(PLEASE NOTE: The editors of Psychology Today online kindly suggested that I add to this blog some essays that I have previously posted on the site about my new book, whenjohnnyandjanecomemarching.weebly.com/blog.html. The following one was posted there on 03/06/2011. Tomorrow, I will post the one that followed this one and was posted on 03/07/2011).
Copyright ©2011 by Paula J. Caplan All rights reserved
Studs Terkel on interviewing:
"The first thing I'd say... is ... ‘Listen'. It's the second thing I'd say too, and the third, and the fourth....And if you do people will talk. They'll always talk. Why? Because no one has ever listened to them before in all their lives. Perhaps they've not ever even listened to themselves."
How sad that in the intensely psychiatrized world that is the U.S.A. in 2011, we have handed over the lion's share of compassionate listening to those who charge for it. What a coincidence that I had started writing this essay two days ago, planning to finish it today, only to discover on the front page of today's New York Times a report that even those who are classified as professional listeners are no longer particularly inclined to do that work. The story is headlined, "Talk Doesn't Pay, So Psychiatry Turns Instead to Drug Therapy."
There will be two entries about this subject on my blog. The one for today is about what is wrong with our having turned over much of the work of listening to those who are paid to do it, and the next will be about some of the troubling shards in the NYT article.
How often have I overheard in restaurants sentences that still surprise and alarm me, such as, "Her partner died, and she was devastated, but I'm not a therapist, so I told her to go see one." Who decided that for human problems, even intense suffering, friends cannot possibly be enough? That we should not even start by turning to friends or loved ones? In cultures and subcultures with strong community ties, people expect that in the face of catastrophe - whether natural disaster or human calamity like war - they will take responsibility for helping the sufferer to heal and to return to the community.
In psychiatrized America, we hear three main arguments against seeking help for emotional suffering from anyone other than a trained psychologist, social worker, psychiatrist, or pastoral, marriage and family, or other counselor:
(1) "If you are suffering, you need an objective perspective on your problems." An objective perspective might help, but who says that being a trained counselor means the person is objective, has no biases, theories, knee-jerk approaches? And who says that a caring about someone - a friend, a family member - means that one cannot be helpfully objective? In any case, it's simply a myth that such a thing as true objectivity exists in relation to emotional pain. We all - therapists and laypeople - have beliefs, hopes, fears, and conflicts about the things that cause human suffering.
(2) "Friends and family fear offending or upsetting the person and thus should avoid the risk of saying something that could interfere with the friendship or the familial relationship." OK, so we cannot all do this for each other, because in some relationships there is little or no resilience that allows them to survive the ripples or the tidal waves of having different perspectives. But it is remarkable how much simply listening - and sharing times of pain - can help. I can speak from personal experience when I say that I have often been moved and pleasantly surprised by the capacity of some of my friendships to survive and benefit from greater openness. In addition, it's helpful when someone is upset if we ask them, "After you tell me what's happening, will you be wanting my advice or my perspective, wanting me to raise questions to help you talk or explore more, or just plain listen?" Furthermore, dare I say that many therapists, despite their best intentions, cannot handle it when patients bring up certain subjects. A woman who wanted to talk about having been sexually abused said that every time she brought up the subject, her therapist would ask if she wanted a cup of coffee or otherwise change the subject. And a Vietnam veteran told me that his therapist at the VA told him he had to stop talking about the memories of war that tormented him, because the psychiatrist found them too upsetting to listen to.
(3) "To help someone in emotional pain, you must have the knowledge that therapists learn in training." I have never found a therapist who could say in all honesty that they learned in training how to listen respectfully and helpfully or how to care. The most caring and effective therapists I know were caring and effective listeners and helpers before they entered their training programs. This does not mean that nothing in training is ever helpful but just that far more healing goes on in the real world than our psychiatrized society might realize. And as the deeply humane psychiatrist Dan Dorman described in his book, Dante's Cure,  what he has done that helped his deeply troubled patients was not only nothing he learned in his training but rather ordinary, though marvelously patient and longterm, and actually went against what his supervisors and then his colleagues thought he should do.
Not for a moment do I believe that all therapists are bad or never of use. For instance, if your pain comes from being abused, of course you will not turn to just anyone in the family or inner circle of the abuser and expect them to listen in a caring, respectful, helpful way. The problem is that too often, both laypeople and therapists themselves act as though helpful listening is only the province of the professionals...and as though they are more likely than not to be good, caring, respectful, effective listeners. Yet when someone very close to me died, astonishing compassion and support, as well as understanding and insight came from friends. These friends included women I had known to be capable of such offerings, a longtime, male friend who had previously been gracious but extremely reserved, and a man I had only just met. Nothing I learned in my training as a clinical psychologist would have helped any more than what they did.
Nearly four decades of working as a psychologist have taught me that even if one is a licensed therapist, what is most likely to help people who are suffering are the ordinary, non-technical, non-medical approaches. Listening with the intention of understanding is enormously important, and there are others. Patch Adams, the physician played by Robin Williams in the movie named after Adams, lives every moment with an intense focus on bringing love and joy to others. In the company of people considered to have severe emotional problems, what does he do? He offers warmth and humor. He hugs and clowns. Recently, he told me that his record of hugging someone classified in that way was ten hours. Ten hours of caring and clowning. And when my mother, who retired some years ago from practice as a psychologist and has been one of the two best therapists I have known, heard about a young man who was in such emotional pain that he was said to be practically catatonic, she declared, "I want to take him a pizza." No one in her graduate program taught her that, but it was a great thing to do: Rather than focusing on what others called the bizarre aspects of his behavior, she reached out to him as one human being to another, connecting with the parts of him that were not tormented, with ordinary hunger and the appreciation of spontaneous giving. Did Patch's hugging and clowning or my mother's gift make all the sufferers' pain disappear? No, but many who have been through such desperate times have told me how much such offerings stayed with them, provided sustenance, and helped them move toward healing.
As Vietnam veteran David E. Jones writes about the desperate need for compassionate listening in one of the exquisite poems in his book, A Soldier's Story: The Power of Words:
Where is the voice of understanding this Soldier needs to hear?
Who'll take this place beside me when I'm choking back the fear?