An initiation rite is an experiential event that helps one move through a rite of passage. The process facilitates the transition from one stage of life to another. It creates a personal transformation, a momentous metamorphosis – an experience after which one is never the same again. Its social structure reflects the norms of the culture and is typically organized by the elders of the community.

Some cultures use initiation rites to help boys become men. Other cultures have initiation rites for girls as well. Rohr (1992) noted the following based on his review of the anthropological literature, “It seems that it is only the recent West that has deemed it unnecessary to initiate young men. Other wise, culture after culture felt that if the young man was not introduced to the mysteries, he would not know what to do with his pain and would almost always abuse his power.”

The absence of traditions like these in our culture is problematic. We have lost sight of their importance. We are left to discover our own way, to let life initiate us, to find our own path through many confusing cultural expectations and misleading family rules.

Our lack of a focus on “being” instead of “having” in our culture has devastating effects. Addictions of all kinds are rampant and tearing families apart. The divorce rate continues to rise, suicide rates for teenagers and young adults are at an all time high, anti-depressant medication and anxiolytic medications are being prescribed by general practitioners at an unprecedented rate. Jails are overcrowded, and yet crime is on the rise. Stress related physical symptoms account for the majority of medical problems presented to family doctors. We objectify ourselves and others. Women are viewed as sex objects, while men are viewed as success objects.

We are stuck in this muck. But there is hope. We, human beings, are seekers. Our basic need is to grow and self-actualize. There are many ways to free ourselves from this insanity. Therapy is one path. Recovery is another. In fact I believe the main therapeutic effect of the 12 Steps is to help us discover our lost, true self.

Initiation rites progress through very distinct stages, just like recovery. Let’s look at the stages of an initiation rite and see how they relate to the program of Alcoholics  Anonymous and the 12 Steps.
Initiation rites occur in a liminal space that is created specifically for the experience. Initiation rites typically involve four psychological experiences. They are: 1) Purgative, 2) Illuminative, 3) Integrative, and 4) Unitive. I will define each and how they relate to recovery, but before I do I will discuss liminal space.

Liminal Space

The creation of a liminal space, a sacred space, is critical for an initiation rite. It is a special reality created by removing the person from usual surroundings and placing them in a unique environment with a different set of norms and rules, which are quite alien to the initiate’s consciousness. This has a planned, disorienting effect.

Initiation rites for boys often begin in the dead of night. They are awakened and escorted to a spot far away from the village – this becomes the liminal space where they will be challenged to confront themselves and their fears like never before. They will discuss things that they have never discussed openly. This sacred atmosphere allows the elders to create experiences and ordeals that transform boys into men.

Recovery occurs in a liminal space too. Meetings of Alcoholics Anonymous create a sacred space which is quite different than other social gatherings. For the newcomer it is like being Alice in Wonderland, everything that isn’t – is, and everything that is – isn’t. True and honest speaking sets the tone for A. A. meetings. Members are encouraged to openly and honestly, discuss their problems, their failures, their disappointments, their shattered dreams, their doubts, their despair, their self-centeredness, their selfishness, their immaturity, their insecurities, their dishonesty, their grandiosity, their fears and limitations, and their hopes and successes. Feelings none of us would dare openly discuss in public. Honesty, open mindedness and willingness are critical elements of the liminal space that is created in A.A. meetings.

Purgative

The first phase of an initiation rite for boys is to purge them of their boyish spirit and immaturity, of their “Imperial self.” Their self-centeredness, their sense of over importance, and their ego centricity needs to be deconstructed. Their limited self-concept and narrow understanding of life is confronted head on in this process. The “Imperial self” is shattered as the boy comes face to face with his limitations through taxing physical and mental challenges, through confronting intense personal suffering and pain. Through being wounded and bleeding, he learns humility. He learns that he is at once less than he thought he was, and more than he thought he was. This deconstruction is necessary to become a man.

The first of the 12 Steps confronts the alcoholic in a very similar way. It challenges what Vern Johnson described as the alcoholic’s “sincere delusion,” the belief that he or she can control the use of alcohol. This is a paradoxical intervention. The alcoholic surrenders to their powerlessness, to gain freedom from their fatal malady.

