Reflecting on... Faith (in the process)

I remember being advised, as a trainee, to have faith in the process of therapy. I trusted my mentor wholeheartedly but this thing she called ‘the process’ was an enigma. Gradually, I began to disentangle the content of therapy from the thinking-about therapy, although initially, most of my processing happened outside of the consulting room. With clinical experience, the doing and the thinking-about became reconciled, so that for me, the process has a unique identity which is linked to, yet also distinct from, the content. This is a difficult concept to explain, and one I have struggled to illustrate to patients who are finding it difficult to ‘have faith’ just as I did.

Non-believers come in all shapes and sizes. Examples from my clinical practice include the child who wants me to set the agenda; the concrete-thinking father who draws me into philosophical debate and is reliant on logical argument in lieu of emotion; the abused adolescent who perceives each interpretation as an intrusive attack; the mother who screams ‘there is no such thing as the unconscious!’ right in my face; and the boy who yells ‘why do you have to analyse everything I say?’ These clients are focussing on the concrete content of the session and finding it difficult to consider the process. Perhaps they don’t know how. Perhaps they would find it too unbearable.

Non-believers can be colleague-shaped too; professionals from other disciplines who ask: ‘what do you actually do in therapy?’ A fundamental part of what I do is notice, name, digest, highlight and, perhaps most importantly, have faith in the process of the therapeutic relationship, as it alters and develops over time. As psychodynamic practitioners we understand the value of the therapeutic relationship in its own right as, what Winnicott called a ‘good-enough’ experience of maternal preoccupation. This is the process of therapy. In this we must continue to have faith.    

  Published in BACP Children and Young People June 2012