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Seeing Clients with New Eyes: Part 1

This blog is a 3-part reflection about how we see (or fail to see) our clients while acting as their therapists. How we see our clients is central to our understanding of them and how our relationship grows and develops. The Person-Centered model implies a genuine and collaborative relationship between client and therapist. It asks us to view clients undefined by our well-earned expertise. This involves intentionally setting aside – or at least recognizing and reckoning with – our professional loyalties and schooled way of seeing them.

I first became aware of Ralph Ellison, and his book “Invisible Man”, by reading a chapter in Robert Coles’ book “Handing One Another Along”. Dr. Coles pointed out that Ralph Ellison’s novel provided a nuanced explication of the human struggle to see others, often fail to see them, and ultimately come to know and regard them. I read the book and was deeply moved by it. In the novel, the protagonist lamented that he could only be viewed by others as: “themselves, or figments of their imagination – indeed, everything and anything except me”. In doing so, they rendered him invisible. This invisible, nameless protagonist  attributed his invisibility to “ a peculiar disposition of the eyes of those with whom I come into contact. A matter of the construction of their inner eyes, with which they look through their physical eyes upon reality”. He further claimed that for every invisible person there must also be a blind person. As therapists, have we also become blind (blinded) to our clients by our training, personal experiences, and the conveniences and limits of our theories and systems?

Let’s take a closer look at the peculiar disposition of our clinical and professional “inner-eyes”, and how they might be constructed. George Kelly (1955), in his seminal book “The Psychology of Personal Constructs”, theorized that we see others and the world through transparent patterns or templates that we create and “attempt to fit over the realities of the world”. He called these patterns personal constructs. These are mental representations that we construct to interpret (construe) events and place them in some kind of order in our world. We experience the world through the lens of our personal constructs. Personal constructs are contextual and bipolar: we construe what something is by contrasting it with what we believe that it is not. For example, “hardworking” can only be interpreted by differentiating it from our personal understanding of “lazy”.

Personal constructs are more than just words, but also involve feelings and implicit or procedural memories of prior experiences.  We develop hypotheses, make predictions, and start looking for certain outcomes that assimilate with our personal constructs. Our thoughts, attitudes and behaviors are channeled through our individual hierarchies of personal constructs. We essentially sift our experiences through these transparent grids until specific patterns for evaluating and interpreting events emerge and become rote.

Our personal constructs let us make inferences (often faulty ones) and predictions about others without too much effort. We rapidly, and often too assuredly, explain others to ourselves; render them visible in ways that conform to our constructs. At the same time, our personal constructs help us dispense with notions of them that do not fit within the boundaries of our values, disciplines, language games, systems and philosophical leanings.

Ironically, the way that we construe others ultimately says much more about us (personally, and as a profession) than it does our clients.

Ralph Ellison made a strong case in his book for the idea that society has a lot to do with how a person sees others; that we at least partially share constructs with our culture and social groups. Applying Personal Construct theory to Mr. Ellison’s supposition about race and blindness, it can be theorized that the base of a white individual’s personal construct hierarchy, handed down to her and reinforced by societal norms, is the distinction that: to be black is really to be both similar in almost every way to every other black person and, at the same time, not at all the same as a white person. From this base construct (“black” versus “not-white”) hierarchies of increasingly more complex and individualized personal constructs are built, which are influenced by societal and economic incentives. The prejudice and discrimination within these hierarchies are contributed to by a common syllogistic fallacy that rests on this false assumption:  people from my own group are diverse and people from other groups are very similar in many ways(stereotypes). The same risk also exists for therapists; that our personal constructs are shared and typified by professional norms,  training, rehearsal with like-minded people, and economic incentives.

Psychiatry and psychology are replete with typologies and classifications. They are in many ways drilled into us. Categories, with their sophisticated names and implications, are taught at the fundamental level to therapists. We become convinced that we can understand things once we have a name for them. These become so intertwined with the entirety of our systems of personal constructs that they implicitly, and then, explicitly bias the way that we see and construe our clients. Our personal constructs are reified through clinical experience as we search for similarities and differences in our clients: who they are like and who they are not like. We start to increasingly see “kinds of clients” and continuously sort and re-sort them.  Therapists, often unwittingly,  begin typifying (discriminating against) their clients, and then it becomes increasingly easy to see them as: “ourselves, or figments of our imaginations – indeed, anything and everything except them”. Then, we become blind to our clients.

