Humour and the Therapeutic Relationship21/06/2022
Sometimes we need to dip into the archives of our mind to remember to do it differently as a psychologist!
I have been spending the last few weeks reviewing my practice, trying to distil what I do and how I do it. I tried some Socratic thinking with myself….. basically observing myself thinking and ultimately making decisions.
I have always been a strong advocate for the Scientist-Practitioner Model in Psychology. However, as I started to review cases from the past I realised that I used to be more Artistic in my approach…more eclectic. Over the last few years this had been whittled away with the restrictions the profession (and I) have placed on ourselves.
I started to think about what has worked with clients…what has helped them achieve their goals.
A particular case came to mind…one that I had archived in my memories. This intervention fit the Artist-Practitioner Model!
A woman in her mid-50’s had been referred to me with severe post-traumatic stress disorder (PTSD) following a car accident. She had survived with only one bruise after a car rollover (5 times) with her car being squashed and as she escaped from the back window. She had hit a cow at 4.45am on a major highway while travelling at 115km/hr. Everyone had been telling her how lucky she was, but she didn’t feel lucky (never tell anyone how lucky they are after an accident…. Its not helpful).
By the time she saw me (2 years later) she had managed to get back in the car and drive short distances in Adelaide, but she needed to drive on the major highways as most of her family lived 5 hrs from Adelaide. She was overwhelmed by many of the PTSD symptoms, but one that related just to her was waking up every morning at 4.45am feeling like she was still rolling over in the car with the thought “I’m dead“. This would keep her anxiety for the rest of the day on high alert.
I tried all the desensitisation methods over a 6-month period and there was some success – she was able to extend her driving to night time driving in Adelaide and the outer suburbs which she had been avoiding due to the possible animals on the road and to short distances into the Adelaide Hills, but no further. She remained anxious at all times when driving.
Then during a session, I had a thought. “I want to try something new” I told her. She was an artistic person and by this stage we had established a good therapeutic relationship. “It’s a bit different” I said. The anniversary of her accident was in the following week – on a Thursday.
“Meet me at Henley Beach Square and 4.30 am next Thursday. That’s where this therapy will take place” I told her. She smiled and asked if we were finally going to sacrifice something (I had been telling her that psychology was a science and we didn’t work outside of this paradigm or sacrifice chickens…). “No… no chicken sacrifices…. just meet me there and wear something warm in case it’s cold”. She agreed.
I was excited with my plan but still racked my brain to find a therapy I could fit this into…”maybe provocative therapy” I thought….
I prepared for our session on the beach. I took my dog Annie (a French Mastiff) for company and because my client loved dogs. In addition, I took a bottle of chilled champagne and 2 plastic glasses.
We met at Henley Square at 4.30 am. Me with my dog, picnic basket and a hope that this unorthodox therapy would work and her with excited anticipation.
I started to tell her that we need to change her memory of 4.45am from a rollover accident where she thought she was going to die to a beach celebration drinking chilled champagne while we celebrated that she lived and flourished.
She cuddled my dog, laughed and raised her glass to the breaking dawn and shouted “I am alive!” Then she ran around the beach with my dog for another 20 minutes before we packed up and went home.
I saw her in my office 2 weeks later. She was different. I asked her how the last 2 weeks had been. She laughed and said “Great. I have only woken up a couple of times at 4.45am but I think of Annie (my dog) and our beach therapy and smile and go back to sleep.”
She had also been to visit her parents – 5 hrs from Adelaide on a major Highway and while this was in the daytime, she was optimistic that it wouldn’t take long for her to feel comfortable driving down at night. This was our last session.
The one beach therapy at 4.45am at Henley Square had treated her PTSD more than my 6 months of desensitisation and hypnosis. The unorthodox nature of this with champagne (her favourite drink) and my dog assistant Annie had more impact than anything else I had tried.
As I thought about this case and observed myself thinking and feeling (Socrates would have been proud) I knew that I would have to take the Artist out of the Archives and let them co-exist alongside the Scientist. Psychology and all other health modalities (including Medicine) is often more than just science.
P.S. For the next 5 years she would make me the most divine chocolate truffles and drop them off on the anniversary of her “I am alive”.