Those gentle readers familiar with my tales from therapy might have the mistaken impression that I am the best counselor ever and always experience therapeutic success. The preceding two tales about Jimmy and his newly blendered family did nothing to dispute that idea. So, in a fit of honesty, I have decided the let you know what really happens many, many times in my therapy.
Jimmy and his family continued for about ten more sessions, one week with Jimmy and Mom, one week with Jimmy and Dad and sometimes just Jimmy. The closer I got to the family and the more I learned about them, the more obvious it was that Dad and step mom had serious drinking problems and that Dad was allowing the two boys to drink in his home. Mom became more and more ineffective in her efforts to intervene and I was caught in a dilemma.
If I confronted the drinking too soon, I would scare Dad away and rob them of the opportunity to deal with this. If I confronted too late, well teenagers kill themselves with alcohol and cars everyday and I ran the risk of having to see Jimmy’s face float above me as I drifted off to sleep every night. What to do, what to do? Seek clinical supervision and consultation.
I confronted Dad with Jimmy present. His response was predictable and no more than sixty seconds after I had begun, we both knew that this would be our last session. They scheduled, but did not return. Not only that but when the Mom called, she let me know that Jimmy had decided he did not like me (I was a threat to his supply of alcohol) and would not return. I recommended another counselor, but they never called her.
Did I help? I’m sure it was nice for Jimmy to have a little support for a time. But I really did not help to change the dysfunctional pattern that was presented to me.
Is it ok to fail? Oh my god yes it is ok to fail at therapy. I guess that’s why they call is a practice. I have failed so often early in my career; any successes almost seem like simple luck! I guess I am helpful with the presenting problem about half the time and the other half of the time I hope that I do no harm. Usually. I still occasionally have a single session with a person and they decline to reschedule. Or I’ll have a person work for a time and then call to cancel a session and never call back.
I used to take that personally but since I learned to ask them why, I have learned that it is seldom a personality conflict.
One depressed fellow simply said he was not worthy of taking my time up when so many other, more worthwhile, individuals were seeking help. A woman came in for help with her marital problems and I made the mistake on the first session of suggesting perhaps her behavior was contributing to the problem. Never seen again. Or the anxious person who was sure that his solution lay in medication and I suggested that meds only mask the problem but that cognitive behavioral interventions serve to solve them. Gone.
But the most glaring failures I have experienced came from the forensic work that I did for a time. Divorcing couples, locked in disputes over custody and money have trouble being honest with themselves and if they are honest with you, they could lose their kids. People filing for disability claims will lose the case and get no money if they get well. People referred by courts could go to jail if they don’t follow the courts agenda, are always well defended against change and will not disclose illegal activity.
I worked with a couple for ten months, meeting weekly with each of them, and thought I had gotten somewhere with them. When we all three met together, not five minutes went by before their hidden agendas surfaced and there was an abusive screaming match in my office. They both blamed me for the failure and they were right.
I shouldn’t have taken the case in the first place and believe me, I would rather starve than do forensic work again.
But the successes are so rewarding that it makes it ok to fail sometimes. And since I am usually not responsible for the successes, I cannot accept the credit for the failures either. No, the individuals that I meet who get better do so because of courage and hard work and perseverance. But it is really cool to witness the parent and child rebuilding a broken relationship, or the couple rekindling the sparks of love they once enjoyed, or the depressed man smiling and laughing at the little wonders of life that just weeks earlier had eluded him. Or watching the blossoming of the frightened wallflower, wracked with anxiety and guilt. It makes the risks and failures all worthwhile.
Dave Seward
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