Retrospective.

Revisiting...15th November 2021.

This discussion between kit and myself crystallised my unease about attachment theory, and the reparative relationship. It made me question the shape, limits and function of psychotherapy. Specifically it made me feel uneasy about Kit.

In the dialogue on that day, kit tells me about a client who arrived for therapy for three years, who sat with 'clenched fists', unable to accept 'love', and who left 'transformed'. Kit described her case as an example of Richard Erskine's juxtaposition. Kit distilled juxtaposition as, resisting that which we most want and need.

I listened to our dialogue again last night. I was struck by his tone of voice, and the pauses in the transmission. I felt as if he wanted me to feel the impact through his narrative, so I would feel as he had felt. He wanted me to believe? Well there is a bit more to it, what I heard and saw was that as he spoke he embodied the respectful awe that his chosen process evokes in him. 

For me the problem is that he understood his experience through the lens of his beliefs, and then took his interpretation of his experience as compelling evidence, for his beliefs.

Ha, don't we all!

What stands out to me is the absence. The other side is missing; the client's feelings, the other person's thoughts, their rationale, their reasons for three years on his sofa.

Too much is missing. 

Her erasure felt significant.

Kit continued...describing juxtaposition in terms of Attachment theory.

Attachment theory 'diagnoses', or rather it categorises types of problems. If a person says 'when I get close to someone and begin to need them I have to sabotage the relationship' the attachment theory rationale becomes a diagnosis of 'insecure attachment leading to anxious and avoidant behaviour '.  Attachment theory provides a ready made explanation, the behaviour seems the same as that of an 'insecurely attached ' child. The assumption is that the cause of the insecure attachment /'child-like' behaviour is a deficit - the effect of never feeling safe when growing up; of never having a secure enough relationship with an adult that provides security and protection. Attachment theory explains that someone who has learnt that they can't receive as much love as they need, can't receive love until they learn otherwise. 

Ergo, the cure is a relationship with a therapist who can offer the experience of being with a 'safe parent'.

Another massive assumption.

But it is easy to see how Attachment theory, can become the compelling explanation used to justify unconditional, non-erotic love, reparative/reparenting as the cure. 

Of course I'm suspicious!

More accurately I am curious about Kit's motive actually, because just maybe offering 'non attached' love feels, is, or leads to, the same physiological non-self state as created by submission (energy exchange in BDSM), or breast feeding... The 'let down' feeling of wanting to give and nurture state, is an oxytocin moment, literally. 

A feeling of open, total love. 

Just for a moment I wish to bring myself into this. I do not assume that I understand anything about a client, I cannot believe that I can know more than they tell me. There is no reason why I should know more about them than they do. Therapy as far as I can tell is made from a mixture of three things; the ability to make contact with one's emotions. The ability to step out of one's emotions. And the ability to imagine doing the problem differently.  The importance of the not knowing stance begins by refusing to see a person through any theory, a therapist enters the session with nothing else except respect and curiosity. The function of this stance is that the client and therapist create a dialogue that alters the client's position in relation to the problem. The therapist doesn't see deficit or inevitability only an exploration through a terrain that always presents opportunity for change. 

But, a therapist's theory can determine or limit the client's view of their situation, and it can prevent the client from exploring the nature of the changes they feel drawn towards. 

And if a therapist is using a psychological theory as a cover story, as a compelling explanation for them to justify and feel ok about something that isn't OK? This is a problem. 

And I'm not criticising 'safe, nurturing love'. I am criticising the probability that Kit's client might have told a very different story to the one Kit told me about her. And that Kit was so sure that the theory was proved by her distress. The absence of her voice, her reason for being there is too loud in his account for me to ignore.

The part of this that hurts is the question; was Kit telling me about his relationships; that he couldn't accept love because he felt unable to trust? And if he based that on nothing more than a deterministic theory? Well that just leads to self blame and shuts down exploration! 

I offered love freely, openly, honestly...so Kit's reply from theory is from the head, from a book. It isn't from the heart and soul. I was being genuine. To be met with cliché couldn't work for me. 

Especially in the light of my 'therapy' I think difficult questions need to be asked about the ethics of diagnosis or more correctly about the process of ontological problem construction. I'd go so far as to say that diagnosis is unethical when attributing the cause of the client's beliefs, feelings, and behaviour to any theory that reinforces a belief in an explanatory, predictive or deterministic power of a past event. 

My conclusion is that describing the nature and power of past events is only ethical when done in the service of validating the skills, insight and courage of the client, exploring the emotional power of survival and overcoming of the events. I'm also going to say that it is unethical for a therapist to prioritise 'non-attached, safe love' and believe that this is enough. 

Read Bozarth, Brian Thorne, go back to Rogers; radical self awareness is key to the person centred approach. There is far more going on than understanding. Empathy, isn't an intellectual understanding. The depth of empathy required to touch the heart and soul only occurs with attunement.. and this requires the therapist to 'go there' and to go there requires dialogue and emotional intelligence. Otherwise the therapist is imagining and projecting more than they have been told. Radiating good will -warm feelings - talking as if to the Child, isn't enough. But creating a dialogue that can go in any direction and to any depth might well be more than good enough.