Professional Documents
Culture Documents
Sergio Rodriguez-Castillo
California Institute of Integral Studies
Integral Counseling Psychology
May, 2006
In order to use the mutual experience, one must have in one’s bones a theory of the emotional
development of the child and the relationship of the child to the environmental factors
D.W. Winnicott
2
Foreword:
Since I will begin my practicum soon, compiling this “Survival Guide” has been a very
good opportunity to review what I have learned so far in my classes at CIIS.
As most of my classmates, since the first day of my first class of my fist semester, I have
been writing down ideas, concepts and “tips” about how to be become a good therapist;
how to deal with the clients, what to do and what not to do. The list has become very
long, full and meaningful (at least to me). Obviously these tips are highly personal; they
deal with my issues and with those aspects of practicum that concern me the most. I have
tried to be as comprehensive as I could, but again, the focus is in what I need to keep in
mind; therefore, many of these suggestions may not make much sense to other
practitioners.
Finally, it is worth mentioning that, although I have included a bibliography at the end of
this guide, I am afraid that it only represents a very small piece of the material consulted
for this work, since I have incorporated ideas from many readings, classes, conversations,
etc. So many, that it would be impossible to list and give credit to all of them. All I have
done, is to put them together to create this survival guide, for my own use and maybe of
others. Paraphrasing Anthony De Mello, my task has been that of a weaver and the dyer,
so I take no credit at all for the cotton and the thread…
THE GUIDE:
I. The Client
1. It is all about the client.
Everything, even the client’s opinion has about you, has very little to do with you.
The client improvement (or worsening) is more his/her doing than yours. Avoid
feeling that you are instrumental in assisting the client to enjoy life more fully (the
need to be needed) or giving yourself credit for the client’s growth. You are not
that important. Psychotherapy is not so much about what the therapist does or
says, but how the clients experiences; what is being (or not being) said or done.
1
In order to make the writing and reading easier (and since I am the one writing), I will write using the
masculine for the therapist, while alternating the gender of the client.
3
Keep asking questions, keep asking questions, and keep asking questions. Do not
assume that you know enough. Ask about previous therapists, what bring him to
therapy? What does he want to get out from it? Is he here on his own behalf or
was he “persuaded” to come? (if so, who did? Why did he agree? How does he
feels about it?) Is he exited/committed to therapy?
4
main responsibility as a helper is to assist others in finding their own answers.
Align with the client’s healing powers (their unconscious plan to get better).
Think of the therapy room as a setting, a potential space6 and a sacred holding
environment, where client and therapist assemble to grow and (in Winnicott’s
terms) to play.
7. Listen.
We have two ears and one mouth so that we can listen twice as much as we
speak.7
The greatest compliment that was ever paid me was when one asked me what I
thought, and attended to my answer.8
Listen well, listen carefully, listen with your whole self, listen to what is being
said (discrepancies included), to what is not being said, to how is being said, why
is being said and when is being said. Observe the body language; be attentive to
defensive styles and patters. It the client unwilling or unease to talk about
something, if so what is he trying to protect? (What is the affect underneath the
behavior/words?). Everything counts, from the way the clients greets you, how
and where he seat, how he begins the session, the topic he chooses to talk about,
the questions he asks, to the way he says goodbye. When the client asks a
question, ask yourself, what is he really asking? What is the question behind the
question? When focused in listening we are less prone to react, to jump into
conclusion. Is a bit like meditation, if we are able to remain in the present
moment (not reacting, not making inferences or drawing conclusions), we will be
able to see and hear what is really going on. We might be able to realize even
what the client really is telling us, behind all his words and affects.
Listening is an art not easily come by, but in it, there is beauty and great
understanding.9
Listening means immersing oneself in the world of another human being;
allowing oneself to resonate to the spoken and unspoken message.
6
D.W. Winnicottn
7
Epictetus
8
Henry David Thoreau.