But the First Step doesn’t stop there – it goes on to further deflate the alcoholic’s ego or “Imperial self” by shattering his or her reliance on their false-self. This is a very difficult for the alcoholic to accept, but necessary.

Surrendering is critical to recovery and leads the alcoholic to an acceptance of being powerlessness over alcohol and that their life has become unmanageable. This creates a deep sense of hopelessness and despair. This hopelessness and despair is therapeutic. Bill Wilson described the experience as “deflation at depth.”

This is an essential experience in the process of recovery. The alcoholic must be convinced without a doubt or reservation that he or she is suffering from an illness caused by “an allergy of the body and an obsession of the mind.” The idea that an alcoholic can drink like a normal person has to be completely smashed. Bill Wilson recognized the following relationship between hopelessness and recovery. He stated that “Recovery is based upon a spiritual experience set upon a pedestal of hopelessness.”
As in any effective form of therapy, when an unhealthy solution is removed, something better must replace it or we will return to what we know. This is exactly what happens in the next stage of the initiation process as well as in the next stage of recovery.

Illuminative

This phase of the initiate process introduces the initiate to the mysteries of life. It tells the young man what is worth suffering for and what is truly glorious to die for (Rohr, 2007). An important part of this phase of the initiate’s experience is his relationship with the elders. Once the boy has started to let go of his Imperial self, the self-centeredness and other ideas connected to his immaturity, he becomes open to learning.

Lessons are taught and realized through the experiences that force the boy to confront the limitations of his consciousness. Elders provide a context or world view to help him assimilate these new experiences and expand his consciousness. They help the young man in understanding the most important things about life and manhood. By providing an experiential context, the initiation rite grounds maturation in the process of learning from experience, and in the value of having an enlightened witness in your corner.

This process is very similar to what takes place in Alcoholics Anonymous meetings and through AA Sponsorship. AA provides a framework through the 12 Steps to convert weakness into strength, suffering into knowledge, and vulnerability into an asset. The Steps systematically create a momentum of personal transformation that is hard to stop once it begins.

The collective consciousness and wisdom of the AA group becomes a valuable resource to understanding the mysteries of recovery and life. Through AA sponsorship, the newcomer is mentored in recovery, similar to how the boy is mentored by elders. The sponsor becomes the newcomer’s personal guide to the 12 Steps. One drunk talking to another is a cornerstone of the AA program.

Integrative

In order for wisdom to be useful it must be integrated into behavior. It cannot be a purely an idea or intellectual exercise. It must be pragmatic, it must be relevant to the desired outcome of the initiation. In the case of the boy he must learn things that will help him claim his place, as a man, in his society. Initiation is always about transforming. Rohr (2007) believes the essential messages of a male initiation must communicate the following:

• Life is hard – if convinced of this early in life a man will not waste time trying to avoid it or search for the easiest possible way. He will learn how to turn weakness into strength, pain into knowledge, doubt into certainty. He will be able to respond to what life expects from him rather than to impose unrealistic expectations on life and then get angry when others refuse to cooperate with his nonsense.
• You are going to die – the certainty and reality of one’s death must be made very real. The young man must live as one who has already died the first death and is not protecting himself from the second. Suffering is part of the deal.
• You are not that important – humility is of central importance  for truth and happiness in this world. Humility keeps a man rightly situated in the world. Littleness or ignorance or making a mistake is nothing to be denied or disguised or ashamed of, but rather gives a basis for all community, family and service
• You are not in control – the illusion of control must be surrendered by a deep experience of one’s own powerlessness. Usually, only suffering accomplishes this task, especially unjust suffering or struggling with things one cannot change.
• Your life is not about you – an initiated man realizes that his life is a part of something much bigger than himself. This is the essential summary experience. Human experience takes on a dramatically different character. We call it spirituality or “holiness.”

These concepts reset the young man’s expectations. His perspective on life is transformed, it is enlarged, his consciousness expanded.

Working the 12 Steps results in exactly the same thing. For the man or woman who has descended into an alcoholic abyss, and who has surfaced on the other side, there is an ultimate new shape to the universe. Life is re-enchanted, life is re-calibrated or recovered, and now works in a way other than expected. The alcoholic finds a solution to their alcoholism that is embedded in a set of solid psychological and spiritual principles.

