One of my favorite scenes in the movie, The Wizard Of Oz, takes place almost at the end of the movie. Dorothy, the tin man, the lion, and the scarecrow have killed the wicked witch of the West. They are holding her broom as they plead with the Great And Powerful Wizard to grant them their wishes. They still haven’t realized that this great wizard is a silly charlatan, who has used social psychology to rule over a land of midgets. Who revealed the fraud? Toto the dog! The humans, with their intelligence, could not see the holes in the story; they were seduced into believing that they knew what was what. Toto, though, lacking all of those seductive human social and psychological vulnerabilities, could see the truth and reveal the liar for who he was.

This scene reminds me of how political ‘power over’ systems control and rule over those who are subordinate to them. That is why engaging the politically silenced into treatment is done with a basic cognitive tool: destabilizing the sense of certainty that makes the power-over-me appear so powerful. For sure, the abused child or wife or the employee who has been taken advantage of have really been told that a new balanced arrangement in the relationship is impossible. Or the depressed client has seen with his own two eyes how cruel and confining the world can be. But such ‘hearings’ and ‘seeings’ alone can do little to trap us. It is our imagination, fueled by fear and our psychological vulnerabilities that traps us in prison and irons. Our job is to point out the inconsistencies in the narrative. We ask questions. We make observations. We look for moments when the client felt a measure of freedom and then we work with the client to repeat those moments and to expand on them.

Enjoy the snow everyone!

A client comes for treatment. He’s suffering. He’s confused. He’s ambivalent. He doesn’t know what he wants. But there is one thing that he is clearly afraid of: any changes in his social status. Humanity is a highly social species: just as the body needs oxygen, the psyche needs to social membership. Any threat to that membership, whether real or imagined, will evoke fear and avoidance. Clients need that membership even when that membership comes with an unspeakable costs. Therefore, we must proceed gently. Speaking against tribal affiliation, a destructive family relationship, work environment or any other social connection must be done, if ever, with great care. What we can do is to begin speaking about feelings, self worth, ambitions, failures, and any thing else that is taboo outside the four walls of our offices. With this beginning, we can weave a helpful therapeutic relationship with one of its goals being a change in the client’s social position.

עד כה, התייחסנו לקליינטים שקשיי התקשורת אתנו ועם עולמם הפנימי נובעים מחוסר מודעות לתוכן פנימי או חסרה להם שפה מילולית לתאר את מה שקורה בפנים. נשים אותם בצד ונתייחס לאלו שמושתקים עקב ניגודים ‘פוליטיים‘. 

נקדים שכשמדברים על פוליטיקה איננו מדברים על מפלגות, פריימריז, וחברי כנסת. אלא, אנו מדברים על עצמאות ויכולת של כל בן אדם לפעול ולחשוב ולדבר כעצמאי בתוך החברה שלו. חברות בחברה דורשת ויתורים ברצון ובחשיבה. היא גם כופה גבולות על הבעה עצמאית ואוטנטית אם הבעות הנחשבות כמסוכנות להיררכיה של החברה. זה לא המקום לכנס לסוגי חברות ואיך מאשרות עצמאות למי ועוד נושאים חשובים. מה שרללונתי פה שחברות במשפחה, זוג, מקום עבודה, מדינה,וכל זוג חברה אחרת היא דורשת מחיר ולהרבה קליינטים המחיר היא שתיקה הן בדיבור הן בפעולה ואפילו לפעמים במה שחושבים.

’אם אלמים למה הם מגיעים לטיפול?׳ אני שומע אתכם שואלים. ולזה יש כל מיני סיבות: מהן: הפנייה היא לסיבה אחרת.מישהו ׳שומע’ שמקצועי ספיצי יכול ל׳פתור׳ בעיות בקשב וריכוז, או בזוגיות, או בכעסים, או בזה או בזה. יש עוד מצב שה׳סימפטום׳ כל כך מפריע לסדר יום ופוגע בנורמות של החברה שהגבולות של ההיררכיה לא מסוגולת לבלום את ביקוש לעזרה. ויש, ה׳נושרים׳ שמסתבכים בחברות תחליפיות ככנופיות וחבורות שנמצאות בשוליים. משם, דרך המשטרה וגורמים חיצוניים עם מספיק כח, הנושרים מגיעים לטיפול. ויש אחרים שמוצאים איזהשהו דרך, בגלל כאבים אדירים ואכזבות רבות, ובאים לטיפול.

