal.

......................................................................................................4

Follow the client.

..........................................................................................................4

Clients already know the answer.

....................................................................................4

II. The Therapy ...................................................................................................................................... 5

Therapy as a Relationship and a Holding Environment.

......................................................5

Listen.

.........................................................................................................................5

Let the affects flow.

.......................................................................................................6

Don’t push the river.

......................................................................................................6

10.

No right, wrong or simple answers.

..................................................................................7

11.

Encourage responsibility.

...............................................................................................7

12.

Don’t decide for the client.

.............................................................................................8

13.

Validate the client’s feelings.

..........................................................................................8

14.

Be empathic.

................................................................................................................8

15.

Be nondefensive.

...........................................................................................................9

16.

Do not judge your clients.

..............................................................................................9

17.

Symptoms are metaphors.

............................................................................................10

18.

Objectionable clients.

..................................................................................................10

19.

Beware of labels

.........................................................................................................10

20.

All is present in the session.

..........................................................................................11

21.

Therapy is a process.

...................................................................................................11

22.

Cut back on interpretations

...........................................................................................12

23.

Appreciate silence.

......................................................................................................12

24.

Be totally present but don’t turn into a full-time therapist.

.................................................12

25.

Acknowledge the anxiety in the room

............................................................................12

26.

Believe your clients’ stories, but with a grain of salt.

........................................................13

27.

Notes-taking.

..............................................................................................................13

28.

Be grateful.

................................................................................................................13

29.

Intersubjectivity.

.........................................................................................................13

The Therapist ....................................................................................................................................... 14

30.

Do not confuse your role with you.

................................................................................14

31.

Watch your own feelings & fantasies

.............................................................................14

32.

Work in yourself.

........................................................................................................14

33.

Your job is not to teach, save or rescue you clients.

..........................................................15

34.

Don’t try to fix, cheer up or fine-tune your clients.

...........................................................16

35.

Don’t try to know it all.

................................................................................................16

36.

Neither better, nor worse.

.............................................................................................16

37.

Personal Modeling.

.....................................................................................................17

38.

You’ll make mistakes

..................................................................................................17

39.

Be honest, transparent and candid.

.................................................................................17

40.

You are a human being.

...............................................................................................17

41.

Be yourself.

................................................................................................................18

42.

Humor.

......................................................................................................................18

Bibliography ......................................................................................................................................... 19

Foreword:

Since I will begin my practicum soon, compiling this “Survival Guide” has been a very
good opportunity to review what I have learned so far in my classes at CIIS.

As most of my classmates, since the first day of my first class of my fist semester, I have
been writing down ideas, concepts and “tips” about how to be become a good therapist;
how to deal with the clients, what to do and what not to do. The list has become very
long, full and meaningful (at least to me). Obviously these tips are highly personal; they
deal with my issues and with those aspects of practicum that concern me the most. I have
tried to be as comprehensive as I could, but again, the focus is in what I need to keep in
mind; therefore, many of these suggestions may not make much sense to other
practitioners.

Finally, it is worth mentioning that, although I have included a bibliography at the end of
this guide, I am afraid that it only represents a very small piece of the material consulted
for this work, since I have incorporated ideas from many readings, classes, conversations,
etc. So many, that it would be impossible to list and give credit to all of them. All I have
done, is to put them together to create this survival guide, for my own use and maybe of
others. Paraphrasing Anthony De Mello, my task has been that of a weaver and the dyer,
so I take no credit at all for the cotton and the thread…

I. The Client

1. It is all about the client.

Everything, even the client’s opinion has about you, has very little to do with you.
The client improvement (or worsening) is more his/her doing than yours. Avoid
feeling that you are instrumental in assisting the client to enjoy life more fully (the
need to be needed) or giving yourself credit for the client’s growth. You are not
that important. Psychotherapy is not so much about what the therapist does or
says, but how the clients experiences; what is being (or not being) said or done.

2. Learn about the client.

Learn to develop, from the first meeting, a sincere interest and appreciation for
the client. Learn about her

life, hobbies, family, interests, world, idiosyncrasy,

habits and addictions (alcohol, drugs, sex, food, gambling, etc.), socioeconomic,
gender, cultural, educational and religious contexts, the way she relates to others,
what “pushes her buttons”, how does she feels about herself, about significant
others, about therapy, etc. Encourage the client to talk about her feelings,
thoughts and fantasies, including those about you and your feelings thoughts and
fantasies.

