In Search of a Friend

Image via Europeanna Ibaxx

I believe, without discrediting the profession entirely, that some of the benefits derived from psychotherapy could just as well be provided by close friends and family members. Psychotherapy is a relatively young field, but even still, there is evidence that the most important factor in whether or not it actually works is the relationship between the therapist and the client. And if establishing a good relationship is the main way people benefit from psychotherapy, it stands to reason that they could potentially experience some of these same benefits if they established similar kinds of relationships outside of therapy. In fact they should be encouraged to do so by the therapist. What matters most in the final calculation, is the dynamics that are created between two people, not, in totality, who the two people are. 

Freud told a story that helps to illustrate this point. He was working with a patient who was suffering from mental distress, loss of sleep, and a lack of appetite. He and the other physicians involved in her care had failed in their attempts to improve her condition which was only worsening. Until one day, a friend of the patient actually came and abducted her from the hospital and brought the patient home with her to care for her there. How she accomplished this is either unknown or unstated, but a year later Freud once again became involved in the care of this patient and was surprised to discover her in a much better condition than the one she was in when he last saw her.

What is more likely is that it was the care she received from her friend that made the crucial difference. 

Freud credited himself for the change in her condition, attributing it to the lasting effects of his treatment, but this is unlikely because the little that was said about the treatment, spoke only to how ineffective it had been in helping this woman. What is more likely is that it was the care she received from her friend that made the crucial difference. 

And it is safe to assume that this friend of the patient must have cared a great deal about her if she was willing to abduct her from a hospital. To this friend, it must have felt more like a rescue mission, and a serious responsibility to nurse her friend back to health. Her steady presence and consistent care is what allowed this woman to heal and start to become whole again. 

Most of us have our stories like this. Stories of being in a low place in life and needing the love and support of someone else to carry us through. Sometimes that someone else is a therapist or a doctor, but as the story illustrates, it does not have to be. We can all provide this type of care for each other, and it is important that we do so because not everyone has access to professionals and even those who do might not have access to them in their time of need. And in those times, what we need, in reality, is a friend who will barge in and save us. 

Therapists are skillful and curious learners, which eventually, we hope, will allow us to help someone in need.

The thing that therapists are trained to do well is listen. We listen to what is said and what is not said. We look at the actions of clients and understand that this is a form of communication that must be listened to as well. Through listening we form opinions and make interpretations, and as we get to know our clients better over time, we can make quicker, more accurate judgments about what is happening to them, or at least we should. The necessity of all this listening really implies that therapists are not experts on our clients’ lives, because we have not lived them. Therapists are skillful and curious learners, which eventually, we hope, will allow us to help someone in need.  

And yet, it is possible for the friends and family that we keep closest to us to also learn and possess this intense curiosity about others. Friends and family may be even more capable of quickly becoming experts on our client’s lives because they have bore witness to them and have lived in close proximity to them for much longer than we have as therapists. It seems unwise for their testimony to be neglected.