Income Typical?

This is a particularly interesting article from Ode Magazine, focusing on the 'Neuro-typical' brain.

Imagine if we did this with cultural distinctions (“People from Holland suffer from altitude deprivation syndrome”) or racial differences (“Eduardo has a pigmentation disorder because his skin isn’t white”). We’d be regarded as racists and nationalists. Yet, with respect to the human brain, this sort of thinking goes on all the time under the aegis of “objective” science.

There is no standard brain, no standard race, religion or standard culture.  And there is no standard class, either, even though the psychotherapy profession functions as one. Imagine if people were only allowed to train as counsellors and psychotherapists if they were white, middle class Christians . . . wouldn't there be uproar from within the profession itself, and from groups and individuals who use the profession?

I'd say that there's no outrage from outside of the profession because, for people on low incomes therapy is seen as an indulgence or something so far beyond cultural expectations that it doesn't come into awareness. Many of those people who do get free or low cost counselling are so grateful (in a different way from a paying customer-client who is paying for something that they can get anywhere) and feel cowed by the formality and intensity of this completely unusual experience that they conform to a role. (This is what research on the counselling of international students, genetic counselling, disabled clients, and all other client group/ therapist research proposes, which is why good therapists are concerned to be non-directive.)

There's no uproar within the profession because there's so small a group of therapists who've experienced meaningful poverty. One in five people in the UK suffers from enduring poverty - Google 'one in five poverty' for pages of stats: how reflective of society is psychotherapy? It's a circular problem - there are so few therapists who've experienced meaningful poverty that it's just not an issue.

Empathy and Experience

The article which had the greatest influence on my understanding of the role of empathy and shared experience in therapy was not academic or peer reviewed. It was a review in the Times newspaper of a biography of Lee Strasbourg, the creator of Method Acting. The famous anecdote of Dustin Hoffman in Marathon Man suddenly clarified my unease with many therapists’ statements on their empathy for people whose experience they share little of.

Hoffman spent three nights awake in order to play a character who was tortured by having his dental nerves drilled. When he arrived on set his co-star, Lawrence Olivier said, "Why not try acting? It's much easier." Hoffman was acting. By spending three days without sleep he was not experiencing torture, he had chosen to go without sleep in order to improve his performance. There is something about choice – and the power to be able to change that choice – that seems missing in the literature of empathy. An able-bodied person can choose to spend a week in a wheelchair, but if he’s in a fire he can get out and run. A person with a reasonable income can choose to live on the equivalent of benefits for a week or a month but they will not know the anxiety of being under neighbourly and state surveillance, always robbing Peter to pay Paul or the banal, recurring evil of an Incapacity Support Tribunal.

Thoughts from a single parent, benefit-dependant friend:

All I would say is that it doesn’t matter what profession a person is in, if they haven’t got any first hand experience of what it is like to be on a low income, especially over a long period of time (images of Portillo living the life of a single parent for a week spring to mind here), then they do struggle to appreciate the various ways in which it can impact on ones life and that of your family. Those that say they do – lip service.
The majority of people who need help are from the poorer sector and either can’t afford it, aren’t offered it, may not even be fully aware or have sufficient understanding of how it works or how it could help them AND if they do, often it will be a trainee so they might not receive a decent standard of counselling.

Don’t her statements demonstrate some of her ‘issues’? Won’t the therapeutic relationship work these issues through? Does it matter if she’s right or wrong? Maybe, maybe not. Personally, I have great faith in the Person Centred therapeutic relationship but it has to be based in a genuine and full-blooded foundation rather than one entirely dependent on funding for 6 sessions.

The pat answer to the question of empathy is that we all share similar experiences and can use them to empathise with the experience of the client. There’s some truth in this but the existence of specialist support groups speaks to the importance of the truly shared experience. People can communicate in intimate shorthand without having to explain or pull their punches for the sake of the listener, a shared journey with close companions, people who don’t need to be orientated within the experience or told everything for there to be a sense of kinship.

Connection has been categorised and simplified, codified and reduced to a technique. “You can empathise with a woman who’s lost her baby because your dog died.” Not really. One of my peers wanted to prove that online counselling was able to provide Buber’s I-Thou relationship between client and counsellor. That this person wanted to prove anything in research was a measure of her need. Despite discussions she went off and did the research which demonstrated that an I-Thou relationship was indeed possible in online counselling.

Buber spoke of moments of I-Thou relationship, brief (but timeless) instances beyond speech touching the realm of mystery; fragile, unrehearsed, attuned to agape. This goes beyond empathy into the realms of perfect love and perfect trust, connection rather than relationship, existential meaning-making and life purpose.

Buber is wonderful to read: dense, rich and complicated it takes time to absorb his wisdom. There are many other authors who build on his work and create their own whose writing is accessible and not in the least mystical without losing any gravitas or wisdom. Working at Relational Depth by Dave Mearns and Mick Cooper brings together the philosophy and research into client/counsellor connection and challenges counsellors to viscerally connect with the experience of the client.