למרות הפניה לטיפול ועזרה, האלמים האלו מתלבטים על מכונתם לדבר נגד הנורמות מאופן רציני. זה לא מפתיע; קשרי נאמנות לא בקלות מותרות. ולכן, אנו נכנסים לשדה מוקשים בזהירות ובחכמה ועם מוכנות ספוג כמה פצצות. ועל זה נמשיך מחר. 

Until now, we’ve been discussing clients who have difficulty communicating their inner experiences with us. Their inability could be stem from an innaccesible inner world. It could also be due to their lack of verbal language that allows them to communicate their inner world and feelings to us. We’ll put them aside for now so that we can focus on those who’re unable to speak because of ‘political’ considerations. 

Of course, when we speak of political consideration we’re not speaking of elections and primaries. We’re speaking of what is allowed for each individual members of a social grouping. All groups, whether they are marriages, friendships, or work relationships, have rules which limit and shape autonomy and expression. In some relationships, the cost of membership is silence.

‘So why do they come for treatment?’, I hear you asking. There are many reasons. Among them: Clients may come for other, ‘acceptable’ reasons which don’t threaten the rules of the relationship. In other cases, the ‘symptoms’ have become so extreme that the rules no longer seem to apply. For others, a downward spiral of connections with fringe groups and gangs allow them to break out of the control of their primary social group.

Regardless of how they arrive for treatment, group loyalty runs deep. These clients are ambivalent about violating social taboos. We can respond with wisdom and caring as we make our way through various minefields strewn before us.

More on that tomorrow.

Shavua Tov!

For many, proxies and doubles become ‘experiencers’ and spokesmen. Certainly, these proxies can do nothing to satisy the basic human need for authentic expression and to deeply experience life in all of its riches.

We turn to doubles and proxies when we feel as though we have no words or our shame leads us to the presumption that our words and actions are not ‘liked’. Granted, that speech is a dialectic of mimicry and improvisation. A baby must mimic; he says ‘mama’ or ‘dada’ simply because he lacks a vocabulary. As soon as a utters those words, he suddenly and joyfully finds a new world of communication opens to him. The hope, of course, is that such mimicry will serve only as a kind of artificial ‘scaffolding’ through which he is able to create and improvise his own personal experience.

The tragedy occurs when the child or the teenager or the adult is silenced; he1 is too ashamed to open his mouth. For him, there is no acceptable place for his words; it makes no difference whether this conclusion is justified or not. He finds some relief in others, fantasizing that they will speak for him. He chooses strong, well spoken, influential, charismatic, and multi-talented characters (Harry Potter, for instance) who he fantasizes speak the words that need to be spoken and do the deeds that need to be done; words and deeds that he believes he lacks.

The relationship that ‘happens’ in psychotherapy is THE place for another chance; a chance to open his mouth, to be encouraged, to be guided and supported, and validated so that that stifled voice becomes a sweet, mighty part of cosmic celebration.  

Shabbat Shalom Gut Shabbos to all!

Josh

1 Please excuse the exclusive use of the male gender. After some experimentation with various gender inclusive writing techniques, I’ve come to the conclusion that they are simply too wordy. No gender bias is intended. 

We’ve been discussing ways to reach clients who lack a language with which to share their internal world with us as well as those who seem to be cut off from their inner world.

In order to move forward, a brief few words on proxies and doubles will help.

All of us are familiar with serious sports fans. These are crazy people. Perhaps, some of us are such people. For a real fan, the connection to their team or favorite player whisks them away to a magical place; they become so consumed by their target that they forget themselves. True fandom goes beyond simple identification; it’s to let that player or team do and be all the things that the fan cannot do or be.

Of course, the use of proxies is not limited to sports; we find artistic proxies, style proxies, political proxies, moral proxies, spiritual proxies, scholarship proxies, power proxies and many many other kinds. These are all people or objects, some real, some not, who via identification (and then some!) do things for us that we cannot do.

