Christian Billington

It was going to be a tough case. During intake, the client had been particularly resistant to any sort of disclosure. To be honest, given his tight-lipped demeanor, I was not really sure why he sought therapy. His unwillingness to do more than moan and just sit there expressionless, near-catatonic, dead to the world, made me believe something was not as it seemed and there were deeper issues at play.

I have been reflecting a lot recently about therapy. A recent post discussed clients’ plans that fail to come to fruition (see ‘a bit awry.’) A further thought occurred as I was writing said post. Another common theme with clients involves what I consider to be the ultimate variable, the ultimate uncontrollable, the ultimate enforcer of plans, intentions, dreams and ultimately when this entire shebang is finished, like it or not. So what is this omnipotent variable?

Plans. We all have them. Some pan out and some do not. Some are intricate pieces of mastery while others are basic with few steps and little external influence. The more complex plans tend to involve greater steps, involve more important but uncontrollable variables such as relationships and time. So is it any wonder that with so many different possibilities that fall outside of the locus of control, that the clients we often see are deeply affected by plans gone awry?

A huge part of the practicum experience was supervision and planning. I spent at least two hours a week discussing cases and planning what to do next. As laborious as this felt at times I am grateful that my supervisors allowed me to use their experience as a guide, enhanced by my ideas, a systems perspective and four years of school. So how did the planning work?

What do you do when a client is apparently in a free fall? They report, of course, that “this time it will be different.” They will change, they are ready, and it is time. Then the next time you see them - usually just a few days later - they resemble the same blown out, angry wreckage that you spoke with just days before. How does this sit with you?