Chapter 33 Love and Psychotherapy

I don't quite remember what motivated me to enter the profession of psychotherapy 15 years ago.Of course, I believe that I want to help others.Other branches of medicine also contribute to human health, but in my opinion, the procedures are too mechanical for me to adapt to.I also find it much more interesting to communicate deeply with others than to put my hands on the patient from time to time to check the patient's condition.The maturation process of the human mind also attracts me more than the changes of the flesh or viruses.I didn't know at the time how most psychiatrists help others.I just imagined that they would use some kind of charm or magic to magically untie the patient's knot, and I have always wanted to be such a magician.It did not occur to me that my work was about the maturation of the minds of my patients, or even my own.

For the first ten months of my internship, I was responsible for caring for seriously ill hospitalized patients.I think they need drugs, electromagnetic therapy, and professional care more than me.However, I still learned the traditional meaning of "charms" --- the skills of psychological interaction with patients. Shortly thereafter, I began seeing my first patient, whom I might as well call Marcia.Marcia sees the doctor three times a week.For quite a long time, I have been uncomfortable with her treatment.No matter what I asked her to talk about, she basically kept silent.She also refused to speak more of what was in her heart in the way I provided, and she refused to say even a word.In some respects, our views and perceptions are also very different.After repeated efforts, she made adjustments to some extent, and I also adopted more various treatment methods.However, although I mastered various therapeutic techniques, I could not bring Marcia any greater help.After a period of therapy, her vice persisted: as in the past, she always indulged in multiple relationships with men.For months, she continued to show me her unabated behavior, and it went on for a year.One day, she suddenly asked me: "Do you think people like me are hopeless?"

I was not mentally prepared for how to answer her question, so I just asked vaguely: "You seem to want to know, is my opinion of you right?" She said that was exactly what she meant.So next, what should I say?Which spell should be used?Should I answer, "Why do you want to know what I think of you?" "What do you think I think of you?" or "Marcia, it doesn't matter what I think of you. Myself." At the end of the day, I didn't make these evasive, innocuous answers, they were just evasive excuses.Marcia had been seeing the doctor three times a week for a year, and I had reason to give her honest answers.

However, there is no precedent to follow for how to answer her questions, and no professor has ever told me how to speak truthfully about the character and personality of the patient in front of the patient.I had no such training in my previous medical education, nor did other doctors.I believe that if you speak your mind, you may become passive.I was thinking nervously, feeling my heart pounding.In the end, I chose to take the risk.I said, "Marcia, you've been seeing the doctor for a year. To be honest, our relationship is not going very well. It's mostly confrontational, which makes us both bored, nervous, and irritated. Nevertheless, I want to tell you that During the year, you were able to endure inconvenience and show great perseverance by coming to see your doctor week after week and month after month. You couldn’t do this if you weren’t a self-respecting, growth-seeking person. You How can you be hopeless if you work hard to make progress? I can tell you with certainty that you are not hopeless. You are also entitled to my respect."

Before long, Marcia chose the most suitable one among dozens of men who had ambiguous relationships, and started a serious relationship with him.They later got married and lived happily ever after.She is no longer that self-defeating, overindulgent girl.Since our conversation, she's opened up more, talking about her strengths as well as her weaknesses.Our pointless confrontation also disappeared.The treatment is getting better and better, and her condition has improved a lot.I took a risky treatment method, which not only reversed her attitude and began to actively cooperate with the treatment, but also did not cause any harm to her, which not only guaranteed the quality of the treatment, but also became a turning point in the whole treatment.

What kind of enlightenment can the above example bring to us?Should psychotherapists be open and honest and tell their patients their views?Of course not.The psychiatrist should take appropriate treatment measures according to the actual situation of the patient, and it should be based on a basic premise: the doctor must treat the patient honestly, and must be consistent.As a doctor, I respect and love Marcia, and it's all from the bottom of my heart. Moreover, my respect and love for her has special meaning for her, especially when we have known each other for a long time and the treatment is getting deeper and deeper—the turning point in the treatment has nothing to do with my respect and love for her, but It is related to developments in the doctor-patient relationship.

A similarly dramatic turn occurred during the treatment of another patient (let's call her Helen).Helen saw a doctor twice a week, and after nine months, her condition still hadn't improved, and I didn't like her personally.After getting along for a long time, she still wears a thick mask.I don't know what the problem is.In my bewilderment and chagrin, I studied her case for several nights without gaining anything. All I know is that Helen doesn't trust me.She also complained that I don't care about her and even said that I only care about her money.Nine months later, one day in therapy, she said, "Dr. Pike, you can't imagine how depressed I am. You don't care about me or how I feel. How do you let me communicate with you?"

"Helen," I replied, "I think we're both depressed. I don't know what you'll think when you hear me, but to be honest, you've given me the most headaches in the ten years I've been in business." Patient. I have never experienced this kind of experience before: I have been in contact with patients for so long, but there is no progress in treatment. Maybe you think, I am not the right doctor for you. I don’t know why. I don’t Willing to give up halfway, but you do confuse me. I can't figure out what's wrong with our cooperation." Helen suddenly showed a happy smile, "Then it seems that you still care about me." She said.

