The Cartesian Split in Therapeutic Thinking

Renee Descartes said: “I think, therefore I am.” In saying that, he lead western thought away from the body and its information channels. His “thought” process and structured style of thinking helped our culture learn to not value and not attend to information we receive from non-logical, non-evidentiary sources. This blog examines some of the problems that can come in therapy from being one dimensional in the Cartesian sense.

What do you do as a therapist, when you encounter a client who is at least as well educated as you, and probably smarter? What if you have clients who are verbally glib and use the same “intellectualization” skills that you possess in order to protect themselves from the anxiety they are feeling about whatever has brought them to your office? I have been blessed to have this problem many, many, times. For whatever reason, many of my clients have been both educated and verbally skilled. They are quite able to rationalize and explain their behaviors and feelings in ways that are facile, self-deprecatory, and self -serving. They operate, in the jargon of the field, “in their heads.”

For me, these clients are seductive. They, like me, enjoy playing with words and are willing to spend time and money “talking” to me while we both philosophize about our understanding of their fascinating lives and complicated problems. I have to be careful of these clients because, if I want to work with integrity and help them ethically, I can’t spend their time and money indulging my passion for clever word strategies that amuse me and validate my “cleverness.” Working with this type of client (who, by the way, is paying for my expertise) provides an opportunity for my ego to get in my way. If I play along, I allow and support their avoidance of the reality of their own problem. In this situation, I become an enabler and a fraud. I have to remind myself constantly that these people are in my care and I have a responsibility to help them. They are not my friends with whom I am playing an intellectual game. We are on the clock and I am getting paid for my professional knowledge and skill, not my adroit, verbal dancing performance.

I was talking with a colleague this week who had a client coming to see her regularly. The client could be described by the discussion above. He was well educated, verbal and adroit. He radiated intellectualism and was possessed of a glib verbal façade. The client was passionate about a topic that fed into my colleague’s counter transference issues. The therapist reported that it was very difficult to continue to see the forest for the trees, as she worked with this client. This client wanted to talk about a topic the therapist loved to discuss and had extensively researched. The client was knowledgeable and interested in this topic and found it intellectually stimulating to discuss it. In her own life, the therapist does the same thing with this topic. Her concern ethically was how to conceptualize this client apart from the interest in the topic that she finds so fascinating and intellectually invigorating.

My friend was aware that it was seductive and self-delusional for her to continue to indulge him in the philosophical discussion of this topic. She was looking for a place to stand where she could understand and frame the conversation in such a way as to not have it trigger her own counter transference reaction, and in such a way that she could “interpret” it to the client. Her goal was to do it in a way that was useful to identify his coping strategies and the underlying issues that were causing his anxieties. What she wanted to do, without “judging” or “arguing,” was to reflect to the client the pattern she was observing. How could she step out of the conversation as an excited and equal participant, and reflect to the client the “payoff” he was receiving by staying in his head? How could she make him realize that he was analyzing the problem to death, but never changing his behavior or his way of conceptualizing the problem so that other strategies might present themselves for action?

My friend was aware that her client was not a person of action. He was not making any moves or experimenting with any new choices of action or thought, he was just talking around the same old circle again and again. And by engaging in the intellectual discussion of a favorite topic, they could continue to beat around the same old bush. Many people do this, they mistake talking about something and “understanding” it as proactive steps that lead to change. Talking is not action. Change does not come from “discussion” it comes from doing something differently. How does one recognize and learn to respond in a new and different way to the same old song when it plays? If one chooses a new way to behave, might that new behavior cost? What might it pay? Why should one try it? What would be the first step? These are questions that the therapist needs to be able to ask the client, then, be able to have the client stop and consider these questions openly. The discussion of therapy then moves to focus on these new experimental behaviors. But, there is more to the problem and its solution than just that.

The piece that is missing, when a therapist can step back from the “attractively similar client” who speaks their language and is interested in the same topics, is the “body work” not the mental work. The “body work” requires the client to get out of his or her head and begin to recognize and experience the feelings that must be addressed. At least for these specific examples I have presented here, of the verbal intellectualizing client and therapist. What they both tend to do is avoid and “miss” the information channel from the body. What do they feel? Do they feel anything? How do their feelings impact their behavior and their understanding? Are they self-aware and self-honest? Or do they hide behind their intellectual acrobatics. I am reminded of stories about dog -fights between airplanes. When a jet has another jet hot on its tail it can release a bundle of chaff, which will confuse and misdirect the radar of the other jet and its missiles. When this happens, at least electronically, the jet can hide in the electronic cloud of misdirected and distracting data that the computers on the missiles have to evaluate as they seek for a target. This will give the fleeing jet an opportunity to turn the tables or to run away to fight another day. Many of us use the same kind of chaff in order to hide in plain sight. We throw out “distracters” and hope that people will chase them, instead of continuing to bore in on us as the target of their interest.

As a therapist, what I want to do with this client is get them to stand still, be quiet, and become aware of their body channel, not their intellectual one. I ask them to consider several questions. What do you feel? What does your gut tell you? What is your innate sense of how to understand this? I want to get them out of their head and into their body. I believe that there is information there which lies dormant when they only utilize one channel of experience in order to problem solve. As a way to get them to do this, I may have to spend time in therapy teaching them to get centered and to do some guided imagery with them (if they trust me enough to let me lead them to this place.) We work on helping them to learn to be quiet and still. When they are quiet and still, something will come to them. They will become aware of it and can experience it in a completely new way. If they learn to listen to this new perception, then they can use what it offers them to solve their problems in a new, different way. An analogy I often use is that clients will go around three sides of a square to get to an unconsciously predetermined destination that they intended to go to all along because they cannot use this other channel of “knowing” in order to go straight from one point to another. They are used to following a “script” of a previously learned verbal and intellectual channel to know and understand the issue that they are working on. This script costs more and takes longer, if indeed, it ever gets them to the place they want to go. To find the shortest way to the destination, or resolution of the issue, they must rewrite the script using all of their faculties, both intellectual and emotional. In short, they must feel their emotional reality in an honest self aware way, not just intellectualize it.
In the spirit of full disclosure, my friends who are therapists tell me I am very capable of using these techniques with clients. But I still need some work in being able to use them for myself. I tell my friends they are just intellectualizing, of course…….

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2 Responses to The Cartesian Split in Therapeutic Thinking

  1. Emma says:

    Thank you for your article! I’m a student therapist working with a client a lot like this. She presented with anxiety and my suspicion although we have only had a few session together is that the stillness causes great anxiety, hence the business, and verbal busying. Would you proceed in the same way outlined here with a client like this? My feeling is I need to spend a lot more time building a relationship? But then I have also found silence and stillness difficult to cope with in the past in my own personal therapy.

    • Brett Newcomb says:

      Hello Emma, every therapist has to decide how much history to listen how important it is to the client to be able to uncover and relate it. There are risks that constantly recycling historical stories works as a deterrent to progress though so at some point you have to encourage movement. I like the hear and now approach of reflective listening, where one identifies that the client is feeling anxiety or fear or whatever you see, softly and gently communicates that with acceptance. Gradually shift them into an awareness of how what they feels colors or limits their options. Don’t tell them, just notice and wonder. Ask things like “is it possible that this anxiety is an example of a way that you resist accepting your own strength?” You have to develop the safe place, and one way to do that is soft constant reflective observation of reality. Good luck. Brett

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