Unitive

The final phase of an initiation rite involves reuniting the initiate to society. A ceremony marks the return of the boy to his society and he is now recognized and celebrated as a man. He is reunited to his community as a man who is now ready and willing to take his rightful place. He becomes a true citizen in the deepest sense of the word.

An essential therapeutic outcome of working the 12 Steps is that the alcoholic now reunites with his family and community and becomes a true citizen. He is no longer a liability, but becomes a respected member of the community, and an asset to his or her family.

Summary

As you have seen, the stages of recovery can be compared to the stages of an initiation rite.
During recovery, we are purged of our false-self (our defiant-self), and we are assisted in finding our lost, true-self. We learn to “be,” and live, life, based on a set of spiritual principles. Our consciousness is expanded and we discover a new purpose in life. And finally, during the process of recovery, we integrate many disowned parts of ourselves, and become re-united with our families and our communities.
The process is remarkable indeed. Recovery involves a personal transformation, a momentous metamorphosis – an experience after which we are never the same again.

References

Grimes, R. L. (2000). Deeply into the bone: Re-inventing rites of passage. University of California Press.
Rohr, R. (1992). The Wild Man’s Journey. St. Anthony Messenger Press.

Rohr, R. (2007). Personal communication.

Understanding our culture’s role is one part of the story, but the rest of the story is more personal and more painful. I hope to show you how we participate in creating our own problems. What I have to say is tragic. We become our own Judas. We sell ourselves out. We betray ourselves by abandoning our real-self and embracing an idealized image, a false-self. As terrible as this is, it seems like the right thing to do at the time. Let’s look at how this happens.

We are each born with a true-self. We are like the acorn, genetically programmed to become a unique oak tree. But the acorn cannot fulfill its potential unless it grows in a nurturing environment. The environment and climate has to provide certain things for the acorn to grow. There has to be adequate sunlight and water. The soil needs to contain certain nutrients. It cannot be exposed to harsh conditions until it is well rooted or has matured to a certain point. If all of these conditions are adequately met then the acorn will eventually become what it is destined to be: A beautiful oak tree with a set of unique qualities and characteristics. The success of our human development is very similar.

If we are encouraged to mature along the lines of our true-self then we too will fulfill our destiny, and become who we were meant to be. Our true-self will unfold; we will be self-actualized. So what experiences do we need for this to happen? There are at least three critical psychological components in our development. They are to be seen, to be celebrated and to be emotionally coached to honor our true self.

Let me explain each. When I say we need to be seen I mean we need our parents or other care givers to mirror back to us the true essence of our spirit. This mirroring helps us see ourselves. We see who we are by looking at ourselves through their eyes. This forms a sense of self, it molds our self-concept. It helps us realize who we are and what is important to us. For example, if a six year old boy is very excited about seeing a new species of a bug crawling on the sidewalk a highly tuned in parent might say, “You seem so excited to see that bug. You are very curious about life and love discovering things.” This is reflecting or mirroring the child’s experience.

This rarely happens. We have lost sight of the importance of recognizing one’s essence, instead we have unfortunately emphasized positive feedback as essential for good parenting. Parents are told to jump at every chance you get to positively reinforce their child’s self-esteem. You can go to any park in your neighborhood to see firsthand what I am about to describe.

Johnny is at the neighborhood park with his parents and having a blast swinging as high as he can. It was only a couple of months ago that he needed his parents to push him on the swing, but now he is growing up and can swing independently. He is proud of his achievement and loves the stimulation of the swinging. He cries out as he propels himself to the top of his arc, “Mommy look at me!”

His attentive mother innocently responds, “That’s great Johnny.” She evaluates his experience instead of mirroring it. She labels what he is doing as “great.” Johnny takes this in, he assimilates this information. He realizes that he can get his mother to say he’s “great” if he performs in a certain way that pleases her. If his mother continues giving him this kind of feedback eventually Johnny will be doing things to get her to say “great.” He will have lost sight of doing things intrinsically important. This kind of response to a child teaches him to ignore who he is, what he feels and what is important to him. Instead he becomes focused on performing to please his parent.

