For a few weeks now, the therapeutic relationship with Ms. F. has felt different because I have started to wish for a good future for her. The problem is that I have a clear picture of this “good future” myself.
Ms. F. is in her mid-fifties and looks back on an unstable life. Relationship breaks, job changes and moves followed each other with a frequency that made me dizzy even in the first interview. When we met, she was unemployed and struggling with what career path she wanted to pursue.
As an aspiring systemic therapist, goal neutrality has become an important value for me. The patient is and remains the expert of her own life and sets the direction of the therapy process. At least that’s what my ideal image of myself says – and it was deeply scratched while working with Ms. F.
When Ms. F decided to return to work as an educator, a job she learned in her twenties, I felt relief. The uncertainty first made her and then me nervous. She felt wonderful for the first few weeks of work. She beamed when she talked about the children, had found one of the few daycare centers with sufficient staffing levels and was valued by her superiors. I was sincerely happy for her.
But slowly something changed. She became restless and was skeptical as to whether she could trust her positive feelings. She reported minor team conflicts and dissatisfaction with work processes. When she finally began to fundamentally question her profession as an educator, it felt like a personal loss to me. I wanted to shout to her: “Don’t give up! You’re on the right path!” At the same time, I was angry with myself – I longed for more neutrality. I knew that Ms. F. was the only one who had to approve of her life and its twists and turns.
Ms. F. began to repeatedly come late to work and get into conflicts with her colleagues. It was like I was forced to watch an accident in slow motion and from the sidelines. When I described this experience in supervision, my supervisor looked at me attentively. “You really care about this woman,” he stated. “Yeah, sure,” I replied.
“Does she know that?” he asked. “Of course not!” I said indignantly. I want my patients to know that I value them and see the good in them. That I am genuinely interested in her. But that they are important to me? Doesn’t this overload the therapeutic relationship with too much emotion?
“Let’s first see what this could be good for. Could what is too much for you be too little for her?” my supervisor asked. I thought out loud: “Do you mean that her decisions are so important to me because she doesn’t actually care about them?” “Maybe?” he asked back. “Does your patient know the basic feeling of being important? To herself and to others?”
I thoughtfully recapitulated my conversations with Ms. F. Biographically, she had received little of the support that is needed to find one’s own identity and to be able to endure frustration. I began to see my caring no longer as unprofessionalism, but as an attempt to compensate for something missing.
Ms. F. had no children, but was a passionate godmother. “If you imagine your godson was in your position, what would you want for him?” I asked her. The answer came immediately: “That he takes a breather. That he takes time to develop. He could always break off.” “And if you imagine that a person who has your best interests at heart would wish the same for you?” Ms. F. seemed touched, but shrugged her shoulders and said, “Then I don’t know what I would do.”
“Would you like to find out?” She was silent for a long time and then said quietly: “Sort of.” With this cautious and diffuse answer, Ms. F. set foot in a new inner world. The question “How do you want to develop in the long term?” no one had ever asked her. Alternatively, she had made decisions based on desire and displeasure, on spontaneous conflicts and impulses. “At first I thought it was about what I wanted,” she said a few months later, “but now I know: it’s about who I am.”
Tabea Farnbacher was born in Hanover in 1996. She works as a psychologist and psychotherapist in training in a psychiatric clinic in the Ruhr area. Since 2016 she has also been working as a stage poet and lyricist. Farnbacher has received several awards for her writing, including the Federal Prize “Meetings of Young Authors”. In this column she writes about her experiences and development as a young therapist.
Transparency note: There is no therapist without patients – that’s why this column tells about people in psychiatry. Since the protection of those treated is the top priority, the case studies are heavily modified in terms of their socio-demographic and biographical data and appear at intervals of time. The reported encounters retain their emotional core.
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