Appreciations (5) …my patient clients

Appreciations (5) …my patient clients

Torrey Orton
June 9, 2009

I realised the other day that I am seriously thankful for the therapy clients who come my way…who put themselves hopefully in my hands for a bit on their presently stumbling way to their clearer ends. It is an act of faith/hope by them to do so - either a renewal of it for those who have been in the chair before, or a first finding of it for beginners. Just to make the step is already to be well on the way to a better life. But, it involves a kind of submission. So, I am repeatedly thankful for their forbearance with my stumbling efforts towards them, which often call into question my confidence in the help I offer.

The trying that’s required to make that first effort and then, to our surprise often, to continue as the pathway becomes more cloudy and obstructed by the discoveries of exploration is the most impressive wonder of the work. And sustaining the fine balance between the motivation of fear and hope is the most trying task.

Some of these come by personal referral. Those whose willingness I enjoy the most are those assigned to me by the intake therapist at a psych shop where I consult part-time. They have no prior knowledge of me to help them through the initial period of blind faith required to get confident enough to focus wholly on themselves and little on me.

The intake therapist of course sings my praises as especially appropriate to the client’s needs, experience, etc. Many, however, including the personally referred, have questionable prior experiences of therapists as a part of the history they bring into my rooms. Another bunch of new clients are really new to therapy and somewhat wondrous both as to what will happen and whether they really need to be there anyway (Am I sick, crazy, etc.?) or have any hope of really getting over whatever it is that afflicts them.

Both of these concerns are lively and seemingly interfere with the work. In another frame, dealing with them is the work and signals the key challenges both for our relationship (what does happen here) and their self-understanding as ‘sick’ or not. Current mental health practices and marketing have increased awareness of problems and the likelihood people will act on them by seeking help. They also magnify the sense that every glitch of the spirit or twist of a relationship is a sign of potential for a few days (or a lifetime) in a psycho lockup or on meds.

So, helping them decide how ‘sick’ they are is a core task, but not always clear on the surface, nor easily resolved. A turning point seems to be admitting that their ‘sickness’ is a lifetime condition which can also be called a personal history…. a subject we all have in our repertoires and which we work to shape in desirable ways and directions, though not always with the help of the fates.

In this context – a relationship which is solely about them and about their most vulnerable parts – the energy and commitment to self which clients display and deploy is a daily joy for me and, eventually, for them. It is a place where I experience the good will of people towards themselves and their important others (even the most hated).

I am discovering as my case load increases that I can draw on their efforts for examples to enlighten others who often wonder if it is only them who have this or that problem. While there is a broad potential community of the troubled, it is not easy to find. You can’t just carry a placard in the street advertising your desire to meet fellow troubled travellers. There are lots of web sites – virtual communities – but they haven’t the same impact as a living face and voice.