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Empathy and Challenge

katherine said Sep 25, 2007, 3:18 PM:

Hi WH and hi Clare too,

I think you raise a really important point, which is, what is a practical integral psychotherapy? I think this is really what this pod could aim to discover. My curiosity is definitely about how therapists are applying the model and the benefits they are seeing.

I also really resonate with your emphasis on empathy and the therapeutic relationship. Certainly, empathy and it's pre-requisite–presence are high order capacities.

My opinion with reagards to Wilber is that I think we need to keep in mind that Wilber's work is what he calls a map, not the territory. I've heard Wilber paraphrased as saying that his theory is the view from 10,000 feet. (I may have that slightly wrong but that the general idea. If anyone knows the actual quote please feel free to throw it in.) Or put another way his work is the theory, ours is the practice.

That said, Wilber's model includes the humanistic psychologists, specifically Carl Rogers with his emphasis on empathy, congruence and unconditional positive regard, which you also, I think rightly, highlight in your post.

I think it would be a great place to start to examine our own beliefs and experiences about empathy and relationship from an integral perspective. I would offer that each of the psychological theories that Wilber includes has a distinct view of the client/therapist relationship with differing focuses ranging from transference/countertransference to safety, to creating enough distinction between client and therapist personalities. I was also really intrigued by Jon's assertion that transference/countertransference is largely a subtle realm phenomenon. An full spectrum analysis of the therapeutic relationship would be very interesting indeed.

I would like to put forth an idea/question to see if it sparks further interest and debate.

Rollo May one of the great existentialists was asked to judge a client-centered therapy session. His response was “that he often felt that there were not two distinct people in the room. When the therapist only reflects the patient's words, there transpires 'only an amorphous kind of identity rather than two subjects interacting in a world in which both participate, and in which love and hate, trust and doubt, conflicts and dependence, come out and can be understood and assimilated.” May was concerned that the therapist's overidentification with the patient could 'take away the patient's opportunity to experience himself as a subject in his own right or to take a stand against the therapist, to experience being in an interpersonal world.'”

The larger quote is from Current Psychotherapies 6th edition year 2000 editors Corsini and Wedding.
The internal quote is from The Problem of Evil: An Open Letter to Carl Rogers by Rollo May, 1982 in The Journal of Humanistic Psychology

So my question revolves around an idea, which is relevant in therapy, in personal relationships, and in relationships with spiritual teachers. How do we know when to empathize and when to challenge/confront? Certainly, empathy is essential, however, sometimes empathy can be taken as collusion and we don't want to collude with clients' erroneous beliefs or their behaviours that are causing them difficulty. How much can you look after someone's ego and still give them an opportunity to grow?

I recently had an experience where I was given some no-holds-barred feedback about some work I had done. My ego was crushed. It's still lying on the floor in a million pieces, and right now I feel like I'm looking at it wondering if I should bother to pick it up and put it back together, or not. Clearly, a short term depression has set in. But the strange thing is, I feel oddly less defensive, more open, more loving, more humble. For me at least, moments of clarity and fullness of heart often follow experiences of loss, pain and ego-shattering failures. I feel stronger. And I have the opportunity to reflect on why I didn't do a better job, how I tend to castigate myself when I don't do well, and how I expect a very minimal effort to be rewarded with praise it doesn't deserve.

I wouldn't want to deny my clients the experience of realizing they are not prisoners of their ego desires. And at the same time some clients are very fragile. Serious depression is a real possibility and the therapeutic relationship can be destroyed by a lack of empathy.

I think it's simple to say that we need to be aware of both challenge and empathy. Simple enough to say we should have empathy for a client while at the same time challenging them. But, I think, in practice this very fine balance requires incredibly skillful means. I'd love to hear how exactly you/we as therapists negotiate it.

There is an interesting discussion on integral naked between Diane Hamilton, Sam Bercholz and Viddyudeva about this topic. I think you can find it on Integral Naked listed under Guests/Viddyudeva/A Cry for the Middle Way

Also Willow Pearson has a beautiful and thoughtful article about therapeutic presence called Integral Practice for Psychotherapists: Therapeutic Presencing. You can find it on her website www.lionessroars.org under Psychotherapy on her menu. Then, in the left hand column there is a link that reads: Integral Practice for Psychotherapists.

Blessings,
Katherine

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Re: Empathy and Challenge

WH said Sep 25, 2007, 6:56 PM:

Hi Katherine,

Thank you for the thoughtful comments.

Durwin's response to the original posting of this topic was:

I hear your concerns about the challenge of going from the 50,000 feet of integral theory to the 5 feet of therapist and client. I think many of us who are interested in integral theory have struggled with this.

I agree that Wilber does include the full spectrum of developmental models, and hence an equally large number of possibilities for how a therapist relates to the client. I think this is one of the most useful (for me) elements of his work. And I also think it addresses the Rollo May quote you offered.

The “mirroring” that May witnessed is appropriate to a whole other level of wounding than May's existential approach. Mirroring, as far as I can tell, is most appropriate with clients who have a fragile self-sense and never received the essential mirroring they needed from the parents. I've seen this among my personal training clients that had abusive childhoods (I learn more about my clients in the training session than even their spouses know sometimes), and consequently have low self-esteem and a too-permeable self.

May's existential approach would seem more suited to those with healthy egos but who are seeking some deeper relationship with self and world. So to him, the session he witnessed would look “wrong.” Clients with early developmental stage wounding might, however, initially need that entangled relationship with the therapist in order to build a more solid ego structure.

In regard to your questions about empathy and knowing when to challenge, I think these are important questions for all of us. There has recently (among integral bloggers) been some backlash against KW and II, a sense that it has become cultish (I have no idea if there is any foundation for this), and it has caused a lot of people to take a step back from KW's work, which I think is useful. Too many of us were simply blown away by the beauty of it that we didn't ask any validity questions – I think that is changing.

Related to your thoughts, I wonder if there is a spectrum of empathy (a developmental line?), from mirroring all the way up to true compassion (in the Buddhist sense), which includes empathy, but can, as part of its “skillful means,” also be challenging. I can only think about this as theory, since I am not a therapist, but it seems this might be one way to look at which form of interaction with clients might best serve their needs.

I agree completely with what say about the power of ego being shattered, how freeing that can be. But as you suggest, it's a fine line. The client would need to have a healthy enough ego to withstand such an experience. [One of the issues I have with Mark Epstein is that he doesn't make that distinction in his books – all clients are candidates to have their egos dissolved.]

Thanks for the tip on the Willow Pearson article – I downloaded it today.

I hope to hear what others hear think on these topics as well.

Peace,
Bill

Re: Empathy and Challenge

Patrick [no longer around] said Oct 1, 2007, 9:54 PM:

Bill,

Nice text. As for me, it has alwys been clear that Wilber had no experience in the client-therapist relationship, in a professional way. This is not a problem for me, as I think it is not what he’s working on, as Katherine rightly said.

But, this becomes a hindrance when Wilber and I-I start to dig in psychotherapeutic tools, like the 3-2-1 process. This is supposed to be “great” shadow work, but I think it is a bit weak. This process completely avoids the relationship in the therapeutical process as you have both mentioned above.

Katherine,

When to empathise and when to challenge?

Great question. I personally challenge self destruction and self glorification, or when people under evaluate themselves or over evaluate. Now the question is who decides what is over and under evaluation? Well, it is absence of a dynamic process for me which is the symptom of it. Stucked in non dynamic guilt (under evaluation) and stuck in non dynamic anger or inflation (over evaluation).

Be well,

Patrick