Services and Fees

Boyd Eustace is a licensed clinical professional counselor, and Board Approved Clinical Supervisor, with over 25 years of experience providing psychotherapy, coaching and mentoring, agency consulting, and clinical/general supervision. Boyd provides psychotherapy and coaching services for adults, young adults, and couples in his private practice located in the Mount Vernon area in Baltimore City.

My psychotherapy fees are set affordably so that my services are accessible to as many people as possible. Insurance is not accepted, but, at your discretion, you will provided with a detailed receipt with a diagnosis which can be forwarded to your insurance carrier to be reimbursed for out of network benefits if you are eligible.

My fee for psychotherapy is $90 per 1-hour session. The initial evaluation is typically a 90-minute session at an adjusted rate of $115. We will assess your problems, help you identify self-defeating themes, set short-term goals, and I will introduce you to the REBT/CBT paradigm during the initial session (s). We will then begin working together to reduce your emotional disturbances, as well as modify your patterns of responding to situations, so that you can flourish in life, work, and relationships.

Psychotherapy is an investment that can change your life. It is typically brief, and you should expect to find some level of emotional relief, as well as improvement in your career and relationships, within the first few weeks of treatment.  The initial goals and tasks of therapy usually relate to reducing pain and removing obstacles to successful living and healthy relationships. Then, the goals and tasks often progress to include the domains of personal growth and flourishing. Psychotherapy works best when you complete home assignments and rehearse adaptive ways of thinking and responding to your life circumstances.

Psychotherapy sessions are scheduled on a weekly or bi-weekly basis, but are also flexibly scheduled as your resources permit.

My fee for life coaching services is $250 per month. This fee includes: Two 90-minute sessions per month; Two follow-up emails per week; One 20-minute phone call per week; a daily goal-tracking spreadsheet that can be co-monitored on Google Drive or a shared document site; hand-outs and other resources. I use a Rational Emotive Behavior Therapy life coaching approach, but also bring in other resources and strategies from 30 years of career and relationship training experience.

My fee for clinical supervision is $80 per 1-hour session, but sometimes a sliding scale is provided for graduate students in training based on the student’s resource limitations and professional growth objectives.

I also provide corporate workshops and agency consulting and training.  My fee depends upon the needs and requirements of the agency.

Appointments for psychotherapy and life coaching are available weekday evenings at 5 and 6 pm, Saturdays from 8 am to 5 pm, and Sunday mornings from 9 am to 11 am.

Phone: 443-964-1969.

You may also fill out the contact form below and I will respond to your inquiry within 24 hours.

Rational Emotive Behavior Therapy Ideas for Effective Living by Walter J. Matweychuk, Ph.D.

  1. Emotional Responsibility: People a life give me the opportunity to get upset. I can choose not to disturb myself when they create adversity for me so I can take constructive action. I can choose how I feel when life is rough.
  2. Unconditional Self and Other Acceptance: Humans are born mistake makers. It is best to accept myself and others unconditionally because we are human. Reject and penalize misbehavior, but fully accept the fallible human.
  3. Uncertainty Tolerance: I dislike uncertainty. I can act and live well despite it. Even though I may fail, I can take calculated risks to achieve my goals.
  4. Discomfort Tolerance: Frustration and discomfort are difficult to bear. I can and will tolerate the discomfort required to achieve my important life goals.
  5. Self-Direction: Without approval from others, I can choose to make my own choices in life and be responsible for the outcome of my decisions. I am willing to pay some price for owning myself and my choices.
  6. Vitally Absorbing Interests: I will tend to be healthier and happier if I maintain a vitally absorbing interest and significant human involvement.
  7. Tolerance of Life: Utopias do not exist and it is best to accept the difficulties of life. I will change what can be changed and not upset myself over what cannot be changed. I can have some degree of happiness despite my adversities.
  8. Acceptance: Things do not absolutely have to be as I want them to be. I disturb myself by demanding reality to be as I think it should be instead of accepting it as it is and striving to control and change what is within my domain of influence.

Epictetus, Epicurus and the Core Concepts of REBT

Albert Ellis, the creator and architect of Rational Emotive Behavior Therapy (REBT), as well as the progenitor of Cognitive Behavior Therapy (CBT), read and studied philosophy extensively in his early years, especially Hellenistic philosophers.  His studies led him to believe that it is people’s own ideas and beliefs, as opposed to external events (i.e., the actions or opinions of others), that cause emotional and behavioral disturbances. The primary goal of the REBT lifestyle is for people to live life creatively and successfully, with a minimum of self-inflicted perturbation.

