By Dani Sazo
The demand of the sexually impotent is exhausting. Often, the struggling person believes that he has not tried hard enough, and therefore, like Sisyphus, he is condemned to ascend and descend, convinced that he will be able to reach the top of the slope, yet the stone always ends up rolling back downhill. His sexual life is really pure masturbation. There is no longer any relationship; he has stopped looking the Other in the eye. The enjoyment has been consumed by a morbid and permanent self-evaluation. Paradoxically, the impotent is also convinced that his erection is almighty and that joy will never be possible without it.
Likewise, the psychotherapist can find himself exhausted in his consultation, exhausted from looking in himself for solutions to all the misfortunes of his patients. Behold the Lamb of God, which taketh away the sin of the world. “Am I asking the right questions? What am I supposed to say now? How am I going to save this person?”. What a cross! But such is power: the power to change people; the power to know that someone else needs you. It is little surprise, then, that in the middle of the 20th century Michel Foucault expressed the history of psychiatry and psychotherapy as a means of segregation and social control [1]. We psychotherapists had forgotten the Other, absorbed in our ability to distinguish between the "normal" and those who needed to be saved. What a curious History of Madness [2]!
The sad thing is to discover that behind all this perfection and omnipotence lies nothing but fear of failure. At least that is how Begoña Rojí and Raúl Cabestrero [3] describe it when speaking of the therapist's attitude towards power. The more inadequate a therapist’s professional competence is perceived to be, the greater the therapist's struggle to control the content and direction of a session. This is how these authors also explain the therapist’ irritation when patients disobey or resist their prescriptions. “Resistance” or “Poor adherence to treatment” are some of the mouthfuls that we psychologists have coined to deny the impossibility to be almighty.
This conundrum reminds me of “The three Christs of Ypsilanti” (1964), Milton Rokeach’s controversial work that depicts the actual meeting and conversations of three psychiatric patients who each claimed to be the Messiah. The book begins with a sentence by Bertrand Russell: “Every man would like to be God, if it were possible; some few find it difficult to admit the impossibility.”. The surprise is to find out that there were four Christs, and not three. In subsequent editions, Rokeach, the psychologist in charge of arranging these meetings, would add an apology acknowledging that he “really had no right, even in the name of science, to play God and interfere round the clock with their daily lives”[4]. At least it seems that the encounter helped one of them to recover from his delirium.
Devoting oneself to professional psychotherapy necessarily implies staying trained in therapeutic techniques and being aware of research that improves clinical practice. But it is important to remember, as Carl Whitaker said, that “if the therapist allows himself to be seduced by delusions of grandeur, therapy becomes useless”. After all, "the only person who can live the life of the patient is the patient himself." Inspired by the impact of the peace movements, this peculiar family therapist reminded his students that the most effective way to escape the temptation to be God in the consultation is to declare oneself as impotent[5].
After finishing treatment, a psychotherapist asked her patient what had been most useful to her during the sessions. The patient answered with another question: “Do you remember that time when a bumblebee fluttered through the window?”[6]. How to forget that session! The therapist, allergic to bees, had ended up under the table cowering in terror while the patient chased the insect out the window. Since that day, the patient explained, the therapist had stopped seeming like a perfect and inaccessible person. This allowed her to open up. From then on, “everything began to fall into place”.
This example suggests that weakness is the way [7] to a healthy and useful therapeutic relationship.
As a Christian, this aspect of my profession has always moved me deeply, especially in recent years during my experience participating in a Reflecting Team. In the mid-late 1980s, in northern Norway, Tom Andersen and his multidisciplinary team were looking for ways to improve the efficiency and quality of the public mental health service. In the harsh region of Tromso, this optimistic and inveterate work team begins to meet with therapists and researchers from all over the world who were influenced by systemic psychology and the emerging social constructionism. Each of these individuals was convinced that collaboration between professionals and institutions was vital for the recovery of their patients.
