The
utmost delicacy is required in communicating to counselees the nature of their
personality rigidities, since they may feel as vulnerable as a dental patient
hearing the results of an examination. Yet therapists have an ethical mandate
to impart this information when it contributes to understanding psychopathology
or helps the counselee participate more effectively in resolving presenting
problems.
Consider this as you approach a counselee:
A good dentist knows to say, “Okay, this poke is going to sting a bit, but then you’ll feel better.” Patients still don’t want the needle and may resent the dentist for the invasiveness of the shot. But they do want the end result of healthy teeth.
So, when you are going to administer some truth serum to a counselee, and you anticipate temporary pain, you can say, “I’ve been pondering something that may represent new information for you…and may be a little shocking. But once we develop the overview, this insight will serve you well. Should I go ahead?”
Rare is the counselee who will stick fingers in both ears and shout, “No!” If you’ve developed decent rapport, something inside the counselee will say, “This is why I’m here.”
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| Rapport-building Psychotherapy |
“Ron,” I said, “we’ve reviewed pretty thoroughly how your parents left you to your own devices a lot, and didn’t much encourage conversation or activities in your life.”
“Right,” said Ron, waiting for the poke. “I grew up all alone.”
“Well, I’m afraid there are repercussions to that scenario that have lasted to this day.”
“You mean that I don’t like people?”
“Exactly. And more than that, you’ve built a castle around yourself and filled the moat with water and alligators so that nobody can get close to you.”
Ron smiled wryly. “My first wife would agree. She’d pester me for days to talk to her and then I’d bite her head off.”
“The bad news is that this will never go away on its own. The Compass Therapy name for it is the schizoid Loner pattern, or schizoid personality disorder.”
Ron sat up in his chair. “Does that mean I’m schizophrenic?”
“No. Schizophrenia is a genetic illness in which you have hallucinations and live in another reality. The schizoid personality pattern just means that you’ve split off your thoughts from your feelings, and this brings a hollow numbness inside. Then, to keep this loner pattern intact, you detach from people and withdraw into a shell. Does that make sense?”
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| Schizoid Loner Pattern |
Ron nodded. “That’s me. I could stay on my computer for weeks if I didn’t have to go to work.”
“That’s a very honest assessment. Would you like me to tell you more about the consequences of this pattern so you can think over whether you want to keep it or not?”
“Go ahead.”
“The Loner pattern won’t let love in or out, won’t let you seek friendships that involve opening up, and will make you live and die a lonely man. How do you feel about that?”
“I guess I knew deep inside something like this was happening. I just got used to it and figured it was bad karma.”
“Actually, Ron, a fair number of counselees I’ve worked with started out even more schizoid than you. They somehow found the motivation to give life a second chance. You know, trying to see other people as more than just pests to get rid of.”
“Sounds hard to do. I get nervous when anybody’s around. I just like to be quiet with my own thoughts.”
“But isn’t that just what brought you into therapy—that you’re sick of thoughts rolling around like marbles inside your head?”
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| Marbles Rolling |
Ron shifted uncomfortably in his chair. "I do get tired of hearing them."
“Perhaps one of our goals, along with diminishing those repetitive thoughts, can be to enrich your connection to people. There’s no good reason you can’t learn to have feelings and express them like anybody else.”
A look of relief came over Ron’s face. “Okay, but I’m going to need training wheels like a little kid on his first bike.”
“That’s what we’re here for. It’s safe to learn some new things now. And you’ve got plenty of intelligence to help you along.”
By being upfront and direct, I began shifting Ron’s concentration to actualizing growth and laid a foundation for the ongoing transmission of information about his schizoid Loner pattern even as he began to outgrow it.
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