The Client Who Changed Me

Stories of Therapist Personal Transformation

Jeffrey A. Kottler, Ph. D., Jon Carlson, Psy.D., Ed.D.

• Publisher: Routledge
• Year: 2007
• eBook ISBN: 9781135425791
• Topic: Psicologia
• Subtopic: Salute mentale in psicologia

Although the impact that clients can have on therapists is well-known, most work on the subject consists of dire warnings: mental health professionals are taught early on to be on their guard for burnout, compassion fatigue, and countertransference. However, while these professional hazards are very real, the scholarly focus on the negative potential of the client-counselor relationship often implies that no good can come of allowing oneself to get too close to a client's issues. This sentiment obscures what every therapist knows to be true: that the client-counselor relationship can also effect powerful positive transformations in a therapist's own life.

The Client Who Changed Me is Jeffrey Kottler and Jon Carlson's testimony to the significant and often life-changing ways in which therapists have been changed by their patients. Kottler and Carlson draw not only upon their own extensive experience - between them, they have more than fifty years in the field - but also upon lengthy interviews with dozens of the country's foremost therapists and theorists. This novel work presents readers with a truly unique perspective on the business of therapy: not merely how it appears externally, but how practitioners experience it internally. Although these stories paint a complex and multi-layered portrait of the client-counselor relationship, they all demonstrate the profound and unexpected rewards that the profession has to offer.

Chapter 1

FROM CLAY TO FIRE

A Mythological Tale

Myths are central to the core of human experience in all cultures and contexts. They are, in the words of Joseph Campbell (1991), “public dreams” in the same sense that dreams are merely private myths. They provide a window into a culture, whether that viewpoint looks at matters of cosmology, sociology, or a profession such as psychotherapy. Without myths, Rollo May (1992) argued, a society will rupture just as clients' own search for meaning will collapse unless their search for “truth” involves replacing limited stories with other myths that provide a new foundation on which to stand.

Throughout human history, there have always been myths and cultural stories related to godlike figures who provide guidance and nurturance for vulnerable mortals. The stories of Zeus, Neptune, Thor, Buddha, Jesus, Mohammed, Moses, and others all portray super ordinary beings who work on behalf of human beings, who often cannot manage their own affairs without some divine intervention. It was even said that the gods invented humankind as a source of entertainment, just as the novelist Tom Robbins once commented that water invented human beings as a means for transporting itself from one place to another.

In all their interactions with human beings, gods were almost never changed by these encounters—the influence moved in only one direction. The gods, by definition, were immutable, as constant as the stars. Their job was to change others while remaining impervious to change themselves.

Contemporary therapists might find these points relevant to their own training. We are taught from our very first courses that we are to avoid meeting our own needs at all costs, that we are to remain objective and detached. We are instructed to enforce clear, consistent, and impenetrable boundaries that prevent possible “boomerang” effects in which we might be inadvertently changed for the worse. It is as if, like the ancient gods, we are supernatural beings who, through training, supervision, and supreme self-restraint, are able to remain above the fray that affects mortal beings. Any possible counter-transference effects, or personal reactions, can thus be worked through to the point that we return to the position of clarity. We have been warned that the consequence of letting one's guard down can be disastrous, not just for our clients, but also for ourselves.

Prometheus was one god of ancient Greece who was credited with no less than the birth of humankind. It was Prometheus who first created mortals out of clay figures. These were beings who led lives without even the most basic necessities—they were helpless and vulnerable, cold and hungry, without even the most basic means to take care of themselves. In other words, human beings were flawed, miserable, and without hope.

Prometheus saw himself as the champion and advocate for mortals, a voice of compassion and caring. He lobbied on their behalf and attempted to help them take care of themselves. Zeus, the Lord of all gods, refused to assist in this matter. In fact, he specifically forbade Prometheus to fool around with humans, and ordered him to attend to the more important celestial business. Moreover, he was suspicious and annoyed by Prometheus, who had powers to see the future but refused to share what he had foreseen.

But Prometheus became more than a little attached to his “clients,” these mortal beings who were so interesting and unpredictable. When lobbying on their behalf failed to persuade Zeus to permit divine intervention, Prometheus decided to take matters into his own hands. There are times, after all, when a helper must trust his own heart, even when this path may conflict with the wishes of one's supervisor.