Below are some words written by Epictetus (50 AD – 135 AD) and Epicurus (341 BC – 270 BC) that epitomize the REBT philosophy, and certainly influenced Albert Ellis’ formulation of REBT principles and concepts.

Epictetus:

“Men are disturbed not by things, but by the notions they form concerning things.”

“When therefore we are hindered, or disturbed, let us never attribute it to others, but to ourselves.”

“When, therefore, anyone provokes you, be assured that it is your own opinion which provokes you.”

Excerpts from “The Handbook” by Epictetus.

 

Epicurus:

“Of all things most desirable, once got, we must have something else.”

“We need prudence to avoid cheating ourselves with short-lived pleasures that cost too much; wisdom to choose the simpler pleasures that cost less and last longer.”

“Some things are bound to go wrong in every life. That is our misfortune. But there is no need of brooding over them in gratuitous grief after they have gone, or dreading them in gloomy anticipation before they come. If either in anticipation or retrospect these evils are permitted to darken the hours when they are physically absent, that is not our misfortune; it is our fault and our folly.”

Excerpts from “Principle Doctrines” by Epicurus.

Reflection

REBT theory remains grounded in, and informed by, philosophy as well as science. Albert Ellis wrote about the contributions of Logical Positivists, especially Karl Popper (the pitfalls of inductive reasoning and a priori justification) , while developing REBT principles. REBT therapists are committed to teaching scientific thinking, and encourage clients to scrutinize and test their beliefs, inferences, conjectures and conclusions.  This allows clients to think rationally, and therefore act better and feel better.  He also wrote about how Constructionists and Postmodern thinkers shaped his supposition that unhealthy emotions are created by personal mental constructs, as opposed to some particular and definitive objective reality. He postulated that people help create their own unhealthy emotions and problems, and, inasmuch, they can also create their own emotional solutions.

While REBT has evolved in part due to Existential and Constructionist thinkers, the approach still owes its foundation and much of its saliency to the Hellenistic philosophers. Epictetus and Epicurus remind us that when other people and the world create adversity for us, we can (to a large degree, and with practice) choose how we think, feel, and act in those situations. They admonish us to pursue long-term, rational pleasure as opposed to short-term pleasure that may cause significant pain down the road. Finally, they teach us that life is lived in the “here and now” and we can choose not to waste our present moments fretting about the future or wallowing in the sorrow of past defeats and failures.

Writing this post and re-reading Epictetus, Epicurus, and Aurelius over the past few days has been a reminder to me of how prescient and timely their words remain several thousand years later. We remain incurably fallible and messed up as a human race. We haven’t really evolved much; the world has changed and many of our challenges are different, but the same themes show up when we are angry, jealous, depressed, anxious, envious, guilt-ridden and shamed. The philosophical perspectives offered by these ancient thinkers still apply.

 

 

 

 

 

 

REBT Anger Management

Major themes, thinking, and behaviors associated with unhealthy anger (Identified by Windy Dryden in his book “Dealing with Emotional Problems,” 2012).

Common Themes:

  • You have been frustrated or a goal has been obstructed in some way.
  • Someone or something has threatened your self-esteem.
  • Someone has shown you disrespect.
  • Someone has transgressed one of your personal rules.

Thinking:

  • You overestimate the extent to which others acted deliberately
  • You see malicious intent in the motives of others
  • You see yourself as definitely right and the others as definitely wrong
  • You are unable to see the point of view of others
  • You plot to exact revenge
  • You ruminate about the other’s behavior and imagine coming out on top*

Behaviors:

  • You attack others physically
  • You attack others verbally
  • You attack others passive-aggressively
  • You displace the attack on to another person, animal or object
  • You withdraw aggressively
  • You recruit allies against the other

 

Setting Goals For Anger Management

The RE-CBT approach helps clients develop realistic goals for changing the thinking and behaviors  associated with their unhealthy anger. Often, angry thinking and aggressive behavior are self-disturbing and self-defeating responses to unmet desires and personal goals. Clients may think that their anger is necessary to enforce rules or to not appear weak to others. Clients may feel powerful over others when angry, and at other times may feel inadequate and powerless. It may take some work for clients to see that many of the perceived benefits of anger are short-term, but the pain and destruction of anger are debilitating and long-term. The REBT/cbt therapist helps clients discovers if and how this pattern has been true in their life, and then agree on specific goals to change and reshape their ingrained patterns of angry thinking, feeling, and responding.

