Sintaxis de la capa de macrobloque

Arrogance or overconfidence as a novice can be a serious stumbling block to becoming a competent psychotherapist. Kruger and Dunning (1999) found that incompetent people often suffer a double burden of not only can they not do something properly, but they also do not have the commensurate ability to recognise that they do not have the necessary skills. As such they are “unskilled and unaware of it” (p. 1121). Senior psychotherapists (E2, and E4) spoke of how young psychotherapists start off with a sense of overconfidence (B4) and through the years one learns one’s limits and how humbling the profession makes one. Participant E2 reflected, drawing on developmental psychology, that “as a young therapist there is narcissism in that, ‘There is so much I can do’, whereas now the complexity of life becomes more real. It’s not so easy”. He felt that initially when one starts out there is a “tendency to oversimplify therapy”. Over time, he found that young psychotherapists “grow out of that narcissism and realise that, ‘Suffering is real. I actually have to sit with it’”.

I was young when I trained as a clinical psychologist in my 20’s. So, I was really young and inexperienced…, and I think you are aware of that, even just dealing with these students, that being selected as a clinical student, you are arrogant, you think you can already change the world by being selected. So, that was unfortunately, with my first patients, I realised is that, ‘I’m not the guru and I don’t have any wisdom. I only have techniques and that is very superficial if I’m not there in the here and now’.

… I remember vividly after I’ve met Rogers, I realised that I need to find inner peace. I need to be in the moment and to be with my patients. And, I couldn’t do

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that. I was out there talking… It was, ‘I need to perform, I need to be the expert’ And, I wasn’t an expert then. I wonder will we ever become experts? But, that I realised I needed- and I had a lot of discomfort in myself, coming from a certain background etc. So, that was a wake-up call, when I realised, ‘I don’t have the patience. I complete sentences for my patients… (Participant E4).

I think last year it was (masters coursework year)- I don’t know if it is just

because being like a brand-new sort of therapist… You climb onto, or I did, climb into this one-upmanship, that: ‘I have got like seven years of theoretical

knowledge, I am going to teach you, I am going show you’ … Where this year (internship), it is just been like, coming down to earth and realising these are people, everyday people. Young/old, different races, different genders… mental illness can affect anybody… And, that they too can teach you something, and, you know, you too are sometimes damaged… So, you can’t be yourself as this perfect person, who is going to change everyone… And, definitely learning. I think starting off my process last year was like, ‘Oh, I am going change everyone, and I am going to teach you how to be better, and you can’t change everyone’. And, I think that, you know, people want to change themselves (Participant B4).

I think when you are a newly qualified therapist you have so much knowledge. You have been given so much knowledge. You think you know a lot and sometimes you think you know what your clients are needing based on theory, based on what you have learned, all the reading… you try and impose that on your clients… it’s good to hold that knowledge in the back of your mind, but to listen to where your client is at the moment and what they are needing at the moment… The anxiety is comforted by, ‘I have got knowledge. Let me give knowledge. Then I am making a difference’. I am working too hard essentially… Imposing on them… it’s a key skill a good therapist needs…to wait and distinguish… ‘What do I think the client needs?’ and… ‘What is the client illustrating they do need?’ (Participant C6).

Rousmaniere (2017) speaks of how young psychotherapists avoid sitting with a client’s pain. He proposes that a key task of developing psychotherapists, which is a unique

115 developmental task of psychotherapy, is psychotherapists needing to learn to tolerate and work with the suffering and anxiety that clients bring to session. Rousmaniere elaborates that

psychotherapists need to hear and accept a client’s suffering without trying to compulsively resort to solving it. Being receptive to what the client exactly brings as they bring it conveys to the client that the psychotherapist can honour, manage and work with their distress as well as respect the client’s ability to confront their own problems. To offset the psychotherapist’s “experiential avoidance” (Rousmaniere, 2017, p. 98), psychotherapists need to relate to their clients as they show up rather than relating in ways the psychotherapist wants the clients to be (Frederickson, cited in Rousmaniere, 2017, p. 100).

We used to joke in our training and when I was just out of training, that you get two kinds of therapists or psychologists: ‘You get a therapist and you get a psychologist. And, a psychologist has learnt all the skills and practices them by books and does what they do in therapy. The therapist is the one that really engages’.

And, I think the successful therapists can be both… You get psychologists that are very successful by the number of clients that they see, the money that they are making, and it becomes a revolving door – not a revolving door, but like a sausage factory. Then you get those therapists that invest and really sit with their clients in their struggles, and I think those become very good therapists. And, they are able to deal with clients and their very personal issues. So, it’s the ability to sit with difficulties (Participant C7).