Prometheus discovered an unguarded gate into Olympus—a back door, so to speak —that gave him secret access to the fires that burned at the portal to the sun. He stole some burning embers and delivered them to humans in order to provide them with warmth and light.

Not surprisingly, this enraged Zeus, who did not take kindly to upstarts who challenged his authority. A certain degree of altruism could be tolerated, but not when it went against his explicit desire. Prometheus was therefore taken, in chains, to be taught a lesson he would never forget, and would also provide a lesson to others who might consider disobeying orders. Prometheus was chained in the Caucasus Mountains, where he was to be tortured by the same ritual every day: an eagle would attack him and eat his liver. By the next day, the prisoner would have recovered, only to be attacked again and again, for all eternity.

If the story were to end here, this would hardly be a very encouraging lesson for therapists who allow themselves to become overinvolved in their quest to help people and who, in turn, became affected by this helping journey. If anything, this would be another in an endless series of stories we are told to warn us against such efforts. Our clients, who feel as if they are made of clay, may cry and plead for deliverance, and we should do all we can to help them (short of stealing fire), but never, we are told, should we allow them to penetrate our core. Bad things happen under such circumstances—that is how we are supposed to get the sort of compassion fatigue that feels as if our livers are being eaten every day for a thousand years.

Zeus felt some pity for Prometheus. Or, if not pity, then he still wanted the prophecy about his own future that only his captive could know. Yet even with the offer of his freedom, Prometheus refused to tell Zeus who would be the mother of his child. Again it seems that this would have a very unhappy ending for those who stick to their ethical convictions, even with dire consequences.

Prometheus' actions were so highly admired by humans and many gods alike, that a few volunteers came forward to sacrifice themselves so that he might regain his freedom and continue to work benevolently on behalf of mortals. We learn from his actions several important lessons:

1. People need “gods” or advocates to bring “fire” in order to move beyond a claylike existence.
2. If we are to allow ourselves to truly care for our clients, and to act as courageous advocates for their rights, we, too, may suffer pain and loss of sleep. Prometheus actually had this to say about doing therapy: “It is easy of him who keeps his foot free from harm, to counsel and admonish him who is in misery” (Aeschylus [525–456 b.c.], 1926).
3. Myths and stories may be told in very different ways, implying quite different lessons; Prometheus may be viewed as benevolent, heroic, and altruistic, or as narcissistic, oppositional, and arrogant.

Naturally, there are limits on our applying the myth of Prometheus to the work and lives of contemporary therapists. In this postmodern era, we are hardly “gods” or supreme beings whose job is to deliver fire to figures of clay. We are as much partners in a journey, or perhaps guides who have familiarity with the territory, contour maps of the terrain, and some experience exploring the trails in the vicinity. Ideally, we don't have to “steal” fire from others, or provide it for those who are helpless; rather, we teach clients to build their own fires so they can survive on their own.

FROM MYTHS TO REALITIES

Changes associated with doing therapy are very often framed in negative terms. Practitioners are thus admonished to monitor carefully the toxic effects that can result from getting too close to their clients' issues. Freud (1910) warned that such counter-transference reactions can pollute the relationship as well as diminish the clinician's ability to remain objective. Others have written about the sort of burnout and compassion fatigue that can infect therapists who allow themselves to overpersonalize their work. A pervasive message is often communicated to beginners in the field: “Be very, very careful, or you will become ‘infected’ by the negative energy of your clients. You can end up another casualty if you allow them to get to you.”

Yet like any changes that take place as a result of some transformative experience, they can be for better or for worse. It is certainly true that therapists (and their clients) can suffer terribly if certain boundaries are collapsed. It is also the case that the personal and professional aspects of our lives can become so fused that it is difficult to maintain a healthy balance. Carl Rogers (1972), for example, describes how he lost his sense of self in a relationship with a particular client to the point that he teetered on the brink of a nervous breakdown. Dozens of other volumes present similar cases of situations in which therapists were irrevocably changed—mostly for the worse—because they didn't maintain their detachment. They were punished as Prometheus was punished for stealing fire.