This systemic view led Andersen and his colleagues to work as a team during therapy sessions. The team watched sessions behind a two-way mirror. At some point of the session, the therapist leading the session would go to the other side to listen to the ideas and to receive support from the other professionals. One day, though, the unexpected happened: after reaching an impasse in the middle of a family therapy session, the team invited the family and the therapist to listen to their reflections. They turned on the light behind the mirror and started a dialogue about the session that was taking place. At the end of the team's conversation and disconcerted by this intervention, both the therapist and the family began to comment on the ideas that had just been discussed. The atmosphere had changed. The tension of the session disappeared and new ways of dealing with the problem flowed. This time, it was the patients who observed and listened to the professionals and then commented on their conversation. The roles had been exchanged!
From this experience came the Reflecting Team and since then, this methodology and its conceptual foundations have gradually set a standard in clinical practices, even so in the training and supervision of novel therapists around the world. I discovered this way of working through the teachings of Professor Miguel Garrido Fernandez (University of Seville), whose sense of humor [8] and therapeutic perspective [9] have inspired many of the reflections that I share in these lines. Through an agreement with the university, Garrido directs the reflecting team [10] [11] in which I participate in the Social Services of San Pablo, a working-class neighborhood in the city.
The pleasant surprise of the families we serve never ceases to excite me when they discover the attitude and methodology of the team. Some of them have gone through numerous treatments and psychological consultations. They are exhausted from receiving gloomy diagnoses and prognoses in sessions of a few minutes with professionals who, in many cases, they will hardly see again. Suddenly, they find a team of people who show interest in their ideas and who invite them to talk about what the professionals think. The children often look through the mirror to check that we are not police officers spying on them. The parents become nervous before the cameras until they realize that the therapists are being watched as well.
Influenced by the thoughts of authors such as Humberto Maturana and Gregory Bateson, Tom Andersen considered that this democratic nature of the Reflecting Team is based on a conception of reality as "the reality of the one who perceives it" [12]. Andersen believes that “radical constructivism […] does not deny ontological reality – it simply denies the human who experiences it the possibility of acquiring a true representation of it” [13]. Hence the humble, and somewhat kinder, position of the Norwegian method. The therapist and the patient discuss the dialogues of other professionals, since “no description will be better than the others; all are equally valid” [14]. God is dead. Now he is just a therapist with curiosity and good questions.
How difficult it is to accept the mortal condition! Above all, for the health professionals, who have always been praised for our ability to be an example for our brothers, comfort mom and take care of dad. This descent from the clouds is not at all easy. Some people end up getting married, earning a master's degree, or writing an essay in the process. However, I suppose that as a Christian, I was destined to succumb to this reality at any moment. God chose the weak of the world. I imagine that is why, more than a century ago, G.K. Chesterton, speaking of democracy, would say that "there is something psychologically Christian in the idea of seeking the opinion of the marginalized instead of opting for the device of accepting the opinion of the prominent" [15]. No description will be better than the others; before the God of the Bible they are all equally invalid. Therefore I believe that what unites the Christian therapist with his patients is “the common awareness of human weakness” [16], the need for a Savior.
This declaration of impotence, which could mean the deepest disappointment and hopelessness for humanity, is actually the beginning of liberation and the end of demands for the Christian. In his “Midnight Musings of a Family Therapist” (1989), Whitaker states that “one of the great qualities of the priestly counselor” is that he has an unconditional positive regard “built in” [17]. This unconditional regard refers to the accepting attitude of the therapists towards their patients, “an outgoing positive feeling without reservations, without evaluations” [18], like a mother's love for their children regardless of their behavior.
According to Whitaker, the Christian therapist, considering himself a child of God, has been given the gift of an absolute unconditional regard which allows him to be more spontaneous and free. Nothing can separate him from the love of the Father. He must be professional and he will have to be educated, but he knows very well that there is only one Savior, one single cross, one sacrifice once and for all. It is finished.
I wonder if that is not how one begins to relax. It is in that rest that one can openly acknowledge one’s own impotence. Then, looking up, we meet the Other. The game of glances begins, the conversations throughout the night; the lover's hand crosses the window and almost without realizing it, we are in bed, ecstatic in an unexpected joy.
