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Love, Hate & Health Professionals

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Love, Hate & Health Professionals IJCP Volume 20 • Issue 3 • Autumn 2020 Practitioner Perspective Love, Hate & Health Professionals By Dr Coleen Jones and their patients as ‘clients’. This discussion is about the shadow side of ‘caring’. Often it is a simple misunderstanding of what ‘caring’ really means. It is a misunderstanding of how the mental state of seriously ill and troubled clients impacts on the well-being of the therapist. We live in a Western world purporting charitable, philanthropic and altruistic intentions in relation to others. This is a denial of the full range of emotions contained within our palette; both love and hate are present, and they are essential to our work. We need to have access to our fullness of being. It is my belief that we concern ourselves t present we are confronted by a world-wide with understanding both love and pandemic, which has placed psychotherapists and hate, generically speaking. A We are not living in the realm of other healthcare professionals in a most challenging rainbows and unicorns when we and demanding situation. The current situation often magically work with seriously ill or requires more of caring professionals than what they troubled clients, but rather face the blood and guts of turbulent are effectively able to give. In one way this quarantine emotions. There is no place for period is a creative void, allowing some individuals to sentimentality. It is dangerous rest and reflect, while others are stretched to breaking for both therapist and client, and in excess can lead to death. point. This means understanding what thoughts and emotions get stirred have worked for over 44 years the 'mental health' services. My up in the therapist by the client; I in the field of psychology, own training in psychodynamic thoughts and emotions which are counselling and psychotherapy. psychotherapy has alerted me often denied. Mostly the hour goes Half that time again I have worked to the implications of caring - by pleasantly and swiftly. It is the training therapists at university caring too much and caring too longer-term impact of the work that postgraduate level. I currently little – often at the expense needs to be understood. supervise the work of 'caring' of the counsellor, therapist, For this reason, I am turning professionals in a wide range of social-worker, psychiatrist inter to the seminal paper written by disciplines. What concerns me alia losing their life, sometimes Donald Winnicott called “Hate now is the extent of burnout, loss through suicide. Let me refer in the Countertransference” of life and the tragedy of suicide generically to all ‘caring’ (1947, p. 194). If you are in a wide range of professionals professionals in all disciplines reading this for the first time, working under the umbrella of in this article as ‘therapists’ please consider making a copy 4 Irish Association for Counselling and Psychotherapy Volume 20 • Issue 3 • Autumn 2020 IJCP for every professional whom you unless the relationship is totally know including your GP as it may t is important that the confidential, well-grounded and save lives. It is equally useful to Itherapist is in touch the supervisor, a person who parents and practitioners. with and has worked has attended to their own old Following the atrocities through issues relating to wounds. According to Winnicott it committed during the 20th century his/her own sexuality, as is not possible to be exclusively particularly the second world war, it will probably be acted nice and loving in relation to the we have turned towards being work, in relation to others and 'nice' to others. When what we out in some or other way in relation to clients. The 'nice' really need is to be 'real' and clients might stir up envy when grounded as parents, workers and wounded healer' (CW16, par 422) they finish therapy/treatment carers. Significantly, Winnicott archetype comes to mind. We and leave the therapist who is writes this paper immediately may be trying to fix ourselves, by now tired and drained. A bit after the war as a powerful fix a cold mother relationship or like the parent who sees their 20 reminder. When Winnicott talks attend to our unmet childhood year-old bouncing out the door on of 'love' he is talking generically needs. We need to establish a Friday night for a night of fun, of those feelings of compassion, a safe space and a secure pleasure and sex, with money in admiration, fondness and liking, relationship where reactions that their pocket, while the parent is we mostly have towards our are evoked in working with clients left tired and drained after a week clients. While 'hate' generically can be processed. How we feel at work providing the backup and includes a range of emotions such in response to what the troubled where-withal for that pleasure; as irritation, loathing, weariness, client brings us is called the note that the envy and resentment envy or even pure hate. How does countertransference. Winnicott is denied and hidden under the the therapist feel when the client writes that the therapist must: guise of generosity - “we were arrives late, forgets appointments like that once”. In the case of the or does not pay them, but then “be so thoroughly aware of the ‘not so nice’ client, the therapist arrives hungover or flaunting all countertransference that he can mostly hides the fact that they are recommendations relating to his/ sort out and study his objective overjoyed when the client does her health and wellbeing Winnicott reactions to the patient.” (1947, not show up or leaves therapy. says: p. 194) The therapist may avoid the task of contacting or “grasping the “the analyst’s own hate [needs Donald Winnicott was a thorny nettle” and working through to be] extremely well sorted out paediatrician for most of his difficult issues with the client. It is and conscious…however much life and therefore worked with perplexing, for example, when the he loves his patients he cannot children who were sick rather therapist feels sexually aroused avoid hating them and fearing than troubled. He had a deep by the client and is pulled into them, and the better he knows understanding of normalcy and a confusing erotic transference. this the less will hate and fear play. It is the idea of creative play The therapist might feel mortified be the motives determining what occurring in process supervision to express and work through this he does to his patients.” (1947. and in the therapeutic space. reaction with anyone else, but a p. 194) Supervision which follows is private and trusted supervisor. the essential engagement. The In the supervisory space the Therapists have their own space where clarity emerges, therapist can begin to understand unresolved, developmental issues where the therapist can express that the client is probably acting which are mostly repressed and/ and understand why she feels out, acting seductively as a way of or only briefly touched on in irritated by a client who displays avoiding his/her early childhood training; mostly because they grandiosity and eschews the need pain and confusion. It is important think they have been drawn to for therapy and who may even that the therapist is in touch with the work in order to 'help' others. imply that it is the therapist who and has worked through issues In fact, we are drawn to the needs the therapy more! The relating to his/her own sexuality, work because we, sometimes, supervisory space is very delicate as it will probably be acted out in have our own deep unresolved though. It can take us into deep, some or other way. We may now issues. Jung’s idea of 'the old wounds and can be exposing understand how teachers and Irish Association for Counselling and Psychotherapy 5 IJCP Volume 20 • Issue 3 • Autumn 2020 coaches etc have strayed over what I call acts of commission, this line. hat my experience to use a legal term, in other Ambivalence is the experience Whas shown me is words trauma; bad things done of simultaneous and contradictory the fact that in most to them. He also refers to clients attitudes or feelings (such institutions, supervision who missed out on experiences as attraction and repulsion) degenerates into case iii) what I call acts of omission. toward an object, person, or management This means that these clients action. According to Winnicott are unconscious and do not the neurotic client experiences know what they don’t know and ambivalence as an either/or lighting a match in an old coal don’t know what they are missing phenomenon and experiences the mine - explosive. Or alternatively or where the gaps are in their therapist as splitting, sometimes take the therapist into realms lives. This means that they are loving and sometimes hating of dark despair, feelings of often developmentally delayed. them. A healthy individual has incompetency and self-loathing They present as competent the capacity to hold both love and which are implosive. adults but in fact feel inside like hate simultaneously. A healthy It is the therapist’s terrified teenagers and are often individual might love their sister responsibility to ensure that as vulnerable as children. The for being warm and personable resentment does not creep into therapist may be the first person and be able to tolerate, and at the therapeutic space. This may to meet and address these gaps. the same time hate the fact that happen when the therapist goes The therapist therefore needs to she is mostly late or forgets seriously over time with the stay contained, not go beyond things. Whereas for the neurotic client.
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