What has so often been ignored, however, are those times when therapists are changed for the better. Some of the earliest psychoanalytic revisionists, such as Carl Jung and Harry Stack Sullivan, recognized the times when therapists and clients actually reverse their roles. Irv Yalom, known for his frankness about the intimacy he has experienced in some therapeutic relationships (Yalom, 1989), also reveals how he has been helped by his clients. He even describes the therapist and client as “fellow travelers”—both on a journey of discovery together (Yalom, 2002, p. 8). Taking an even more extreme position, the great family therapist Carl Whitaker once claimed that all the therapy he did was for himself. He felt that unless he had potential, and interest, in growing as a result of his interactions with a family, he wasn't interested in working with them. He believed that if clients couldn't help him to grow, he couldn't do much for them either. Therapy, to Whitaker, was always reciprocal.

When we attempt to help clients deal with personal struggles, we often end up helping ourselves with similar issues. When we heal others' pain, we heal our own. We find ourselves talking in sessions, preaching lessons to our clients, and then realize, suddenly, that we are really talking to ourselves. We end up taking the advice that we offer to others when we tell them such things as the importance of living more in the present moment, or spending more quality time with loved ones, or behaving in more fully functioning ways.

Then there are the things we learn from our clients every day. With each conversation we are pressed to examine themes that we may have ignored, challenge our most cherished beliefs, and explore our own most vulnerable areas. In a sense, when doing this type of work, there is nowhere to hide. Clients bring to sessions all those forbidden subjects and secrets that are rarely discussed anywhere else. And with each session we conduct, we become more knowledgeable about people and more wise about the world.

There are times when we come home from work positively bursting with new lessons we can't wait to share with loved ones. “You won't believe what I learned today!” is such a common refrain that our families give us amused looks. Of course, then they also give us their attention because they, too, can't wait to hear about some new insight or understanding.

These are rather small, if interesting, lessons that might accrue each day or week. There is always some new refinement of technique that develops, just as there are advances in our understanding of what we are doing and how we are doing it. Goldfried (2001), for example, collected a series of “clinical events” that precipitated conceptual revisions among well-known theorists. There is constant learning with regard to the nature of the human condition. We are always adding to our knowledge base about different cultural groups, individual differences, and the infinitely creative ways that people cope during adverse conditions.

What we are interested in are the really big changes that therapists have undergone as a direct result of their work. We are talking about once-in-a-lifetime transformations that therapists are still working to integrate into their lives.

In spite of prohibitions to the contrary, and a reluctance to speak about this almost forbidden topic in public, there are a lot reasons why this phenomenon of reciprocal changes in therapy could so easily occur, perhaps the most significant of which is the heavy and intense feelings circulating in the room.

No matter how placid we pretend to be on the outside, there are times when we are just as emotionally activated as our clients. At times we feel scared, if not terrified. It is not uncommon that we may feel frustrated or even angry, even as we work hard to stay neutral. The conversations are often steeped in confusion, complexity, and ambiguity. There is drama (and entertainment) in the sessions that rivals any of our favorite films or plays. There is authentic intimacy in the relationships, built on many hours spent talking about the most personal things imaginable. When things are going well, there is a kind of transcendent empathy when it feels as if we can feel the client's heart beating and the soul speaking. How could we not be affected by such an intense level of engagement?

In On Being a Therapist, Kottler (2003) speaks about the ways that clients, as distracted and disoriented as they may be, as amateurish as they may be in their efforts, are still powerful change agents in our lives, for better or for worse. “Whenever we enter a room with another life in great torment, we will find no escape from our own despair. And we will find no way to hold down elation we feel as a witness to another person's transformation—just as we are the catalyst for our own” (pp. 256–257).

It might be more accurate to amend this quote by adding that the client can be the catalyst for our changes. Just as we say and do things that are deliberately and strategically designed to influence people in desirable directions, so, too, are clients doing the same thing. They are working just as hard to win our approval and recruit us over to their worldview. They do this not just because they want support for their positions but also because they are just as convinced as we are that they are right and others are mistaken or misinformed. Eventually, we usually win the battle of wills, but this is mostly because of our training and experience. But that's not to say that clients don't get a few licks in along the way.

Then there are all the inadvertent and unintentional ways that clients trigger our growth and learning, all without having the slightest idea about the fireworks going on inside us. In a book about changes that experienced therapists undergo (Kahn & Fromm, 2001), Spiegel (2001) speaks of the ways he has been changed by the cancer patients he has worked with over the years, how their struggles to come to terms with their impending deaths have caused him to live his own life more intensely. Rather than feeling despair working with dying people, he reports how inspired he feels.