9
J. Krishnamurti
5
So when you are listening to somebody, completely, attentively, then you are
listening not only to the words, but also to the feeling of what is being
conveyed, to the whole of it, not part of it... You can only listen when the mind
is quiet, when the mind doesn't react immediately, when there is an interval
between your reaction and what is being said. Then in that interval there is a
quietness, there is a silence in which alone there is a comprehension which is
not intellectual understanding. Listening has importance only when one is not
projecting one's own desires through which one listens. Can one put aside all
these screens through which we listen, and really listen?10
Clients are whiney, clinging, depending children and need to mature. Life is
tough and every man is for himself. The sooner they learn this, the better. Should
not we force them to grow up? Keep shattering their vain hopes, stepping onto
their clinging fingers for them to see reality. Of course, it will hurt us more than it
will hurt them, but it is for their own good; right? Wrong.
At times, it seems hard not to be critical to clients. Of course it is easy to get the
impression that clients make their lives harder than necessary, they should know
better. They are full of resistances and defenses, they behave childlike and
illogically. We should point this to them, right? Wrong.
Clients are just blind not to realize that whatever is going on in therapy is not
about us, it is about their parent, mother, brother, sister, whatever. They are not
sophisticated enough to see this, but luckily for them we are. Should not we point
it to them every time they do it? Wouldn’t we do well in explaining them that
they are kidding themselves, that they would be better of facing the facts?
Wrong.
10
J. Krishnamurti, Book of Life
11
Sigmund Freud
12
Carl Whitaker
6
Being critical as above, we become the latest version of the clients’ parents,
teachers and preachers, telling them how inept they are. Pointing out what they
do wrong would not help and instead will reinforce the precise assumptions
underneath the behavior (the pathogenic beliefs) that they are trying to eradicate.
Respect the client’s views and struggles. Whenever you thin that you know better
what she should be doing; seriously consider the possibility that it is her who
knows best and work hard to try to discover the ways in which she is right.
Whatever words we utter should be chosen with care for people will hear them
and be influenced by them for good or ill.13
Be thoughtful, considerate and gentle. Respect the client’s pace. You will not be
doing her any favor by pushing or forcing her to realize something (even if it has
been clear for you since day one). Don’t push the river.
There are no simple answers or solutions to any of the client’s problems. The
client is –at the very least– as a complicated human being as you are.
The therapist is engaged in the art of making subtle suggestions, many of them
more by our deeds that by our words. Point to the client whenever she does in the
therapeutic relationship the behavior she is working on. When making
observations, use “parts” instead of general statements.
13
The Buddha
14
Oscar Wilde
15
Sigmund Freud
7
12. Don’t decide for the client.
The client will test you. He wants to know if you are reliable, solid, “safe” or just
like the rest (usually but not always his parents). Remember that he has never
seen you before and he has a lifetime of being and acting who he is. He wants to
know if you can handle his feelings, tolerate the intensity and don’t pull back.
But keep in mind that he will also try to “pull” you to gratify his needs, confirm
his fears or comply with what he believes you want (all of which would amount to
a self fulfilled prophecy)
Never make decisions for the clients or guide them to the conclusion you think is
best (even if you think you are right). Instead help them to own their actions,
their feelings and face reality (but don’t push them). Resist the temptation to give
advice. Your task is to help clients discover their own solutions and recognize
their own freedom in action, not to deprive them of the opportunity to act freely.
Remember that the client may feel inadequate, deficient; even by the fact of
coming to a therapist. Communicate to him (by deeds more than words) that he is
Ok, that you are not judging him and that you unconditionally accept him. Do not
dismiss or deny their feelings, quite the contrary, validate them (even it you think
there are “wrong” they are entitled to them) and encourage them to feel them.
14. Be empathic.
The patient, as I finally grasped, insisted –and had a right to insist- that I learn to
see things exclusively in his way and not at all in my way. 17
Empathy is not a technique but an attitude. Put yourself in your client’s place.
You’ll learn more about your client by allowing yourself to feel what she is
feeling than by trying to figure her out. Empathy does not necessarily imply love,
affection or compassion; it can be expressed in disagreement or in accord, and
that it does not imply a fusion with the client. Alternatively, it can be achieved by
actively arousing, or letting oneself be pervaded by an absorbing human interest
in the person one wills to understand. It implies approaching the client with
understanding, respect and wonder,18 to establish a relationship.
Whenever you don’t understand, ask the client for help, when you think you
understand, check with her. Never assume that what you think or feel is what the
client is thinking or feeling. You are two different persons with different
16
Schutz, William; Elements of Encounter, p. 100, Joy.
