Nora had been thinking about getting help for
years but just recently she had begun to feel desperate enough to do it. In the
past few weeks, she had experienced terrible fear and hopelessness which would
crescendo every few days into full-blown anxiety attacks: she would become short
of breath and
light-headed, her heart would pound, and her thoughts would race towards seeing
herself dying of a heart attack. She began to dread going out in public, fearing
that she would have one of these attacks when no one would be there to help. She
was 53 now and had experienced a few of these attacks when
she was in her early twenties but they had never been so strong.
Nora had recently become extremely frustrated with
her husband, Charlie, because he would not talk to her about anything
significant or personal. She knew that their marriage had been dying a slow
death for many years and she was frightened about their future together. She was
also frustrated with
Charlie because he was so critical and angry towards their only child, Quinn,
who was now 18. Quinn had just recently gone off to college and Nora was
worrying about him everyday. She told herself over and over that he would not
take the medication for his asthma, that he would not get enough sleep,
that he would drink too much, and that he would flunk out. Every day Nora woke
up to the sound of her own distressing thoughts: she found herself dwelling on
how afraid she was for Quinn and how angry she was towards Charlie. She had
woken up this way every day for weeks. She would continue
to think this way throughout each day except when she was preoccupied by her
duties at work.
She realized that she needed professional help
but she was afraid to seek it out. She had always been able to handle her
problems herself and had never wanted to see a "shrink". A few weeks after Quinn
left for college, he had a severe asthma attack and ended up in the hospital.
Nora became totally
obsessed with her worries about Quinn. She felt that there was no way out of her
daily agony of anger and fear. She called her best friend Gloria who had needed
professional help when she had gone through a very painful divorce. Gloria told
Nora that she had seen Dr. Susan Kleinfelter during this difficult time and that
Dr. K had been very helpful to her. Gloria gave Nora Dr. K's phone number and,
after Nora argued with herself for another week, she called and set up an
appointment. She felt ashamed that she couldn't get herself out of her current
difficulties by herself.
She felt afraid of what she might find out about herself and her marriage from
the doctor. As the appointment approached, she had strong urges to cancel it but
she went anyway.
At the appointed hour, she found herself in a small but tastefully decorated
waiting room nervously shifting in her seat while pretending to read a magazine.
After about ten minutes, a rather petite, professionally dressed, and
enthusiastic woman of forty came into the room, smiled at her warmly,
shook her hand and said, "Hi, you must be Nora. Welcome. I'm Dr. Kleinfelter.
Why don't you come back this way to my office so that we can get started."
Within the first few minutes of their session, Nora began to pour out her anger
towards her husband and her worry about her son. She felt uneasy talking so
critically about them to Dr. K, as if she were betraying them to a stranger. At
the same time, she hoped that Dr. K would take her side against them and get
them, somehow, to make the changes she knew they needed to make. Even in these
first few minutes, a therapy triangle was beginning to form.
Sigmund Freud began the modern practice of
psychotherapy a little over one hundred years ago. Although Therapy has changed
greatly since the 1890’s. Every relationship between therapist and client
throughout the history of psychotherapy has been part of a triangle of
relationships. Although therapy has changed greatly since the 1890's, every
relationship between therapist and client throughout the history of
psychotherapy has been part of a triangle of relationships. Because every client
is part of a multi-generational stream of humanity called a family, every
therapy affects and is affected by the client's family. This is true whether the
therapist ever meets the client's family (as in
family or couple therapy) or the therapist never meets any of them (as in
individual therapy). Often this triangle goes unrecognized by the patient, the
therapist, or both but it still exerts a powerful effect on the success or
failure of therapy. In the pages of this book, I will explain how the therapy
triangle
works so that you can get a clear picture of how treatment can work for you.
Every year more than ten million Americans do what Nora did: begin a
relationship with a therapist. Nora came to Dr. Kleinfelter because of anxiety
symptoms and family problems but people come to treatment for many other
reasons: depression, grief, behavior problems in their children, alcohol and
drug problems, anger, marriage problems, divorce, the struggles of caring for
aging parents, sexual problems, and stress-related headaches, to name only a
few.
As we just saw, Nora was beginning to form a therapy triangle. She was angry and
frustrated with her husband and her son but could not successfully deal with her
problems with them without outside help. She came to a helping professional
because of her anxiety but also because she wanted
Charlie and Quinn "fixed" so she wouldn't have such distress. Dr. K felt
pressure even early in the first session to take Nora's side against her
insensitive husband and her irresponsible son. This web of relationships between
the client, the therapist and the client's important family members is
the "therapy triangle". It is always present in therapy; how the members of that
triangle handle themselves has a great impact on whether therapy is successful
in bringing about lasting changes. Understanding how the therapy triangle forms,
how it can prevent lasting change from taking place, and how it can promote
lasting change is the subject of this book. |
