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Look, Mom, I'm an Ethnographer Now!

Here is my half-assed reflection on the nature of a therapeutic relationship. CBT therapists create relationships where they are experts. Psychoanalysts create relationships where they are … ethnographers.

For a while, I could not figure out why I couldn't stand CBT, but I appreciated psychoanalysis. I tried to debunk the ideas CBT clinicians communicate to their clients, but my arguments did not sound convincing. The difference is not in the content; it is in the relationship.

Different forms of therapy/coaching are quite alike in the ideas they try to illuminate for their clients. However, the way they communicate these ideas to clients is very different.

CBT therapists (and most coaches) create expert-novice or teacher-student relationships. They tell the client what is wrong with him (e.g., "dysfunctional thoughts" or "lack of self-compassion") and give a prescription for fixing it (e.g., worksheets, frameworks, exercises, etc.).

Some people like it. But I, as a client, only feel the clinician's need to be right and their lack of interest in me (because they already figured me out!). They may even be right! But I just cannot get over their attitude.

What about psychoanalysts? Freud suggested that an analyst should model himself after a surgeon. But something does not click with me in this analogy. Perhaps it is because of the intent to fix someone.

My metaphor for an analytic relationship is ethnographer-subject. An ethnographer is a curious, attentive observer trying to understand his subject's life and culture (i.e., the psychic world).

This world is quite foreign to the ethnographer and has its inner logic, values, and traditions. He observes every detail (including the subject's reactions to him) with interest and attention. Yet, he cannot fix anything in this world.

As he is doing his job, he communicates his understanding back to the subject, helping him understand himself. This understanding helps the client ("subject") to fix whatever he chooses.

This metaphor brings to the forefront something that David Bell stated in one of his lectures: psychoanalysis is not a form of therapy. It is a way of studying the mind. The therapeutic effect is a byproduct.


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