17
Heinz Kohut
18
In an I-Thou fashion.
8
histories, educations, levels of tolerance, needs and idiosyncrasies. You never
really “know exactly how she feels”.
15. Be nondefensive.
Better curious than furious.
Whatever feelings clients express about you, be interested, encouraging and
without judgment. Acknowledge the client’s reactions and assume that they are
accurate. Always be willing to ask yourself what you did to provoke any
particular response, and be willing to encourage the client to talk about it.
Whatever the stimulus, do not preen when praised and do not punish when
attacked19. Don’t attempt to justify yourself or to dismiss the client’s reasoning
with an interpretation.
Look down at me and you see a fool; look up at me and you see a god; look
straight at me and you see yourself.22
In as much as you are able to keep in mind constantly that your client is a human
being, just like you, but perhaps you have been luckier than him. You ought to be
able to stop from judging and instead unconditionally accept him. Again, a
religious simile might help to clarify this point. It has been suggested that the
most remarkable feature of Jesus was the fact that he knew that, as a human
being, he was not better than the rest of us. Highly evolved people everywhere
share such feature. If they do not judge, how could you?
The concept can be taken even beyond, to the spiritual realm of “oneness”. If you
keep in mind that neither the client nor you are your “personae”, but parts of the
whole (just like two drops of water in the sea), what is there to be judged? If you
can see through the illusion of separateness and acknowledge that we are all one,
there is nothing to like or dislike about the client. Being all one, who is the one
judging and who is being judged?
19
Michael Kahn
20
Native American adage
21
Heinz Kohut.
22
Charles Manson
9
17. Symptoms are metaphors.
Neurosis is the inability to tolerate ambiguity.23
Symptoms are artistic creations of the psyche, a magical attempt to alter an
unbearable reality. There is always a good reason for whatever the client does.
Reframe symptoms as efforts to grow. Every symptom has a reason, a meaning,
there is wisdom in them. A symptom is a solution; ask yourself a solution to
what? What is its purpose or function? Symptoms are symbols pointing at
something; but in as much as possible, think of horses, not zebras24. Honor the
symptom, since it is doing something for the client. What is the client getting out
of it? Try to focus in the roots, not in the leaves, but do not ignore the leaves
either (which is what is visible anyway).
I know that there are people who do not love their fellow man, and I hate people
like that!27
If there is something you particularly dislike about the client or you would like to
change in her, first take a good look within and find out if it not something that
could better be changed in you. Are you perhaps projecting something?
23
Sigmund Freud
24
Galloping footsteps should evoke suspicion of horses before zebras. More obvious hunches should be
entertained before rarer ones.
25
Terence
26
Carl Jung
27
Tom Lehrer
10
might be useful to develop some preliminary hypothesis, do not get attached to
them. Every person, every situation, every problem is unique. Accordingly, there
is not such thing as a text-book neurotic, teenager, mid-life crisis, divorce,
depression, etc. The moment you label somebody as a “bipolar”, “ADHD”,
“depressive”, etc. you’ll stop looking at the person and only see the label, you will
loose the unique individual before you and only see psychopathological
symptoms. In that very moment, you’ll stop seeing the person and start
disregarding anything that does not fit with the diagnosis. This is a well-known
fact, applied to our profession. Krishnamurti28 used to say that the day we teach a
kid that a fluffy, colorful moving object is called “a sparrow”; he/she has lost
something29. From that day on, every time he/she sees a new (and unique) similar
fluffy thing, he/she will say, “Oh, another sparrow, I know sparrows”.
...let go and submit to the therapeutic process rather than trying to run it.
…recognize our helplessness and focus not on how to do the work but on how
to let the work happen, how to restrain our impulses to block the process…
accept a far humbler (and more difficult) role than that for which our academic
training prepared us. We must witness rather than guide, enter into the
patient’s pain rather that cure it. … We must be willing to be confused and lost
if we are to accompany someone into chaotic, uncharted areas of [the
patient’s] soul”.32
It is the search that matters, the asking of the questions. Therapy, like life, is a
28
As quoted by Anthony De Mello
29
That is the awe for its uniqueness.
30
Carl Whitaker
31
Rainer Maria Rilke
32
Sullivan, B.S.
