Trust: The High Hurdle of Therapy

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All relationships are either therapeutic or non-therapeutic. Or perhaps I should say, sometimes therapeutic and sometimes not. A relationship with a counselor is not exempt from this complication. Bloggers in treatment suggest that no other topic so unsettles the soul.

The heart is easily torn. A therapist tries to get inside a patient in a way more intimate than most sexual encounters. The client is expected to strip down before the healer in a metaphorical sense. Remember, our custom of shaking hands derives from the need of two souls to prove they are unarmed — that to be near is not to risk injury. Even without weapons, however, danger is there.

Partners in friendship, love, and therapy make assumptions. Sometimes these unstated beliefs undermine the possibility of understanding and trust. Trust is like a garment made out of words and expressions; actions and expectations. In the space of less than the 50-minute hour, the fabric is woven, unwoven, and back again. By a shift in the body and a smile. By a raised eyebrow and a word well-chosen, poorly chosen, or misunderstood. By silence or its lack. By whether the counselor recognizes the tiniest of tears in the corner of an eye. By whether the patient — gaze downcast and terrified — misses the same evidence she would otherwise observe in the healer.

Too often we expect the impossible of people to whom we are close: that if we are cared for, the other will know what we are feeling and thinking automatically. “He should be able to tell,” we say to ourselves. This belief shifts the responsibility for the achievement of trust and understanding to the other; whether a parent, a spouse, or a psychologist. Sometimes it is reasonable, often not, especially when both parties are adults.

Part of what makes understanding hard (even if we do not assume the other owns a crystal ball) is a question of access. No one else can get inside our head. We have knowledge of ourselves, or what we think we are, in the bright light of the mind. We possess an internal and effortless but utterly precise grasp of our own meaning. Yet for all the clarity available on the inside, our counterpart is in the dark, far from the possibility of direct observation. He cannot see within us, only the outer disguise and armoring. He may consult the dictionary meaning of our words and interpret our expressions and movements, but not more. Relationships die when the other is obtuse and insensitive, and also when too much is expected.

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No one is a mind reader. The job of comprehension leading to trust is a duet, not a solo performance. Like all good performances, it takes rehearsal. Repeated rehearsal.

Therapist and patient, when they are well-matched and both working hard, spin a spider’s web as the session begins. The fibers are fine, almost invisible. With time, the net grows. If strong enough and recreated session after session, the strands thicken and better bear the weight of personal disclosure. Yet they still can be torn and retorn.

This is not necessarily a bad thing. All of life must be tested and resilience can only grow out of disappointment. We live in a world of unreliability. Nothing is permanent and yet we seek permanence. So we weave the web — together. With familiarity, the strands are more easily rewoven when a rift develops. Confidence grows. A safety net seems possible.

Remember, this is an act of becoming, not of being. There is no “one and done” here. Repetition, persistence, and continued effort despite the fraying of hope are required.

Nothing above absolves the therapist of the need for finely tuned sensitivity, laser-like focus, and dedication. He must do his best to recognize messages often disguised; must take care not to injure. Nor does this free the patient from taking incredible risks to reveal herself, even though her history says revelation and vulnerability will result in a terrible end. Tearable of the thing we call trust, and terrible to the heart and body.

The most damaged of clients want to be known, but are afraid to be known. They are frightened to show themselves to anyone. Thus, their coded messages are misunderstood. Nonetheless, courage is essential. The unfairness of having to take one more risk carries no weight. They must do so repeatedly. Their healing is otherwise impossible.

Perhaps therapists should recite a disclaimer to the most damaged patients at the outset of treatment:

I want to understand you, but I am imperfect. I will not make a clean catch of everything you say. You might have to repeat or rephrase. You will test me, but I am helpless without your willingness to trust — to help me help you. This is asking a lot. I apologize, but there is no alternative. I will disappoint you, but I am earnest. We must keep trying to weave a beautiful fabric, like a magic carpet. One that will help carry you until you can fly without the support of a tapestry to bear you aloft.