"Huh?" I asked. "You don't care about me so you won't be depressed." The next time we met, Helen was completely different.She used to avoid talking about many things, but now she seems to be a different person.She told me exactly what she had experienced and felt before.In less than a week, I found the crux of her disease and quickly established the ideal treatment plan. My response to therapy had special meaning for Helen.The premise of my appropriate response is that our relationship has deepened and that we have both made efforts for treatment.One of the most important principles of psychotherapy is not to rely on simple incentives, not to resort to any "spells" or to adopt special treatment methods, but to make a mutual commitment between doctor and patient to make extraordinary efforts.The therapist must carry out self-improvement for the growth of the patient, accepting the risk of no retreat.They have to consistently care about their patients and are willing to go the extra mile for it.In other words, true love is the most important factor in making psychotherapy work smoothly.

Today, there are so many Western psychology works that make people dazzled, but most of them ignore the topic of "love".It's unbelievable.The wise men of the Hindu sect pointed out: Love is the source of strength.However, in Western psychology works, only a few articles analyzing the success or failure of psychotherapy occasionally mention the issue of love.And, at most, they refer to traits such as "kindness" and "compassion" that contribute to the success of psychotherapy. The subject of "love" seems so embarrassing to psychologists that it is rarely brought up.There are many reasons for this, one of which is that we often confuse true love with romantic love.In addition, we focus on the so-called "scientific treatment", thinking that it is more rational and specific, and it is a measurable treatment method. Of course, psychology also belongs to the category of scientific treatment.Relatively speaking, love is an abstract thing, something difficult to measure and beyond reason, and therefore cannot be classified as a scientific treatment.

