Therapeutic Selves

by Selene Vega

Santa Cruz CAMFT Newsletter, Nov/Dec 1994, Therapists for Social Responsibility column

One of the members of our Therapists for Social Responsibility group was visiting South America studying shamanism this summer, and this took our discussion into the realms of different healing practices in other cultures. We explored some difficult issues, such as what makes a shaman from another culture worthy of respect in his/her own culture and how might that differ from our own evaluations of a shaman, coming as we do from an entirely different culture with our own perspectives.

Listening to this member's descriptions of what impressed her, what stood out for me was that she looked for some of the same qualities that we attribute to good therapists here, no matter what their theoretical orientation. Particularly, she noticed accurate empathy - the shamans that impressed her got who she is, what her issues are, sometimes without her even saying anything. They were able to come up with interventions that seemed to her entirely appropriate given the specific issues of the individual, rather than applying standardized tasks. She seemed to have the most respect for those shamans that modeled healthy, functional relationships with their families and the world around them.

I pondered this after that meeting, and came to the next gathering with a question that many of us find ourselves asking as we practice this somewhat strange profession: What is therapy? What is it that we do that makes a difference for our clients? How is what we do different than or the same as the healing work that is done in other cultures?

Those two factors that engender our respect for the shaman and give him/her the ability to have impact on those who come for help (at least the Westerners) may take a different form than when we see it in a therapist here, but it may be the context that is different, not the attributes of the healer. The first is complete presence and attention to the client and accurate empathy with their current state (as well as permission to be in that state, feel those feelings, etc.). For clients who have never experienced that, never had anyone just hear them, this can be transformative. It can set a basic foundation of trust that allows for our further interventions to have an effect - and it can, all by itself, be the beginning of a shift in the self-perception of the client.

The second factor is the modeling that can be seen as a meta-communication that underlies whatever techniques or approaches we use. We talk about the therapist's use of self, but what I'm referring to goes beyond anything we say about ourselves. We reveal ourselves as human beings by our presence - it has less to do with self-disclosure than with the inevitability of our exposure, just by virtue of being with and interacting with our clients.

The boundaries that we place around our relationships with clients are perhaps essential in the culture we live in. Unlike the shaman in a small tribal group, we lack the cultural agreements that provide the distance, respect, and containment the shaman's community takes as unspoken givens. Something essential is lost, though, in our isolation. Those who work in settings where their contact with clients is broader than weekly one-hour sessions may have more of a sense of the therapeutic possibilities involved. In a halfway house, a residential addictions treatment program, a school setting - anywhere that a therapist has client contact beyond the "official" individual or group sessions - the therapist can be a model through all of the interactions that a client observes or participates in.

Our skills at intervention are certainly essential to our work, but it's worth pondering the importance of those aspects of our being that we bring to our interactions as therapists (and in the world outside the therapy room, as well) and realize the impact that these have on the people we have contact with. The society we live in may not provide automatic respect for those of us in the mental health professions, but we can generate that respect by working to bring consciousness to all of our interactions and by continuing to work on ourselves.