The Isolated Therapy Office

Another of my archived columns from the mid-90s. As I reread this, I find myself wondering how much our interconnectedness through the internet has changed things.

The Isolated Therapy Office

by Selene Vega

Santa Cruz CAMFT Newsletter, July/Aug 1995, Therapists for Social Responsibility column

What a strange paradox the work of a psychotherapist is. We sit with an individual or family in a closed room, separate from the rest of their lives, often separate from their relationships, definitely separate from the culture in which their ideas and values have formed. It would be so much more effective to change the environment in which we and our clients live! Unfortunately, though most of us would like to see our culture move towards health, and may be doing our best to help it along in our small ways, we’re not really expecting overnight miracles. In the meantime, we can at least create a safe respite for our clients. From there, we attempt to facilitate a change in the interactions that our clients have with the world outside our office door.

There’s something to be said for the perspective that can be gained from that distance. Perhaps our clients can see a bit more clearly when they are not in the thick of things. In the quiet of this place apart, the relationship we develop with them can move them in ways that seem impossible while they are surrounded by the messages of family and culture. From this safe space, with our support, they can begin to form their own sense of who they are and who they can be.

Of course, the changes that begin in our offices must be sustained in daily life, and this is often the most difficult part of the therapeutic process. We may be working against the cultural current, and our clients may feel as if they are swimming upstream to maintain their progress. Support groups can be a partial remedy for this, particularly if they meet frequently. For example, 12-step groups can provide a community that counteracts the media messages and reinforces the changing values and behaviors of a newly recovering addict. At least their members have a subculture to model and encourage new ways of being that may feel out of step with the rest of the culture.

The cultural messages that our clients incorporate into their own thinking may attack even the concept of therapy. The idea of seeing a therapist may make a client uncomfortable when they are told there is something wrong with them if they can’t “work out their problems” on their own. Those who value therapy as a means of growing further, or finding deeper satisfaction in their lives, or other non-pathological reasons, are a much smaller percentage of the population than we may want to believe. Santa Cruz and the Bay area have a larger than usual sub-culture that honors psychotherapy as part of fulfilling human potential and increasing our effectiveness in the world. Traveling around this month in other parts of the country has reminded me that this is not true everywhere.

I’ve been reading James Hillman and Michael Ventura’s We’ve Had a Hundred Years of Psychotherapy and the World is Getting Worse. Hillman and Ventura are concerned about the navel-gazing focus of therapy. They raise many questions about how therapy may be working at cross purposes to social change by keeping people engaged in their individual process without a sense of how that might connect to the rest of the world. That separation and distance that I mentioned at the beginning of this article is one of the aspects of therapy that they see as a problem. How can we help people to be more active in their world by taking them out of it?

I wish I had answers to the questions Hillman and Ventura raise, but even they don’t have answers. They have at least brought to light some issues that are worth pondering, and this is a first step (much as we often tell our clients that their awareness of what they need to change in themselves is the first step towards actually changing it). If we all begin to think about the paradox of therapy taking place so isolated from the cultural context in which our clients’ problems are born, perhaps we can find ways to bridge that isolation. Bringing our own awareness of the world into the work we do can be our first step.