If his mother said, “Wow, Johnny, you seem to really like what you are doing. It’s important to do things you like.” She is giving Johnny a very different message. Evaluations lead to emotional dependency. Mirroring leads to self-awareness and self-respect.

Being celebrated is also very important. While being seen develops a sense of who we are, being celebrated helps us claim our space. When we are celebrated we develop a sense that we are important and that we have the right to be. It’s mind blowing to stop and realize that there are some of us who have never heard their parents say something like, “I am glad that you were born!” or “I am glad that you are my son or my daughter.”

Being seen helps us become aware of who we are whereas being celebrated helps us feel that we have the right to exist. Two incredibly important qualities for self-realization and self-actualization. The third thing we need is to be coached to honor our true self. When we are coached to honor our true-self we develop an internal compass that points to true North. We will have a personal reference that will guide us during difficult and uncertain times. These three things are at the heart of effective parenting.
Unfortunately we rarely experience this kind of parenting. Early in life we all become anxious that we won’t be loved and accepted. We have what Dr. Karen Horney (1950, Neurosis and Human Growth) described as “basic anxiety.” This personal anxiety interacts with the nonsense in our culture which is amplified by poor parenting and eventually overrides our natural development. We veer off course. We become compelled to find a solution for our anxiety.

The quest to discover a solution to this basic anxiety has been called the “search for glory.” We must find a way to be loved and accepted or else —– and we do. We construct an idealized image of who we are supposed to be. This is our false-self. The false-self is the solution to basic anxiety which was discovered during our search for glory.

Our basic solution typically forms around three different unique themes: The self-effacing solution – The appeal of love, The expansive solution – The appeal of mastery, and Resignation -  The appeal of freedom. In all of these solutions the alienation from our true-self is the core problem.

If the appeal of love becomes the focus of our solution we become people pleasers. We feel inadequate, inferior, guilty and contemptible. We must not think or feel superior to others or display any such feelings in our behavior lest we won’t be loved. Self-assertiveness makes us anxious. Therefore we can easily become victims in relationships. We dare not stand up for ourselves. We long for help, protection, and to find a passionate and spiritual surrendering love. We try to figure out what someone wants us to be and we mold ourselves to their image. We become chameleon like.

If the appeal of mastery becomes the focus of our solution then we try to get love and acceptance by excelling, by being the best, and by being superior. This is the opposite of the self-effacing solution. We tend to manipulate or dominate others to make them dependent upon us. We strive for power over, either through becoming superior or by being ruthlessly vindictive. We identify with our idealized image and become arrogant and narcissistic.

And finally, if the appeal of freedom attracts us then we will withdraw from the inner battlefield and declare ourselves uninterested. We will resign from the so called rat race. This is the most radical of all the solutions. We become indifferent. We give up and stop trying. We become underachievers. We are seen as having all kinds of potential, but no ambition or desire for success.

As our idealized image crystalizes into a false-self we develop a pride system that rewards and punishes us to insure that we develop according to these idealized specifications. We feel good about ourselves and proud of ourselves when we act or behave or think or feel the way we think we should (reward) and we hate ourselves when we do not (punishment). Our “shoulds” become a tyranny that exercises absolute control of our life. We are driven to be the way our idealized image demands and we dare not question its authority. These specifications and the demand of blind obedience are absolute and breed a pervasive “black and white” thinking in our lives.

So we sell out during this search for glory. We sell out big time. We lose ourselves in this process. We abandon and alienate ourselves from our true-self. We conclude that we aren’t good enough as we are and therefore we must become something we aren’t to be OK. What a tragedy. We reject ourselves for an ideal. We swallow whole and uncritically this entire nonsense. What we don’t realize at the time is that any life based on self-rejection will never be fulfilling or satisfying. Something in us aches to be who we are. It is this pain that manifests itself in a myriad of symptoms. I believe that this is the spiritual thirst that Dr. Jung discussed when he was communicating with Bill Wilson about alcoholism. Therefore it is what is right about us that creates problems in our life, not what is wrong with us. It is abandoning our true-self that sets in motion a juggernaut that destroys our life and opens the door for addiction.