There's another reason why experts keep silent about "love": They believe that the doctor should keep his distance from the patient, which is deeply rooted in the traditional therapeutic concept.Followers of the famous psychologist Freud believe in this concept even more than Freud himself.According to their point of view, the patient's love for the doctor is "transference", and the doctor's love for the patient is "counter-transference". These are abnormal phenomena, they can only bring more problems, and should be avoided as much as possible . I think this view is ridiculous.Empathy has always been regarded as an inappropriate emotional response and psychological effect. However, during the treatment process, doctors can listen to the patient's heart for several hours. They neither interrupt the patient at will, nor make judgments. They can give patients unprecedented care and greatly relieve their physical and mental pain. In this case, it is completely normal for patients to fall in love with doctors.And, in quite a few cases, the very nature of transference prevents the patient from actually falling in love with the doctor.After all, transference is only a transient psychological phenomenon that allows the patient to feel the power of emotion for the first time, making it easier for the treatment to work.Some patients cooperate with the treatment, follow the doctor's advice, and use the treatment to make their minds mature. It is natural for the doctor to have a good impression and even love for such patients, and there is nothing wrong with it.Incorporating family affection into the treatment can make the treatment better. At this time, the love of the psychiatrist for the patient must be like the love a competent parent gives to a child. Many people have mental illness because they lacked the love of their parents or received deformed love when they were growing up.Doctors give patients more love and care, so that their psychology can be compensated and the disease can be cured faster.If a psychiatrist cannot truly love his patients, he cannot make the treatment effective, let alone achieve immediate results.No matter how well trained a therapist is, without true love, or a lack of self-improvement, psychotherapy will fail. Since love and sex are closely related, we might as well discuss a little about the sexual behavior of doctors and patients.Psychotherapy has an element of "love" and "intimacy." Therefore, patients and doctors are prone to mutual sexual attraction, and the possibility of sexual intercourse also increases.Some colleagues in psychology condemned those psychologists who had sex with their patients.In fact, they may not really understand why.Frankly, if I had carefully weighed the matter and decided that intimacy (including sexual activity) with the patient was necessary for her mental maturity, I might not hesitate to choose this course.However, in my 15 years of practicing medicine, this particular situation has not occurred to me, and it is difficult for me to imagine that it will occur. As mentioned earlier, the role played by a competent psychologist is basically similar to that of a competent parent.It is obvious that competent parents cannot have sex with their children.The responsibility of parents is to help children grow up, not to use children to satisfy personal desires.A responsible psychotherapist will try to help the patient recover as much as possible, rather than satisfying his own needs through the patient.Parents should encourage their children to pursue independence, which is also the responsibility of doctors to patients.In the absence of such a duty as a premise, if a psychiatrist claims that he has sex with his patients not to satisfy his own desires, but to encourage his patients to become independent, then his statement must be nonsense and cannot be called Convinced. Of course, some patients do have a tendency to be sexually seductive, and it is easy to transform their relationship with the psychiatrist into some kind of sexual relationship.This only hinders their freedom and growth.Existing theories, as well as the scant evidence, suggest that the therapist's sexual intercourse with such patients only makes the patients more psychologically dependent and thus only hinders their mental maturity.Even if doctors and patients have not developed to the stage of sexual behavior, just talking about love is harmful and not beneficial.As I said before, if you fall in love, your ego boundaries will collapse and your independence will regress dramatically. When the therapist falls in love with the patient, the former cannot objectively face the latter's situation, nor can he distinguish their respective needs.Healers love their patients, and should not flirt with them lightly.The doctor must respect the independent personality of the loved one and distinguish the roles of himself and the patient.Some psychiatrists even believe that, except for treatment, private contact with patients is not allowed at other times.I respect the starting point of this point of view, but I don't think it is necessary to make such strict regulations.Of course, I have had failures in this area in the past: I have been in private contact with a patient and have not been of much help in his treatment.At the same time, I interacted with other patients in private, and as a result, each of them gained different degrees.I have also performed psychoanalysis and therapy for several close friends, and they have all been successful.Generally speaking, even when the treatment is successfully concluded, the doctor should be calm and careful to ensure that his private contact with the patient is never to satisfy personal needs and disregard the patient's interests. Since modern psychotherapy theory dares to go against the tradition and define psychotherapy as the process of true love, then in turn, can true love make psychotherapy more effective?If we truly love our partners, our parents, our children, our friends, we can perfect ourselves to make them mature. Does that mean we are also treating them?I think the answer is yes. If my wife, children, parents or friends have a mental illness, they are either cranky, self-deceived, or unfortunately in other difficulties, I will definitely help them without hesitation, communicate closely with them, and try my best to help them. improve their condition.In the process, I will also endure pain and continue to discipline myself so as to achieve self-improvement.I treat them as I treat patients who pay money to see me.It never occurred to me that I should separate my professional life from my private life.It is impossible for me to ignore my family and friends and hide my professional knowledge and all my love just because they have not signed a bond with me and have not paid me any medical bills.How can I be a good friend, a good father, a good husband and a good son if I don't take every opportunity to use what I have learned to help the people I love as much as possible and try to promote their spiritual maturity Woolen cloth?And, I trust that my friends and family will treat me the same way and help me with various problems.Although sometimes my children criticize me too frankly, and their so-called "advice" may not be very mature, but after all, I have gained a lot of enlightenment.My wife has helped me as much as I have helped her.Likewise, if my friends are blind to my personal problems and never show me any real concern, I can't think of them as real friends.In fact, without the guidance and help of my family and friends, my growth and progress would have lagged considerably.All emotional relationships based on true love are actually psychotherapy relationships that encourage and promote each other. Of course, I have not always viewed the above issues in this way.In the past, I have valued my wife's compliments more than she has criticized me; I have nurtured and nurtured her dependence no less than I have supported and encouraged her independence.As a father and husband, I see myself simply as a provider of food and clothing for the family. My responsibility is to bring home ham and bacon. My ideal family is a place where the atmosphere is warm, not challenging.I used to think that it was absolutely dangerous, harmful, and immoral for psychologists to routinely practice psychology on friends and family members in order to reinforce their professional identity.In addition to my fear of abusing my profession, laziness also contributed to my above awareness.Providing psychological treatment to family members is of course also a kind of work. Working eight hours a day is obviously easier than working sixteen hours.Moreover, it is easier for doctors to fall in love with such a patient --- a person who, with hope and desire, takes the initiative to set foot in your professional field, seeks your help, and wants to use your wisdom to get support; a person who is willing to pay you , let you diagnose and treat him (her), and each time is limited to 50 minutes.On the contrary, it seems that you are not easy to fall in love with another kind of people-the kind of people who regard your attention as an obligation and make various demands on you at will; Will beg you for guidance. In fact, you still need self-discipline in psychotherapy with your family or friends, and its intensity is no less than that of working in an office, and it even requires more love and effort.In my opinion, as one perseveres on the road of mental maturity, one's ability to love will continue to grow. If a psychiatrist is too limited by external factors, he should not try other psychological treatments beyond his own ability.Psychotherapy without love is not only impossible to succeed, but even harmful.If you can "love" six hours a day, then you should be satisfied, because your ability to love is already greater than most people.The journey of mental maturity is long, and you need more time to learn self-discipline to make yourself more capable.Only then can you do psychotherapy with friends and family.To be able to love others all the time is an ideal, a goal that takes a lot of effort to achieve, but you can never be perfect in a short period of time. On the other hand, even laypeople, if they are caring, can practice psychotherapy without serious training.That said, psychotherapy for friends and family is not just for professional psychologists, but for everyone. Sometimes people ask me when they will finish therapy, and I tell them, "When you can be a good therapist yourself." This conclusion is actually more applicable to members of group therapy.Many patients don't like this kind of answer. Some people say: "This is too difficult! To do this means that I have to be in the thinking when I interact with others. I don't want to think so much. I don't want to work so hard. I want to be happy.” I often remind them that human interaction is an opportunity to learn and educate each other, which is an opportunity to give and receive treatment.Missing such opportunities, we can neither learn nor teach others.Even so, patients can feel nervous and intimidated.What they say is from the heart, they don't want to pursue too high a goal, and they don't want to make life too hard.Consequently, even with the most experienced and caring therapists, most patients do not reach their full potential.They get to a certain stage and they end treatment in a hurry.They may be able to grit their teeth and embark on a short road to mental maturity, or even a considerable distance, but it is difficult to complete the journey.Spiritual travel is too difficult, so that they are only satisfied with being ordinary people, and do not want to approach God.