In order to make the writing and reading easier (and since I am the one writing), I will write using the

masculine for the therapist, while alternating the gender of the client.

Keep asking questions, keep asking questions, and keep asking questions. Do not
assume that you know enough.  Ask about previous therapists, what bring him to
therapy?  What does he want to get out from it?  Is he here on his own behalf or
was he “persuaded” to come? (if so, who did? Why did he agree? How does he
feels about it?) Is he exited/committed to therapy?

3. Clients want to heal.

When the eye is unobstructed, the result is seeing; when the ear is

unobstructed, the result is hearing; ... When the mind is unobstructed, the result

is wisdom; When the heart is unobstructed, the result is love. If you could get

rid of illusion, you would be happy.

Have compassion for all beings, rich and poor alike; each has their suffering.
Some suffer too much, others too little.

Clients want to get better, to solve their problems, to be happy; they just do not
know how. Be kind to every client you meet, remember that each one is fighting
a great battle within and come to you to be their ally (not their savior, mother or
judge). Acknowledge their courage in trying. Be empathetic and supportive to
their efforts and patient with their (some times seemly unending) wandering away
of the “real” issues. Remember that you are always dealing with two clients: the
one that wants to change (with whom you’ll build the therapeutic alliance) and the
one for whom everything is “just fine” and does not want you to “rock the boat”.
Hold them in their process. Help them by pointing the way they stand in their
way and how to remove obstacles for growth. We are witnesses, not guides.
Relax; you are only a facilitator, not the protagonist of the story.

4. Follow the client.

Let your communication be, Yea, yea; Nay, nay: for whatsoever is more than

these cometh of evil.

Start with what you have. Ask “what is going on?” “Where is the distress?”
Clients know what they want to talk about and deal with. The therapist never
writes the agenda for change, clients do. Beware, in as much as possible, of your
unconscious agenda and ask where is it coming from?

Whatever happens is good; fear is good, anger is good, resistance is good,
openness is good. All is well. There is neither plan nor agenda.

5. Clients already know the answer.

...the maximum help you can give patients is to foster reliance on their own

resources rather than yours.

Even if they do not know it. Help them discover those answers within. Your

Anthony De Mello

The Buddha

Mt 5:37

Strupp & Binder

main responsibility as a helper is to assist others in finding their own answers.
Align with the client’s healing powers (their unconscious plan to get better).

II. The Therapy

6. Therapy as a Relationship and a Holding Environment.

See therapy as a reliable and understanding relationship where two people work
together towards free spontaneous growth. It is not about clever interpretations,
but the therapist’s ability to develop a safe environment for the client,
encouraging her to try her own solutions, walking together in the therapeutic
relation, where two persons meet, relate, and by means of it, healing occurs.

Think of the therapy room as a setting, a potential space

and a sacred holding

environment, where client and therapist assemble to grow and (in Winnicott’s
terms) to play.

7. Listen.

We have two ears and one mouth so that we can listen twice as much as we

speak.

The greatest compliment that was ever paid me was when one asked me what I
thought, and attended to my answer.

Listen well, listen carefully, listen with your whole self, listen to what is being
said (discrepancies included), to what is not being said, to how is being said, why
is being said and when is being said. Observe the body language; be attentive to
defensive styles and patters. It the client unwilling or unease to talk about
something, if so what is he trying to protect? (What is the affect underneath the
behavior/words?). Everything counts, from the way the clients greets you, how
and where he seat, how he begins the session, the topic he chooses to talk about,
the questions he asks, to the way he says goodbye. When the client asks a
question, ask yourself, what is he really asking? What is the question behind the
question? When focused in listening we are less prone to react, to jump into
conclusion. Is a bit like meditation, if we are able to remain in the present
moment (not reacting, not making inferences or drawing conclusions), we will be
able to see and hear what is really going on. We might be able to realize even
what the client really is telling us, behind all his words and affects.

Listening is an art not easily come by, but in it, there is beauty and great

understanding.

Listening means immersing oneself in the world of another human being;
allowing oneself to resonate to the spoken and unspoken message.

D.W. Winnicottn

Epictetus

Henry David Thoreau.

