Monday, April 11, 2011

More about Listening

How we organize what we hear and observe is influenced by our own subjectivity, our experiences, and our theories. Because no theory holds the ‘truth,’ we must hold our theories lightly, recognizing that each person’s reality is perspectival, and recognizing that the meaning of the material need not be fit into the procrustean bed of a theory. As I listen and muse on what is going on in the therapeutic dyad, I often think I am like a juggler, with many plates in the air at once. I must simultaneously consider whether or not I hear at this moment a familiar sigh or theme from the patient; whether or not the present narrative or relational paradigm harkens back to the patient’s childhood events; what, if any, are the transference counter-transference implications; what happened in this past moment or last session or over the months or years of analysis that contributed to this coming up or happening now; and so on; all the while being open to the unknown and to surprise in a free floating reverie with evenly hovering attention!

Listening is dialectical (you can never stand in the same river twice), which means patient and therapist influence each other and neither is ever the same again. Listening is intersubjective, containing within it both the listening and the being listened to. Listening allows space for creativity (Winnicott) and for the, as yet, unformulated and unspoken. It is a gift we give our patients, interested in every word and gesture. It is a gift our patients give us, along with the privilege of their trust. When we listen, we do not seek to confront or contradict the patient, though we may sparingly ask for clarification. Many people have never experienced such genuine attentiveness from another.

As communication is both explicit (with words and common gestures) and implicit (perhaps what Freud referred to as unconscious to unconscious communication) we must listen as well with our perceptions and unconscious perceptions. We attend to the texture of feeling and gestural communication and not just to words or content or to conscious understanding and insight. We become comfortable, not impatient, with silences when the patient may need to be with some caring other without the pressure to produce or perform. Each therapist will have a unique interest in this or that part of a story, evoking a resonance with something in the therapist’s personal history. Each therapist must find her/his own way of expressing, in a way contributory towards patient growth, what has meaningfully affected us.


Roia said...

And, indeed, this is what makes being a therapist most fascinating- that listening can take so many forms and level and that it is always unique to a particular therapeutic (or non-therapeutic) moment in time.

Tim said...

The theme here is very similar to Dorpat's Climical Interaction and the Analysis of Meaning. I think someone incidentally DID take the torch from Dorpat. I think he would have been very happy to read something like this from a fellow analyst. As far as I know he was peerless among his colleagues. I think you would make him proud. Dorpat passed away suddenly in 2006, but evidently his
spirit still carries on.