Confessions of a Counselor.

There is the scientific basis to my profession of counseling; then there’s the art of it. Looking back over my thirty years of practice, I have to admit that so much of what determines success or failure for a psychotherapist is based in art.  During counseling grad school, I used to look over at my wife’s MD/Ph.D. studies in medicine and science with envy.  It seemed so much more measurable…so much more objective!  There was a body of material, followed by a test on that material.  There was the “See one.  Do one.  Teach one.” of clinical training.  Sure, a physician candidate was capable of scarfing and barfing facts merely to pass a test.  But, like a pinball machine’s redundant rows of flippers, prospective physicians, and physician-in-training would eventually re-encounter that material again and again with layers of supervision and support, as well as scrutiny and accountability.  Making it through a system like that, I told myself, would provide a practitioner with a sense of confidence and authority upon completion of training. Having provided counseling to many physicians and physicians-in-training, I now know that neither physicians norcounselors are immune from Imposters Syndrome.  Even after thirty years and many tens of thousands of hours of practice, there are still nights when I can’t get a client out of my head for fear that my approach wasn’t what it should have been or could have been.  

Perhaps the most profound reason for humility in my work as a counselor has to do with the myriad factors that hold a client’s beliefs, behaviors, and relationship styles in place.  Some are cognitive, some are unconscious, some are developmental, some are somatic, some are cultural, some are intergenerational, some are part of a dance of family systems including intricate patterns of causality, rules and roles.  At any given moment, a counselor must be able to keep full attention on the client, while simultaneously reading the impact that the client or couple is having upon the therapist’s experience in the room.  A deep and thorough knowledge of one’s own biases, and knowing how to bracket them is essential for ethical practice.  Developing the ability to read the interplay between transference and countertransference is crucial.  “What is the client projecting onto me, and what am I projecting onto them?” 

A healthy tentativeness about a therapist’s  interpretations eventually led my profession to a post-modern debate that posedthis question: “Is it even possible to know what is objective in the client’s world?  Is it all just a matter of perspective?”  This all sounds highly academic until someone in a session pipes up with a phrase like, “It takes two to tango!”  It practically seems like common sense that, in any given conflict, both spouses contribute to the problem.  Over time, this academic question found some fairly hard-edged answers.  In situations where there is a power differential, perhaps everyone in the relationship system is part of the problem, but not equally.  A battered wife does not cause her husband to give her a black eye, or broken bones, no matter what she said or did just before he hit her.  A victim of child abuse is in no way responsible for their trauma.  

To put an even finer point on it, neuro-psychology research has shown the malleability of human memory.  In any given memory, there is the part that happened in the real world, and the part that was constructed in the imagination through various associative mechanisms.  In good counseling practice, it matters if a recovered memory can be verified in reality or not when the content of that memory has the potential to blow a family apart. Look at the needle that an ethical counselor must thread.  Are there such things as repressed memories that can be uncovered in counseling?  You bet!  Is it possible to provide suggestive material in a session that stimulates the creation of a false memory?  According to valid and reliable research:  the answer is also, Yes!  Time and again, my profession has shown the importance of a humility in our interpretation of what is true and false, objective, and subjective.  Regardless of the particular theoretic school that animates a therapist’s practice, his or her art must bend to reliable processes of verification.  Truth matters in a counselor’s office, as well as in marriages, families, churches, and corporate life together.  Truth and the trust that flows from it is a foundational element in all relationships.

It seems to me that our culture has arrived at a moment when truth and its knowability have been called into question.  Perhaps, like my profession several decades ago, we are in a moment, when our culture as a whole, has been humbled about the knowability of what is objectively true.  It is also likely that we live in an age of disillusionment.  Over the decades, one institution after another, that we had counted on to always and everywhere convey the truth have failed to do so in some significant ways.  Given the fallibility of every organization, andgiven the malleability and fallibility of our own truth-seekingprocesses, perhaps a certain amount of skepticism and even disillusionment is necessary… even healthy.  But just as a marriage cannot exist without truth and trust, a society that cannot access a common sense of what is valid and reliable will not long endure.  Perhaps it is time for each of us to take a good hard look at how we track down what is true and false, what simply feels true because of its compatibility with our biases, and what is true.  In his theological system, Thomas Aquinas asserted that another name for “God” is “Truth.”  In the Christian scriptures, Jesus says, “The truth will set you free” (John 8: 31).  What procedures will you put in place to serve the truth in a wholehearted way?  

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