A client brings up an issue and we realize, as we are responding, that it is one that we have not yet fully resolved. We talk about finding meaning in life and discover new meanings for ourselves. We confront a client about some action taken, and soon realize that we were talking as much to ourselves as to the client. A particular conversation comes back to haunt us, gripping us in a way that we can't let go of unless we face the underlying issue. New decisions in our lives are based, in part, on dialogue we have had with clients. On and on the parallel process continues, every week, day, and hour.

Finally, there are the unconscious changes that we experience as a result of work in the trenches. Over time, the ways we look at the world, the ways we interact with others, the ways we see ourselves shift gradually as a consequence of our encounters with clients. We may be seen by the public as the gurus, the wizards, the healers, the oracles whom pilgrims visit in order to seek enlightenment, but it is one of our most closely guarded secrets how much we gain from such helping encounters.

SOME AMAZING STORIES

In the stories that follow, you will have the opportunity to hear from the most prominent therapists in the world. These are the theorists, scholars, researchers, and clinicians, from a wide variety of orientations and contexts, who have most shaped contemporary practice. They are the professionals who have written the classic texts and conducted the most significant research in the field. Each of them has logged tens of thousands of hours, seeing people for a variety of reasons and presenting complaints. They have spent a significant part of their lives in the company of others in excruciating pain.

Among all those people these therapists have seen and helped, we wondered which client, or even which particular session, changed them the most. As they think back on their illustrious careers, who (or what) stands out as their most significant transformative experience that occurred while they were helping someone else? This could have been a seminal case that helped shape their conceptual ideas, but more likely it was an intensely personal transformation that changed them forever.

Each of our participants was interviewed and asked to tell his or her own story. We pressed them for details and fleshed out the context of the experiences so as to present them in a way that puts you, the reader, right there in the room with them. It is our belief that contained within these narratives are the keys to transformative and lasting changes, the kind that endure throughout a lifetime. If we can understand better how this phenomenon occurs in the lives of those who help others for a living, we may very well develop a clearer framework for how to initiate such changes more effectively in the future.

Chapter 2

JEFFREY A. KOTTLER

About Last Night

Like many therapists, I joined the profession not only to help others, but also to help myself. It seemed to me that spending one's life talking to people about their most intimate secrets, their most pressing problems, and their most disturbing behavior was an excellent way t...

Table of contents

• Cover
• Half Title
• Full Title
• Copyright
• Contents
• About the Authors
• 1. FROM CLAY TO FIRE: A Mythological Tale
• 2. JEFFREY A. KOTTLER: About Last Night
• 3. JON CARLSON: Self-Surgery to Remove the Transponder
• 4. VIOLET OAKLANDER: The Kitten That Roared
• 5. FRANK PITTMAN: An Affair with an Alien
• 6. ROBERT NEIMEYER: Using Metaphors to Thaw a Frozen Woman
• 7. ALAN MARLATT: A New Name
• 8. ALBERT ELLIS: Learning from a Difficult Customer
• 9. BRADFORD KEENEY: A Family of Pirates
• 10. JOHN GRAY: Little Things Make a Big Difference
• 11. STEVEN LANKTON: Clients Tune Me Up
• 12. DAVID E. SCHARFF: The Patient Who Taught Me to Be a Therapist
• 13. PAT LOVE: The Broken Heart
• 14. LAURA BROWN: A Spiritual Awakening
• 15. KEN HARDY: Mister Black Doctor
• 16. MICHAEL YAPKO: Caught in a Controversy
• 17. JOHN MURPHY: A Language of Shrugs
• 18. JOHN KRUMBOLTZ: The Story of the Sun and the Wind
• 19. PAUL PEDERSEN: A Lesson in Humility
• 20. LENORE WALKER: Finding Justice with a Sledgehammer
• 21. BARRY DUNCAN: When Courage Is Enough
• 22. LEIGH McCULLOUGH: The Lady Cloaked in Fog
• 23. PATRICIA ARREDONDO: The Client Who Inspired Her Therapist
• 24. HOWARD KIRSCHENBAUM: A Flood of Feeling
• 25. How Clients Change Their Therapists
• About the Contributors
• References