“What about Bob?” The Need for a Compassionate Approach

Amy and I recently watched the movie What about Bob? In it Richard Dreyfuss and Bill Murray hilariously deal with the professional code among therapists to never allow their patients into their personal lives. In the movie Murray, the hapless patient Bob, worms his way into the hearts of his therapist’s family members during the good doctor’s family vacation literally driving the “t” crazy. It really is a funny movie, but its premise is an unfortunate reality.

Somewhere in the evolution of the professional code of ethics for therapists, it was decided that a good therapist should stay detached from the personal life of the patient. I’m not sure if this code evolved because of ethical violations in which therapists have become intimately involved with patients. Or maybe this state of affairs is seen as a necessary buffer because of patients like Bob who are naturally so desperate to be part of a loving family they never knew. But whatever the reason, this code has castrated one of the most important elements of a healing strategy for the many broken-hearted people seeking help: compassionate love.

In response to the movie Amy told me, “I would never be open about my secrets with ‘C’ (her theophostic facilitator) if she didn’t share with me her secrets, too.” At the girls’ weekly theophostic session their facilitator often shares about her family and personal prayer requests. My girls consider her their friend, and they believe it is mutual.

Amy then proceeded to tell me about some of the patient/therapist relationships of the ladies on Karen’s overcomers’ forum. In her opinion the best t’s were the ones who were willing to be personally involved with the patient.

Let me draw a picture for you. In my crude understanding of this professional code, the therapist and patient are involved in trench warfare against the past trauma. However, the patient is the soldier in the trenches getting muddy, slimy, lice infected and shot at continuously by the enemy while the therapist acts like a general. The general safely calls out instructions from above to the private assuring the besieged that he, the general, knows what he is doing and to “just trust him.”

I understand this is a caricature. And my intention is NOT to invalidate all the VERY good things professional therapists are doing. BUT this is how such a relationship FEELS to many patients. When childhood trauma victims were first traumatized, my guess is the overwhelming majority stood alone during the abuse. I know my girls did. And it is that feeling of aloneness that often is more damaging than the abuse itself. Sh!t happens to all of us. But it is when we have to go through things alone that life takes it greatest toll.

So what I wish for is a professional code that takes a more compassionate stance. Why shouldn’t a therapist be friendly beyond a professional relationship? To me compassion is the act of rolling up one’s sleeves to jump into the fray and help another person. Here’s the picture I see of the ideal therapist, or theophostic facilitator, or caregiver like myself for a broken hearted person:

Imagine a movie about the 1800’s where a person is heading for “California or Bust” and she has hired someone to be her guide and take her safely to her destination. This guide is trusted to not only know the way to get there, but a good guide in the movies also is willing to risk his personal safety to protect the one in his charge. The guides that we despise in the movies are always the ones who abandon those in his care if danger or difficulty comes. The guides we emulate as worthy heroes of a story always are willing to risk all to make sure everyone safely arrives.

And that’s what a person with DID needs from the “guide” who will help her heal. She or he needs to know that she is NOT alone this time as she faces the demons from the past. This is a cardinal rule of mine when I am dealing with my girls: “If you are scared, you call me, wake me, come and get me no matter what time it is. I NEVER want you to have to go through a trigger event alone. That was the first time. Now you have someone with you who loves you and will stay with you no matter what.” That rule is the reason I now always carry a cell phone so that they can reach me if needed.

I know no therapist could EVER do what I have done for my girls. But as spouses, friends or significant others, we MUST do more. Until we adopt a more personal and compassionate view of helping those suffering through mental and personality disorders, until we are ready to risk our own personal safety and comfort to lift up the broken hearted, until we are willing to say, “whatever you need…” and mean it, the broken hearted will KNOW they are still alone. And if helping them heal is our goal, this is a huge barrier to emotional health that must be removed.

Blessings.

Sam, I Am

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10 Comments (+add yours?)

  1. davidrochester
    Aug 08, 2010 @ 13:53:43

    I think clients tend to be pretty strongly divided on this issue, possibly based upon what their own childhood experiences were. If they grew up as the emotional (or literal) caretaker for parents or relatives, a therapist who shares *anything* about their personal life can seem needy, and the client may assume the caretaking role, wanting not to trigger the therapist’s sensitivities or sore spots. The problem with being friends with a therapist is that friendship is a two-way street, and the therapeutic relationship should be a one-way street — as parenting ideally should be, where the full deliberate benefit is focused on the client (or child) and the rewards to the therapist (or parent) are not about the other party being obligated to give back. In a true friendship, that obligation/expectation is there, and so the more the line is blurred between therapeutic framework and friendship, the more the client may feel expectations and obligations that absolutely should not exist in a relationship designed for the client’s sole benefit.

