 I have been asked to write something about a statement I made to a friend when I said, " For me, a good therapist needs to be a Risk-Taker". Perhaps a little too often, we therapists seek to encourage our clients to take risks while we, ourselves, prefer sitting back in our chair and make clinical observations on how they are doing. When a client makes the first phone call for an appointment or comes for their first interview I make it a point to voice appreciation for the courage and risk-taking they have called on to take that step. I remember what it is like to hover over the phone and pluck up the nerve to dial the number of a total stranger with whom I am about to disclose things I have told no one. In my mind, as written in my introduction to the Healing Process, it is Side by Side - the Client and Therapist together on the journey towards Health. It is a SHARED Journey, in which courage, and willingness for honesty,integrity, truth, vulnerability, mistakes, victories, setbacks and progress is truly SHARED . All these things come under the heading of RISK-TAKING . How many of you ex and current clients, in, or done, with therapy, asked the therapist in your first interview, " Tell me, are you a Risk Taker?" If you didn't,it might be a good question to add to your list should things not be working out as you wished, or if you are shopping for a therapist. I would like to speak to a few of the ways we, as therapists, can evaluate where we are on the spectrum of basking in the therapist comfort zone at one end, to way beyond preconceived expectations required from a therapist at the other. CHOICE. Our clients have absolutely NO CHOICE of how therapy will go for them. It is not possible to foresee the things that will arise, the heights to climb and depths to plummet, the twists and turns expected and unexpected, the emotional carousel of up and down moods going round in circles traveling nowhere. There is NO CHOICE of what memories or flashbacks will surface, when and how clearly or if they would be brief or haunting, night after night, day after day - perhaps even years. CHOICE doesn't enter the realm of the Subconscious or the Unconscious and what might push up through those layers. Men and women who deal with Dissociative Identity Disorder (DID), previously known as Multiple Personality Disorder.(MPD), may have years before there is the ability to CHOOSE exactly when, and where, how, and who, will come out. ( meaning which alter personality or part will take over the body and be seen and interact with the public). Much more comes under the uncontrolled than the controlled when working through past traumata, abreactions (reliving memories as though they are actually happening in the present though they orginated in the past), and one cannot control what lies in unawareness. Thus, the client comes into our office - taking monumental RISKS with no choice in the matter if they truly want the therapeutic work. BUT The Therapist, on the other hand, every minute of the time spent with his or her client HAS A CHOICE. At ANY given moment, whatever is being listened to, wherever the client may be, in whatever mood or memory, the Therapist can CHOOSE to be WITH the client side by side, or distanced by clinical approach, methodality, personal agenda or discomfort. Grad. school fantasies of sitting looking earnestly at ones clients with empathizing nods now and then to show ones understanding, ( true or not), and offering wise counsel, is NOT what therapy is all about. The Risk Taker Therapist (RTT), who literally walks beside with their client RELINQUISHES CHOICE , facing WITH the Client whatever manner of trauma confronts them from minor to major events. Therapists working with DID,(Dissociative Identity Disorder)are dealing with multiple clients in one body. So, with anywhere from two to hundreds of different personalities the risk-taking is compunded in correlation to the size of the inner system. When it comes to this diagnosis, sadly, there seem to be less and less Risk Takers amongst Mental Health Professionals, Counselors willing to take on Multiples. Why? because there are Risks attatched to this. - The Risk of law suits from relatives or friends and very occasionally the client, proclaiming False Memory Syndrome. Therapists have found themselves facing fines of thousands of dollars, of costly court fees, defamation of character, and ensuing interruption in their practice to say nothing of the attending effect on therapy with the client. Therapists are not taking on more DID clients and some have terminated with those they had. Multiples seeking the help they so desperately need must find a Risk Taker as well as one who understands the condition and BELIEVES in it. - I do not know the stats on Believers and Unbelievers of DID but am appalled when I hear of this Psychiatrist and that Psychologist or Social Worker or Counselor who avers that Dissociative Identity Disorder