The unconscious is the Key to all-important knowledge ….
It is very easy to get caught up with the client’s avoidance … I do it all the time. I try to console
myself with the fact that if I was to burrow into every opening a client presents, every
opening that we could potentially explore, we would both, very quickly, become exhausted
and dismissive of the process.
It’s often a tough call to ‘go in’ or ‘stay out’ of those openings. More important, is to know
where you are at any given time in this process with a client, and so as a psychotherapist,
why you might ‘go in’ or why you might ‘stay out’ of those openings.
The client in this story was recovering from a devastating accident. Her entire life changed in
that microsecond. She was taken from a full and active life, into traction; with the doctor
saying, ‘… there is a high chance you won’t be able to move again’. His reports read; ‘she
was quadriplegic on presentation …’.
I often wonder how someone deals with the shattering news of this nature.
Such was her tenacity, that this doctor now openly refers to her as having made, ‘a
miraculous recovery’, he also says, ‘She is an extraordinarily motivated woman’. She refers
to him as a genius, together they co-created the ultimate duo in healing. Between them they
were a formidable force, creating that miracle.
He cut her throat and released the pressure on her C4/5 and C5/6 just the correct amount, in
just the correct location, at just the correct time … allowing her to walk and have *almost
complete use of most muscles, though some are less cooperative on certain days; reminding
her to keep at her challenge. Amid other things, she is an artist, plays the piano, taught
dance lessons and is a firefighter. This was an active body.
She never has, and still does not, give up any challenge in her new life. This includes her
psychological recovery and her various forms of physiotherapy treatment. The exercise
physiologist, in referring to her accident says he has, ‘not seen this kind of muscle recovery’.
In her darkest days unable to walk she even researched medication to understand its
limiting effect on spinal cord injury recovery rates.
For us, in our psychotherapy task, we are still working on her trauma of that time, with
many other pre-accident complex issues that butt up against every session we have, and
not least how she lives her daily life.
In the particular session, I am about to discuss, we were working on what I would call
‘storytelling’. Her talking me through the difficulties of day to day life; me gleaning
During her dialogue, I felt a dark and despondent feeling in my body. I ignored it. Knowing
she was in crisis right at that point in time and knowing she needed to narrate her trauma as
she saw fit. I also knew we needed to do two things in this session; unravel as much of the
distress that she was in, and make an immediate plan. As a result, I don’t ‘go in’ on this day,
and I do know why. What I don’t really know at that point, was why I bypassed my ‘dark and
A few minutes later Saydee roused herself from her deep snoring siesta. She walked sleepily
over to the client and tapped her on the leg.
I clocked this with great interest and immediately took notice of what they each did next.
While Saydee can be quite interactive with clients who show her they are dog-friendly she
rarely, if ever, gets up mid-session and does intervene in the middle of her counting
I attempted to avoid an initial hypothesis while I watched the client’s response, closely. She
laughed and said ‘what a funny little dog you are Saydee’, a common phrase this client uses
to Saydee. This client knows and loves dogs … in fact all living things.
About now I am making an assessment; do I segue the session and ‘go in’ … attempting to
process what just happened, or do I ‘stay out’. I was also wondering if I was handing the dog
too much credit and aptitude?
Or do I return to our conversation and collude with the client’s comment, ‘yes she is a funny
little dog’? I write many stories of Saydee’s interventions in my book,
I know this little dog well enough to know she has picked up something we both might be
missing, or worse, ignoring.
At that moment I take more seriously my earlier dark and despondent feeling in my own
body, plus I am considering the dog’s unusual behaviour. Importantly I consider what might
be going on for the client at a deeper level than our current narrative.
I decided to ‘go in’. I looked at the client and used the dog as the opening line … ‘that’s very
unusual for Saydee to do, to just get up out of a deep sleep, cross the room and randomly
tap in that way’. I noted with interest the client was staring at me. I went on to begin an
interpretation … ‘I’m just wondering if in our ‘doing’ conversation is there something more
you need or want to express, and that something else might be going on for you’.
She also knows this dog as well, she knows her own dogs … she knows dogs in general. Her
face relaxes, her eyes fill with tears. ‘Now you mention it, something has been nagging me
and I just keep pushing it down … like I want a strategy that will alleviate everything
problematic … but I know that’s just not going to happen … is it?’
I nod in agreeance.
Her suppressed feelings are liberated. Her fear, sadness, and anger all in the room.
Saydee’s work is done. She saunters off to her bed and rapidly falls back into her deep
We have a rich, but the sad session, giving the client answers to more than she could have
hoped for on this day which began with strategies.
I thank this client for her permission to tell this story.
Was the feeling I mentioned earlier in the session, transference and or countertransference
… one of the powerful events to occur in the room between client and psychotherapist.
Watch out in the coming months for my guest blogger’s interpretation of this phenomenal
unconscious interaction that is so frequently missed in the therapeutic room. To read more
on the topic of psychotherapy click this link
Or to learn more about psychotherapy through my book click here
Or to read about some of Saydee’s interventions click here to
buy my book
* Using the ASIA impairment scale which indicates the extent of spinal cord injury (SCI):
A = Complete: No sensory or motor function
B = Incomplete: Sensory, but not motor. The function is preserved below the neurological level
and extends through sacral segments.
C = Incomplete: Motor function is preserved below the neurological level. Most key muscles
below the neurological level have a muscle grade of less than 3.
D = Incomplete: Motor function is preserved below the neurological level and most key
muscles below the neurological level have a muscle grade that is greater or equal to 3.
E = Normal: Sensory and motor functions are normal.