    Reply

    • Sam Ruck
      Aug 08, 2010 @ 21:08:33

      Hi David,

      Good to see you again. You’re premise is that a therapeutic relationship and parental relationship must be totally one-way in order for it to afford any benefit to the one in the patient or child position. I respectfully refuse to accept that premise. If you re-read my entry, you will see that I in no way espoused that a therapist “bare all” to the one he is helping. That would be harmful. I realize that it is safer to keep things “professional only” but my contention is that safer doesn’t mean better: just safer.

      Thank you for your comments because I’m sure your reaction to this means others would react the same way. I hope that my response clears up any misconceptions about what I am calling for.

      Blessings.

      Sam

      Reply

  2. David
    Aug 08, 2010 @ 22:10:49

    No, you don’t suggest that the therapist should bare all, but you do suggest the sharing of “secrets,” which implies privileged or painful information. If it weren’t privileged or painful, it wouldn’t be secret. It’s easy for someone in therapy to regard secrets — even when shared in a collaborative sense — as burdens.

    Reply

    • Sam Ruck
      Aug 09, 2010 @ 00:25:21

      David,

      When people with DID or other emotional problems are treated like total emotional invalids, it impedes healing. Yes, it is safer to never “share” a burden, and yes, the unwise sharing of a burden might overburden the patient, but healthy human beings share life together, and that means sharing burdens, and secrets and goals, and….life. In the beginning my wife and the insiders were essentially emotional invalids, but once I got them stabilized the more they were engaged into real life and two-way interpersonal relationships the more they got grounded into the real world, and THAT is what spurred them to seek greater healing because suddenly they had other people than only themselves to worry about.

      Sam

      Reply

  3. davidrochester
    Aug 09, 2010 @ 00:45:49

    Indeed — but the topic I am referencing specifically is a therapist sharing “secrets” or “burdens” with a client. Of course emotional healing involves engaging in real life, but what I am specifically talking about is your mention of a therapist or healer sharing burdens and secrets with a client. This seems to me to parallel the damaging experience many emotionally wounded people have of their parents inappropriately sharing secrets and burdens, leaving the child (or in this case, the client who is in the child’s position in the relationship) with the inappropriate role of caretaker to the figure who should be providing the nurturing/caring.

    I am not saying this with any attachment to arguing with you or to being “right.” But it does raise a bit of a red flag for me, simply observing your situation, that your wife may be in a “healing” relationship that is, in some ways, mirroring circumstances that may have contributed to her splitting in the first place. As I’m sure you know from your obviously extensive research into DID, the keeping of secrets, the burdens of adults … these are things that contribute to dissociative processes. Sometimes a recreation of that dynamic feels very “right” and “good” to a dissociative client — and there are many therapists who don’t maintain good boundaries with clients in that regard.

    Again, my intent is not to be critical or contentious, but simply to share observations gleaned from 21 years in and out of therapy, and from the perspective of someone with DID who has a very high-functioning life and relationship (with another DIDer). So I’m not coming at this from an emotionally stunted perspective, but rather, looking back on my own therapy experiences, and considering the vast array of therapy experiences I have observed in others, both DIDers and otherwise. Yes, truly deep personal caring from the therapist to the client is a wonderful thing, and is helpful to healing. But I would continue to question whether personal disclosures to the client are helpful. I know you disagree with me, and of course I respect that. I am not saying that the DIDer should refrain from engaging in real life; but rather, that the therapeutic dyad has a framework that partly frees the client to be utterly selfish, because that is often what the therapy client needs — for the youngest, neediest, most ego-based parts of the self to be allowed complete freedom. These are far younger parts than those you deal with in loving your wife; they are infants, toddlers — greedy, desperately needy, desperately selfish parts that need to be accepted with nothing expected in return, as they should have been originally. It is hard enough in any therapy relationship to really let those parts out … but it is harder in a framework where the client has a two-way dynamic with the therapist. The therapy relationship isn’t real life — and for the deepest work to be done, for that reparenting of the most primal and hidden parts of the self … it can’t be real life.

    Reply

    • Sam Ruck
      Aug 09, 2010 @ 10:09:12

      David,

      I don’t mind the discussion. I don’t feel threatened or demeaned and I hope that goes for you, too! There are MANY different roads that lead to healing. Maybe this is one of them. In my blog, I’m just trying to share what is working for my wife and girls. They would be unwilling to be in a one-way relationship. The “secrets” that their theophostic facilitator shares with them are never of the same weight, but they are real and transparent. Their facilitator’s daughter recently lost a pregnancy. She found out about it right at the beginning of one of my wife’s sessions. So Karen prayed with her facilitator, and then left. It meant so much going both ways that Karen could be that compassionate. Her facilitator mentioned over and over the follow week how good it was of Karen to be thoughtful and allow her to cancel the bulk of their session.

