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The Stance of the Therapist

Similar to any other form or modality of therapy, the position, role and stance of the therapist needs to be consistent with the epistemological principles underlying the therapeutic approach of the therapist. The stance described here should be understood in this light. Similarly, it needs to be reminded that when it comes to questioning the ethics of any particular action or set of actions, these actions needs to be understood against the epistemology that gives rise to them.

 

Authenticity

 

The therapist is a real human being. He is not a blank canvas on which the client projects their internal world, and he is not an expert that knows better. Authenticity is often described in different therapeutic traditions, and here it speaks to the humanness of the therapist. In working with couples the therapist uses his full humanity, which relates to the therapeutic use of self. This same self needs to have gone through a process of personal growth and development, the purpose being for the therapist to be able to separate his own personal issues that may be triggered on the one hand, and on the other being able to therapeutically use the resonances that arise between the couple and the therapist. Our humanity is in itself a tool that extends beyond our intellect. Our emotioning and embodying, as Maturana describes it, are in themselves powerful tools that can in service of the therapeutic process.

 

Warmth

 

Working with couples is not about theories and techniques, but about creating encounters. Some of the role of the therapist is to provoke and disrupt, but if this is done in isolation it becomes mechanical and potentially aggressive. For this reason it is essential that the therapist can create and express a real sense of warmth when in the room with the couple. This has nothing to do with smiling and being friendly, but everything to do with the couple experiencing the therapist as being fully present and interested in them. I go even further to say that warmth requires that the therapist finds a way of truly seeing, understanding and anticipating how each partner sees themselves and each other, and that this is legitimate. This means the true absence of judgment, and the real ability to draw on the self in understanding how someone may feel and behave the way they do. When this happens there is a natural resonance that emerges, which is experiences as empathy, connection and warmth.

 

Curiosity

 

The therapist takes the stance of the curious, in encountering each couple from a new and fresh perspective. Curiosity in this sense means suspending theories and technique and immersing oneself in the experiential world of the couple. And doing so with an openness to discovering the world of the couple, rather than confirming to what extent they match some theory or frame of reference. Curiosity furthermore means not making assumptions and not drawing conclusions, but giving each couple to space and opportunity to "emerge" in the internal world of the therapist. With this I am referring to that point when one "sees" the totality of the couple's world, where one can easily slip into the perspective of either side, where one can resonate with the feelings and behaviours that take place there.


Humour

 

Carl Whitaker said that humour is to therapy what aneasthetics is to surgery. As such part of the positioning of the therapist is a place of being playful with the couple, and being able to draw on humour and even benign sarcasm. This does not mean that the therapist is a clown or comedian, which is not the case at all. humour is one of the tools that can be used to lower intensity at certain points, especially within the context of the more challenging roles of the therapist. Such playfulness can both make it easier for the couple to engage, as well as make provocative interventions more palatable. However, humour and playfulness is also directly related to warmth and authenticity. The therapist is a real human being, and the world of a couple is not always just serious. A playful approach at times can defuse habitual patterns from escalating, and well-placed sarcasm can stimulate self-reflection. Above all, play is an essential quality of any couple relationship, and something that often has become lost by the time they see the therapist. Humour and playfulness therefore not only models such behaviour, but also stimulates the emergence of other aspects of the selves of the partners to emerge in therapy.

 

Neutrality

 

The therapist does not take sides and remains neutral for as long as there are two people involved in the process. Neutrality means forming an equal relationship with each, and not assuming a position of expertise or authority in working with the couple. Neutrality also means that all couple behaviour are equal - physical aggression is not seen as more important than emotional aggression, shouting is not seen as more problematic than silence, excessive pursuing or engaging behaviour is not more valuable than excessive withdrawal. This having been said, it does not mean that the therapist is amoral. All of this applies for as long as the couple are both engaged. When the latter changes, the nature of the role may change.

 

Irreverence

 

It is assumed that couples are not fragile, which is similar to a systemic and constructivist view of individuals and families in therapy. When we assume that couples are vulnerable to the slightest of our interventions, we end up protecting and shielding them. For this reason the provocative and challenging aspects of working systemically can sometimes be seen as not making clients feel safe and contained enough. It needs to be reminded that we work with relationships, not individuals or emotions in isolation, and relationships are extremely resilient and tough. In the theoretical discussion earlier mention was made at how couples, like all social systems, respond to perturbations or interruptions. As such the stance of the couple therapist needs to be understood against the epistemological background on which it is founded.

 

Irreverence is about not taking everything that is said by the couple at face value. It is about not being limited to the emotional tone and mood set by the couple. It needs to be understood to what extent the couple not only presents with their particular blueprint, but continuously enact and conserve it. This means that the therapist will constantly experience a pull to one or both of their polar opposites, or be at risk of being seduced by the particular narrative and frame of the couple. Irreverence implies looking at the seriousness of the couple's presenting concerns, yet at the same time not being caught in the seriousness. Paul Watzlawick wrote a book who's title captures the essence, namely "the situation is hopeless, but not serious".

