Oh, you poor dear

I’ve been thinking recently about the type of training we give people who are becoming therapists. We tell them to take a good history, to assess the health of their client, and to walk with the client through their world in a non-judgmental way.

Recently, it struck me that if therapists are not taught to think systemically, they might end up not only not effective in helping their clients, but they may even harm them.

Let’s take, for example, Mrs. Q. (not a real person). She was married to Mr. Q. for a period of 15 years. They had several children and then after a period of worsening conditions between them, divorced.

Mrs. Q. shows up in Susie the therapist’s office. Susie (I am calling her Susie because she is representing the naive way in which many non-systemic, poorly trained therapists respond) listens to Mrs. Q.’s story. It seems that Mr. Q. was a disaster from the first day of the marriage. He neglected to take out the trash at least a couple of times a week. He didn’t give Mrs. Q. nearly enough assistance with the children and with household tasks as she wanted. He didn’t spend as much time and money on her as she wanted.

Susie, in an effort to understand more of what was so awful about the marriage asks about physical abuse. Mrs. Q. says there was no physical abuse. Susie asks about emotional abuse. Aha! Yes, there was emotional abuse. What did it consist of?

Sometimes Mrs. Q. had an idea that Mr. Q. didn’t like.
Sometimes Mr. Q. wanted to go somewhere or do something that wouldn’t be Mrs. Q.’s choice.

Susie being a good therapist would follow the complaints with some version of “oh, you poor dear.” which is fine if you are trying to assist Mrs. Q. to feel justified and righteous, but which is not helpful if you are trying to help Mrs. Q. understand what happened and perhaps experience less pain in any future relationships.

In order for Mrs. Q. to grow from her experience, she has to take the time to examine what her part was in initiating, sustaining, or encouraging interactions that left her feeling frustrated and/or angry. That is not the same thing as blaming her, because fault is not something that can be determined even were we to have videotapes of the entire marriage and both partners’ running commentaries. What is important is whether Mrs. Q. can see what her part was, to take responsibility for what was truly her part, and to see that she may have different options in the future.