The careful reader will be struck by how many visual metaphors I have used in this essay. I’ve tried to achieve your understanding by reference to what can be seen. In so doing, I have also been underlining how difficult it is to express oneself by abstract words alone. Put differently, how challenging is the therapeutic task of achieving understanding.

In the fairy tale, Rumplestiltskin, a miller’s daughter is said to be able to do the impossible — spin straw into gold. Such is the goal of therapist and patient, both at the wheel. They too must weave. Without even straw. They hold only the memory of pain on one side and a strained, always imperfect empathy on the other. Gold of a different kind — understanding, trust, and healing — can come of their teamwork.

Is this only a fairy tale, too?

Not if you have seen it happen.

The top photo of a spider web on a pasture is the work of Nijeholt. The second image is a Magic Carpet created by איתמר סיאני. Both are sourced from Wikimedia Commons.

Expecting Your Mate to Read Your Mind

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“He/she should know what I want.”

Therapists make a fortune from those who believe that everyone in the world is intuitive; that each person is born with the gift of being able to peer into the mind of the other. And, most importantly, that a person who really loves you (or even a very good friend) will know what you want without it having to be put into words.

Such people come to couples therapists expecting that the counselor will be able to train the patient’s spouse to do this. The problem, as they see it, is in the other, not in themselves.

There are a few iffy assumptions here:

  1. Any reasonably intelligent person (I’m including men here, if you will permit me to put that word together with the word “intelligent”) has an innate capacity to know the wants and desires of a partner who has not directly stated them.
  2. Such a person is further able to know the order in which such requirements are to be fulfilled, despite the absence of any ranking of those priorities by their partner.
  3. The same individual is always listening for hints that might suggest what the lover wants and in what order the lover wants them. He/she is terrific at “getting” the subtlest of those hints because he/she is a master of understanding tone of voice, body language, and even silences.
  4. The fulfillment of an unstated desire is worth more than getting what is wanted by asking for it directly. Having to ask for the thing you want somehow diminishes its value.

Are these assumptions correct?

No, no, no, and no.

Partners, even those who are sensitive and devoted, have only an approximate idea of some of the things that would please the spouse. If they don’t know the items on your list, they certainly can’t get the expected order of importance right.

It would be nice if your friend were telepathic, but his/her lack of capacity to read your mind should not diminish the value of what he tries to do to please you, even if you have to give him directions along the way. Isn’t there something appealing in a person whose affection for you is so great that he is willing to make the effort to understand something — do something that is not intuitive and doesn’t come easily?

And, do remember, your loved one is not always paying attention, as in the following cartoon showing a long-time patient and his therapist:

"Oops! I've just deleted all your files. Can you repeat everything you've every told me?"

“Oops! I just deleted all your files. Can you repeat everything you’ve ever told me?”

A few practical suggestions (follow them at your own risk):

  1. Ask your spouse to tell you what he/she thinks will make you happy. Do this with the iPads and smartphones put away, the TV and radio off, no music in the background, the wine bottles corked, and the kids asleep or out of the house. Assuming that he doesn’t say, “Nothing will make you happy,” you are off to a good start: you are talking without distractions.
  2. If that question is too broad, be more specific. Ask your spouse what he imagines would make you happy in one or two of the following areas: housework, taking care of the kids, running errands, making a living, time spent together, romance/sex, attitude, and whatever else you can think of that is important.
  3. Don’t condemn, mock, or laugh. Don’t criticize. Don’t start any sentence with the words “How can you not know…” Just listen. Take notes if necessary.
  4. Don’t assume that you can read his/her mind any more than he can read yours. Don’t assume the worst possible motives for his failure to give you what you want. Recognize and praise what he has done right that you might otherwise tend to minimize or ignore.
  5. Choose only one or two of the areas on which you wish to concentrate. (I realize I’m repeating this, but you should try to start small). Tell your mate where he is right and where he needs a bit of help. Give him that help. Tell him precisely what you want. That is, if you want him to take out the garbage by 8PM without a reminder on Tuesday night, say so. If you also want him to replace the garbage bags, say so. Don’t assume anything. Make your desires as explicit and behaviorally descriptive as possible. Remember, you are dealing with someone you believe to have missed a few years in school.
  6. Ask the other to paraphrase what you’ve said. He will probably not do a great job at this. Keep at it until you feel that he actually knows what you are asking for because he has specified all the details in his own words, not because he says “OK, I’ll do that.”
  7. Don’t ask for the world. If you want a man to put the toilet seat down every time he uses the W/C, you should realize that (for certain men) asking for a round-the-world tour would be more easily achieved.
  8. Be sensitive to the possibility that he may stop listening to you if you go on too long, start hammering him, or if he has other things on his mind. It is better for your conversation to be relatively brief with full attention than longer, but with periods of inattention.
  9. If you are getting exasperated try to end the conversation and make plans to pick it up again. Rome wasn’t built in a day.
  10. End on a high note. Say thanks and mean it. He/she is trying to get this right.