J. Krishnamurti

So when you are listening to somebody, completely, attentively, then you are

listening not only to the words, but also to the feeling of what is being

conveyed, to the whole of it, not part of it... You can only listen when the mind

is quiet, when the mind doesn't react immediately, when there is an interval

between your reaction and what is being said. Then in that interval there is a

quietness, there is a silence in which alone there is a comprehension which is

not intellectual understanding. Listening has importance only when one is not

projecting one's own desires through which one listens. Can one put aside all

these screens through which we listen, and really listen?

8. Let the affects flow.

To urge the patient to suppress, renounce or sublimate her... transference would

be, not an analytic way of dealing with them, but a senseless one. It would be just

as thought, after summoning up a spirit from the underworld by cunning spells,

one were to send him down again without having asked him a single question.

Do not try to placate anger or console a cry. Help your clients to go deeper in the
direction they are going but do not push them; intensity does not necessarily equal
progress. When, in your opinion they need it (don’t do it because you cannot
handle them) teach them to titrate their affects.

9. Don’t push the river.

Psychotherapy must proceed at its own pace and any effort to speed it or slow it

because of the character of the therapist can only be destructive.

Avoid the “this hurts me more than it hurts you” critical attitude:

Clients are whiney, clinging, depending children and need to mature. Life is
tough and every man is for himself. The sooner they learn this, the better. Should
not we force them to grow up? Keep shattering their vain hopes, stepping onto
their clinging fingers for them to see reality. Of course, it will hurt us more than it
will hurt them, but it is for their own good; right? Wrong.

At times, it seems hard not to be critical to clients. Of course it is easy to get the
impression that clients make their lives harder than necessary, they should know
better. They are full of resistances and defenses, they behave childlike and
illogically. We should point this to them, right? Wrong.

Clients are just blind not to realize that whatever is going on in therapy is not
about us, it is about their parent, mother, brother, sister, whatever. They are not
sophisticated enough to see this, but luckily for them we are. Should not we point
it to them every time they do it? Wouldn’t we do well in explaining them that
they are kidding themselves, that they would be better of facing the facts?
Wrong.

J. Krishnamurti, Book of Life

Sigmund Freud

Carl Whitaker

Being critical as above, we become the latest version of the clients’ parents,
teachers and preachers, telling them how inept they are. Pointing out what they
do wrong would not help and instead will reinforce the precise assumptions
underneath the behavior (the pathogenic beliefs) that they are trying to eradicate.

Respect the client’s views and struggles. Whenever you thin that you know better
what she should be doing; seriously consider the possibility that it is her who
knows best and work hard to try to discover the ways in which she is right.

Whatever words we utter should be chosen with care for people will hear them

and be influenced by them for good or ill.

Be thoughtful, considerate and gentle. Respect the client’s pace. You will not be
doing her any favor by pushing or forcing her to realize something (even if it has
been clear for you since day one). Don’t push the river.

10. No right, wrong or simple answers.

The truth is rarely pure and never simple.

In psychotherapy (and maybe in everything in this world) there is no absolute
truth, right or wrong.  Things are useful and useless (in Patañjali’s Yoga klista and
aklistah); and even these are relative to each client’s specific situation and
moment in life.  What may be seen as an undesired resistance in one client may be
a healthy self-preservation mechanism for another that has kept him “together”.
Keep in mind that defense mechanisms are unconscious means of self-protection.

There are no simple answers or solutions to any of the client’s problems. The
client is –at the very least– as a complicated human being as you are.

11. Encourage responsibility.

Most people do not really want freedom, because freedom involves responsibility,

and most people are frightened of responsibility.

Be realistic when establishing goals. Don’t do for the client what she can do for
herself. Don’t make promises of solving problems or create false expectations
(don’t seduce the client). If you take onto yourself the responsibility your clients
need to learn to direct their lives, you’ll be blocking rather than fostering their
growth. Allocate the responsibility where it belongs, with the client. Our job is to
gently assist them to learn to make choices independently and have the courage to
accept the consequences of those choices.

The therapist is engaged in the art of making subtle suggestions, many of them
more by our deeds that by our words. Point to the client whenever she does in the
therapeutic relationship the behavior she is working on. When making
observations, use “parts” instead of general statements.

