The Tao of Therapy

Things are progressing well at the camp I work at for kids with Asperger's Syndrome. (See previous posts, and this one will make more sense.) Once again, I've learned that the relationship can do most of the work of healing.

Many years ago, Carl Rogers astutely and repeatedly insisted that people basically will heal themselves when they are in the context of a healthy therapeutic relationship. Subsequent research has strongly supported this; the school of therapy used affects the outcome far less than the qualities of the professional in the relationship (as perceived by the client).

During the first week or so of camp, I was, Thinkers will remember, a little distressed by all the obscene language, digusting references and endless physical wrestling. (Not that we wanted to outlaw all of this behavior. A little of it in teenage boys is to be expected.) Today, incidents of that kind are less frequent, and eager participation is up noticeably. Some of this probably flows from kids getting used to the new people they were suddenly supposed to hang out with five hours a day for six weeks in a row. Also, one of the prime instigators was going through a medication change and might now have settled in with his new prescriptions.

But I think that the biggest factor of all was simply time -- spent in a group that is framed around fun, creative activities and mutual respect. We counselors work quite hard to respond to the campers in a positive way, looking for the campers' strengths in any situation, no matter what they do, or, for that matter, don't do.

They have seemed to begin to understand that we mean it. They're so used to being ostracized for their different behavior (unusual tone of voice, pedantic speech patterns, obsessions with one particular interest, physical awkwardness -- all visible in many teens, butfar more so in most Aspies). Perhaps they were simply pre-empting our expected criticism with negative behavior, to maintain a sense of control of the social situation, a sense that is rare for them. They come to us already bruised, and perhaps if we continue to handle them with care, they'll flourish even more. Time will tell.

I experienced a similar curve at my internship at the college counseling center this year. I charged out of the gate determined to make a difference in my clients' lives -- in a brief 10 sessions at most. By half-way through the year, I realized that, while I was having a positive effect a reasonable amount of the time, I was putting out way too much effort. When I relaxed and trusted the intelligence and instincts of the person sitting across from me -- and, most of all, the process of the relationship -- clients actually improved more quickly and effectively. And *they* were the ones, appropriately, who did the work, although I might instigate it here and there, or keep it on track.

It's certainly not the same thing as laying back. In some ways, I'm more tuned in more of the time using this approach. But it's a relaxed alertness. I love this discovery (even the second time around), because it means that I don't have to do anything other than what comes naturally to me in order to be helpful. I listen, I reflect or comment or react, I give respect, I am honest and genuine. And they see that, feel that -- and start acting the same way, especially toward themselves. And that, of course, is when the improvements really start, and are most likely to last.

Group vs. One-on-One: Being Aware of Lenses

I've written a few posts about my new job working with teenagers with Asperger's Syndrome. Today, yet another insight dawned on me on the drive home. I've worked in the human services with people in groups before, but never in a psychological setting like this, and of course, the experience is bound to give rise to a few realizations.

Today, I realized that some of my campers aren't too terribly different in age and functionality level from some of the clients I had this year at the university counseling center where I interned. Then I realized that those same campers would look radically different to me in that dyad format.

Since the university is small, I occasionally had the chance to observe my clients interacting with their friends around campus. Occasionally, I was quite surprised to see someone behave quite differently than I expected. Folks I had worked with at the counseling center who were polite and eager-to-please sometimes behaved quite differently with a group of their peers. By the same token, when we counselors have a one-on-one conversation with any of the campers this summer, they almost always come across much more intelligent, kind and aware than they present while in the group.

Though we are taught this in school, it's coming home to me now in a three-dimensional way. As I grow as a counselor, it'll behoove me to bear in mind the settings in which I don't get to see the client. It's often in their day-to-day relationships that folks experience their psychological distress most acutely. If I only see them one-on-one in a quiet room with a professional atmosphere, I need to do a lot of translating while they give accounts of their daily lives.

By the same token, if I only see them working it out within the bump and bustle of group dynamics, I might miss the graceful intelligence or glowing generosity hiding within their quieter heart of hearts.