One last word. This will require you to change, too. Indeed, it is just possible that the love of your life fails to do some of the things you want because he doesn’t think you are attentive to his own desires. In other words, that the two of you are involved in a kind of tit-for-tat game of withholding and passive-aggressive expressions of anger.

You will also have to recognize that you too have a limited power to read his mind; that it is only fair that you permit him to go through the same kind of 10-point exercise I just described, allowing him to determine whether you are fully aware of his wishes and giving him an opportunity to set you straight.

Being direct but not vicious is an art that must be perfected for relationships to survive in the best possible way. You won’t get back to “the days of wine and roses” by hitting your spouse over the head with a mallet, however tempting that might be. You want him to look at you with stars of love in his eyes, not seeing stars after the blow you just delivered to his noggin.

It is not a subtle point, I know. Still, I had to make it because otherwise you would have had to read my mind!

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The top image is a Poster of Alexander Seer, sourced from Wikimedia Commons.

The Limits of Reason: How to Think about Your Date, Your Boss, Your Mom, etc.

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As a therapist, I hear a lot of concerns from my patients about parents, bosses, romantic partners, and so forth. The thoughts often take the form of “Why did he do that?” or “What was he thinking?”

Some of this is worth questioning. In life it is useful to take the role of the other person, to look at things from his or her perspective, to try to “understand” that individual’s motivations and reasoning process.

But, there are limits. Here are just a few that make understanding difficult:

1. People don’t always carefully weigh their decisions before making them. We humans frequently think and act impulsively or emotionally. It can be a bit harder to fathom an ill-considered act than one that is carefully reasoned.

2. The person whose mind you wish to enter may not know himself well at all. When you recall what he says are the reasons for his actions, you need to be aware that he may be fooling himself. Alternatively, he might be dishonest with you, giving you less than a full set of data, trying to prevent himself from looking bad in your eyes, or attempting to protect you from being hurt by the truth.

3. We all act in self-serving ways much of the time. The same person who says that he hates it when someone ends a relationship without explaining why — not even making contact or returning phone calls — might well avoid the discomfort of a final farewell or confrontation himself when he decides that a relationship should end, thereby doing the very thing that has been done to him.

4. Most people, in or out of therapy, are often indirect in expressing their unhappiness with you or their disappointments about your behavior. (Marital conflicts and parents talking to children can be noteworthy exceptions to this general rule). But, in the absence of direct communication, it is difficult to be a good mind reader. Indeed, crystal balls are in short supply whenever I go shopping.

5. When trying to understand others, we look for some form of logic. To seek something that is often missing within the person is a pretty big misunderstanding of how people think and act.

6. You may not have enough history and background information to make an accurate analysis of what drives this individual to do what he does.

7. Do you really know the person well “under the skin?” There is often a mismatch between what is happening on the inside and what is occurring on the outside. Put differently, the contradiction between surface appearances and internal truth often affirms the old saying, “Don’t judge a book by its cover.”

