A previously mentioned quote in this paper has been very influential on my developing practice. At an Interactive Drawing workshop I attended the manual had a quote “lean back or you’ll fall in [to the content]” (Russell Withers, 2007)… I find this a very useful quote – because I was “falling into the content” when I first worked at this unit. Instead of stepping back and having a look, I became absorbed by what the clients were experiencing and felt a responsibility to fix them and to understand exactly what was going on for them. I felt that I needed to always understand the “why” things were occurring instead of seeing/observing “what” was occurring first. I was not being present, or being ‘with’ my clients.
As I process and reflect on all of the data gathered in this project, another question comes to mind: Do therapists need to uncover the actual meaning? Following the interview with the OT and the CP, I began to wonder whether the processing in a session is more about helping the client to
process and reflect for themselves – not the therapist processing for them.
“You cannot teach people anything. You can only help them discover it within themselves” (Galileo in ThinkExist.com, 1999-2006)
The therapist is reflecting on what the client MIGHT be thinking or expressing. Therapists can reflect on their own reactions to what the client presented in a session, a therapist can reflect on his/her own actions in the session, a
therapist can reflect on any countertransference that may have occurred, and even reflect on what he/she believes the client is trying to express.
I see processing the experience of a session as three fold. The client does/or does not do their own processing, the therapist provides a safe and supportive environment to assist/facilitate the client(s) to process and reflect on their experience and the therapist reflects on his/her own experience and perhaps what they think the client’s experience is in the session. “Processing
is a necessary part of instruction…without processing, the activity is simply an experience with limited outcomes and value” (Project Adventure, 2003, p45). With this client group there are times, especially when playing music, where there is an emotional response, and then the processing of this response is difficult if not impossible. Perhaps the client having an emotional response without fully processing it is a starting point - A valuable stepping-stone to client awareness and mindfulness. Helping a client to become aware that a response occurred and identifying what the response was, is a step towards processing why it happened. With adolescent mental health patients, perhaps finding this place to start, an opening, a way to help them view their emotions has great value and the processing starts with the therapist. The client is perhaps too unwell to begin to understand what is to be learned from the session – the therapist’s responsibility is then to begin the process of
reflection. To try, through observation of client music, words, body language and actions to reflect on what the appropriate therapeutic response should be that would supply the client with what they need at that moment.
An interesting point is that the literature and the interviews support the concept of therapeutic empathy. After observing and being mindful during a session, a therapist should try and establish empathy with a client. Empathy is defined as “the intellectual identification with or vicarious experiencing of the feelings, thoughts, or attitudes of another” (“Random House”, 2006). This would indicate that a therapist must process enough about the client in order to provide a reflection of the client’s feeling state. Based on experience, training and what is observed, a therapist is intuitive about what empathetic response is appropriate. This is an assumption – or perhaps a more accurate term would be an educated assumption. This seems contrary to most of the data in that therapists are taught to make observations, not assumptions. Deducing what would be an appropriate empathetic response seems to ride on a very fine line between the two.
With this client group, it is very difficult to draw conclusions about what is happening for a client. What I have realized through this journey is that reflection and processing of what occurs in a session is not with the intent to
know without a doubt what is being expressed. It is not with the intent to “fix” or “cure” the clients with the perfect intervention. What the processing and reflection is for, is to get a sense of what a client’s needs are, it is to attempt to deduce the appropriate empathetic response, it is to provide sessions (present and future) that are relevant, meaningful and supportive. It is not a mystery that is trying to be solved in one session – it is a puzzle that is being put together for the client and the therapist, piece by piece.