The Buddha

Oscar Wilde

Sigmund Freud

12. Don’t decide for the client.

The client will test you. He wants to know if you are reliable, solid, “safe” or just
like the rest (usually but not always his parents). Remember that he has never
seen you before and he has a lifetime of being and acting who he is. He wants to
know if you can handle his feelings, tolerate the intensity and don’t pull back.
But keep in mind that he will also try to “pull” you to gratify his needs, confirm
his fears or comply with what he believes you want (all of which would amount to
a self fulfilled prophecy)

Never make decisions for the clients or guide them to the conclusion you think is
best (even if you think you are right). Instead help them to own their actions,
their feelings and face reality (but don’t push them). Resist the temptation to give
advice. Your task is to help clients discover their own solutions and recognize
their own freedom in action, not to deprive them of the opportunity to act freely.

13. Validate the client’s feelings.

Approaching a person with the intention of really being honest often reminds me

of taking a cold shower. The anticipation is frightening, the initial impact

shocking, and the outcome, refreshing, cleansing, and invigorating.

Remember that the client may feel inadequate, deficient; even by the fact of
coming to a therapist. Communicate to him (by deeds more than words) that he is
Ok, that you are not judging him and that you unconditionally accept him. Do not
dismiss or deny their feelings, quite the contrary, validate them (even it you think
there are “wrong” they are entitled to them) and encourage them to feel them.

14. Be empathic.

The patient, as I finally grasped, insisted –and had a right to insist- that I learn to

see things exclusively in his way and not at all in my way.

Empathy is not a technique but an attitude. Put yourself in your client’s place.
You’ll learn more about your client by allowing yourself to feel what she is
feeling than by trying to figure her out. Empathy does not necessarily imply love,
affection or compassion; it can be expressed in disagreement or in accord, and
that it does not imply a fusion with the client. Alternatively, it can be achieved by
actively arousing, or letting oneself be pervaded by an absorbing human interest
in the person one wills to understand. It implies approaching the client with
understanding, respect and wonder,

to establish a relationship.

Whenever you don’t understand, ask the client for help, when you think you
understand, check with her. Never assume that what you think or feel is what the
client is thinking or feeling. You are two different persons with different

Schutz, William; Elements of Encounter, p. 100, Joy.

Heinz Kohut

In an I-Thou fashion.

histories, educations, levels of tolerance, needs and idiosyncrasies. You never
really “know exactly how she feels”.

15. Be nondefensive.

Better curious than furious.

Whatever feelings clients express about you, be interested, encouraging and
without judgment. Acknowledge the client’s reactions and assume that they are
accurate. Always be willing to ask yourself what you did to provoke any
particular response, and be willing to encourage the client to talk about it.
Whatever the stimulus, do not preen when praised and do not punish when
attacked

. Don’t attempt to justify yourself or to dismiss the client’s reasoning

with an interpretation.

16. Do not judge your clients.

Don't judge a man until you walk a mile in his moccasins

Remember that the freedom to express feelings depends on the assurance that they
are value-fee, that they will draw neither blame nor praise. How could you judge
a client? Remember that most probably you would be doing the exact same
things had you growth in his family and had his life. “Empathy is vicarious
introspection, a method for inquiring into the subjective experience of
another...”

Get interested not judgmental. Kohut teaches that it is hard to

change and grow until someone has really seen (and I would add understand)
where we are now.

Look down at me and you see a fool; look up at me and you see a god; look

straight at me and you see yourself.

In as much as you are able to keep in mind constantly that your client is a human
being, just like you, but perhaps you have been luckier than him.  You ought to be
able to stop from judging and instead unconditionally accept him.  Again, a
religious simile might help to clarify this point. It has been suggested that the
most remarkable feature of Jesus was the fact that he knew that, as a human
being, he was not better than the rest of us. Highly evolved people everywhere
share such feature.  If they do not judge, how could you?

The concept can be taken even beyond, to the spiritual realm of “oneness”. If you
keep in mind that neither the client nor you are your “personae”, but parts of the
whole (just like two drops of water in the sea), what is there to be judged? If you
can see through the illusion of separateness and acknowledge that we are all one,
there is nothing to like or dislike about the client. Being all one, who is the one
judging and who is being judged?

Michael Kahn

Native American adage

Heinz Kohut.

Charles Manson

17. Symptoms are metaphors.

Neurosis is the inability to tolerate ambiguity.

Symptoms are artistic creations of the psyche, a magical attempt to alter an
unbearable reality. There is always a good reason for whatever the client does.
Reframe symptoms as efforts to grow.  Every symptom has a reason, a meaning,
there is wisdom in them. A symptom is a solution; ask yourself a solution to
what?  What is its purpose or function? Symptoms are symbols pointing at
something; but in as much as possible, think of horses, not zebras

. Honor the

symptom, since it is doing something for the client. What is the client getting out
of it? Try to focus in the roots, not in the leaves, but do not ignore the leaves
either (which is what is visible anyway).