Too much time trying to figure out another person is unproductive. For this reason and those cited above, I encourage my patients to set some limits on the amount of time they spend attempting to get into someone else’s head. At bottom, I think, what most of us are looking for is the understanding that will allow us to return to the relationship and put it right, now that we have found the “answer” to what transpired. Or, something that will console us or produce the closure that we are hoping for at the relationship’s end. By attempting to “understand,” we are frequently seeking a sense of intellectual control, partially to acquire information that will prevent future disappointments, but also to compensate us for our loss and to silence the nagging internal voice that asks “What happened?” and “Did I do something wrong?”

It is better, beyond a certain point, to consider several things about oneself:

a. Why did I choose that person to be with? (Obviously this doesn’t apply to your parents; nor does it always apply to bosses or co-workers).

b. How did it happen that I missed the early warning signs of trouble? Oh, I know that you might think that such signs didn’t exist, but it could be that you ignored them, minimized them, or had a blind-spot for them.

c. Why didn’t I set some limits on the relationship in order to prevent the other person from injuring me? And, if I tried, why did my efforts fail?

d. Why didn’t I leave the relationship earlier?

e. What, if anything, did I contribute to the problems that occurred between my friend/partner/lover/boss and myself?

f. Have I grieved the loss or disappointment fully (including attention to both my sadness and my anger)?

g. What do I have to do differently in order to minimize or avoid problems like this in the future?

Instead of addressing the situation in these ways, with these questions, most of us spend no small amount of time ruminating, and then looking for something we can say to the other person to get them to behave as we wish. With some individuals that is possible, but not with everyone.

Jackie Robinson’s breaking of the baseball color-line is instructive in this regard. As you might know, Robinson and his boss, Branch Rickey, agreed that he would not respond to the abuse from fans, players, and coaches that both expected he would receive when he became the first black man in the 20th century to play in the Major Leagues. But, despite two years of taking every racially demeaning insult known to mid-century white males, he succeeded in playing well. Moreover, by this time there were other blacks in the Major Leagues and a great experiment in civil rights had succeeded.

If the story I’ve heard is true, Robinson and Branch Rickey had a conversation at the beginning of Spring Training at the start of Robinson’s third year with the Brooklyn Dodgers. They agreed that Robinson could now be himself, and fight back with words or fists, if necessary. Soon after, the Dodgers played the Philadelphia Phillies, who did not know that Robinson was no longer on a leash. The middle-aged man from the deep south who coached third base therefore once again began the verbal onslaught that he had performed with impunity for the two previous seasons. Robinson called time and walked over to the third base coaching box.

Remember that Robinson had lettered in four sports at UCLA, including football (as a running back). More than most, he radiated intensity, strength, courage, and intelligence. So it was that Robinson moved within inches of the bigot, looked straight into his eyes, and said: “If you ever say anything to me like that again, I’ll kill you.”

Now, I bring this up not to recommend death threats, but rather to point out that Robinson knew exactly who he was dealing with. He knew this man was not going to be persuaded to behave himself by high-flown verbal eloquence; he knew that spending much time thinking about this man’s character was a waste. What Robinson knew for certain was that there was only one thing he needed to understand about his nemesis (his intolerance) and only one approach that would work:

  • I’m bigger and stronger than you are, so if you don’t stop, I will beat the crap out of you.

Everything changed that day as others quickly realized that Jackie Robinson was not a man who could be insulted any more.

Of course, we all need to spend some time thinking about others and why they do what they do. But, endless rumination on the subject rarely is enlightening or successful in making us feel better.

Some people are like boulders. They are big, hard, insensate, obdurate, and potentially damaging objects. It is essential to see their potential to injure and realize that when you are downhill from such a human bolder, you are in danger.

If you understand how gravity works and get out-of-the-way, that is all you need to know and do — all you can do.

A shame, but true.

The image above is The Thinker by Auguste Rodin.