Increasing client understanding

Increasing client understanding

It seems that therapy is a response to distress in life. The client comes with distress in living and hopes in relationship with their therapist to improve things. This distress something might point at something specific or be vague.

Therapy seems helpful in a few ways, one of which is that it can increase a client’s understanding. This can be helpful as it can help them to make different choices based on new information and to take a different attitude to themselves, one of curiosity. It can also help both minimise the problem and to offer solutions as it can break the problem down so that you can see what keeps the problem going, where the problem developed and what the effect of the problem is.

To increase understanding with a client then there seems a variety of stages you need to go through.

1.       A loving relationship between therapist and client

2.       Listening

3.       Exploring

a.       Focussing

b.       Enquiring

Loving relationship

The first stage seems a loving relationship. Being in a loving\caring relationship then the client feels safe and can explore more difficult areas in themselves, knowing they are safe if its uncomfortable when they explore.

Indeed, if they don’t feel safe, part of their mind will be involved in trying to protect themselves (possibly from the therapist), so they will be less able to explore and understand.

The effects of being in a loving relationship for the client seem to be that this can be a model of a relationship they can have to themselves, they also experience  being valuable to another which can influence their self-esteem.

Listening

The next stage that follows is listening. Listening means both to what is said, how it is said, and to the thoughts and emotions that it generates in you. As you listen there can be different meanings that you may hear, the content of the message of how the world is, the implied but unstated,  the purpose in stating the message,  the way the message is delivered which adds nuance and the context of the message, what was going on that drew these words out.

With listening you can never be sure that you understood what the client is saying. Indeed, as a client speaks I guess they are saying many things, things they are aware of and things they are less aware of. As a client speaks they are also listening with you for the first time to this thing they are saying. So, the listening needs to be dialogic, with you checking you what you have heard.

Listening can be difficult with the client talking quickly, moving between subjects, making large statements. Thus you can get lost as you are trying to understand what has just been said then the client can move on.  If you think out loud with the client, ie verbalise your thoughts, then this can disturb the flow of your client. It seems then that how you listen to the detail, to the overall sense of what is being said, to the overall feeling of what is being said depends on how your client talks. A client who talks quickly and doesn’t give you time to reflect seems to invite this reflection, and seems to invite the listening to a broader focus, to the activitiy that the speaking has, rather than its content, for instance, ” It sounds like you are trying to work out all the problems that you could be having.”

In the listening then you might want to start to have emerge what it is that is therapeutically important for the client, what is it that needs our attention, or what maybe do we learn as we try and work this.

The effects of this  listening for a client seem to be a model for their self relation, that can increase the depth of their listening to themselves. They can also feel validated and valued that their being is worth listening to which again can have an effect of their self-esteem.

Exploring

If an object of understanding emerges in the listening, then we can explore it. This exploration has two axes, in time, or across time. I have distinguished these two activities, focussing when we explore the object in the present, and enquiring that explores the object through time.

Focussing

This is a phenomenological enquiry, that can gently start to understand what this object is, this timid deer that shows itself.  If the object of understanding is say drinking too much, then we might ask what the experience of drinking is, what is the too much of it. As we ask about experience we try to stay as much with the sensation that is presented, in the body, the emotions, the thoughts and behaviours.  As the object emerges so we might discern layers, as the first layer of phenomena show then it can in turn point to another. Each layer gives us the foot hold to view something less obvious.

As much as we can focus on phenomena of what shows itself, what also seems significant is the context, the expectation of what should show itself.  So, in the case of drinking too much, the sense of what I should be doing seems to inform this object, what others might think, how I understand this behaviour as defining me, how I engage in it, a hiding away or a reckless abandon

The effects of focussing can deepen the meaning of the activity to the client, so for drinking too much that might start by an understanding of I like it to in the face of anguish, I hide myself by drinking such that I can’t feel my thoughts, or my body and I sleep. Again, in this deepening of meaning this models a way the client can behave to themselves in terms of exploration.

Enquiring

As we understand the presence of the object of understanding then we can start understanding it by context.

The context is temporal: how can we understand more about how this object began originally, i.e. onset, or happens, i.e. trigger. How can we understand what the effects of the object are in the future? How can we understand how this problem develops from trigger to highest point? What is the helpful intention that this object has for you?

The effects are then to understand the component parts of object, what builds it up which can reduce the scale of the problem, provide a greater sense of agency and responsibility, first this happens, then that, then that.  In noticing the effects of the object then this helps evaluate the object as you can see how the effects accord with your values.

Conclusion

A client’s understanding of themselves seems far more important than therapists understanding of their client.  If a therapist has a greater understanding of their client, well they might be wrong and if they give their understanding fully formed to their client and treat on the basis of that then it leaves the client with a demonstration of how they don’t know, how they need another to explain themselves to themselves they are a stranger to themselves.

A client to increase their own understanding means they will be more attached to it than if its given from someone else, and it also can develop their way of being with themselves such that that way of being can be re-used