18. Objectionable clients.

I am human and let nothing human be alien to me.

Everything that irritates us about others can lead us to an understanding of
ourselves.

What to do with a client that you just find unacceptable? (whether because you
dislike her, because her presenting problem overwhelms you, etc). There is really
not such thing as an unacceptable client/problem (within the limits of your own
physical integrity). If you find it hard to accept someone with unlovely qualities,
think of the person as being up against those qualities inside. Keep them in your
heart, even if you disagree (even hate) with their behavior and/or ideology. One
can accept the person while disapproving the action. Just as with children, even
when they do “wrong” we remember that they are only children and as such, not
evil, just do not know better. In other words, the fact that one censures the
behavior; does not mean that one condemns the child. Think about what the
client’s being through. Find the scare child within her. Connect to her
humanness.

I know that there are people who do not love their fellow man, and I hate people

like that!

If there is something you particularly dislike about the client or you would like to
change in her, first take a good look within and find out if it not something that
could better be changed in you. Are you perhaps projecting something?

19. Beware of labels

As well as diagnosis, syndromes, disorders, acronyms and the like. Although it

Sigmund Freud

Galloping footsteps should evoke suspicion of horses before zebras. More obvious hunches should be

entertained before rarer ones.

Terence

Carl Jung

Tom Lehrer

might be useful to develop some preliminary hypothesis, do not get attached to
them. Every person, every situation, every problem is unique. Accordingly, there
is not such thing as a text-book neurotic, teenager, mid-life crisis, divorce,
depression, etc. The moment you label somebody as a “bipolar”, “ADHD”,
“depressive”, etc. you’ll stop looking at the person and only see the label, you will
loose the unique individual before you and only see psychopathological
symptoms. In that very moment, you’ll stop seeing the person and start
disregarding anything that does not fit with the diagnosis. This is a well-known
fact, applied to our profession. Krishnamurti

used to say that the day we teach a

kid that a fluffy, colorful moving object is called “a sparrow”; he/she has lost
something

. From that day on, every time he/she sees a new (and unique) similar

fluffy thing, he/she will say, “Oh, another sparrow, I know sparrows”.

20. All is present in the session.

Life isn’t mind over matter, it is present over past, and present over future.

The client will bring into the session whatever he is dealing with outside.
Focusing in the relationship (while keeping in mind the client’s history,
background and context) will help you both to elucidate what is really going on.
“So, how are you and I doing today?” At the moment of the encounter between
therapist and client, the client’s whole world is present; all the significant
relationships, basic hopes and fears; all are present and focused on the therapist.
Make and effort to check into the “here and now” each session.

21. Therapy is a process.

Live the questions now. Perhaps then, someday far in the future, you will

gradually, without even noticing it, live your way into the answer.

Psychotherapy is a walking together, a constant unfolding, a process that
accelerates the development of a person, a series of experienced events that
catalyze the natural growth of the psyche. Enjoy the ride with the client as she
unfolds.

...let go and submit to the therapeutic process rather than trying to run it.

…recognize our helplessness and focus not on how to do the work but on how

to let the work happen, how to restrain our impulses to block the process…

accept a far humbler (and more difficult) role than that for which our academic

training prepared us. We must witness rather than guide, enter into the

patient’s pain rather that cure it. … We must be willing to be confused and lost

if we are to accompany someone into chaotic, uncharted areas of [the

patient’s] soul”.

It is the search that matters, the asking of the questions. Therapy, like life, is a

As quoted by Anthony De Mello

That is the awe for its uniqueness.

Carl Whitaker

Rainer Maria Rilke

Sullivan, B.S.

journey, not a destination. The process itself is healing, even if certain goals are
not achieved.

Life is an unanswered question but let's believe in the dignity and importance of

the question.

22. Cut back on interpretations

Psychotherapy is not making clever and apt interpretations; by and large it is a

long-term giving the patient back what the patient brings…[I]f I do this well

enough the patient will find his or her own self and will be able to exist and to feel

real.

