More than Magic - Page 4


Terr has many lessons for therapists in her 15-year adventure with Cammie: follow your gut, be a person, and emphasize the independence and agency of your patient. Other lessons include, when you can, step lightly and speak with humor. Also Terr warns us there can only be one cook in the kitchen, one boss of a treatment team. Cammie had myriad doctors and specialists, but Terr let it be known she was in charge. Terr had seen other cases botched because of confusion or control issues, so her advice to other doctors and therapists is: make sure there's a clear line of authority and that everyone knows who has the final word.

Terr integrates so much good material and has so many engaging vignettes with real therapeutic value that I don't want to shortchange her narrative. But many of these stories also make me wary because they bring up that old bugaboo about "instant change." Terr's notion of a magical moment, a turnaround, isn't the equivalent of a religious conversion from on high, however. We know Cammie had no instant transformations in her life—all her changes were magical, but in a human sense. Actually, they were more like steps, and all of them were embedded in a therapeutic framework of dedicated, deliberate work.

A crucial theme resurfaces constantly: the spontaneity of the moment and the risk a therapist has to take to replace a professional mask with the face of a real human being. Remember the old social worker-101 advice: start where the client is? Many of Terr's collected vignettes seem to be reteaching this lesson. We read of a psychiatrist who takes his sullen, adolescent patient for spin in his red Corvette, creating a breakthrough with a kid who only seemed to care about cars.

One 8-year-old boy was having difficulty in the bathroom, so he'd often foul his pants. His shrink began accompanying him to the toilet and coaching him from the next stall. More than a few of their early weekly sessions were spent "relearning bathroom dynamics." Treatment became a kind of therapy by toilet training: expressions of rage against the boy's father would follow a successful bowel moment.

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