Reflections on Practice

Waiting without hope.  A reflection on practice

By Michele Hayes

Research is providing us with more, and more robust, evidence spotlighting the impact of the therapeutic relationship on the outcome of therapy. It suggests that supporting sustainable growth for clients is less about the modality and more about the I-Thou relationship co created in the therapeutic frame. This important research is of immense value to the field for many reasons. Not least because it rightly acknowledges the hard earned discipline and craft of the professional more than the tools or instruments used within the profession. It confirms that clients are not problems to solve or personalities to knock into shape. Instead, it confirms that the therapeutic work occurs at the confluence between therapist and client, at the relational meeting edge. When we view the work as alchemical rather than transactional, it also means that therapists are not all knowing and are not the holders of ‘the answer’ to a particular struggle. Therapists can step out of that narcissistic arena. In fact it is essential that we do so.

Clients arrive reluctantly into the therapy room with their disempowered selves, having run out of options, eager and willing to hand over power to the professional. The self- help resources that are promoted in magazines, social media and, yes, in some therapy rooms, seem to collude with the disempowerment of clients by outlining simple steps towards the desired solution. They offer a binary vision; this is the way to succeed and this is how you fail. When encountered in isolation from a therapeutic relationship, this formulaic approach risks amplifying the client’s sense of failure and fuels their diminished sense of self. Surely if ‘it’ can be done in ‘7 steps’ or there are ’12 things’ to do there must be something intrinsically wrong with me if I continue to struggle. The client may spiral downwards because the message suggests that the simple answer is ‘out there’ but that they alone cannot see it. If the solution is so simple and logical then it must be the client who is the problem, right?

Reflecting on the role of the therapist and therapy itself, it presents as an oxymoron of a profession. Clients come to us with a belief and hope that we know what they don’t; that we can solve their issue. ‘Solving the issues’ translates, often, as having ‘the answer’. However it is when we connect with what we don’t know, and can’t know, that something amazing happens. It becomes possible to live the question and explore the terrain with new eyes. Attention is drawn to the conversation that isn’t being had or the shadow of what is initially thrust into the light. Without light there is no shadow and shadow requires light to emerge. The two are inextricable bound together and it is the dance between them that leads to a perception from which we create meaning. Layered into this is how therapists come into relationship with the phenomenon of this dance. At the confluence of the client and therapist’s stories, the personal perspectives of each party co create the perception. This manifests within and finds expression through the therapeutic relationship.

Using the world of art as our guide here, it is the darkest parts that give the subject of a painting, photograph or sculpture, shape and definition. Our personal perspective impacts how we experience this expression. Standing in a different place can enable a transition from meaninglessness to meaning; a fragmented image can suddenly take on shapes we never expected. This openness to move and relate can be as subtle and delicate as a slight turn of your face, the flick of an eye or even just staying engaged for long enough to see other things (I am reminded of the optical illusion of the old hag and the young woman). At other times we may be required to make bigger shifts in perspective to see what is in front of us. These are shifts that may feel uncomfortable and we could resist them. How do we support ourselves to stay open and curious when these things challenge us?

As therapists I think we are tasked with standing and exploring from different perspectives and reflecting, with open curiosity, to support our clients in the meaning making of their lives. Instead of holding the answers, we ask the questions that expand and deepen the client’s self view.

This is where I encounter a personal struggle with the notion of ‘hope’ in therapy. Research has named ‘hope’ held by the therapist as a particular indicator of ‘successful’ client experience. Perhaps it is semantics, but for me, it is less about ‘hope’ and more like ‘faith’. Not ‘faith’ in any religious/spiritual sense of the word but that which takes the guise of ‘trust’. Whilst ‘trust’ is intrinsic in ‘hope’ it is not explicit enough in the lived and felt experience of all that is possible in the I-Thou relationship. In sessions with clients it is my trust and faith with the process itself rather than the content that enables me to sit with unknowns and to remain open and curious. If I were to ‘hope’ then I might miss the ‘hopelessness’ in the client. If I leap to what is possible then I miss the struggle and impossibility in what they bring. In other words I would lose the shadow and, in turn, lose the full dimensional perspective of the experience.

