The blog posts grouped under JOURNAL OF A THERAPIST are inspired by the HBO series In Treatment (starring Gabriel Byrne as psychotherapist Paul Weston). Each post will be a commentary to a situation presented in one of the Season 3 In Treatment episodes, which then will be applied and developed so that it is helpful for as many people as possible. Please feel free to share your thoughts and emotions in the comments section after each post (you do not need to reveal your identity). Your opinion is extremely important, as it stimulates a creative dialog. I look forward to hearing from you.
There are ten years since I ask myself, under different circumstances and with different words, what is the nature of the therapeutic/counseling relationship? Of course, the easy way to answer is to refer to the theoretical orientation of the therapist. There are two poles and a huge range of options in between. On one hand there is the pure Freudian psychoanalyst, who tends to a have distant, almost indifferent, relationship with the patient, whom they benevolently supervise from somewhere above. On the other hand there are some of the humanistic therapists who do exactly the opposite: they tend to make themselves small, as they put the client on a statuesque pedestal, creating a relationship where they rarely challenge the client, since they are convinced they need to cater to every single need of their clients. In my opinion, both these polarized approaches to counseling and coaching have as a result an actual lack of genuine relationship. Behaving as a cold expert or as an over-concerned friend is not in the best interest of the client.
One of the clients of Dr. Paul West is Sunil, a 56 years old male from Calcutta. His wife has died and he was brought to Brooklyn to live with his son and daughter in law.
There are two issues I would like to point out here.
1. Cultural Sensitivity and Cultural Appropriateness.
Sunil experiences an intense cultural clash. He sees counseling suited just for mentally ill people and Dr. Weston decides to join with him at a different level than he does with the majority of his patients: he allows Sunil to smoke during his session, since he says that this is the only pleasure he has left. And he prepares Indian tea to share during their sessions.
These gestures of the therapist are probably seen by most therapists as inappropriate, a crossing of the client-therapist boundary.
Are they?.. How can we determine what is culturally appropriate in the counseling relationship? Is it ok to offer tea and cigarettes to a man arrived from a culture where these activities are a prerequisite almost to social relationship, a man who has great difficulties adapting to the extremely abstract social interactions from New York, USA?