Changing Angry Thinking

The core irrational beliefs that typically contribute to unhealthy anger are:  demanding that others or life “should,” “ought-to,” “has-to,” “must,” give them what they need and desire when and how they require it; unconditionally deserving what they demand from others and life; low-frustration tolerance in the form of “I can’t take this;”  labeling and globally rating others as bad or conniving or dishonest, while rating themselves as a victim; and awfulizing and catastrophizing. Clients’ inferences or assumptions about others and events often include exaggerations and misperceiving. However, clients can learn less upsetting ways of construing and interpreting events. Even during the initial sessions, negative automatic thoughts, inferences, and core beliefs associated with unhealthy emotions are identified . Once pinpointed, these thinking errors and irrational beliefs are challenged and replaced with more effective, tolerant ways of thinking.

Learning Alternatives To Angry Thinking and Aggression

Teaching new skills is an essential part of anger management. Anger often results when clients do not have the adaptive skill-set to get what they want from their environment. Consequently, they might respond with aggression, passive-aggression, or even passivity that results in an eventual blow-up. It is important to teach assertiveness, effective communication, problem-solving, boundary-setting and other skills to help clients respond appropriately to realistic obstacles and transgressions by others.

Changing Angry and Aggressive Behavior

It is often necessary for therapist and clients to establish a plan to decrease and/or eliminate aggressive and destructive behaviors.  This plan should involve a specific, detailed definition of the behaviors that clients want to change. The REBT/cbt therapist helps clients identify situations that trigger angry thinking and aggressive behaviors, and then arrange consequences in their environment to decrease the likelihood and severity of aggressive behaviors. Client are encouraged to persevere in their efforts to modify their aggressive and passive-aggressive behaviors. This persistence also has a positive influence on self-discipline and frustration tolerance. Positive behavior changes in one area can lead to other adaptive behaviors that have a positive impact on relationships and overall functioning.

Final Thoughts About Unhealthy Anger

The main goal of REBT/cbt anger management is for clients to properly assert themselves, make requests instead of demands, and remain calm and non-aggressive during and after unsatisfactory situations. This requires both learning new skills and rehearsing alternative ways of thinking and behaving. Anger is a normal and often healthy response to unfairness and provocation. However, it does not have to damage homes and friendships, hinder careers and life-goals, or destroy peace of mind. Clients can learn to let go of their grievances and get on with living their lives productively and peacefully.  A properly trained and experienced REBT/cbt therapist can help.

Boyd Eustace, LCPC

August 21, 2018

 

 

 

 

Signs of a Healthy Relationship

The following are signs of a healthy intimate relationship:

  • Despite disagreements, you like each other, trust each other, and respect each other.
  • You mutually support each other’s pursuit of what is important.
  • You share an acceptable number of common interests, but also support separate interests.
  • You share power.
  • You do not rely on one another for validation.
  • You each have a degree of self-reliance.
  • You have similar values in most important areas, and have worked out ways to manage           disagreements.
  • You are compatible sexually to a degree that satisfies each partner.
  • You enjoy non-sexual time together.
  • You are interdependent. You know that you can rely on each other and believe that you are stronger together than separately.
  • You give each other a sufficient amount of appreciation and attention.
  • You respect each other’s privacy.
  • You each take responsibility to give the relationship the time and attentions it needs.

Kristine Doyle, Ph.D., Albert Ellis Institute

A Little Bit About Rational Emotive Behavior Therapy

RE-CBT is a philosophical and empirically based therapy. It was originally developed by Dr. Albert Ellis in 1955, and was the first Cognitive Behavior Therapy.  Dr. Ellis based his approach on the philosophy of the Ancient Greek philosopher, Epictetus, who wrote: “people are not disturbed by things, but by the view that they take of them”.

I practice Rational Emotive – Cognitive Behavior Therapy (RE-CBT) because it is flexible, effective, and person-centered. It helps clients develop a philosophy and lifestyle that promotes healthy thinking, emotions, behaviors, and relationships. It also stresses unconditional acceptance of self, others, and the world. RE-CBT does not just attempt to resolve one specific problem, because problems in life are pervasive and inescapable, but strives to alleviate disturbed thinking and emotions when problems indubitably do occur. This allows a person to go through life, which is complex and always in flux, with a calm and rational approach that is less upsetting and more adaptive.