11
journey, not a destination. The process itself is healing, even if certain goals are
not achieved.33
Life is an unanswered question but let's believe in the dignity and importance of
the question.34
22. Cut back on interpretations
Psychotherapy is not making clever and apt interpretations; by and large it is a
long-term giving the patient back what the patient brings…[I]f I do this well
enough the patient will find his or her own self and will be able to exist and to feel
real.35
Our role is not to make clever interpretations, but to let the client explore, play
and be creative with whatever he is bringing to therapy. Kohut explains how
interpretations are irrelevant, since it is the client’s experience of the relationship
(being understood and seen) what has a real impact. Must probably client are not
even interested in listening to “brilliant” interpretations.
12
appropriately. The client most likely feels anxious and you should be too
(especially in the first session). Normalize the situation without belittling the
client’s feelings. Acknowledge his courage in being there, and provide some
assurance that it was the “right move”, that she is not crazy and that there is hope.
Many times, even if we want to, we cannot tell the truth because we ignore our
real motives, which have been repressed long ago, buried in the darkest cave or
our mind (our shadow). Our unconscious is always there, like a puppet-master,
pulling strings of which we are not even aware. How can our clients be fully
honest with us when we cannot even be honest to ourselves? And since we all do
it, nobody should be condemned for it. All the same, always remember that, in the
session, reality is not as important as the client’s perceptions.
27. Notes-taking.
Do not take notes during the session but do not rely on your memory either. At
the end of each session, write about the main issues discussed, your feelings and
unfinished business. Use a few minutes before the session to review such notes.
28. Be grateful.
The privilege of entering into another’s life is among the highest a person can
ever get. Be thankful of the honor of being a witness of the client’s struggle and
story and a confidant to her. Our clients trust us with what is most valuable for
them, their life stories, their fears, their feelings and desires. It is a privilege and a
responsibility to be the recipient of such treasures. Honor and respect that and
vow to do your best to assist them to find their own answers.
29. Intersubjectivity.
The meeting of two personalities is like the contact of two chemical substances: if
there is any reaction, both are transformed.37
You are me, and I am you. Isn't it obvious that we “inter-are”?38
In the therapy room, as the client begins to go deeper into himself, so too does the
therapist into his own self in a series of reciprocal transactions. The therapist is
not an objective viewer, removed of what is going on in the session; as such, he
37
Carl Jung
38
Thich Nhat Hanh
13
cannot be the arbiter of reality. The truth we believe about ourselves, the world
and the client, is no more (though no less) ‘real’ than that of the client. All we
can ‘know’ is our own psychic reality. The client is affecting you (and you would
do well in welcoming this) at least as much as you are affecting him.
The Therapist
30. Do not confuse your role with you.
By acceptance I mean a warm regard for him as person... ...no matter what his
condition, his behavior, or his feelings.39
Transference is powerful. It is about you, but do not take it personal. Remember
that the client hate, admiration, sexual desire, etc., may have less to do with you
than with her past and ways of organizing experience. Don’t let yourself be
destroyed or demoralized by the patient, even when she ignores you, attack you or
deprecate you. Many times, erotic transference is not about sex but early longing
(usually a longing for a parent-child connection), so (i) do not take it personal, (ii)
don’t criticize the client, (iii) don’t join her, (iv) allow the feelings to persist,
without gratifying them.
Trust yourself. You know more than you think you do.40
Trust your own feelings and intuition. Where does this “x” feeling comes from?
Does it come from your own past/needs/stuff? Or is the client’s transference or
projective identifications? Be willing to share them (if they are for the client’s
best interest). Be attentive to what is going on inside you. How are you feeling?
Are you confused? Bored? Angry? Happy?
39
Carl Rogers
40
Dr. Spock
14
If I had six hours to chop down a tree, I'd spend the first four hours sharpening
the axe.41
The key to warriorship and the first principle of Shambhala vision is not being
afraid of who you are. 42
The nature of therapy requires the therapist’s commitment to his own growth,
which makes him a perpetual patient, thus avoiding becoming a therapeutic
technician (kind of keeping a beginner’s mind). You have blind spots that your
clients will trigger or at the very least detect; be open to hear about them and
explore them. The fact is that we all are like snails; wherever we go, we carry on
our back a shell full of our psychological stuff (our unresolved issues), which will
not go away until we deal with it. No matter where you go, “you” will be there
with you. Gnothi Sauton43.
