“So where did we leave off last time?” a client recently asked at the start of the session. Having just read my note from the previous session, I had a very good idea of where we left off. I might have simply reminded him of our previous discussion, and we might have simply continued where we left off, seemingly making progress towards the goals of treatment. The problem is that things are rarely so simple… What’s in a question?People ask questions in therapy for all sorts of reasons. The reason I might not answer the question in a straightforward manner is because I don’t regard the question as a straightforward event. In fact, as a psychoanalyst, I don’t regard most of the problems my clients struggle with as “straightforward” problems. We are complex and intelligent beings, and the things we say in treatment - even the questions we ask - are the medium through which our very complexity is communicated. The conscious things we say are often motivated by unconscious thoughts and feelings we’re not aware of that need to be explored and better understood. From a psychoanalytic perspective, to simply answer questions, without considering the greater context within which they are asked and the potential meanings they might contain, is to fail to appreciate the immense complexity of the person in our offices. Possible Meanings of QuestionsThere are numerous potential reasons why someone might be asking, “Where did we leave off last time?” For instance:
All of these possible reasons are why it is imperative to be curious when a client asks a question. Listening to and answering questions at face value often causes therapists to miss these underlying dynamics that then lay dormant only to surface in other ways. A psychoanalyst tends to hear most questions as statements the person is making that need to be better understood. When clients ask me where we left off last time, I often simply ask in reply: “Why do you ask?” Back to the Question…Back to my client at the beginning. When I asked why he was now asking where we left off, he acknowledged he was hoping to “buy time” since he was unsure what to talk about. I asked how it made him feel to not know what to talk about. He explained it made him very anxious and eventually confessed he tried numerous other strategies of allaying the strong anxiety he felt in sessions. We came to learn that his anxiety about speaking in sessions was very similar to his anxiety in social relationships and that he often superficially engaged in conversations with people that appeared meaningful. It was only later that he felt relieved to be alone and by himself when he no longer had to perform. This was how he had been feeling about talking in treatment, and we finally had the chance to discover its operation within our relationship - hiding in plain sight. This launched us into a much more meaningful discussion concerning his anxiety in relationships and what he does to fill in spaces that protect him from anxiety but that ultimately insulate him further from feeling deeply connected to others. A Brief DisclaimerWhether or not a therapist answers questions should, by no means, be considered some kind of “rule” or index by which to evaluate a good from a bad therapist. Additionally, many questions merit an answer. Questions like, "what's your theoretical orientation?" is an example of an excellent question to ask your therapist (read more about this important question here). Not answering certain questions can not only represent a defense on the part of the therapist, but may also be unethical. What I'm trying to illustrate instead is that there are many nuances contained in human interactions. Mining these nuances for the precious data they contain is a hallmark of a psychoanalytic approach to treatment, and this can have a major impact on helping people live lives that are more meaningful, loving, and authentic.
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