Saturday, November 03, 2007

C is for Clients

...and yes, that's what we actually call them. Or you, as the case may be. Unless we have the magic Doctor in front of our name when we might also call them (or you) patients. Often we just refer to them by time, as in "My ten o'clock." But never by diagnosis, since that is verboten, not to mention forbidden, by the rules of the various boards that license us.

...and yes, I'm seeing them again.

...and yes, I'm questioning myself again.

The clients that I thought I wanted to treat when I was in school--the poor, the needy, the really fucked-up--well, maybe I was wrong. Maybe when I insisted that the one kind of client I never wanted was the Middle Class Woman Who Whined, maybe anyone with an ounce of understanding about things psychodynamic could see that this was a huge case of countertransference. Which none of my instructors thought to mention to me.

Basically what it means is that I didn't want to treat myself. Or people like me. Who I seem to think are weak, sniveling people with weak, sniveling issues to deal with. Like wobbly self-esteem and shitty mates and tedious workplace traumas. No, I wanted the real thing: Bring me your psychotic, your medicated, your traumatized, personality-disordered huddled masses--and I will wave my torch of empathy and grant them instant calm, if not bliss.

Well, ha! And ha! again. The huddled masses--they are so incredibly complicated, not to mention relatively hopeless, and sometimes scarey. They live in neighborhoods that are alien, in houses that are so tiny and ramshackle as to be barely there. If they live in houses at all, because remember, my very first client was a schizophrenic homeless woman.

I loved her. Not literally, but all the parts of her that were middle class, and dealing with a overbearing mother. But not so much when she started getting into the groups of martyred soldiers who were following her down the street, beckoning to her from doorways, trying to entice her into a life of sin. I knew delusions when I heard them. But from a middle class woman? Was it possible--? Nah, it was just me, middle class me, having a major countertransference issue.

Countertransference is a good thing and a bad thing. It's part of what enables psychotherapy at all, but damn, I'd rather not have my shit forced in my face where I can't ignore it. But my choices, it seems, are either to face it--or find an excellent excuse when I don't want to be a therapist after all.


  1. I think the hopelessness of the thing would be the hardest. While sniveling house wives can be helped - give her a plan, some sense of self, some prozac and be done with it, the true hard cases, the schizophrenics, the addict the manic depressive must really try the soul and patience of even the greatest therapist.

  2. yeah, i hadn't thought of it that way. oh god, now i'm depressed!

  3. Uh, I feel the need to defend the fucked up middle class woman here. Last time I checked, middle class women can be dealt as shitty a hand of genetic cards as our more and less fortunate sisters. I'm not talking about suburban woman navel gazing, but the hard shit.

  4. mrs g: (1) see how quickly I'm responding? that's because I haunt my in-box, just hoping for a comment, and
    (2) I think what I'm onto about my countertransference is that I don't want to think of middle class woman who whined (MCWWW) as me...with my years and years of therapy. Of course, I never whined as my several therapists can attest. My plaints were always direct and, well, pithy. So in defending the MCWW, you are in fact defending me. Thank you.


So--whaddaya think?