So many of the qualities of the work of psychotherapy fascinate me: the inherent intimacy, its progress, the intricacies of the mind, and the intricacies of the heart; so much of it being so ordinary; and yet, simultaneously, so amazing. What drew me to the field was my deep desire to understand the human mind, a craving to dance in the deepest recesses of man’s soul; but, what initially sustained my love was its wellspring of knowledge, and its myriad ways of healing. I wanted to learn every available treatment method, hoping to discover which one was the absolute best.
So, as I was in school, searching for the best methods, I was presented with, what was to me then, a startling conclusion; I was told that they all worked, each one; and I was completely stunned! I couldn’t accept that each type of treatment was just as good as the other; and, I had to know why. It was somewhere around that period that I first read the works of Irv Yalom, discovering his revolutionary thinking. Yalom, quite some time ago, said something that also left me floored, this time with more skepticism than the first: he said, in his apparently infinite clinical wisdom, that the psychotherapeutic endeavor was only of secondary importance, as it was the relationship that healed. According to Irv, therapy was more of an intimate bond than a relationship between a skilled technician and her ailing patient. For him, intimacy was key, marking a significant break from the medical consensus, which at the time perceived the therapeutic relationship in a more generic way.
What?! That can’t be right, I thought; I was sure that he was just another quack peddling bullshit. So, being as obsessed with science as I was (and still am), this idea didn’t sit well with me. I was convinced that the methods were far more important than their administrator, that as long as you stuck by your manual, treatment would always go according to plan; only with hindsight am I able to see how wrong I was. Therapy, friendship, parent-child relationships, romantic love, all of them carry in them the same implicit theme: a vital intimacy which helps sustain our well-being and our purpose for existing, our deep-seated reason to live.
One of the most profound lessons I’ve learned in my practice, and for my life, is that you can make mistakes as long as you have a strong foundation for your relationships. If your lover, your spouse, your child, and yes, even your patient, knows that you care for them, mistakes become more tolerable, and more acceptable, because there’s a closeness, and a bond for which words are mere shadows, being only inferior representations of the real thing. So, in therapy, as well as in life, one ought to create intimacy with others; and, in order to do that, that individual has to first provide help, to show another how much they care. And, that’s exactly what I try to do for my patents.
How much of my evidenced-based therapeutic methods have actually worked (and to which degree), I really can’t say. Will I continue to use them because I’ve seen, and have read the literature on, their therapeutic results? Absolutely.
But, what I am sure of is the smile I see on a young client’s face when he sees me in the waiting room, the gratitude of a patient who thanks me for listening (and, as an inevitable accompaniment, caring), and the self-acceptance which is fostered through an explanation of what makes a certain set of behaviors understandable in its context. A smile, a laugh, a revelation, a thank you; these are all of the aspects of treatment which make the work worth while, and which inform me of my importance for it. There’s no question that my training was needed, and that I’ve taught my patients skills that they’ll use long after their sessions have reached their endings; but, were they the most significant? I don’t think so, not anymore. It’s the little things that they remember, more so than the generic skills. What my clients search for is what all of us search for: acceptance from someone whom they respect; through it, they establish self-compassion. But, respect only arrives via authenticity. So, the majority of my work remains about sincerity, or at least attempts to. Through their honesty, I receive the privilege of seeing how much they care about our work; through my honesty, they get to see how much I care about them. And that’s important, I think; because it is the relationship that heals, after all.