      I understand that other girls in my wife’s network like Sophia who is only 2-3 years old have no ability to have a two-way relationship. And with her it always is one-way when she and I interact. But she’s the only one. Alleylieu and Amy are both older and so there is more of a two-way relationship, but still nothing compared to what I have with Karen. It’s real-life, David. With ordinary children their age and their abilities determine their ability for interaction with me, but at some point if the child doesn’t start growing up and putting back into the relationship, then we have the social mess that we are seeing in America today: a bunch of 20 and 30 somethings who still act like adolescents or worse.

      I understand your concern. I really do. And I’m honestly very glad you have been so willing to discuss it with me here because I’m sure you aren’t the only one that this would raise a red flag with. But as I said before, safer doesn’t mean better. Just because it is safer for a therapist to keep everything “professional” and one-way doesn’t mean I think it is better.

      Sam

      Reply

  4. Kay
    Feb 17, 2011 @ 08:55:25

    I know this is an older entry, but I’m reading backwards in your blog.

    When I was initially dx’d with DID, it was through a theophostic “counselor”. There were a lot of things that happened over the course of almost 3 years that I spent in that relationship. One of the most damaging things was that the therapist continually tried to tell me about how it related to his life, or “sharing secrets”. Not that what was shared was inappropriate in nature, but it was very damaging for me. This was a counselor who was trained as a therapist, who had other DID clients including ones who were “healed”.

    I don’t need for a therapist to be my friend. I need them to be a sounding board, someone who can be on my side and still be the voice of reason when called for. I need them to help facilitate my healing.

    I’m also quite biased against theophostic counseling. Many of the people are not professionals, but “lay ministers”. I do not know if that is the case here. The one I saw was accredited and had his MSW. I was pushed in my healing – because doing it the theophostic way is “supposed” to be faster than “traditional” talk therapy.

    Obviously there were a lot of unique circumstances involved in my experiences with this. I can say that I have met others who have been severely wounded by this healing approach. I have yet to meet a person with DID who found it helpful as a primary source of therapy. I have met one woman who had already laid the ground work of trust and internal co-operation on some levels who found it a good supplement.

    Support people out side of therapy are wonderful places to learn to have that two-way interactions. People who can understand the nature of dissociation and the effects of trauma – and who can be there to support as well as to slowly be supported in their own life issues.

    All I can say is that I spent 3 years, “looking” like I was making progress. It’s taken me twice as long to undo the extensive harm it caused me.

    Apparently this has gotten longer than I had intended. I think that perhaps I needed to write it for my own benefit first and foremost.

    Reply

    • Sam Ruck
      Feb 17, 2011 @ 20:38:58

      Hi Kay,

      I’m sorry you had such a negative experience with theophostics. It sounds like your facilitator was the problem because my girls have found it very helpful. And I understand you desire something different from your therapist than my girls do from theirs. I only brought up this subject because my wife and some of the ladies she knows through the internet desire a counselor who is more involved in an APPROPRIATELY personal way. I think the counselor-patient relationship is like a dance and it shouldn’t be taken personally if the “fit” between the two isn’t right.

      Sam

      Reply

  5. Tommi
    Oct 02, 2011 @ 23:59:03

    Sam,

    I come from a DID family as well. I am one of 20 or so inside. Anyway, I just wanted to tell you that you hit on something that I found to resonate with many of us:

    “She or he needs to know that she is NOT alone this time as she faces the demons from the past.”

    We need to know that somebody is going to be there for us, no matter what, when we are hurting and scared. Before I read this post, I was not able to recognize what it was that we needed from people so desperately. We have been telling people that “we only wish to be accepted for who we are as individuals.” And this is true, but I think you’ve really captured the idea well. I think what we have been trying (and failing somewhat) to say is that we just need people to be there for us.

    We have a professional counselor instead of a theosophic facilitator, but she is also a Christian, which gives her methods a certain flavor. But one thing she does is allows us to KNOW her as an individual. We may not know what is going on in her life, but we know we can consider her a friend and trust that she’ll be there for us. She does not share “secrets” per say, but she does allow us to get to know her very well. Our T is also very good about making sure she has a personal life outside of clients and keeping a certain level of “professional-ness” (if that’s even a word). But she does so with warmth and love. I don’t know how she does it, really, but I couldn’t ask for a better counselor.

    What I’m trying to say is that there is a fine line between allowing a client too much into your personal life and not enough. I don’t think that either extremes are good. However, I do feel that being able to trust your T will be there no matter what is the most important thing. And with us, our T has proven that she will be there when no one else will.

    So thanks for your little discovery that has helped me understand me and my family just a little bit better.

    — Tommi

    Reply

    • Sam Ruck
      Oct 03, 2011 @ 10:17:09

      Hi Tommi,

      I’m glad this spoke to you. I know so many people have A LOT of problems with their therapists. And I don’t think everyone’s needs are the same. If you are happy with your relationship and it is what you need, then no one else should try to take that away from you. My girls love the lady they see and we all feel fortunate to have her helping us on this journey.

      Sam

      Reply

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