Yet another thread on Reflective Practice.
- Jul 27, 2021
- 6 min read
Updated: Jan 19, 2023
This one is a little different. I have written previously on the same topic, but at a broader level and to appeal to the psych community to consider supervision spaces for reflection.
Do you Reflect on your practice?
This one is more controversial, unedited rant and on the lines of the dangers of not having said spaces.
Due to personal reasons, I started a sabbatical from April 1, 2021. Its only of relevance in the context of this write up- in the manner that I had to then refer some of my clients out, since they had to continue therapy.
I had taken a great efforts to find therapists who were trained, continued reflecting and learning despite finishing their formal education. It was then I realized how hard it was to find a good therapist in India!
Though the social media platforms give us this idea that we have so many mental health practitioners out there, all creating reels and content, when it came down to finding one, it felt like I was in a ‘searching for a needle in a haystack’ situation. I realized how only a few were trained, the ones who were- stopped at formal education and didn’t continue updating or learning, or reflecting about their practices. And to put it very coarsely in some cases they had the legitimate degrees in place, but was engaging in unethical practices. I was left with a handful of reflective practitioners’ who i could genuinely recommend to my clients.
The problems of not reflecting about ones psychotherapeutic practice are many. I would like to highlight a few to put things in perspective.
We are human dealing with another human being- To Bluntly put it, we are human, not gods, who know it all. To clarify, some mental health professionals forget that our training does not protect us from being blinded to our own human biases and judgements, and reactions. We have a blind spot – our own unique personality structures and personal life experiences that unconsciously can enter the therapy room. This has to be addressed. After sometime many even develop a sort of god complex, some a more subdued still dangerous attitude of being mechanistic and detached from the client (to name a few). All of this can rupture the therapeutic relationship from the get go, and then there is no real therapy happening, but a power game between 2 people. in the end it will be more about who wins. and most often the client loses, since sadly they have the patient tag.
We are dealing with as grey an area such as the matters of another humans psyche– This is yet another reason why one must ensure they get supervision, and continue education. Every day we uncover more and realize the psyche is an ocean, and we have barely begun to explore it. If you just settle for a formal degree in your hand, you are doing a grave injustice not just to the client, but to yourself- your growth as a mental health professional. Abroad , licensure exams are mandated periodically so that there are some external structure ensuring the professionals continue education, and at least the clients are protected. If not great work, at least the basics are covered, and little to no harm is what it ensures. Sadly this is not the case in India.
What you learnt is generic- the person who is sitting in front of you is unique and a person, not a symptom or a walking-talking diagnosis! – Every time a new patient comes and sits in front of remember you have never encountered this human in exactly same permutation and combinations before (neither in textbooks, nor in you internship and training, neither in your ‘years of practice’). In fact remember this every session even with an old client, you never know what changed in between sessions. They are unique. they are a whole human being. not just a symptom. a diagnosis. your patient. they have an identity beyond the therapy room. Respect that.
The harms of trying to copy, repeat techniques from scratch from textbook, than learning the art of therapy- This applies to even the training spaces which had internship. The beginner therapist especially must be wary of this. This does not however exempt the experienced ones, due to the first three points which we already covered. In their own anxiety of wanting to do work that ensures progress, there is a rigid repetition of technique forgetting the client in question and the context. there is no flow or flexibility as therapists rigidly cling on to their respective schools, forgetting the entire point of doing therapy– you can even call it the cardinal rules.
like for example-
Its the relationship that heals said Yalom
but if you can’t relate in a healthy therapeutic interaction with the patient like for eg- either talking more than the patient, or less than what he/she needs, or talking about irrelevant content that strays from the therapeutic context, what are you doing? Am not say we are immune to this just cause we reflect , but maybe its time to think about it and create a space to think about it and understand why and what can you do differently.
Eric Fromm on Active listening-
Active listening, not listening to judge and diagnose, label and make the client feel emotions that not going to be therapeutic in the long run- disclaimer – this isn’t a pointer against formal clinical assessment and diagnosis which we need to get a clinical picture – but for eg if a therapist keeps calling a person who has problems with addiction – ‘You are a drug addict, accept it.’ that isn’t therapy, there are therapeutic ways of building insight and taking responsibility of ones behaviors than just blatantly labeling your client.
Freud on the therapist being a blank state where the client can freely associate and work through their transference-
Here he means the therapist cannot become more prominent than the client in question- not literally start a staring match and doing nothing! I feel Freud has an reputation that’s unfair to his genius or for bringing psychotherapy to mainstream.
or as Rogers put it- the 3 necessary and sufficient conditions- Genuineness and congruence, Unconditional positive regard and Empathetic understanding.
Here he is not telling you that you go on a tangent on your personal life, neither does he say don’t. Yet what we fail to notice, is he said to remain genuine and reminds when necessary, and for eg. its not a sin to use self disclosure as a ‘technique’ not as an everyday practice if it benefits the client, but there’s an art to it as well- you don’t have to start with “you know, I was born on so and so in so and so place and then this happened..”- you get the drill-for those who didn’t, your entire life story I mean.
I think I will stop my rant here.
Concluding remarks-
The art of doing psychotherapy isn’t easy and doesn’t come to you, just cause you did your degree in psychotherapy (or allied fields). Art always takes time and effort, and continuous reflection and practice for refinement and you still have the potential to make bad art. And so its of utmost importance for you to contain said ‘mistakes’ to a few sessions at best, than the entire course of you journey with your client/patient, and cause additional trauma to them.
For these reasons, you must engage in reflection- self reflection, peer to peer supervision, with a experienced senior member, trained in the school of thought you respect and are leaning towards, if you are experimenting enough try out a supervision group which caters to a different school of thought and to stretch this a bit consider personal therapy for yourself.
Even despite said steps remember you are after all human, and stay open to the idea that you are far from perfect yourself. Stay open to the human on the other side. Many a times, they have experienced and dealt with a lot more than you have. and there are chances each of them might teach you a thing or two about life.
Despite being on a sabbatical from clinical work, I continue said spaces in my life. ( I go for supervision and personal therapy)
I offer supervision to beginner therapists. ( those interested can fill out the form –https://forms.gle/n852CSue6KcySPek7 and/or send a mail to lyngeorgy@gmail.com
For potential clients I have created a referral loop on my website – in the manner that if they fill out the form, ( for this, please go to my webpage- https://www.lyngeorgy.com/ and check out the chat box ) I try my best connect them to therapists who do the work.
For therapists who are doing the good work, i can refer/ connect you to said clients- please reach out to me by filling out this form- https://forms.gle/Up1i419X44426zFo8 and/or send a mail to lyngeorgy@gmail.com after.
So do expect delays in getting a reply, but rest assured if you reached out in the above formats you will get one.
Take care. Reflect.
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