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Time to Know

Robert "Bob" Fancher, Ph.D.: Thu, Jan 27th 2011

"Thanks for being patient," the guy (let's call him Joe) said as he shook my hand and left the office.

He'd begun to session by saying, "I've been working up to what I want to talk about today for a while. It's really scary."

holding handsHe'd been working up to it for well over a year, and when he said what he needed to say, I understood why. He was ashamed, and terrified of what his weighty revelation might portend.

Therapy, done well, routinely brings out what's difficult to face, to say, to understand.

In most therapeutic relationships, getting to the place where such things can be said takes a while.

Even in therapies where there is no dark secret, the therapist's knowing the patient-and the patient's making him- or herself known-doesn't happen quickly or easily. Knowing the patient as an individual, not as one more example of a type, a diagnostic category, or some other sort of generic textbook specimen, requires a great deal of information. That takes time. And it takes trust.

Trust on both people's parts. The patient has to trust the therapist's intentions, integrity, intelligence, and insight-and his or her heart. The therapist has to trust the patient's accuracy and truthfulness.

Trust has to be earned. Which, again, takes time.

Time itself won't get the job done, of course. A therapist can misunderstand a patient, or guide the patient by mistaken notions, for a long, long time. And a patient can create and embellish a fundamentally wrong story for as long as breath and money hold out.

But what has to happen for knowing to take place requires time.

So I don't trust short-term therapies. I find utterly bizarre and incredible the notion that a therapist can know much about an individual in just a few sessions, and I am quite sure that virtually no one talks candidly about his or her deepest worries and darkest deeds soon after meeting a stranger.

But it's not just short-term therapies that militate against a patient's being known. Any sort of programmatic therapy-any therapy based upon preconceived notions and mechanical methods-makes sure that the patient will get with the program. Or quit.

Either sort of therapy leaves people like Joe-of whom there are many-simply to carry their secrets, still, alone. And it leaves all of its victims-I mean, patients-with ways of living that have little to do with the truths of their singular lives.

When I think of therapy as secular pastoral care, one thing I know is this: the theories that therapists use to interpret suffering generally fall somewhere on the scale from fairy tales toplausible hypotheses, but one caring human can provide for another a place to be heard, to be cared for, to be known. We can provide for another a place to struggle with whatever torments have befallen him or her, in the company and care of another. If we will.

That's much scarier for the therapist than teaching "skills ," or "correcting distortions," or whatever other whistling-in-the-dark illusion the therapist employs to pretend to know more than anyone knows, to distance himself (or herself) from the murkier, troubling realities of conflicted human finitude. To be present to the suffering of another soul, devoid of mythical certitudes, is to know life in its fearsome confusion, to see through a glass darkly, to know the fecklessness of human vitality.

In the many months before Joe could speak to me as witness and counselor to his terror, I often despaired of helping him. I knew the picture he'd presented made too little sense, that something more must be happening. I'd not managed to move him out of his defensive terror. Now, though, I think we have a chance. I think we can muddle through, bringing to bear a multitude of possibilities on his behalf.

Maybe we won't make it-my "success rate" is pretty good, but hardly one hundred percent. But we have a chance now. We have a better idea of what we're dealing with.

And that's a whole lot more than Joe would have if I'd tried to get him with the program, quickly.


Robert "Bob" Fancher, Ph.D.

Bob Fancher, Ph.D., is the author of Health and Suffering in America: The Context and Content of Mental Health Care and Pleasures of Small Motions: Mastering the Mental Game of Pocket Billiards. He is founder, CEO, CFO, marketing director, chief clinical officer, janitor, owner, and sole employee of Life Therapy Counseling Services in Portland, Oregon.

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