Many emotional problems are in fact rooted in practical problems, and may have a clear precipitating event. However, the unhealthy negative emotions and behaviors often accompanying these problems are, at least to some degree, created and maintained by a person’s own interpretations and evaluations of them. RE-CBT provides a flexible model that helps clients systematically unpack their internal dialogue about adverse events or relationship situations. Clients learn to recognize and define their automatic assumptions, inferences and conclusions about specific troubling events (or thoughts and emotions). Then, clients practice challenging and replacing irrational interpretations or meanings that have been applied to them. This process allows clients over time to restructure their unhealthy core beliefs and maladaptive personal scripts from which they sift and channel their experiences (consciously and unconsciously) and construe events.

RE-CBT therapists are committed to helping clients unconditionally accept themselves, others, and the world.  Unconditional acceptance is a key ingredient to emotional wellbeing and progress in therapy. RE-CBT philosophy posits that all humans are incurably fallible; prone to mistakes, misperceptions, and poor behavior under certain circumstances.  These shortcomings make up only a small part of who we are in totality, and are not attached to our human worth and value.  For that reason, it is illogical and unhelpful to globally rate or depreciate ourselves (or others) based on a few known aspects of an incalculable human being. At the same time, therapists encourage clients to recognize and change habits and behaviors – especially in relationships – that are unhealthy or block their life-goals.

The work of therapy is typically active-directive and collaborative. It is meant to be brief, when possible, and therapist and client usually begin working together for positive change during the first sessions. RE-CBT helps clients get on with their life (get unstuck) with flexibility, serenity, and effectiveness. It’s aim is for clients to live a happier and more fulfilling life.

Therapist self-disclosure and the therapeutic working alliance

The following passages from the book: A Practitioner’s Guide To Rational Emotive Behavior Therapy, 3rd Edition (DiGiuseppe, Doyle, Dryden & Backx, 2014) address issues related to clinician self-disclosure, and give examples of how answering personal questions by clients can benefit the therapy process and working alliance. It almost goes without saying that self-disclosure is person-centered and models unconditional acceptance as well.

The therapeutic working alliance, along with the nature of the therapist, accounts for the vast percentage of treatment outcome variance (70%+). Answering clients’ personal questions can strengthen the therapeutic working alliance. Additionally, clients’responses to the therapist’s direct answers to personal questions are grist for the therapy mill. It may help clients identify irrational global ratings of self and others. It can also help both therapist and client discover hindering differences in their epistemic styles, find irrational beliefs or inferences about their relationship, and expose erroneous, tacit agreements between both parties to resist change.

The authors wrote:

“As clients get to know us and form a bond, they think of us as people and friends. They will normally have thoughts about what type of people we are and want to know things about our personal lives. Clients will come out and ask such personal questions about your age, your interests, your relationships, your children, etc. What should you do, and how will your response affect the therapeutic relationship? Albert Ellis always recommended just answering the question directly and factually, and only providing the amount of detail for which the client asks; then he would get back to the questions about the client’s emotions or beliefs.

Perhaps you are surprised that we recommend the therapist respond immediately to client’s questions. Our rationale is that with such a reply, the therapist is modeling good communication in an open, spontaneous relationship. This position, of course is quite different from more psychodynamic therapists, who usually reply with, “why do you want to know” or “why is that important?”. Such a response seems like a dodge and distancing maneuver to the client. In REBT, the relationship rests on sincerity. It is usually preferable, therefore, to answer questions fairly and honestly, and then to deal with the individual’s subsequent thoughts and feelings.

Are there limits to the therapist’s self-disclosure? There probably are. The REBT therapist knows that there is nothing inherently shameful; however, there is information that you keep from other people as well. If the question is too personal, it is quite reasonable to say that you don’t feel comfortable sharing that information. After answering them directly, you might ask clients how they feel about this new information, how they feel about you, and what their reasons were for asking. For example, perhaps the client looks at you as a mystical deity and then rejects you after learning that you are merely mortal. This pattern may well reflect what the client does in everyday relationships, so that you will be able to dispute the irrational beliefs associated with this problem.

Clients could develop a dependency on authority figures in such a way that they cannot take advice except from people who are better than they are (authoritative epistemology*). This type of dependency often results in self-depreciation. By exploring this with the client, they may respond, “you’re a doctor and I’m just a patient”. You can then guess that they are doing the same thing with other people in their lives, such as their boss, the president of their company, or the provost of their university, etc.. It will benefit these clients if you can demystify the rest of their gods in addition to yourself”.

