Saturday, September 5, 2009

A therapist's attachment**






I ran a short workshop last week on attachment and attachment in the psychotherapeutic process. Some interesting comments came out of it as participants gave feedback and asked questions.


At one point we spoke about the longer term attachments that can happen in therapy. One of the participants had been reading this blog prior to the workshop and asked a question about pre-verbal issues and their treatment.


I was going to suggest we did a demonstration rebirth but decided against the idea! With pre-verbal issues one is usually dealing with the more psychotically damaged person quite often with characterological problems or what is sometimes known as personality disorders or a third degree impasse in Transactional Analysis terms.


Doing co-therapy with Mary Goulding


The question was asked about how one treats the pre-verbal client and my answer was with attachment in the transference relationship. And amongst other things it is through this the client learns how to self soothe. The only problem is that it takes time. I am not aware of an expedient way to treat such characterological problems.


The question was then asked, how long is that? Usually 1, 2 or 3 years but in my answer I noted that my longest client ever was about 11 years. A very paranoid man who saw me once a week for about 11 years. There were a few breaks in that time but not many and none of them were long breaks. This brought a flurry of comment and questions.


After I stopped seeing him finally, he left and that was that. Months later on christmas day there was a knock on my front door. I went to see who it was and it was him! He said hello and handed me a Christmas present. We had a discussion for about 10 - 15 minutes and he left.


The paranoid personality type


This left me a bit perturbed as he had come to my home uninvited. This man could be very paranoid and could have created all sorts of paranoid beliefs system about me in his head. However I just let it go, did not hear from him again and forgot about the whole thing. Then next christmas day there was a knock at my door and when I opened it there he was again! I got another gift, we talked for 15 minutes and he left. This has continued every christmas since.


This has been good for me because after 11 years I got to know him very well and of course I developed an attachment to him. Of course as a therapist I need to be very careful with this and so forth. But after 11 years I had developed an attachment and this once a year continuity I like because it is a continuity of our relationship.


Sometimes clients complain that the therapy relationship is a one sided attachment wise which I agree with and then they complain that the only reason I see them is because they pay me and that if they died I wouldn’t even go to their funeral. Well if the man under discussion died I would go to his funeral.


The complaining clients are correct however and I would not go to the funerals of most of my clients should they ever have one. However I can recall two that I have gone to. At one I was even asked by the husband to give a short eulogy, which I did. That was of a woman who I saw for five years most of it at three times per week. So it was an intense therapy relationship and yes I did develop an attachment to her and I was moved by her death and emotionally moved at her funeral.



Let me tell you, that is not an easy thing to do, to see a client three times a week! What the heck are you going to talk about! If I see her Monday and then again on Wednesday there is not a lot of time for something significant to happen. However we managed.


At the workshop I also mentioned that over the years a few clients had legally changed their surname to mine. This brought consternation from some of the workshop participants asking if that was professional and ethical. My response was what is wrong with it? I can’t stop them anyway but of course they wanted me to agree with it which I did.


This has not happened for a long time and was in the early 90s if I recall correctly. These people had read about the Schiffian school of Transactional Analysis where Jacqui Schiff’s clients would change their name and so it was a follow on from that.

I must say that regarding the attachment or therapeutic relationship from my point of view this did have an impact. To me it meant something special and I was indeed very glad for them. I have not seen or heard from them for a long time now which is a bit sad. So clearly I did have an attachment of some kind with them.


Graffiti


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