 

Irreverence enables the therapist to maintain a position different from what the couple presents. For example, a couple starts arguing and screaming at each other, including insults and namecalling. A position of irreverence allows the therapist to way until they finish, not interrupting even, and then simply stating "so is this what typically happens at home", thereby clearly taking a stance of not being pulled into the drama of the couple.

 

Choreographer

 

The therapist does not assume that it is their role to develop insight, educate or teach the couple. Insight is especially important here since it can often be the Achilles’ heel of therapist. Therapy in terms of shifting relational blueprints can take place in complete absence of any form of "insight". This is a critical aspect. Systemically "understanding", "insight" and "psychological mindedness" can very often reflect the incorporation of language as behaviour to maintain the pattern.

 

Constructivism holds that "instructive interaction" has very little real impact. Similarly, the therapist does not see his role as being to teach the couple new skills or abilities. This does not mean that there is not some guidance involved in trying new ways of relating, but this forms part of setting the stage. The couple therapist is not invested in getting all couples to speak in a particular way, for example, using "I" messages and so forth. He is more interested in preventing the couple from doing what they would normally do, and perhaps giving them some examples of alternative ways. The real change does not come from learning, but from actually experiencing alternative ways of communicating. As such the therapist is a choreographer who may use some props initially until the actors find their own style and way of participating.

 

Catalyst

 

Insight, understanding and psycho-education are neither the aims of therapy, not the role of the therapist. The stance of the therapist is to act as a catalyst that seeds ideas and stimulates change, without actually being responsible for the way such change takes place. Another way of saying this is that the therapist acts as choreographer and stage manager, creating the conditions in which the couple's typical behaviour is disrupted or inhibited on the one hand, and opportunities are created for new and different behaviour to emerge.

 

Although psychological mindedness and being able to meta-communicate about the relationship are helpful, they are not the aim of the therapy itself. The goal is not to create mini-therapists. At the same time, the aim is not to act as a guide or mentor for the relationship. This would imply, consistent with a systemic perspective, that the therapist has indeed become part of the client system in serving a function that needs to be served by the couple and their social support network.

 

It follows on a systemic approach that any therapy that continues for too long will imply that the therapist and the therapy itself has become part of a new re-organised client system. For this reason couple therapy needs to be relatively short, with a focus on stimulating the process of change, and letting the couple reorganise using their own resources. Over extensive time structural coupling is inevitable as systemic process, which means that if the therapist remains involved over the course of time, the chances exponentially increase that they themselves, and their interventions, will become part of the relationship blueprint. At this point the therapist has lost all ability to act as a catalyst for change.

 

Disrupter

 

The therapist actively aims to set the stage in which certain experiences are more likely to emerge. He is also actively trying to interrupt the system, or the couple, to do what it normally does. As such the therapist is aiming to prevent the habitual pattern from unfolding, and setting the stage to allow for new behaviour and experiences. To do requires a more active, participatory and directive position as a therapist. The couple therapist will interrupt conversations, ask people to hold with what they are saying or simply remain quiet for a while, and so forth. These interventions in themselves generate intensity since the couple as system is experiencing and responding to them as perturbations. This requires the therapist to have a thick skin in being able to remain active and take initiative during sessions, despite the potential emotional and interpersonal response.

 

Intensity Modulator

 

Following the above the therapist works consciously with the on-going intensity level in the room. He assumes that a certain level of emotional intensity is needed, just as fire is needed in cooking. He actively intervenes at times to increase intensity, just as he actively intervenes at different times to reduce intensity. This requires that the couple therapist is comfortable with high levels of emotional intensity, which can manifest in a range of intense emotions and interactions. A couple therapist who aims to keep every speaking calmly all the time will miss the valuable catalytic role of emotional intensity in terms of the change process.

 

Authority

 

Couple therapy is not a democracy. The authority of the therapist needs to be visible in the session. This is not to be confused with being an expert, or any other position based on boosting oneself in the eyes of the couple. Authority refers to the role of the therapist in defining structure and being an active participant in the couple therapy process. The therapist is not gently guiding and suggesting, but clearly defines the structure of therapy, the groundrules, the sessions, and so forth. This is part of the role of being the choreographer, and should not be confused with being authoritarian. Authority refers to actively defining and structuring the space for the emergence of certain experiences, not being bossy, controlling or enthralled with one's own expertise. Carl Whitaker said that the therapist needs to win the battle of structure, and the client the battle for initiative. Authority is about creating the container for the therapeutic process, being direct when needed, holding individuals responsible for their behaviour, and challenging behaviour or processes that undermine the therapy process.


Storyteller

 

The therapist is a storyteller, which means constantly listening and weaving different aspects of the couples lives and experience together into a narrative that allows for change. This requires the ability to see and understand patterns, as well as the ability to think in terms of images, metaphors and stories. The process of assessment is essentially about collecting the elements and then weaving a story in the language of the client that is not only different from the story they have been telling, but familiar enough that they can relate to it. As such a good story naturally moves away from blaming and encourages understanding, connection and empathy for each other. The process where couples move from their opposing sides towards the middle happens best when they are seduced to do so through the narrative that the therapist weaves, and through the experiences that he choreographs in the session. The storyteller entices and inspires the couple to look and experience each other differently, facilitating the emergence of initiative in starting the process of moving closer.

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