  • my addition to the text

These passages provide food for thought. The straightforward approach to self-disclosure implies a more pluralistic stance and acknowledges that clients are not passive recipients of treatment, but are instead active agents in the therapy process. Pluralism in therapy suggests that information is shared both ways and that the therapist is upfront and explicit. Directly answering personal questions from clients, when possible and ethical (not harmful), often helps the client find his voice and trust the relationship.

The four domains of the working alliance are: 1. Bond; 2. Goals; 3. Tasks; and 4. Views (views of each other as persons, the roles they play, and the perceived world each inhabits). As noted by these highly regarded authors, self-disclosure helps demystify and humanize the therapist. The therapist as a flawed fellow human, unconditionally relates to the client so that she may feel more comfortable expressing a world view and model of the mind that differs from the therapist. It also helps the therapist give up her narcissistic epistemology (Albert Ellis’ term for the position that our ideas must be correct because we are skilled and trained clinicians) and promotes a level of mutual trust that allows the therapist to admit mistakes, share and dispute her own irrational beliefs about the therapy process, and use suppositional language instead of declarative sentences (DiGiuseppe suggests using suppositional language and Socratic dialogue) This egalitarian, non-authoritative and non-parental, alliance increases the likelihood that the client will feel at ease to set his own goals for therapy and life. The pluralistic approach, which involves two-way sharing, encourages tasks of therapy that are: flexible, chosen by the client, and adapted to her unique pathways to change. All 4 domains of the working alliance are often strengthened through appropriate therapist self-disclosure.

“Seeing” others: Contingency and the Human – Perspectives from Philosophy by Gerald Phillips, Ph.D.

The two essays offered by Boyd on his recent posts raise questions that have important connections to concerns in the philosophy of science as well as aesthetics. The following observations are offered only to outline some ideas put forward by philosophers that support Boyd’s assertions. I am not a therapist. I cannot directly speak to those concerns. But I can offer some insights I have found useful from the work of a couple of contemporary American philosophers, Joseph Margolis and Richard Rorty. Part of the effort here is to briefly explore the phenomenon of contingency. The points that Boyd makes bring contingency into focus in ways that show that many of our efforts to construct more stable theoretical foundations and develop a more “professional” and “clinical” approach to patients (students, colleagues, and practice in general), can be deleterious to the very outcomes we believe we are pursuing.

If there seems to be interest in further discussion, I would be humbled and very happy to share in further interactions. I would also add that none of these ideas will be entirely new to most readers who would be attracted to this blog. I am simply trying to lay out a general perspective which I have found useful in thinking about the ideas Boyd and I have discussed, and that Boyd offers here.

American philosopher Joseph Margolis offers the following distillation of forty years of philosophical thought: He argues that the “structure of reality and the structure of human thought are inextricably symbiotized.” They are not independent entities, standing somehow separate from each other. The final, linking term for Margolis is not perhaps the expected one. Rather than synthesis, Margolis calls the relationship between mind and world symbiotic. The term synthesis is commonly associated by many of us with ideas or concepts, is also a prominent thesis in biology, implying that two different ideas or phenomena are somehow united into one. In most syntheses, both elements (or, each member of the collection of elements involved in the synthesis, should there be more than two) must give up significant aspects of their particularity in order to produce the synthesis—the synthesis is, in some ways, both significantly more and less than the individual entities incorporated into it.

Symbiosis is a term closely associated with nature, with the biological, although like the term synthesis, it has become a term utilized in several fields. There are types of symbiosis in the world (and in our own bodies) that are not only parasitic, but mutually beneficial. In many symbiotic relations, neither side of the relationship sacrifices the essentials of its particularity to take part in the union. Margolis’ use of the metaphor of symbiosis is, therefore, very apt, since it captures this mediation between mind and world in a manner that shows neither side as consistently dominant. There is, in fact, a kind of play between the two.

Margolis continues: “there is no principled means by which to ascertain what it is that mind contributes to what we take to be the world’s structure, or what the ‘brute’ world contributes to our sense of the world.” One could go further than Margolis here, saying that the line between the two, or the relative percentages supplied by either cognition or the world, change; those percentages may be radically different in different circumstances. Richard Rorty’s comments present us with something of the huge question that language opens up when we consider that the vast percentage of our world view is a linguistic construct. Rorty produced what are perhaps the most straightforward, comprehensive, and compact articulations of complexities attendant to the way in which humans use language, relate to each other and the world, and come to grips with their own uncanniness.