Our role is not to make clever interpretations, but to let the client explore, play
and be creative with whatever he is bringing to therapy. Kohut explains how
interpretations are irrelevant, since it is the client’s experience of the relationship
(being understood and seen) what has a real impact. Must probably client are not
even interested in listening to “brilliant” interpretations.

23. Appreciate silence.

See how nature - trees, flowers, grass - grows in silence; see the stars, the moon

and the sun, how they move in silence...we need silence to be able to touch

souls.

Befriend silence; become comfortable in it, inside and outside the therapy room.
If during the session, what does it tell you? Who provoked? Observe the process
and how it fills (or not) the room. Doing nothing is doing something. Sometimes
is good and even necessary to leave the patient alone, and not insist that every
little thing means something (even if deep down you know it does).

24. Be totally present but don’t turn into a full-time therapist.

Your clients deserve (and are paying for) your full undivided attention during the
session, but do not carry them on your shoulders once the hour is over. Avoid
losing yourself in your clients, learn to “let clients go” and do not carry around
their problems until you see them again. You will certainly think (and even
worry) about them during the day, but do not be their therapist 24x7. Trust that
they have the capacity to live their lives and make their own decisions outside the
session. Likewise, don’t “therapize” your partner, family and/or friends. Be the
best therapist you can be for your clients, but leave that “persona” in the therapy
room.

25. Acknowledge the anxiety in the room

A journey of a thousand miles begins in the first meeting.

Anxiety prevents the person’s internal communication system from functioning

Especially when the number of sessions is limited.

Tennessee Williams

D.W. Winnicott

Mother Teresa of Calcutta

appropriately. The client most likely feels anxious and you should be too
(especially in the first session). Normalize the situation without belittling the
client’s feelings. Acknowledge his courage in being there, and provide some
assurance that it was the “right move”, that she is not crazy and that there is hope.

26. Believe your clients’ stories, but with a grain of salt.

Remember that people (you included) do not always tell the truth. Even if they
are being as honest as they can possibly be (and many times they will not be that
honest), you are only listening to your client’s side of the story. Keep looking at
clients in an I-Thou way, honoring their self-exploration efforts, while
acknowledging that there are many things going on during the session. Bear in
mind that some clients can be too hard on themselves (or on others) and can over-
pathologize themselves or those around them.

Many times, even if we want to, we cannot tell the truth because we ignore our
real motives, which have been repressed long ago, buried in the darkest cave or
our mind (our shadow). Our unconscious is always there, like a puppet-master,
pulling strings of which we are not even aware. How can our clients be fully
honest with us when we cannot even be honest to ourselves? And since we all do
it, nobody should be condemned for it. All the same, always remember that, in the
session, reality is not as important as the client’s perceptions.

27. Notes-taking.

Do not take notes during the session but do not rely on your memory either. At
the end of each session, write about the main issues discussed, your feelings and
unfinished business. Use a few minutes before the session to review such notes.

28. Be grateful.

The privilege of entering into another’s life is among the highest a person can
ever get. Be thankful of the honor of being a witness of the client’s struggle and
story and a confidant to her. Our clients trust us with what is most valuable for
them, their life stories, their fears, their feelings and desires. It is a privilege and a
responsibility to be the recipient of such treasures. Honor and respect that and
vow to do your best to assist them to find their own answers.

29. Intersubjectivity.

The meeting of two personalities is like the contact of two chemical substances: if

there is any reaction, both are transformed.

You are me, and I am you. Isn't it obvious that we “inter-are”?

In the therapy room, as the client begins to go deeper into himself, so too does the
therapist into his own self in a series of reciprocal transactions. The therapist is
not an objective viewer, removed of what is going on in the session; as such, he

Carl Jung

Thich Nhat Hanh

cannot be the arbiter of reality. The truth we believe about ourselves, the world
and the client, is no more (though no less) ‘real’ than that of the client. All we
can ‘know’ is our own psychic reality. The client is affecting you (and you would
do well in welcoming this) at least as much as you are affecting him.

The Therapist

30. Do not confuse your role with you.

By acceptance I mean a warm regard for him as person... ...no matter what his

condition, his behavior, or his feelings.

Transference is powerful. It is about you, but do not take it personal. Remember
that the client hate, admiration, sexual desire, etc., may have less to do with you
than with her past and ways of organizing experience. Don’t let yourself be
destroyed or demoralized by the patient, even when she ignores you, attack you or
deprecate you. Many times, erotic transference is not about sex but early longing
(usually a longing for a parent-child connection), so (i) do not take it personal, (ii)
don’t criticize the client, (iii) don’t join her, (iv) allow the feelings to persist,
without gratifying them.