Author Bio
Daniel Sazo lives in Seville with his wife Dámaris and their two dogs, Noa and Milú. As a clinical psychologist, he works both in a medical center and on his own private consultation. Currently he is also finishing a Psy.M. in Family Therapy (University of Seville) where he collaborates with the Family Counseling and Therapy Unit from the social services of San Pablo. He is a member and deacon of Iglesia Bautista Fe de Sevilla.
References
[1] Bertrando, P. y Toffanetti, D. (2004). Historia de la terapia familiar: los personajes y las ideas. Paidós: Barcelona. p. 120
[2] Foucault M. (2006) History of Madness. Original publication 1961. Translation. Jonathan Murphy. Routledge: Nueva York.
[3] Rojí, B. y Cabestrero, R. (2004). Entrevistas y sugestiones indirectas: entrenamiento comunicativo para jóvenes psicoterapeutas. UNED: Madrid. p. 95
[4] Rokeach, M. (2011) The three Christs of Ypsilanti. Original publication 1964. Afterward from 1981. New York Review Books: Nueva York. pp. 335-338
[5] Whitaker, C. (1992). Meditaciones nocturnas de un terapeuta familiar. Original publication 1989. Translation. Jorge Piatigorakg. Paidós: Barcelona. p. 251
[6] Story from Friedlander, M., Escudero, V. y Heatherington, L. (2009). La alianza terapéutica: en la terapia familiar y de pareja. Original publication 2006. Translation. Matilde Jiménez. Paidós: Barcelona. p. 15
[7] Packer, J. (2013). Weakness is the way: Life with Christ Our Strength. Crossway: Illinois.
[8] Garrido, M. (2021). Psicoterapia y sentido del humor: fundamentos, modelos y aplicaciones. Letra Minúscula.
[9] Garrido M. (2009) El desarrollo de la Terapia Familiar en Andalucía, desde mi experiencia docente e investigadora. Apuntes de psicología. 27 (2-3), 163-172. https://idus.us.es/bitstream/handle/11441/60173/el%20desarrollo%20de%20la%20terapia%20familiar.pdf?sequence=1&isAllowed=y
[10] Jaén, P. (2001) Evaluación y terapia de pareja sistémico constructivista de matrimonios con miembro jugador patológico. Tesis doctoral, Universidad de Sevilla. https://idus.us.es/handle/11441/47906
[11] Marcos, J. (2010). Evaluación de la eficacia de un programa de Psicoterapia Multifamiliar con Equipo Reflexivo en adictos a opiáceos en tratamiento con metadona. Tesis doctoral, Universidad de Sevilla. https://idus.us.es/handle/11441/16000
[12] Andersen, T. (1994). El Equipo Reflexivo: diálogos y diálogos sobre los diálogos. Original publication 1991. Translation. Daniel Zadunaisky. Gedisa: Barcelona. p. 48
[13] Andersen citing Ernst von Glaserfeld in Andersen (1994) p. 48
[14] Ibid. p. 47
[15] Chesterton, G. (2013) Ortodoxia. Original publication 1908. Translation. Miguel Temprano García. Acantilado: Barcelona. p. 158
[16] Tournier, P. (2002). La culpa y la gracia. Original publication 1958. Translation. Elena Flores Sanz. Andamio: Barcelona. p. 148
[17] Whitaker (1992) p. 257
[18] Rogers, C. (2006). El proceso de convertirse en persona: mi técnica terapéutica. Original publication 1961. Translation. Lihana R. Wainberg. Paidós: Barcelona. p. 49
Español
Daniel Sazo vive en Sevilla junto a su esposa, Dámaris y sus dos perritas, Noa y Milú. Como psicólogo sanitario trabaja en un centro médico y en su propia consulta privada. En la actualidad se encuentra finalizando un Máster en Psicoterapia Relacional (Universidad de Sevilla), donde participa en el Servicio de Orientación y Terapia Familiar de los Servicios Sociales de San Pablo. Es miembro y diácono de la Iglesia Bautista Fe de Sevilla.
Comments