According to Rorty, we all fashion over time a personal or “final vocabulary” that we use to describe the world to ourselves and ourselves to the world. This is not necessarily final in the sense of “last,” but rather in the sense of a mature linguistic practice reflecting the accumulated values and insights of an individual living in a particular sociocultural world–subject of course to alteration and revision over time, for no such vocabulary remains stagnant without serious repercussions for the one who practices it. Rorty argues that the final vocabulary of each person is as far as that person can go with language at any point in time. If others cast doubt on the usefulness or value of some aspect of that vocabulary, the person who is using it has no immediate recourse in rebuttal except to remain internal to that vocabulary, using the terms of the vocabulary to justify their ideas and emotional responses, thus producing a circular argument. Going outside of one’s final vocabulary–that is, to just “temporarily” using part of a different vocabulary in response to an inhospitable question–cannot, on its own, serve as a viable solution. To respond in such a manner, one would have to undertake a fundamental restructuring of one’s entire final vocabulary to accommodate inevitable conflicts new material would cause within that person’s final vocabulary. In this negative sense, we see that the final vocabulary embraces an entire world-view–a commitment to a certain world perspective–any change, as we have already noted, will require sensitive and often extensive revisions, and, indeed, concomitant changes in perspective.

An “ironist” is someone who, according to Rorty, has an honest and straightforward relationship with her final vocabulary. She believes that no vocabulary (including her own) successfully meets what might be termed the “gold” standard of describing “reality on its own terms.” Nor does she believe that there is a “meta-vocabulary” that stands objectively outside these various personal final vocabularies that we can use to arbitrate which vocabulary is “true.” There exists no “yardstick,” “standard,” or criterion which brings us into the presence of “truth.” The ironist would therefore be genuinely concerned about the limitations of her own vocabulary. The fact that she also has been impressed with others’ final vocabularies serves only to deepen this concern. She knows, due to the circularity and inherent incompleteness of her final vocabulary, that her–or anyone else’s–vocabulary can ever, no matter how meticulously revised and re-envisioned, reconcile these misgivings.

One of the central metaphors that Rorty uses is that of the “strong poet,” a term he borrowed from Harold Bloome. It lies at the core of Rorty’s confidence in an aesthetic vision of the world that can ameliorate and even perhaps transcend the many pitfalls attendant to our attempts to reduce the world (solely) to rational discourse. What Rorty says regarding the strong poet is as follows: “…the conscious need of the strong poet [is] to come to terms with the blind impress which chance has given him, to make a self for himself by re-describing that impress in terms which are, if only marginally, his own.”

I offer these two examples because I have found them very helpful in my own understanding of contingency or chance. Three things have emerged for me as centrally important: 1.) recognizing relativism as a fundamental aspect of life and thought is dangerous and is fraught with difficulties that seem to proliferate explosively, suffocating our will to move on, 2.) moving on is the only game in town, 3.) Rorty (via Harold Bloome) offers us an apt and very useful metaphor to hold on to in that effort: the strong poet. The strong poet is faced with the “blind impress,” of chance–that is, our DNA, our sociocultural situations of origin, and the evolution of those effects over time, etc., things over which we had little or no control during our maturation. Many humans do not step far beyond the constraints of their origins or of their mature “vocabularies” beyond a few (grudging) tweaks. The “strong poet,” as jointly envisioned by Bloome and Rorty, is not bound by these constraints, in fact, the strong poet actively critiques virtually all the vocabularies she comes across during her life–certainly none more thoroughly than her own. But the strong poet is also a creator of new metaphors, of new vocabularies that re-describe the world in terms that provide both new perspectives on the world and, through these new perspectives, insights into how one might navigate the swirling rapids of life. Obviously then, Nietzsche, Beckett, Schoenberg, Rorty, Sophocles, John Cage, Einstein, Martha Nussbaum, Newton, Tom Waits, Adorno, and many others, many of whom are not strictly “poets,” have contributed to this process of a radically transformative rearticulation of the world. I think this model can be utilized by all of us—in our own lives, our own study and writing, our practice and for our students and patients. One does not need to be a Poet, nor does anyone need to even write, as in journaling, or fiction, or op-eds. I read something recently about a person working with a therapist who discovered that the world could be something of interest, something to be thought about, and that those thoughts could be shared with others. It never occurred to me that such a thing could never occur to anyone!

