Therapeutic Dialogue

Listening to be Reminded

Lots of money is made from self-help books. The brilliant Dr O.C.Drury, who was encouraged by Wittgenstein to train as a medical doctor as well as a psychiatrist described such books as “full of harmless platitudes. A thoughtless attitude to the deeper problems of human life reflects a widespread error which extends even to educated people that for every problem some particular science and some particular expert can provide the necessary answer in a book.” I could not say better. When two people , one highly knowledgable and the other brave enough to face the depths of himself work together in a state of mutual trust and respect; there is no better way to solving a psychological problem.

I worked as a therapist in private practice. I soon realised that the traiings I had done were not very useful, except for techniques. How could we call psychotherapy a science when there are more than 400 ways of doing it? The most important factor that is essential is the ability to create the therapeutic dialogue. I needed to listen carefully to my clients and interrupt them in order to help them to analyse the meaning of what they said. But this was difficult , it made the flow of the talk slow down. Eventually I decided to encourage people to talk, making sure to maintain the rapport. This way I kept my interruptions to a minimum of what seemed to me to be the most important words. This way neither one of us dominated the other.

Harvey Sacks’ experience at The Center for the Scientistic study of Suicide in Los Angeles revealed that the clients did not feel that psychiatrists understood them. They wanted to listen to people who had had similar experiences to their own. The psychiatrist Fromm-Reichmann’s advice to her trainees was that they themselves would not be reminded. Therefore they should not listen to be reminded. Sacks thought she was wrong and that perhaps this accounted for the common complaint of clients that psychiatrists sometimes fell asleep during the consultations!

Listening to be reminded of our own lives is a strong incentive for people to listen. I followed this practice of what we therapists call ‘self-disclosure’ and found that in most cases it stimulated clients to tell valuable experiences of their own that threw light on their problems.

I worked spontaneously, confident that I had a wealth of knowledge in my unconscious mind knowing that as I listened the right words would rise to my lips. If I found myself floundering I would use my sense of humour, the right kind for that particular client. I concentrated constantly and waited for the clues given to me by the prases and words of my clients. Sometimes I recorded sessions that both of us could take home and think about. This too, was a great help.

I discovered that I was getting to the core of being useful to those clients who took our work seriously and eventually managed to solve their problems for themselves. This way both of us were satisfied: my clients improved their powers of logical thinking and I discovered skills I didn’t know I had.