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Psychotherapy as Craft

How Master Therapists Resolve the Toughest Clinical Dilemmas


Sushi
Recently, I read a paper by psychiatrist and pioneering trauma researcher Judith Herman in which she makes the case that, rather than a scientific or technical procedure, psychotherapy is primarily a craft. Crafts, she wrote, “are strongly embedded in the practicalities of daily life, and as such are constantly subject to empirical (though unsystematic) tests of utility. They preserve a highly complex body of knowledge and skill, resisting reductive standardization. They are taught relationally, through a long apprenticeship which fosters discipline, high standards for performance, and an ethic of care. Within their disciplined forms, crafts permit wide scope for individual imagination and creativity.”

Not long afterward, I saw a movie, that exemplifies as no other film I can remember what Herman was writing about—though the subject wasn’t a therapist. The documentary, Jiro Dreams of Sushi, follows the life and work of Jiro, an 85-year-old Japanese Sushi Master. Considered by many to be the best sushi chef in the world, he’s the proprietor of a ten-seat restaurant located in a Tokyo subway station—the first restaurant of its kind to ever be awarded a three-star Michelin review. The movie captures Jiro’s lifelong devotion to his work, his meticulous attention to detail, his unsparing self discipline, and the never-ending pursuit of what he knows he can never achieve: some sort of transcendent, other-worldly sushi-apotheosis. “Even at my age, in my work,” he says, “I haven’t reached perfection.” But like every great craftsperson, he’ll spend his life trying.

Jiro kept coming to mind as I interviewed a series of noted therapists for our upcoming webcast series, The 6 Biggest Challenges Therapists Face. All of these practitioners are, in their own way, master craftspeople, with highly evolved skills in working with particularly difficult clients and resolving clinical dilemmas. Wendy Behary describes in fascinating detail exactly how she gets through to unpleasant, often quite aggressive narcissistic clients—frequently regarded with reason as “impossible” to treat. John Norcross shows us how he changes his own therapy style to fit different kinds of clients, making the obvious—but often overlooked—point that one-size therapy certainly doesn’t fit all clients. Clifton Mitchell explains to us, in a way that can be both painful and hilarious, the common mistakes therapists make that actually increase client resistance, and then gives us play-by-play suggestions for avoiding and dismantling it.

For me, the whole experience of making these webcasts has been a revelation. Sitting at my computer, not only do I get to have a late-life career as a kind of poor man’s Charlie Rose (actually more like Charlie Rose crossed with Wayne of “Wayne’s World”), but I also get to experience something like genuine personal tutorial/therapy sessions with these master practitioners. Sometimes the pretend “therapy session” feels quite a lot like the real thing. In an interview with Dick Schwartz, originator of Internal Family Systems Therapy, I got to tap into my own inner borderline while role-playing a client, and gained a felt sense of how deeply reassuring and empowering Dick’s way of working with a client’s discordant inner parts can be.

With each practitioner in this series, I felt I was truly experiencing the ways very different therapists think and work. It was like getting a close-up look at a master potter or cabinet maker slowly, painstakingly, with great concentration and prowess, turn a piece of raw shapeless clay or plain wood boards into a work of art—you’re fascinated, awed, and enlightened all at once.

The whole point of our Networker webcast series is to help therapists break out of our usual mode of operating, opening windows into the minds of gifted people who work and think much differently than we do. It’s truly rare to have such an opportunity to get such candid, immediate access to what master therapists really do in their consulting rooms. Putting aside the impressive-sounding theories and showmanship of the typical workshop presentation, these interviews offer us all a chance to realize anew just how subtle and richly varied the skills that distinguish the most accomplished practitioners of our therapeutic craft.

The 6 Most Challenging Issues in Therapy
…And How Therapists Can Overcome Them
Starts Thursday, June 21st

Click here for full course details.

Other resources you might find helpful:

Articles
Wendy Behary
The Art of Empathic Confrontation
http://www.psychotherapynetworker.org/CEcourses/audio/handouts/A914/A914_the_art_of_empathic_confrontation.pdf

Janina Fisher
Breaking Free
http://www.psychotherapynetworker.org/component/content/article/301-2011-marchapril/1263-case-study

Richard Schwartz
When Meditation Isn’t Enough
http://www.psychotherapynetworker.org/magazine/recentissues/2011-septoct/item/1518-when-meditation-isnt-enough

Videos
Wendy Behary
Treating the Narcissistic Client
http://www.psychotherapynetworker.org/blog-communities/NetExchange/viewpost/1435_Treating_the_Narcissistic_Client

John Norcross
Customizing Mental Health Treatment
http://www.psychotherapynetworker.org/blog-communities/NP0021/viewpost/1431_Customizing_Mental_Health_Treatment

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