It was the kind of tense stalemate between an angry, critical father and an increasingly withdrawn teenage son I'd seen many times through the years. Greg was a single parent who seemed to regard every exchange with his shy, 14-year-old son, Tad, as an opportunity for a "corrective experience."
However, Greg routinely ended up angry and disgusted with his son, rarely missing an opportunity to find fault, much like his description of his own father's behavior. Rather than focusing on Tad, Greg spent many of our sessions talking about how bad his father had been. In short, therapy wasn't going anywhere.
Finally, in one session, I decided to get Greg's full attention. As he launched into yet another rant about his father, I said, "Forget your damn father, Greg, and focus on helping your son!" I went on. "You came here because you couldn't connect with your son, but every time you approach him, you get tangled up in all your old anger toward your father. It's time to cut it out! Your father's already done enough harm. Don't let him come between you and your son."
Greg was stupefied, and incredulous. "Forget my father ? Stop having these feelings ? What the hell kind of therapist are you?"
"Good question," I replied. "I'm the kind of therapist who hates to see the same painful pattern repeated over and over, and, today, I'm a therapist who hates to see long-dead fathers ruin the bond between their sons and grandsons. So your father isn't welcome in this room, for the time being. I don't want to hear a word about him until further notice. I want all of your attention on your son, and on the present. I want you to focus on doing what your father couldn't do, instead of repeating what he did."
This wasn't a well-rehearsed therapeutic routine. It was improvisation, with a purpose: to flip an all-too-repetitive moment into what I like to call a Big Moment, a therapeutic event that raises the stakes and deepens the possibilities, creating the climate for a conversation that might otherwise never happen. In this case, I knew from Greg's response---a mix of startled anger and hesitance---that I'd gotten his attention with my statement in a way I hadn't been achieving with therapy-as-usual.Learning to Fly
Unfortunately, I entered grad school in the late stages of the psychoanalytic hegemony, when therapeutic impact was thought to derive from the therapist's ability to remain silent for years---not exactly what I had in mind. As a result, my early supervisors diagnosed me with poor impulse control. My play-therapy supervisor used to say to me, "Dave, 'play' refers to the child, not the therapist!"
The guiding principles were pretty much the same in adult therapy at the time. My supervisor would say things like, "That was an excellent interpretation, Dave, but six months too early." And I'd think, "I'm supposed to sit on that idea for six months?!" I believed that the possibility of breakthrough should always be at the forefront. But in most of the therapy I saw and experienced, there was little place for novelty and few indications of real impact. It made no sense to me to move so cautiously through the valuable therapeutic hour.
To me, the most radical and interesting innovation was family therapy, with people like Jay Haley and Salvador Minuchin and Carl Whitaker doing things that scandalized the therapeutic old guard. Imagine my excitement when I discovered this brand-new, brave new world! Minuchin would create stunning metaphors on a stage, in vivo, that visibly changed the family. Harry Aponte would have an outright battle with a child or an adult about their part in the problem. Whitaker would say crazy things.
All of a sudden, I felt a new freedom as a clinician. I stopped waiting for people to bring things up and started leading the way; I stopped settling for small gains and started pushing for more, trusting that there'd be more. True, what I did might not seem thrilling now, but against the backdrop of total analytic quietude, it seemed daring and exciting.The Limits of Creativity and Change
In these days of Managed Care and Therapeutic Minimalism, my biggest concern about therapy is that we don't ask enough of it. Too often, we don't push ourselves or our clients hard enough to make the changes that make a real difference in people's lives. It's taken me more than 30 years to realize that it's the combination of two strange bedfellows---imagination and repetition---that holds the key to change.
I still cherish and nurture my ability to sometimes make a dramatic intervention that gets my clients' attention, but today, when it works, I immediately recognize that I have a new task: keeping it in our sights.
To move clients out of their ruts, their numbness, and their stuck places, we need to get their attention and start their adrenaline going at a rate that wakes them up and helps them to experience the fullness of life again. Creative Big Moments can be indispensable for this. They also get us out of our own ruts and make us feel more alive, making them a great antidote to the pitfalls of this profession and the perils of burnout. Something I've learned as a therapist and a man is that the simplest things to say can be the hardest to do, and can take the better part of a lifetime to learn.This blog is excerpted from “The Big Moment." Read the full article here. >>Want to read more articles like this? Subscribe to Psychotherapy Networker Today!