Playing the Conversational Instrument
I grew up in the Bronx in the 1950s, a now-ancient era, when extended families spent hours visiting each other every weekend. Most of this time was filled with the low-key drone of tales about who was getting married, who was having a baby, who was scheduled for or recovering from surgery, how work was going at the store/office/practice, and, of course, who’d died. Noticeably lacking was much real conversation, at least as far as I was con- cerned. It was all so predictable, unspontaneous—except for Uncle Arthur.
If conversation was a dance for which most of my family members seemed to have two left feet, Uncle Arthur was Fred Astaire. He was a dentist by profession, but his true calling was as a conversationalist. He had a gift for turning whoever was sitting next to him at family dinners, no matter how seemingly dull or stodgy, into a sparkling raconteur, with amazing adventures to recount. I remember Uncle Arthur once performing one of his conversational miracles with my doleful Uncle Jack, whose thick Eastern European accent marked him as the epitome of Old World irrelevance to my teenage self. With Arthur’s active encour- agement, Uncle Jack began recounting a tale of how he’d escaped conscription by the czar’s army in World War I by fleeing to Poland, living from hand to mouth until he accidentally met someone in a small shtetl, whom, by a remarkable coincidence, his father had befriended years earlier. This surprise benefactor wound up helping Jack emigrate to the United States and embark on the great adventure of a new life and of starting his prosperous Lower East Side pharmacy. Before my eyes—and ears—Jack was transformed from a drab background character into the star of an incandescent saga that was a mix of Fiddler on the Roof and Doctor Zhivago.
Arthur interviewed me for many years—about my friends, school rivalries, what sports I liked, my best and worst classes, what I wanted to do with my life. Throughout my teens, we talked (and argued) about books, movies, politics, society, and religion. Through all this improvised back-and-forth, he taught me about the power of conversation to bring a person’s inner self to life—he made my inner self alive to me, introducing me to the new person I was becoming but hadn’t yet started to know. He had no “method,” no training in “joining” with people, no hidden agenda about what he wanted to find out—just genuine curiosity, a gift for asking good questions, and above all, a real interest in what I had to say.
This is, of course, what good therapists do. For all the time we devote to learning techniques for handling clinical issues, the bedrock of all psychotherapy is still a conversation between ther- apist and client. Yet, even though this ability to connect through word, gestures, tone of voice, and body language is critical to what we do, we hear very little about it in most clinical training programs. For all the mountains of books and articles and hours of classroom time spent on psy- chological theory and treatment models, precious little attention is given to helping therapists acquire the skills or craft of beginning a conversation and keeping it going throughout therapy.
Even though talking and listening to people may come naturally to most therapists (if not, we’re in the wrong profession), as the writers in this issue make abundantly clear, it takes conscious thought and long practice to become reliably adept at engaging clients in real conversation, and not anxiously falling back on what sounds like a routinized, Saturday Night Live parody of therapyspeak. As Miles Davis once put it, “Sometimes you have to play a long time to be able to play like yourself.”