This article is by COSRT Accredited Member Anne Chilton
Training, workshops, conferences; they can all add to our knowledge and understanding of what ails us as human beings. We can practice the skills needed to connect with people, we can learn the theories and models about the subject areas we work with, however, its experience that helps us make sense of the information service users give us, link it to the knowledge we have and in turn allows us to use the skills in ways that helps the person sat in front of us.
It’s a complex undertaking and requires us to really think about what the individual is bringing and how we can work best with them. Therapy isn’t a tick box exercise – Person A brings this problem and if I, the therapist do XYZ then things will be better. It’s not that simple, it requires an extra skill, that of thinking.
It’s more a case of Person A brings this situation that is causing them distress or discomfort, I the therapist may think I know about this area and I have a range of skills, tools, knowledge that I could use – however, what is going to be best, how do I use all of that to help this person and most importantly how does the person in front of me make sense of their experiencing and how does it impact them as an individual and within their relationships.
When an individual arrives and unfolds their life, their trials and tribulations and the sense they have made of what has gone before it gives us a map, a guide to how that person sees themselves and the world. How they see their difficulty, it may have threads of what others experience, however it will always be unique to that person. As therapists we then need to look both at the person, their understanding and their situation and find the unique way forward. We will have to set their experiencing within a context, for example, considering time, space, people, circumstance, sound, smell, touch, and anything else that might or might not be seen or experienced as relevant
When people have been abused sexually or if they have seen or heard others being abused, they will have memories both known, somatic and unknown about that abuse, how it happened, when, where, who, how did it happen, what did it sound like, what did they see, and as therapists we need to take these things into account and find out from them how this will fit with the therapy we offer. For example, if the abuse took place at night when they were in bed, is this the best time and place to set sensate focus work? Could we explore if other times in the day or different place have less of a trigger? If the abuser was in front of the individual, with their face close up, might we explore with the person how they feel about being that close with their current partner, would it be better to sit side by side, if they recall music playing, other sounds or even smells surrounding the abuse, could you explore those with them. If the abuse was a sudden assault where they felt control was taken from them, how we then work to ensure the person retains a sense of control whilst they are also vulnerable.
Albert Einstein said that if he had an hour to save the world, he would spend 55 minutes exploring the problem and 5 minutes doing something. Therapy is quite similar; we need to spend time exploring and only when we have a full enough picture do we step into action. And thinking and being creative about what we might do and how this might impact the service user is the key element here. How to creatively and sensitively apply the knowledge we have, to create something meaningful for the service user – and that isn’t usually about ticking boxes.