Counseling ead Thame Sle tle a » atid #. ive Yh ElbowOne Third Alternative Evocative Empathy “The T hope this book will start you on the way to becoming a great thera- pist. In the process of getting started, we will learn some skills together, but the first thing I need to say is that approaching therapy as just a set of skills or techniques will get in the way of your becoming an excellent therapist. Techniques matter, but the quality of the therapeutic relation- ship is more important than whatever techniques the therapist uses. Norcross and Wampold (2011b) summarize the research literature by saying, “The therapy relationship makes substantial and consistent con- tributions to psychotherapy outcome independent of the specific type of treatment. The therapy relationship accounts for why clients improve (or fail to improve) at least as much as the particular treatment method” (p. 98). Norcross (2010) says, “Indeed, of the multitude of factors that account for success in psychotherapy, clinicians of different orientations converge on this point: The therapeutic relationship is the comerstone” (p. 114). The connection heals. It almost seems too simple to be true, but the most powerful factor in therapy is that the client feels deeply known and accepted. The client will also be doing emo- tional reprocessing and increasing self-awareness and problem solving on the path to healing, but this is unlikely to happen without a good thera- peutic relationship. We will also see there is an artistic, intuitive aspect to therapy that is difficult to understand and almost impossible to express on paper. A helpful analogy can be drawn with learning to draw or paint. Most peo- ple can learn to draw fairly well by learning skills such as perspective drawing and shading. Few people, however, can produce art. Becoming an artist probably has something to do with innate talent, and it cer- tainly has much to do with hard work and practice. First, the artist learned the basic skills, but that only made her an adequate painter or drawer. Most of us can probably become fairly good therapists by learn- ing basic skills. Becoming the excellent therapist you want to be will start with basic skills, but be careful not to confuse these “training 24 Part One: Developing Basic Skills wheels” with the artistry of therapy. Having said that, let’s look at the foundational skill of psychotherapy. It has been my experience that beginning therapists feel they have only two options in responding to their clients. Some see “empathy” as some kind of warm and supportive reflection of what the client has just said, and others think they need to gather evidence and give advice, reassurance, and clever interpretations. Neither of these approaches / works very well, but they seem to be the only ones that life prepares us for. There is a third alternative, a skill that will not be easy to learn and that will feel awkward at first, but one you need to master if you want to be a good counselor or therapist. The most important goal of this book is to get you started toward this mastery. There seems to be no clear label for this skill, but I think Laura Rice’s (1974/2001) “evoca- tive empathy” comes closest. To say it plainly, this skill is the fundamen- tal skill for doing therapy. There will be many other things you will have to do, and there will be many times when evocative empathy is not appropriate, but for any of the other things to work, you must first make your client feel deeply understood, especially at the emotional level. I am about to give you a formal definition of empathy that will sound pretty simplistic, but 1 will spend a couple of hundred pages , expanding on that definition. Empathy is “communicated understand- .{ ing of the other person's intended message, especially the experiential/ emotional part.” Every word counts in this definition. It is not enough to understand what the person said; you must hear what she meant to say, the intended message. It is not enough to understand, even deeply; you must communicate that understanding somehow. It is absolutely essential that the other person feel understood—that the understanding be perceived (Barrett-Lennard, 1993, 1997, 2003). The part of the intended message that will be critical is the emotional or experiential / part of the message; therapy involves both an intellectual/cognitive and van emotional/experiential part of the message; therapy is both an intel- lectual/cognitive and an emotional process, and it is dealing with feel- ings that will be the most trouble for your client (and maybe for you and me) (Greenberg, 2012). You will be listening for what your client is trying to say, and one way you will be doing this is to hear the feelings implicit in his message. ‘The business of therapy often involves some pretty painful stuff, and it is easier to talk in cognitive terms. A client might say, “It’s not fair when less-qualified people at work are given promotions.” At one level, this is an entirely accurate statement of fact about simple justice. Obvi- ously, however, it is a very feelingful message—implicitly. Your job as the therapist is to bring the feelings to life in a way that leaves your client with the sense that you understand what was meant. You might say, “I guess you're feeling cheated by that.” Let me explain my thinking as the therapist here. There are two steps I went through: First, I bad to under. ¥ j 3Chapter 1 ca The Third Alternative 5 stand what was meant, and so I was naming to myself several possibili- ties, such as feeling anger, hurt, and cheated. I tried to get a sense of which of these possible feelings the person wanted me to hear. Second, I had to find the most effective words to let him know that I understood. I could have been “behind” him with a simple reflection like, “There’s no justice in a situation like that.” Although this response wouldn't do any damage, it wouldn't be much help either, because it does nothing with the client’s reactions. It is easier to talk about things outside ourselves in objective ways, and this includes the way we talk about feelings. You might have been tempted to word your response as, “That kind of situation can certainly arouse feelings of being cheated.” This is more effective than“There’s no justice in a situation like that” but less effective than “I,guess’you’re feeling cheated by that.” The dif- ference may be subtle, bat it is crucial. In one case we are talking about feelings as things, objectively, as though they can be aroused. In the other, we are naming a particular person's particular reaction in the here and now. We are bringing an experience to life. You might be thinking that my response to my client is pretty tame, since there are lots of other feelings that could be present, consciously or unconsciously. Besides, how do we know that he is not distorting the justice of the situation? Perhaps we should confront him with this or at least get some more information from him about whether the people promoted really were less qualified. You will have to trust me on this for now, but I guarantee you that the fastest way to get to your clients” truth, and to get there ii a way that will help them, is by helping them face the leading edge of what they are trying to say but can’t quite say. The critical guideline is the phrase “the intended message.” Maybe my client does feel more than cheated. Maybe he feels furious or hopeless or vengeful, but I have ta be able to sense what he is trying to say right now and help him articulate that. ca Lead or Follow? Sometimes therapy approaches can be described as “leading” or “following” styles, but this distinction is inappropriate for understand- ing the nature of evocative empathy. In one sense you are following your clients, because it is not your job to determine the content or topic of what is talked about. You are not urging certain issues to the front; you are listening with focused intensity for where your clients are try- ing to go. In another sense, you are leading, since to be most effective, you stay one step ahead by dealing with what your clients only implied. I hope it is becoming clear that there is a critical region where ther- apy takes place. If you lead too far, you will get off the track, take over the direction of therapy, threaten your clients into needing their defenses against you, and probably start giving lousy advice. If you just