A loved one can pity and reassure. If the patient turns to the therapist for this, he will have to be disappointed. Why shouldn’t a psychotherapist console and why go to him then at all, if so?
When it comes to what psychotherapy is, I often hear from both patients and psychologists: «Treatment and comfort.» And it’s true — if the patient does not receive them from me, then why do I need him at all, and maybe it’s better to spend money on pleasures and funs, leaving a matter of time that will console? Moreover, in life many people console, and only a few can console, if they exist at all — so why shouldn’t the psychotherapist console, isn’t that what he was taught?
Starting to work, I, like almost all beginners, did just that. It took years to begin to seriously think about why, why I console and what comes of it.
The most frequent associations with the word “consolation” are mother, grandmother, loved one. The most common language of consolation is words like “you are my little, poor thing” and hugs, stroking: pity and affection. But this is what a person allows relatives and that only in their performance and consoles. As if you dissolve in a person, you dissolve him in yourself, you merge with him.
Can I rely on such closeness in the course of my work, and will it be accepted by the patient? Can I say such words to him and hug and stroke him without the risk of getting into a lot of trouble?
It took a lot of work to realize that I console because I feel uncomfortable, meeting with the mental pain of the patient, and in order to get rid of this discomfort. That is, whether I help him is a big question, but I definitely help myself. Unintentionally, I work primarily for myself, defending myself from the unconscious fear triggered by what is happening to the patient — what if it is the same with me?
It’s like valerian, which you swallow almost in glasses without treating your heart.
The position of a strong, knowledgeable, guardian helps to defend. It mutes fear — at least in the ongoing therapy session, but with other patients, it will assert itself again and again. It’s like valerian, which you swallow almost in glasses without treating your heart.
For the patient, this can serve as a support for his childish attitude and unconscious desire to maintain his symptoms in order to again and again evoke in me the reactions of a caring parent, addicted to psychotherapy as a kind of drug.
From this position, I speak to the patient not in the language of experience, but in the language of reason. Quotes from philosophers, Socrates’ precepts for dialogue, information about the game of biochemistry in the brain, etc. will come to the rescue. etc. But most likely, the therapeutic dialogue does not work out: as the poet A. Radkovsky said: “From the outside, our language is the same, but we speak different languages.” It turns out that a monologue of a knowledgeable teacher is addressed to an unknowing student. It separates, not unites.
A woman in group therapy is working with an aggressive problem and suddenly starts sobbing, almost screaming, «You don’t know what it’s like to be raped by your own father and feel bad all your life, dirty, guilty, not like that, rejected by everyone.»
Her sobs grow stronger, and someone from the group sitting behind her gets up and moves towards her with the obvious intention of hugging and comforting her. I stop with a hand gesture. The patient continues to sob, so that the soul breaks. Full impression that she first said about it.
Psychotherapeutic consolation exists, but not as a means, but as a result.
Then, when she has already calmed down and the work with her is over, I ask her about it. “I told you many times, and always the same thing — they pity, console, reassure, only emphasizing that I am not like them,” she replied. “And now I feel good, and thanks to everyone who did not regret it.” She gave a wonderful lesson to the group and to me.
So is there a psychotherapeutic consolation? Yes, but not as a means, but as a result. And I do not bring it to the patient on a therapeutic platter, but he comes to him himself.
For this to happen, I am required to accept the patient as he is, to respect his right to any — even the most difficult — experiences and their manifestations. In this way, I maintain his self-respect and the ability to use his potential to cope with what brought him to me, with problem situations and with a life that itself, if you think about it, is a problem-solving chain.