Wednesday, February 26, 2014

HAZARDS TO THE THERAPIST'S FAMILY


1. Emotional Drain: Listening all day to people in pain depletes the therapist. At the end of the day
the skillful listener may be exhausted. Home problems seem minor, dull, and insignificant compared to the horrendous stories patients have shared. Many therapists prefer to be left alone at home, while others see homecoming as their first opportunity of the day to unburden themselves and stop the flow of other people's complaints.

2. Interpretation: The psychotherapist's most pervasive intrusion on the psychic lives of their family members is interpretation. Interpretation of dreams, slips of the tongue, or unconscious behavior, whether correct or incorrect, is harmful. Interpretations foster distrust, foment a sense of exposure, and may create excessive self-consciousness in those being interpreted.

3. Questioning and Inquiry: Psychotherapists are trained to ask questions or to reflect back in a way that facilitates better understanding. Many children and spouses respond poorly to continuing questioning, such as "Why do you feel that?" or "Did you consider the consequences?" Lengthy interrogations (which may last 50 minutes and during which the therapist-parent is totally rational and composed) confuse kids, who appropriately expect their parents to sometimes lose their professional composure, become more engaged, and display a normal range of human behavior rather than use the interpretive "Freudian whip."

4. Distancing and Use of Jargon: Another common complaint among the psychotherapist's family members is their parent's or spouse's ability to distance themselves from the emotional realities of the domestic scene. This dispassionate aura, while an important therapeutic mode for some clinicians, is also characteristic of many therapists' intimate interactions. The use of jargon as a means of distancing is usually used as a counter attack when the therapist feels defensive or uninvolved. Often the therapist lashes out with, "you are projecting," meaning, "your anger has nothing to do with me."

5. Total and Uncritical Understanding: Children of psychotherapists often say that whatever they did, their parents always accepted and understood it. In the psychotherapist's words, they were "just going through a phase." Different versions of this theme are expressed in statements like "Oh, he's such a pre-teen," or "How typically adolescent," or "It is just your middle age crisis." These demeaning and discounting comments hurt loved ones even if accurate. The "total understanding" syndrome often manifests to the extent that therapists will excuse all behavior. In their mind the bully is insecure, the wimp has abusive parents, and the thief comes from a poor family. It may be difficult for children to share their frustrations and anger in the light of their therapist-parent's infinite ability to "understand."

6. Labeling and Diagnosing: These therapeutic techniques pose similar problems to those of interpretation and total understanding. Children and partners of therapists are labeled narcissistic, passive-aggressive, borderline, and many other DSM III-R diagnostic categories by their therapist-parents or spouses. Labeling is extremely injurious. Calling children "hyperactive" or "accident prone" is likely to encourage hyperactivity and accidents. Children learn who they are largely from their parents. If they are called offensive names, too often they will internalize and incorporate these labels as part of their identity.

7. Anonymity and Confidentiality in Family Life: The commitment to keep patients' identities anonymous prevents many therapists from sharing their professional lives with the rest of the family. This results in a wide gap between therapists and their families, as the rest of the family is neither aware of nor included in the therapists' professional struggles, pains, wonders, and joys.

8. The Public and Personal Split: The need of many therapists to keep their personal lives completely concealed from their patients often places psychotherapists and their families in difficult, stressful, and awkward situations. Many therapists avoid going to certain parties or joining health clubs, determined not be seen by their patients out of the office. This rigid split isolates and alienates not only the therapists, but their families as well.

9. Jealousy: Family members also may experience jealousy of the psychotherapist's patients. Clients who are anonymous and mysterious to the family have uninterrupted weekly time with the parent/spouse, share their most intimate secrets, and call the therapist at all hours of the day or night. Regardless of how demanding or disturbed they are, these clients are fully accepted by the therapist-parents. Many therapists' children and spouses feel neglected and deprived. Some therapists' children report that they want to grow up to be patients.

10. Responding only to Crisis: One of the most successful means of getting a psychotherapist's attention is to create a crisis situation. Psychotherapists are usually at their best in an emergency in which people are clearly in need of support. This skill is easily transferable from the therapy room to the home. After hours of listening to bizarre and dramatic stories, many psychotherapists are not eager to be ardent listeners to complaints about homework assignments or the car's funny noise. Physical illness, accidents, and other crises often provide, albeit dangerously, the attention that children or spouses of psychotherapists are missing.
11. The Home Office: Working out of the home office adds another dimension to the psychotherapist's already complex family dynamics. The home office can offer advantageous possibilities for therapists and patients. However, it becomes a liability if therapists enforce a rigid separation between patients and family members, and especially if this restricts children's freedom and spontaneity. Children whose parents work out of a home office seem to be much more resentful of their parents' profession due to the added limitations on space, time, noise levels, and general playfulness imposed by the home-office arrangement.

12. Resistance in Therapy: When the family dynamic has deteriorated to the point where outside help is sought, the therapist-spouse/parent may further complicate matters by creating obstacles to the healing process. Resistance to family therapy or marriage counseling is often an attempt to avoid negative exposure. It manifests through initial denial of the problem. Once in therapy there is reluctance to cooperate with the hired therapist. Competition, shame, or becoming a co-therapist are common ways to interfere with therapy. Many patient-therapists use sophisticated jargon during family therapy sessions, clearly an attempt to ally with the hired therapist. These un-constructive gestures support the original mistrust the therapist has evoked in the other family members.

13. Demeaning Tales: Sharing stories and tales about patients at the dinner table is a common activity in psychotherapists' homes. When the stories are not respectful of the patients or when ridicule is prevalent the potential of adverse effects on other family members, especially children, is great. Demeaning stories are not only a reflection of a failed alliance between therapist and patient, but also an alarming warning to the children about their parents' ability to demean others-including their own children.

14. Treating Family Members as Patients: The line between being an involved and loving spouse or parent and a therapist is often very thin. It should be walked very carefully. The danger of treating family members as patients is an over-arching concern and often the context for the many hazards mentioned above. If the therapist-parent takes on the role of therapist in the home, the spouse or child will most likely assume the role of patient and lean towards self-defeating and self-destructive behavior and attitudes. 

Reference: http://www.zurinstitute.com/burnout.html

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