Off the Couch

Thoughts about the therapeutic process, and the dynamics of client-therapist interactions.

Want to Know Someone Better? The Data's In the Details

The truth is in the unimportant things.
  • Meri* had been dating Jon* for two months. She was starting to think that this might be the real thing. And then, by accident, she learned that he was still involved with his old girlfriend. Broken hearted, she asked him why he hadn’t told her before. He said that he was afraid that she wouldn’t keep going out with him. He was right.

Why hadn’t she picked up on the fact that Jon was living a double life? In part because she ignored, as she now realized, certain comments he had made that in retrospect were clear signals that something else was going on. She hadn’t wanted to know. But wouldn’t it have been easier for her if she’d found out before she fell in love?

  • Anya* spent two full sessions talking about her couch. For forty-five minutes two weeks in a row, I listened as she spelled out every detail of the old couch, which she loved, but which was getting old and tattered, and which she wanted to replace. She also described in tiny detail the new couches that she was looking at in every spare moment that she could find in her busy days. She was looking for the perfect replacement, but so far had not found it.

“I must be boring you to death,” she said at the end of the second session. But in fact, she was not.

You might wonder what the connection between Anya and Meri could be. And you might also wonder if worrying about replacing a piece of furniture is really worth talking about in therapy. The answer to both questions is in the details. I have learned that all of the tiny details of a person’s life are key to knowing and understanding her. For one thing, talking about small details of life can lead to important insights about underlying psychodynamics. The American psychoanalyst Harry Stack Sullivan developed an approach that he called “detailed inquiry,” in which he suggested that therapists gather information about all parts of a client’s life. In those tiny details, Sullivan believed, could be found clues to many of a client’s difficulties. (I write more about this in my book Daydreaming: Unlock the Creative Power of Your Mind)

I learned about the importance of small details many years ago, when I was working in a psychiatric inpatient setting. A college student was admitted when she began hallucinating and talking to internal voices that were telling her “to do bad things.” It was unclear whether her psychotic episode was due to mania, schizophrenia, a drug someone had slipped into her drink at a party, or medications she was taking for a physical disorder. But it was very clear that she needed to be in a structured environment where she would not be in danger from the actions the voices were telling her to take.

My supervisor suggested that the best thing I could do with this young woman was to engage her in conversation for brief periods of time every day. “Ask her about her life, about movies she’s seen and books she’s read,” my supervisor said. “Find out what time she goes to bed and what her bedtime rituals are; what time she gets up and what her morning rituals are; what classes she’s taking at school, and which ones she likes.”

I won’t suggest that this client got better because I was asking her about the small details of her life; but as her psychotic thinking diminished, she told me that it had been very soothing to talk and think about the small things that made her who she was. “I felt like I had lost myself,” she said. “And talking about that stuff brought me back to myself.”

In my work over the years with clients with eating disorders, I have found that asking about morning and nighttime rituals often leads to important information not only about how that person takes care of herself (or how she does not), but also about how she feels about herself. A beautifully dressed and made up woman in my practice, for example, admitted that it could take her two hours to get ready in the morning, because as soon as she noticed a single flaw in her appearance, she had to start all over again. That information proved to be crucial in our work, but it might never have become available if I had not been asking about her routines.

To go back to Anya – as we talked about her couch, we were also talking about a number of other, not so mundane things: her attachment issues and fears of letting go; her need for comfort and soothing; and her feeling that only inanimate objects, not humans, could be there for her over time. Talking about her couch was also a way of exploring the changes that were beginning to occur in therapy – changes that she longed for, but also feared. So no, I was not bored by her descriptions of her efforts to buy a new one and discard the old one.

But asking about details is not just for psychotherapists. You don’t have to be rude or impolite to glean details; you just have to be tuned in to them. You just have to know, as my supervisor so many years ago suggested, that details are to be found in information about the mundane aspects of life. What does someone eat for breakfast? How long does it take him to get ready in the morning and what is he doing all that time? What is her favorite television program?

The more details you know about a person, the more likely you are to know him intimately; and the less likely you are to be taken by surprise, the way Meri* was. So ask questions and pay attention to the little things. They are definitely not boring.

 

*Names and personal information changed to protect privacy

Teaser Image Source: http://offinsted.com/couches

F. Diane Barth, L.C.S.W., is a psychotherapist, teacher, and author in private practice in New York City.

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