31. Watch your own feelings & fantasies

Be attentive and own the feelings and fantasies the client elicits in you (fear,
anxiety, sympathy, sexual desire, anger, hate, desire to rescue or to parent him,
furor sanandi, etc), do not try to ignore, suppress or brush them away, they are
telling you something. Keep in mind that the client will try to do to you what he
does to others (and push you to do to him what he is used –or expects– to receive
from others). One way to discover the client’s transference is to ask “what is he
trying to make me do?” Does he want the therapist to like him? Is he asking to
be kicked out or abused by the therapist? Is he trying to seduce you? Does he
want you to take care of him (or vice versa)?  Is he fighting to submit you?
Likewise, you will project your own old patterns and repetitions/ selfobject needs/
organizing principles onto the client.  It is almost like waltzing back and forward,
letting the client guide us (transference) while being very careful not to step on
her toes (countertransference).

Trust yourself. You know more than you think you do.

Trust your own feelings and intuition. Where does this “x” feeling comes from?
Does it come from your own past/needs/stuff? Or is the client’s transference or
projective identifications?  Be willing to share them (if they are for the client’s
best interest). Be attentive to what is going on inside you. How are you feeling?
Are you confused? Bored? Angry? Happy?

32. Work in yourself.

Carl Rogers

Dr. Spock

If I had six hours to chop down a tree, I'd spend the first four hours sharpening

the axe.

The key to warriorship and the first principle of Shambhala vision is not being
afraid of who you are.

The nature of therapy requires the therapist’s commitment to his own growth,
which makes him a perpetual patient, thus avoiding becoming a therapeutic
technician (kind of keeping a beginner’s mind). You have blind spots that your
clients will trigger or at the very least detect; be open to hear about them and
explore them. The fact is that we all are like snails; wherever we go, we carry on
our back a shell full of our psychological stuff (our unresolved issues), which will
not go away until we deal with it. No matter where you go, “you” will be there
with you. Gnothi Sauton

33. Your job is not to teach, save or rescue you clients.

If we can abandon our missionary zeal we have less chance of being eaten by

cannibals.

Therefore, one should act without being attached to the fruits of activities, for by
working without attachment man attains the supreme goal of life.

The setting, the client and even your previous conditioning may be pulling you to
become the client’s messiah, guru or prophet. In such model, everything seems to
depend in the wisdom/knowledge/cleverness of the therapist. Do not fall in the
“enlightened therapist” trap. There is an enormous temptation and pressure for
the therapist to produce something, to intervene in some way, to use a technique,
to ask the right question, to make the right interpretation that would produce the
Eureka feeling in the client, which would help her make sense out of things and
live happily ever after. Bear in mind Freud’s admonitions against the educative
and therapeutic ambitions (furor sanandi) the craving to help, the self-indulgent
hunger for cure

. Don’t try to produce great “breakthroughs”.

Embrace the therapeutic experience not getting attached to results (the fruits of
action), allowing the process to unfold and the transference to form, neither trying
to make things happen nor developing a specific agenda. Understand that client
may apparently “get worse” before showing any therapeutic gains. Also make
friends with the idea that many times you will not know whether a client is
progressing or whether you are being helpful in her growth process. Learn to
function in ambiguity, with now knowing, begin comfortable in a place of not-

Abraham Lincoln

Shambhala tradition

Know Thyself

Carl Whitaker

The Bhagavad Gita (3,19).

Whenever a psychotherapist has too great a need to cure his patients—in order to prove his own worth,

for instance, rather than out of concern for what the patient needs—he will tend to become easily frustrated
and intolerant of patients who don’t get better quickly. Until they learn to recognize and come to terms with
this rage to cure, therapists generally have trouble distinguishing their own needs from their patients’ needs.

knowing, focused on Being rather than Doing.

Observe yourself, especially when you sense a disagreement/struggle with the
client (even if very mild or subtle, even if the client does not seem to notice it). It
may be a salient indicator that you are trying to guide the client to see things
“your way”. Give up your missionary seal.