Finally, I would like to re-emphasize that the therapist or teacher is not the strong poet—he/she may be, in fact, far from it. The point is, that both participants in the therapeutic experience should gain by being in pursuit of his/her own emergence as a strong poet. There is an important observation related to this, one which is my own: In the performance world, many actors have noted the sense that, as well as being immersed in the action of the drama, there is a part of them that “hovers” over it, bringing to the situation a critical awareness of the aesthetic effect of the scene and their part in it. For many years, I thought that the “hoverer” was the actor. Now I believe the hoverer must be the character. The exact nature of the relationship between the idea of the strong poet and the hovering character, I’ll leave to your own consideration.

Seeing Clients with New Eyes: Part 2

Michael Mahoney expressed very eloquently some pitfalls of seeing clients through categorically constructed eyes. He wrote: “Psychology and psychotherapy have become heavily categorical. The profession seems to both breathe and breed classification. Classification is a useful tool, of course. It helps us to organize and communicate our experience. But tools can become tyrants. Abraham Maslow called it the law of the hammer: we start to pound everything. When we fall into the habit of experiencing and describing our clients as their diagnosis, we have lost control of a very powerful tool. More important, we have lost a precious sense of our clients’ uniqueness as flesh-and-blood, trial-and-error persons”.

Person-centered therapy involves seeing our clients without regard to pretext or pretense. We often fall short in our attempts to help clients address their “errors” because we do not see them genuinely or fully as they experience and respond to their trials (“flesh-and-blood”). As Dr. Mahoney described in the passage above, we can lose a real “sense of our clients uniqueness”. We are asked by the Person-Centered model to recognize our own biases – prognostic categories, labels, jargon, theories, systems and frames of reference – as well as identities and labels that we hang on our clients to explain and represent them to ourselves and our colleagues; to render them visible so that we can figure out how to treat them. We could be tempted to rely on our clinical armamentarium, as opposed to helping clients find (construct) and apply their own unique ways of coping and adapting. If clients adopt aspects of an identity that we ascribe to them, it may become the blind leading the blind.

Cultivating a person-centered way of seeing our clients presents us with a conundrum: on the one hand, we want to see them as real and separate from our own biases; but, on the other hand, we feel a tug to hold on to our expertise and the prestige of our role as healers and wise counselors. Being a therapist, supervisor, teacher, or doctor is integral to our sense of identity and ego. We risk seeing ourselves (and being seen by our clients) with more skepticism, more honestly, and as human and fallible. James Baldwin wrote that “the world tends to trap and immobilize you in the role you play; and it is not easy – in fact, it is always extremely hard – to maintain a kind of watchful, mocking distance between oneself as one appears to be and oneself as one actually is”. The Person-Centered optic lessens the safe distance from which therapist and client are accustomed to seeing and knowing each other; closing the gap between who we really are and who we appear to be.  This can also cause us to cast a critical eye on ourselves and our profession.  As Mr. Baldwin noted, this is always extremely hard to do.

As we construct our new eyes, we often display Socratic Ignorance (a term adopted by Albert Ellis) in plain view of our clients. Like Socrates, we become wiser when we understand that we don’t know things, but rely on an inquisitive mind. We relinquish an absolutistic stance and acknowledge that we don’t now what is best for our clients; or, furthermore, which of their experiences are more, or less, relevant. We can no longer collude with clients to be their “healer”, their “rescuer”, their “miracle worker”, the “one who knows” (Yalom). This can be discomfiting. In a sense, we become a beginner all over again (and again, and again); requiring us to sit and learn (grow) alongside the very people who traveled at some expense to see us. They sign in with the receptionist, verify their insurance or pay their bill, wait their turn for us get them, and then are seen by us. They undertake this pilgrimage to be seen by us so that they can be healed, or at the very least, receive sage advice. But we are far more likely to see lasting change and relieve suffering for our clients when we see them through person-centered eyes – those new eyes constructed to construe them as “flesh-and-blood”; to see their individual trials-and-errors, flaws and shortcomings, and their unique capacities and repertoire of responses to the complex world that they live in.

After all, it is the client who must face their own world and live out the consequences of the decisions made in our offices. We go home at the end of the day, drive past other people’s neighborhoods and homes to our own homes (often safer ones), to live our own lives and consequences. Hopefully, because of our day at the office, we can then go back to our friends and family with reconstructed eyes to approach our life with the unbiased openness and  curiosity of a beginner.