doesn't exist. When I hear someone stating this it makes me wonder how they explain away its inclusion in the DSM IV and subscribe to the False Memory Syndrome that is NOT included in the Manual? So the RTT is willing to run the gauntlet of skeptical colleagues to support clients who are not only doubted in the Mental Health arena but subjected to total disbelief in legal circles when cases are brought to court. The RTT is not one to take on a shrinking violet mein where reputation and credibility is questioned. - Once a Therapist accepts a cult survivor, as a RTT they open themselves up to harrassment that can be mild to major depending on how much the client is being "called home" by the cult, if there are cult loyal parts in the client reporting to a handler/controller,and how much has been invested by the cult in the survivor etc. - Where good therapy is enabling healing to take place and exposure of secrets and perpetrator identities become more likely, the harrassment is stepped up, as is sabotage to undermine the therapy from internal and external sources. The RTT is willing to field incoming curve balls of intimidation from all angles and stand by the client through thick and thin. There are perhaps, certain characteristics in a RTT that predisposes them for filling this role. It is an important neccessity that much self work has been done in the Therapist that enables them to remain a stable source of support and availability for the long haul. The rocky road for many clients with different diagnoses can be intense and severely draining on the therapist/client dyad, their alliance, individual coping skills, endurance for stress extremes and ability to handle the unexpected. RTTs do not burn out under duress because they know how to ground themselves and their clients, seek help from personal support sources, balance work and leisure in a timely manner,( this is vital to prevent break down) receive proper supervision and be well educated in their field of expertise. Listening skills cannot be emphasized enough. ( see article on Listening,at: www.goessoftlyishere.com) The not-truly-listening RTT will miss vital innuendos, significant clues in words chosen to express need, meanings in analogies and metaphors used, and a myriad of signposts along the way that point the direction of the client's thoughts and progress. It is in HOW the therapist listens and the accuracy of the listening that the RTT can form a treatment plan commeasurate with the client's best interests. By this, I mean, that sometimes, depending on what is heard, an intervention required might be unusual in the light of traditional standards. For example: A client of mine was talking about seemingly innocuous activities of the last week, and slipped in between various chores the mention of a swing analogy caught my attention, and I suggested we take a walk in a nearby park where there were some swings. During that little outing a memory of a very traumatic event surfaced and led later to uncovering abuse that had gone too long undisclosed in this person's life. One does not usually take a client mid session to a park swing, but had I not been listening carefully or been distracted while a list of mundane activites was being droned out, some important data would have been lying dormant beneath layers of protective symptoms unrelated to the actual event. Some of my colleagues would no doubt look at my intervention as being unneccessary and that the trauma would have surfaced anyway in the course of the work. I do not think this to be true, or if so, it would have not occured till much later as it was buried deeply and the swing allowed a trigger to uncover a secret, and progress was pushed forward significantly afterwards. Perhaps I should mention that this was not a regular pattern in my work! RTTs are not swayed by the approval or disapproval of others, are not concerned about keeping with standardized protocol but follow their intuition overlaid with experience and understanding of the psychological dynamic in a client's subjective sharing. So one could posit that in Risk Taking there is an impact variable on the progress and pace of healing. This is not advocating pushing too much too soon, for this is a No No - but that sometimes, enacting unusual interventions can open up avenues of productive exploration that might otherwise take a while to reach. Self Injury or Self Harm is a subject many therapists avoid even if their clients are doing it. RTTs do not shirk this or run from discussion and processing possible reasons and need for the behavior. MOST of all they will not try to stop it when there is no other option or solution to replace it. While self harm is found in all ages,( Many years ago I worked in a locked Facility with a young girl who walked by me one day looking as though things were fine but something didn't feel right. I stopped her and asked her to roll back her sleeve. She had pushed