For many people proxies however become tools for expression and offer a kind of inner life. This is one of the roles of celebrities in modern life: celebrities (and each culture has such people) have far more appealing lives and ways to express themselves than many of our clients think of their own lives and ideas. They are caught up in the deep shame pervading our culture, a shame born of not feeling that they have a worthy voice or life, to be shared with others. So they let others do the talking for them. 

In practice, then I will gather information on who the proxies are: characters in television shows, newsmakers, rabonim and tzadikim, singers, and celebrities. What do these proxies say and do on behalf of the client? What we do with this data is for coming installments.

אתמול דברנו על הטירונים, שמוזרות טיפול פסיכותרפיוטי גרידא משתיקה אותם. היום, נדבר באלו שחסרים להם שפה לעולם הפנימי משותפת שדרכה הם יכולים לשתף אותנו (ואחרים!) בעולמם פנימי.

בכלל, אנו, לדעתי, מדגשים תקשורת מילולית מדי. אולי זה בגלל החוסר סבלנות התרבותי: כולנו רוצים אינפורמציה מיד וללית אפשרות להתקין שקע USD בכדי להוריד את האינפורמציה במהירות 10 מגה לשנייה דרך כבל, אנו ׳מתמודדים׳ עם תקשורת מילולית. אבל מה שאנו שוכחים שאפילו פרויד (זוכרים אותו?) יותר השתמש בסימפטומים חיצונים (כהיסטריה ועוד סוגי מחלות פיזיות) כגשר לעולם פנימי.

בעצם מה שנאמר פה שאינפרציה1 ללא דרישה לתקשורת מילולי היא הדרך לפתוח לגשר להרבה קליינטים. אנו פשוט שמים לב: איך הם לבושים, איך נראים, ואיך מרגישים פיזי (אני מסתייע ברשימה של מחלות קלות כאבים שונים שאני מראה לקליינטים שקשה להם לדבר). הגוף ונפש מחוברים ולהקשיב לגוף היא גם להקשיב לנפש.

ויש עוד דרך: לפעמים כתיבה היא הרבה יותר נוחה. אני מזמין קליינטים לכתוב: אימיילים, יומנים, שירים, בלוגים, ותגובות בבלוגים של אחרים. בדרכי הבעה אלה קליינטים יכולים לשלוף מעולמם פנימי במנגנון ובצורה מוכר להם ולשתף אותנו במה שקורה. זכור לי לא מעט מקרים שקליינטים באמצע שיחה ׳רגילה׳ פתחו מחשבים ניידים וטלפונים ושלחו אלי (שיושב במרחק מטר) מיילים וסמסים ונהנלנו חלקים חשובים בפורמט זו. כמובן, אנו חייבים גם להתחשב בעצמנו: איך נשתמש בחומר ובגישה זה ואיך לנהל את הצד האתי וגם הצד העסקי.

וגם יש דרכי אחרים וכמובן הרבה הרבה שיקולים. נגיע להם מחר.

Yesterday, we spoke of rookies and their difficulties sharing their inner world with us. Today, we’ll begin considering those who seem to lack any verbal way of accessing their inner world and sharing it with us (and with others!).

In general, and this is my opinion, we emphasize verbal communication too much. The result is a negative feedback look in which many, especially these non-verbal folks, feel out-gunned by us talkative, gabby folks. What we forget is that even Freud (remember him?) used indirect observation of ‘symptoms’ (hysterical reactions for instance) as a bridge to his patients inner world. 

Essentially, what’s being said here is that inference without expectation of verbal communication is the way to bridge the gap with many clients. We simply pay attention: to their dress, how they appear, how they are feeling physically. I make use of a list of common somatic complaints and illness which the client can choose from. The mind and body are connected and by querying the body, I can learn about the mind connected to it. 

And there is another way: writing is very often much more comfortable for clients. I invite my clients to write whether it be in the form of letters, emails, diaries, poetry, blogs, and comments in the blogs of others. Via these methods of expression, clients are able to express themselves in a way that is comfortable and safe for them. In fact from time to time, clients will open their laptops or phones and send a message or text to me, sitting a meter away from them. Of course, we must also consider our own needs including the the ethical and business dimensions of these methods.

Tomorrow we’ll get to some more ways.