The criticism that therapy becomes entrenched in shadow or remains unhealthily attached to suffering may invite a turn away from what lurks in the shadows to focus on the light. However, if we focus exclusively on the ‘hope’, then perhaps we risk hoping for the wrong thing. Maybe we are holding onto something that we personally hope for rather than what the client wants. Can we tell what is our hope from that of the client? Do we collude with exclusively holding hope when, in reality, it is mythical and possibly even delusional? When feuding couples come into therapy, blinded by our longing to keep them together could we miss the hopelessness in what they bring and the work that might actually be in service of the relationship? In our desire to avoid the conflict and rage submerged in another client’s story we might leap to ‘fix’ the situation offering suggestions that afford a short -term level of hope but is thwarted in the long term by the unprocessed rage. I am reminded of a client seeking couple therapy who implored, “ you aren’t going to tell us to go dancing are you, ‘cos I don’t want to go fucking dancing!” The agenda clearly being set had to be the dance of their relationship and not a Friday night date option!

When we avoid the shadows we risk portraying ourselves as bringers of light and holders of the solutions as opposed to supporting resolution within the client. We become too powerful and risk disempowering the client. Because what is implicit in this dynamic is that ‘we know’ and ‘they don’t’.

The challenging implication for therapists in this invitation to work with the light and the shadow and to let go of ‘hope’, is that it brings bring us into direct relationship with our own personal dance. What we carry in the light and in our public story of us as therapists who want to make a difference, sits alongside the shadow and private story of why we are compelled to do so.

In service of illustrating this dilemma I will share a personal experience. For a number of years I worked in a psychiatric hospital and while it was an incredibly valuable experience it could be extremely confronting at times. I loved the therapeutic work and the clinical environment was rich and rewarding. However, there were immense frustrations centred on the bureaucracy and the impasse between clinical and administrative systems that could, at times, be frighteningly at odds with the therapeutic work. At a point when I was feeling especially defeated, depleted and overwhelmed, my supervisor asked why I had actively chosen this particular challenging client base and why I continued to strive in a toxic system; one that did not provide enough support for the therapeutic work. The bright light shone firstly on the desire to make a difference to those in need; to walk compassionately alongside those experiencing intense distress and had found them selves isolated and abandoned. Essentially existing in exile. As I continued to reflect on this I saw more into the hidden shadowy part and the narcissistic wound that was being activated; to be the one who never abandoned the other, no matter the cost to self. In the light, it spoke to the courageous hero in me who never gave up the cause but in the shadows lurked the underlying narcissistic belief in my omnipotence. Of perhaps being the one who held the hope and could do what others could not. It repeated a pattern that always ended in the same rut. Omnipotent impotence. There was a part of my personal narrative so familiar with this dynamic that it had not dared to include the shadow; the there and then of being young, alone and without resources in the face of frightening intensity, trying to make sense of the chaos and manage my safety within it. In the here and now, I had found the perfect arena in which to replicate my distress. I was now an adult and, of course, had trained and equipped myself with professional knowledge that would support me in the best possible way for the quest ahead. With my focus on healing the wounded other, despite all odds, I had re constellated a traumatic dynamic that compounded the wounded self. The question I needed to answer in supervision and reflect on in my practice, was whether as an adult who was differently resourced, I would chose to stay and try and change the system from within or step out and find a different way to heal. Could I give up the hoping, which was a personal longing,  for the impossible? That opened up a whole new avenue to explore in the context of personal development and I took myself back into therapy. It was challenging and difficult to find my ‘no’ to the system and embrace the ‘yes’ to myself. However I stepped out of being embedded in the system I found to be toxic, and worked with the same clinical teams and client base from within my private practice.

The drive to make a difference and the pull towards mastery in the face of adversity, combine to make it incredibly natural for us to avoid the hopelessness in a client’s story; maybe even in our own story. We can perpetuate the myth. We can keep at the coalface of trauma, mining the depths and be so focussed on a narrow goal that we don’t even notice the canary has stopped singing and we are running out of breathable air.

Trusting the process allows us to connect to the potential that, at times, sustainable hope is actually born out of coming into relationship with the hopelessness. But it takes a different sort of courage to stop bravely striding toward the light and to turn toward what is hidden in the shadows.

This challenge throws a spotlight on the absolute and essential value of the supervision process in our work. To co create, with another professional witness, a safe space for reflection and a place to expand the work. The quality and type of supervision that brings spaciousness and a curiosity to explore possibilities, in turn generates room to move and grow. It stands in stark opposition to that which feels binary and judgemental. The gifts we gain in that safe space with like-minded colleagues and mentors, can ripple out into the work with clients and subsequently into the wider world through them. Good quality supervision resources us to wait without hope and dance in the darkness that is light.

NYuXa8kHWait Without Hope

By: T.S. Eliot

I said to my soul, be still, and wait without hope
For hope would be hope for the wrong thing; wait without love,
For love would be love of the wrong thing; there is yet faith
But the faith and the love and the hope are all in the waiting.
Wait without thought, for you are not ready for thought:
So the darkness shall be the light, and the stillness the dancing.