Psychotherapy is often like being a detective. In learning how to be a psychotherapist we go on the hunt for what is the underlying meaning beneath the narrative the client brings. I often find myself thinking as I’m listening to a client describe their week – and a key event that has them troubled in some way – what is this person telling me? What is this really about? Eric Berne referred to his process as learning to speak Martian.
Supervision in Psychotherapy
Supervision in psychotherapy is where we can take our professional questions about our work. In the beginning of our practice it is about learning how to be a psychotherapist with one to one support of another experienced psychotherapist. Supervision is for learning and development, and for support.
Talking about listening for the underlying meaning is something I do with some of the people I supervise. As they are learning how to be a psychotherapist, I will often talk about how we can be distracted from the meaning of what a client is telling us by the subject matter of the narrative. One of the important developments for new therapists is learning to listen to the subtext. Therefore to focus on the underlying psychological process rather than the happenings in the story.
Here’s an example composed from several typical stories from my clients to illustrate what I mean.
Is it really about the toothpaste?
Let’s suppose I have a client who comes and talks to me about how angry she is over the way her partner leaves the top off the toothpaste. She finds this a revolting mess, and hates finding toothpaste all over the side of the sink. She tells me about her seething resentment and anger at having to clean up after her partner again. That it’s not fair that she always has to do this. She describes how she has spoken to her partner about this, but it just gets laughed off as unimportant.
How do we approach this kind of question therapeutically? One way would be to look at alternative strategies around the toothpaste. I might make suggestions to “problem solve” the toothpaste question. I could suggest buying two tubes of toothpaste. I could encourage my client to talk to her partner and tell her how she feels. We could work on my client finding a way to be more relaxed about mess. All of these approaches might go some way to helping my client. However as someone who is interested in speaking Martian with my clients I think about the underlying psychological process.
What is the underlying psychological process?
Therefore this means I will explore with her how this experience might remind her of her history. We talk about how she feels when she cleans the sink yet again. We make connections and see patterns in her experiencing of the world. We begin to understand that this is connected to being the eldest child in a family with four siblings. What it felt like to be the one to tidy up after the other younger children.
So, the messy toothpaste in the present day is a powerful psychological reminder of the past. Of a particularly difficult experience of being a child oneself and being made responsible for the tidiness of younger siblings, when you have no adult power to do so. Of other memories as a teenager where her sisters would come into her room and mess about with her clothes and make-up and make a mess. How powerless again she felt to do anything about this because parents would just tell her to “laugh it off because they’re only playing.”
Past and Present Day
We can look at what is happening today with my client’s partner with a fresh eye. Connections between past and present can be explored. We may see that this is not really about the top on the toothpaste. It is about how important it is for my client to be listened to when her parents didn’t. About feeling that her needs are being recognised, heard and met. About not feeling like the responsibility is always hers to tidy up another’s mess.
Does this example interest you? Would you like the task of uncovering how the past can be influencing our relationships in the present? So, sometimes we get to play detective and the role of psychotherapist is to help the people we work with to understand how history and the present may converge. That sometimes it’s really not about the toothpaste.
Does this sound like the kind of work that appeals to you? If so, you could take our email challenge which is to help people explore more about themselves in thinking about psychotherapy as a career. Or, why not contact us using the form below for a further discussion about training and learning how to be a psychotherapist.