34. Don’t try to fix, cheer up or fine-tune your clients.

Your job is not to “fix” your clients, make them feel better or help them “fit” in
society. Wholeness, not perfection is the purpose of therapy; this has been stated
many times in many different ways. Jung used to say that he’d rather be whole
than good. To accept the good and the bad of life

. Human beings with the

ability to honor life’s darkness as well as its light. The ‘cured’ client would no
longer seek for a happily-ever-after ending, or trying to meet society’s
expectations but be her own true self. Kohut talks about the therapist as a helper
who supports the patient until she “emerges from it [therapy] a more solid and
authentic adult that the one who entered treatment”. It is not a question of what to
do, but how to feel differently, how to be different.

35. Don’t try to know it all.

If you ask me a question I don't know, I'm not going to answer.

Watch out for the myth of psychotherapy: In the therapy room there is one
distressed person with problems and one professional who has it all together

. In

reality, you do not know all the answers and you are not supposed to (even when
you think you have “the” answer, you would not give it to the client, right?).
How could you know what is best for the client? Don’t worry when you don’t
know what you’re doing; worry when you think you do.

36. Neither better, nor worse.

You are neither better, nor worse that you client (and you are not supposed to be)
Together you are just “fellow travelers” in the path of life

. The therapist has to

clear his own path (as much as possible) and then invite others to walk a similar
one together; as someone who, while may have already visited this specific
“country” is nonetheless a wanderer, still learning and discovering new things.

At one level, we are all each other’s manifestations of Avalokiteshvara the
bodhisattva of compassion, illuminating each other through our mutual
interactions.

Klein’s “Depressive position”

Yogi Berra

Michael Kahn

Irvin D. Yalom

37. Personal Modeling.

One must live the way one thinks or end up thinking the way one has lived.

You have a responsibility to your clients. Whether you like it or not, they’ll
observe you (just like children would) to see if you follow your own preach, if
you walk your talk. Even if you do not think that your clients see you that way,
your behavior in the therapy room should be your most accomplished example of
what a healthy human being should/could be. This includes taking care of
yourself and your own needs.

38. You’ll make mistakes

Knowledge rests not upon truth alone, but upon error also.

Face the fact that you’ll make mistakes. Console yourself in the additional fact
that, in an almost paradoxical way, not the therapist’s skills, but his blunders
(including but not limited to the empathic failures) are what promote significant
therapeutic change. According to Winnicott, clients will certainly use your
mistakes in their process; therefore, you would do well in learning to use them
yourself (even if it means a study of your own unconscious countertransference).

39. Be honest, transparent and candid.

Be yourself. Especially do not fake affection. Neither be cynical about love.

Never pretend to be what you are not, or to feel what you do not feel. You can
decide whether you want to share your thoughts and/or feelings with the client,
but in any case, never lie to the client. Be genuine, strive to be transparent, not
wearing any “therapist mask” and do not pretend to be someone you are not.

40. You are a human being.

Some cannot loosen their own chains yet can nonetheless redeem their friends.

Holy men may be in niches, but they are certainly alone. Keep yourself human,
real and accept your limitations and struggles.

The client will affect you. Be attentive to your own process, your own
countertransference (cotransference) and your own selfobject needs. Be
spontaneous. Whenever you think that it would be in the client’s best interest, do
not hesitate to share what is going on within you. Therapists (just as clients) have
needs but keep in mind that therapy is for the client’s benefit. Ideally, as long as
you are aware of your needs, you will be able to discriminate if any given desire
or pull to share comes from you or from the client, and whether it would be
beneficial for him.

Paul Bourget

Carl Jung

Max Ehrmann, Desiderata.

Friedrich Nietzsche

All know the way, few actually walk it.

Be willing to walk the path that your client is walking. If the client walks faster
than you or goes beyond where you are, be willing to learn from him and be
encouraged by his example. By helping in such occasions, you are not being
hypocrite, you are doing your job supporting the client.

41. Be yourself.

Do not attempt to be the Buddha.

It is not about theories but persons. It is not about techniques but being honest
and fully present. What is happening between the two people takes precedent
over the method one is using. Find your own voice and counseling style.

42. Humor.

More errors are made solemnly than in fun

Therapy is important but it need not be deadly serious. Humor can be useful, not
only to break a grim mood, but also helps to keep the therapist sane.

Relax, it is

only therapy. It is serious business but not life itself. You should be able to enjoy
this work. Take this guide with a grain of salt, go out and try it. In twenty years
come back read this guide again and see how you are doing.

–

Bodhidharma

Dōgen

Don Herold