in a row of thumb tacks all up her arm hoping to go undetected). There are severe forms of Self Harm that need emergency treatment. For a Therapist working with someone who has DID it is possible that the host is not even aware of self-injuring parts/alter(s) and could die before help is obtained. The RTT is not afraid to try contacting the unfriendly or hostile part(s) who is determined the body will die. The reason for it might be the result of suicide/self-destruct programming, breaking the No Tell rule, fulfilling an introjected abuser role (meaning, the person has taken in a representation of an abuser who, during a ritual or experiment performs life-threatening behaviors )or some other reason. This speaks to another aspect of a RTT's willingness to SHARE the risk of facing disbelief in Hospital emergency staff uninformed about DID, who might label or see the patient as being attention getting, making a suicide attempt and be unaccepting of the true cause of the injury, namely that it is INVOLUNTARY for the host and internally MANDATED for the part/alter . Therapists without a medical degree have little or no say with attending Physicians, and Psychiatrists advocating for their clients'admission are not appreciated by disblieving Hospital personel. It takes a committed Risk Taker Therapist to withstand opposition and walk side by side with their client to ensure safety and optimum care. Whether the client is a multiple personality survivor or has another diagnosis, it is not uncommon to encounter emotions of pure rage, grief, hurt,terror, feelings that when expressed, many therapists are unable to SIT WITH. A RTT does not flinch from violence, (though will make sure they are not alone if physical acting out is suspected), but raw emotion is likely to trigger the therapist's inability to cope if they have not worked through their own "stuff". All therapists run the risk of tapping into their deepest vulnerabilities when confronted with clients emoting from THEIR inner Feeling hells. Not all are willing to face in themselves a possible reflection of undealt with countertransference issues. (see Psychobabble 2B at www.goessoftlyishere.com) Not all consider this aspect of risk-taking yet the unprepared therapist who does NOT consider it is in danger of becoming overwhelmed and ripe for quick burnout. One risk that therapists I have known tend to minimize or igonore, is the need to go with their CLIENT's interpretation of internal insights, feelings and thoughts about what is happening for/in them. The RTT will weight the pros and cons of going with the Client's belief vs,the Therapist's interpretation and agenda. While there is sometimes true manipulation, fear-based fabrication or outright power struggle in the picture, the observant and carefully listening Therapist will recognize when their client has a truer picture of their condition than he or she. If one keeps in mind our clients are not sitting in the office to pass an hour or two of pleasure, then what they have to say has meaning. There are documented behaviors of manipulators and fabricators that therapists are acquainted with, but the RTT who is looking in the eyes of the client, (see Eyes, at: www.goessoftlyishere.com),whose ear is sensitive to voice tone, and intuition is honed to pick up emanating energy, will "know" when what is being told is coming from the client's truth and experience. This might be diametrically opposed to all the Therapist is thinking from their theoretical approach and training but if they are a genuine and active RTT, they will be willing to go with their client's belief. From my feeble place of observation, both personally and snoopervising others, the overriding of ones analysis of a situation in deference to our client's inner feeling will again avoid unneccessary delay in processing untapped knowledge and memories. All of above musings are about RISK TAKING It is a test to a Therapist's committment to walk side by side and relinquish CHOICE to go where the client must travel who has NO choice. BOTH stepping into the unknown, BOTH learning, BOTH taking RISKS I ask my Colleagues - and survivors can chime in too: " Are you a Risk Taker?" Goessoftly Retired Therapist www.goessoftlyishere.com (Permission for reprints is required).   | LISTENING | RETRAUMATIZATION | PSYCHOBABBLE 1 | PSYCHOBABBLE 2A | PSYCHOBABBLE 2B | Did You Ever Push MY BUTTONS ! ! | Balance | THE INVISIBLE ONES | WEEDS | RECOGNIZING DISTRESS | COMMUNICATION | INTERVIEW (The lighter side) | INNOCUOUS INTERVIEW ? | The THERAPIST as RISK TAKER | TAINTED | CAN I TRUST YOU? | CAN I TRUST YOU? | CAN I TRUST YOU? | Me According to ME | | THE HEALING PROCESS | DISSOCIATIVE IDENTITY DISORDER | POETRY | Biographical Entries | THE OTHER SIDE OF LIFE | STORIES FOR LITTLES (Pigmus and friends) | SEEDLING THOUGHTS TO WATER | | Return Home | Great Links | Sign/View Guestbook | |
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