Research indicates that psychotherapists need to learn to tolerate and work with the negative emotions of the client (Castonguay, Boswell, Costantino, Goldfried, & Hill, 2010). “Our personal emotional capacity serves as a glass ceiling that limits our professional

effectiveness” (Rousmaniere, 2017, p. 101). Highly developed emotional self-awareness and non-reactivity of the psychotherapist is directly linked to the success of therapeutic work with clients which reiterates how the professional and personal functioning of the psychotherapist are so inextricably entwined. American poet Mary Oliver (2006), voices in The uses of sorrow, “Someone I loved once gave me a box full of darkness. It took me years to understand that this too, was a gift”.

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I know what this looks like. I know how it feels like… bring it on almost because I have been to the depth of wherever. You know? I know darkness… I know being totally in a whirlwind of emotions and turmoil. I know it all. “You can give it. It will be okay. I can hold”… … It is interweaved because I cannot see how you can be a psychologist separate from who you are yourself as a person… it’s a

fascinating journey (Participant D3).

In other words, psychotherapists need to put their personal “box full of darkness” to work. To assist psychotherapists in facing the impact of negative emotions in their work, personal psychotherapy for the psychotherapist has been highlighted as an effective strategy to become more comfortable with distress (Rousmaniere, 2017). However, in addition,

Rousmaniere advocates that psychotherapists need to learn the discipline of disidentification in that one learns that emotions flow through an individual rather than emotions being the

individual, this emotional awareness fosters a space that enables psychotherapists to respond to client’s distress more reflectively. It is from a stance of mindfulness that psychotherapists’ capacity for empathy and compassion can increase, as well as enjoy improved self-insight, skills and self-efficacy together with decreased stress and anxiety levels and defensive responding to clients (Rousmaniere, 2017). Emotional-attunement training needs to be a central competency prioritised in training psychotherapists.

In psychotherapy, it’s like we’re a pilot but the most terrified passenger is sitting in our lap. Or we’re like a surgeon, but the patient is not sedated and we have to maintain eye contact and keep asking her how she’s feeling during the surgery. Or we’re like a dancer or musician, but we have to maintain eye contact with the person in the audience who has the worst agoraphobia (Rousmaniere, 2017, p. 105).

As such clients fear coming to psychotherapy and do not want to feel pain and yet psychotherapists need to accomplish the task at hand despite clients’ proclivity to want to abandon psychotherapy altogether.

I think that is part of the danger… that being arrogant as a young therapist, because that, ‘feels so natural for me’ but that was in that lay counsellor’s role. I confused that… a lay counsellor’s role and to be a clinical psychologist… Not just giving advice. That was difficult (Participant E4).

117 Previously being an unofficial or lay psychotherapist can be problematic for trainees. Participants (C3, D2, D5, E2, and E4) all spoke of how psychotherapists in reality cannot save people and that in the process of becoming a psychotherapist, this idea of rescuing people needs to be relinquished. Participant E4 as a then-student and now-trainer has found that masters training is also a process of ‘unlearning’. When an individual enters training they may come with lay helping skills such as providing comfort or giving advice to people in distress. These skills and identity aspects of being everyone’s ear or the fixer/rescuer/saviour need to be reworked in neophyte psychotherapists in order to effectively practice as a qualified psychotherapist (D3).

I will look, ‘Do you want to be a saviour?’... Or, ‘Do you actually want to follow a process with the person?’… “No, we want to save him!”, ‘You know you have got to try and help as many people as-’, that’s not therapy. Therapy is you have to actually got to follow. You are not a leader…, you don’t lead somebody else’s life. Remember, you are taking their power away, you are taking their way of

decision-making (Participant D2).

We sometimes end up thinking that we know enough and we are able to sum up our clients in the first session and, “Therefore…!” - which is counterintuitive if what you are working with or working toward has changed or facilitated the change-. So, if you know everything about the person and you have already summed them up, where does it leave their capacity for change, or yours?... the other thing is the capacity for change in terms, not of becoming fickle, but, in terms of actually becoming more grounded and learning more all the time

(Participant D4).

Coming in as a masters student, you are a raw diamond. You need to open your mind and think. Because, so many students come here. And, why do they want to do clinical psychology? Is that they want to help people. And, that is a very dangerous position to see yourself in. ‘I am the helper, I am the saviour of people’. We know that is not how it works. It’s a co-creation of healing, you and your client. Of course, you come with your expertise, but it is not you that trains a client to be better (Participant E4).

118 Experienced psychotherapists spoke of the learning curve they had experienced in terms of the conundrum of responsibility towards the client in tandem with the self-responsibility of the client. Experienced and senior participants, particularly, spoke of how the need or expectation that psychotherapists have to save or rescue those in need can actually be problematic (D1, D2, D3, D5, E1, E2, E4, and E5). Cain (2000) found that unprocessed personal difficulties can lead to psychotherapists over-identifying with clients and therefore displaying over-responsibility towards clients which proved to be counterproductive for clients’ treatment.