Embrace the therapeutic experience not getting attached to results (the fruits of
action), allowing the process to unfold and the transference to form, neither trying
to make things happen nor developing a specific agenda. Understand that client
may apparently “get worse” before showing any therapeutic gains. Also make
friends with the idea that many times you will not know whether a client is
progressing or whether you are being helpful in her growth process. Learn to
function in ambiguity, with now knowing, begin comfortable in a place of not-
41
Abraham Lincoln
42
Shambhala tradition
43
Know Thyself
44
Carl Whitaker
45
The Bhagavad Gita (3,19).
46
Whenever a psychotherapist has too great a need to cure his patients—in order to prove his own worth,
for instance, rather than out of concern for what the patient needs—he will tend to become easily frustrated
and intolerant of patients who don’t get better quickly. Until they learn to recognize and come to terms with
this rage to cure, therapists generally have trouble distinguishing their own needs from their patients’ needs.
15
knowing, focused on Being rather than Doing.
47
Klein’s “Depressive position”
48
Yogi Berra
49
Michael Kahn
50
Irvin D. Yalom
16
37. Personal Modeling.
One must live the way one thinks or end up thinking the way one has lived.51
You have a responsibility to your clients. Whether you like it or not, they’ll
observe you (just like children would) to see if you follow your own preach, if
you walk your talk. Even if you do not think that your clients see you that way,
your behavior in the therapy room should be your most accomplished example of
what a healthy human being should/could be. This includes taking care of
yourself and your own needs.
The client will affect you. Be attentive to your own process, your own
countertransference (cotransference) and your own selfobject needs. Be
spontaneous. Whenever you think that it would be in the client’s best interest, do
not hesitate to share what is going on within you. Therapists (just as clients) have
needs but keep in mind that therapy is for the client’s benefit. Ideally, as long as
you are aware of your needs, you will be able to discriminate if any given desire
or pull to share comes from you or from the client, and whether it would be
beneficial for him.
51
Paul Bourget
52
Carl Jung
53
Max Ehrmann, Desiderata.
54
Friedrich Nietzsche
17
All know the way, few actually walk it.55
Be willing to walk the path that your client is walking. If the client walks faster
than you or goes beyond where you are, be willing to learn from him and be
encouraged by his example. By helping in such occasions, you are not being
hypocrite, you are doing your job supporting the client.
41. Be yourself.
Do not attempt to be the Buddha.56
It is not about theories but persons. It is not about techniques but being honest
and fully present. What is happening between the two people takes precedent
over the method one is using. Find your own voice and counseling style.
42. Humor.
More errors are made solemnly than in fun.57
Therapy is important but it need not be deadly serious. Humor can be useful, not
only to break a grim mood, but also helps to keep the therapist sane. Relax, it is
only therapy. It is serious business but not life itself. You should be able to enjoy
this work. Take this guide with a grain of salt, go out and try it. In twenty years
come back read this guide again and see how you are doing.
–o–o–o–o–o–o–
© 2006 Sergio Rodriguez Castillo, San Francisco, Ca. U.S.A. All Rights Reserved
55
Bodhidharma
56
Dōgen
57
Don Herold
18
Bibliography
Basch, M. F., (1980) Doing psychotherapy, New York : Basic Books
Corey, G. (1991) Theory and practice of counseling and psychotherapy, Pacific Grove,
Calif.: Brooks/Cole Pub. Co.
Grolnick S. (1993): How to do Winnicottian Therapy. In one's bones: the clinical genius
of Winnicott. Northvale, N.J. : Aronson
Kahn, M., (1997) Between therapist and client: the new relationship, New York : W.H.
Freeman and Co.,
Neill, J. R. and Kniskern, D. P., (1982) From psyche to system, the evolving therapy of
Carl Whitaker. New York : Guilford Press
Strupp, H. & Binder, J. (1983) A Guide to Time Limited Dynamic Psychology, New
York: Basic books.
Yalom, I.D. (2002) The gift of therapy: an open letter to a new generation of therapists
and their patients, New York: HarperCollins.
©
2006 Sergio Rodriguez Castillo, San Francisco, Ca. U.S.A. All Rights Reserved
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