Monthly Archives: December 2014

What is the right intervention?

Student: “Is that the right intervention?

Me: “I don’t live in the land of right and wrong. I live in the land of cause and effect.”

 

Every intervention works until it doesn’t. Then we have to listen to reality instead of our concepts of “right” and “wrong.” An intervention’s usefulness is not determined by the therapist but by the patient’s response.

 

We intervene without knowing how the patient will respond. Every step we take, we walk into the thin air of that unknown response to be, not knowing where the patient will take us. When faced with the amazing complexity of our work, we can feel overwhelmed. Unable to bear the confusion and uncertainty, we may cling to rules.

 

These rules become our security blankets, which we hold onto fiercely. “Always do ____.” At a recent conference, a therapist said to me, “Once I found internal family systems 18 years ago, I never read another book.” How sad. When we adopt a system or set of rules, ritualism becomes a substitute for thinking.

 

In ritualism, we say, “This technique is the right, true way.” If painters thought this way, we would never have had impressionism, cubism, or abstract expressionism. They don’t reduce painting to a single technique.

 

In ritualism, we reduce therapy to a technique. If it doesn’t work, we do it again and again. If it still doesn’t work, we can blame the patient for being “resistant.” At least we were “loyal” to the technique.

 

In scientific thinking, we don’t use the labels right and wrong. We ask: did this intervention help the patient? If not, let’s assess the patient’s response to find out what her need is in this moment, then intervene again to see if we are on track. We are not loyal to a technique but to reality.

 

When we leave ritualism behind, we realize that every intervention is an experiment. Instead of rigidly fitting reality into our rules, we follow principles for exploring reality: e.g., assess the patient’s response to your intervention.

 

I don’t have anything against internal family systems therapy or any other system. They’re all useful. I am only concerned about our misuse of systems. When we become certain that our version of reality is right, unwilling to open up to our patients’ responses, we relate to our system, not to the patient. Every system is a map. But no map is the territory it depicts. That’s why we must hold our maps and theories lightly as we enter the cloud of unknowing that is therapy. In therapy we must find the courage to doubt our previous “rightness” when it doesn’t work. And through that window of doubt, the light of the patient’s reality can enter the therapist’s heart.

 

 

 

Negative Capability

Can we tolerate not knowing the answer? When faced with the fear of the unknown, we can fill it in with false knowledge and assumptions. We might call those assumptions “insights” when they are really just therapist projections.

 

The poet Keats referred to “negative capability”, the capacity to tolerate the unknown, dwell in it, and allow our feelings and experience to bring up the not yet known.

 

We are not epistemological conquistadors. A patient asks, “What does this urge mean?” Then he offers a flurry of projections about possible meanings. He doesn’t know what his urge means. His task: accept the urge, experience the urge and his feelings, the unspoken, until new insights arise out of the felt sense of the unknown. Instead, he relates to his thoughts rather than experience reality, the pathway for all knowing. He relates to his assumptions rather than face the experience of not knowing, and learn from that experience.

 

We can only guess about the unknown, whether it is the future of the stock market or the depths of one’s soul. We don’t conquer the unknown through projections. We learn about the unknown through being receptive, through reverence of the unknown which gives birth to the new you.

When patients try to think their way through life, we sometimes try to think our way through therapy. “Help me think through the solution so I don’t have to  experience the living through that is knowing itself.” Therapy is meant to be a living through of people, not the “working through” of concepts.

After all the readings, trainings, and supervisions, we hope to be omniscient, offering pearls of wisdom that will omnipotently heal others. But wisdom does not come from your mouth to the patient’s ear. Wisdom arises when we embrace, experience, and feel the inner life that waited for your parents’ embrace and now waits for yours. Out of the embrace of the unspoken arises the speakable.

 

As you let all of your inner life move through you and as you help the patient let all of her inner life move through her, we embrace together this unknown that is unknowable until it is accepted, felt, and lived. It is not that we conquer knowledge; we surrender to and receive the bodily knowledge that is always moving through us.

You thought the unknown was a problem requiring a solution. You thought questions needed to be killed with false answers. What if the unknown is not the problem? What if questions do not need to be answered? What if the unknown, the questions, are what we need to allow, experience, and live in? What if those premature answers are simply attempts at ethnic cleansing of the unknown within you?

 

The unknown, the questions you can’t answer, are the pathway to the next version of you. The premature answers, false knowledge, are a detour from true knowledge arising from diving into and experiencing the unknown of you. In fact, premature “knowledge”, based on avoiding experience, reveals our hatred of the Truth.

Not knowing is not a problem. It is the path. The discomfort of not knowing, of having an unanswered question, is the inner call from the Self to Be: come in, dive into the mystery that is you, the depths you have not yet plumbed, meet your destiny which is ever unfolding.

 

Having read, heard, and learned so much, we mistakenly think we have to have answers. Instead, we have to live the questions, keeping them open. Our task is to tolerate the experience of the mystery of our pregnant inner life, so that answers can be born out of the womb of feeling.

 

This not knowing is not passive. Rather, it is the active acceptance of being, our fear of it, and our choice to dive into the fear. And the fear? It is the signal of the Self to Be reaching out to us so we can have this marriage of the inner you and the outer you. From this point of view, you are an unfolding, a mystery about to emerge from the fog, and yet, insofar as we never reach the limits, you are always unknowable, a Self to Be, whose new versions are yet to be seen. The capacity not to know is the very precondition for coming to know. Not knowing recognizes that my wife is larger than my understanding. Not knowing is the precondition for love.