The amazing thing about the 12 Steps of Alcoholics Anonymous is that they systematically de-construct our false-self and help us recover our lost, true-self. As a clinical psychologist I have spent many hours studying the process of change. I can state without a doubt that the 12 Steps are the most powerful and effective solution to our fatal malady. The therapeutic forces they harness are remarkable. If you are struggling in recovery and you haven’t precisely and thoroughly worked the 12 Steps – do yourself a favor and find a Step Sponsor. Not only will this effort prevent further relapses but you will also experience an incredible shift in the quality of your life and in your attitude.

For the purpose of the online CE Course, the article objectives are:

• To understand our psychological development in terms of adopting an idealized image of who we are supposed to be in order for us to be loved and accepted.
• To understand the how abandoning our true-self becomes the core problem and how its restoration becomes the ultimate goal of recovery.
• To understand how “shoulds” are an extension of the tyranny created by the false-self.

Culture is transmitted through the family. Parents teach children their culture’s world view. This world view is like a filter, it defines what is real and what isn’t, it proscribes what is appropriate behavior and what isn’t, it dictates how we should be and what we should feel. It defines what is and what isn’t. It creates a world view that defines everything about our existence. The way this is taught in a family is unique because it is woven into the fabric of our parent’s history.

The most important thing to realize about our culture is that it is excessively focused on “having.” Our culture is based on capitalism. Capitalism needs consumers. Therefore we are hypnotized into believing that our self-worth is determined by what we have, rather than on who we are. We measure success by the quality and quantity of the material things we possess like money, homes, cars, and adult toys — but not our character. I’m sure you heard that quote, “He who finishes with the most toys wins.”

This obsession with “having” infects how we interact with our self and others too. We end up treating ourselves and others as objects and/or possessions. We become obsessed with how marketable we are. Women are typically treated and treat themselves like sex objects. While men are usually treated and treat themselves like success objects. What makes a man successful in his job makes it nearly impossible for him to have a warm and loving intimate relationship. A woman who treats herself as an object cannot be intimate because she is concerned about her image.

More is better isn’t it. That’s what we learn in our culture. I remember the moment I realized that I was in fact addicted to more. It was one of those moments of clarity, an epiphany. It didn’t matter what it was – I wanted more. Addiction is the experience of “one being too much and a thousand not enough.” That fits, doesn’t it. Unfortunately, this applies to nearly everything in our lives. We are rarely satisfied with what we have and even more dissatisfied with who we are.

We are obsessed with becoming something we are not. True self-esteem is rare, we just don’t feel good enough which is crazy because we aren’t even certain of what it means to be good enough. Our idealized image of who we should be is corrupted by these ideals. It becomes all about more, more and more and more. We spend millions of dollars on the latest exercise equipment so we can become more attractive and have a better body. (Unfortunately, most of it is gathering dust underneath our beds, closets or garages.) We pursue schemes to get rich so we can have more money which in some magical way will make us feel more secure. Women spend billions of dollars on plastic surgery to have the “perfect body.” Men are also visiting the plastic surgeon more than ever before. Men become workaholics because they are devoted to having a successful career in order to have a better life. We turn into humans, doing and performing, rather than humans, being (sic).  What a tragedy!

Another nonsense in our culture is that life should be easy and gratification instantaneous. We become obsessed with finding the easier, softer way and then we want instant results. We have lost the ability to wait, to have patience. Well, life isn’t easy and most worthwhile things don’t come easily. But nobody tells us that. Instead we are bombarded with messages that tell us to take a magical pill and your headache will immediately disappear. There is no need to figure out a better way to handle your stress. If you are depressed, take an antidepressant it will make you feel better. No need to figure out what you are doing that makes you depressed. We buy weight loss medication on TV that promises to help us lose weight while we sleep, so there is no need to spend hours in the gym. It’s easy.

When we finally turn to drugs, they really work. I mean really work; instantaneously we feel better. We are sexier, more fun, more comfortable, more relaxed, more spontaneous. We are free from fears and concerns. We are free from the false-self that develops in this insane culture. I had a friend say that he didn’t know if he was born an alcoholic, but the moment he took his first drink he knew that an alcoholic was born. We are set up by this nonsense to become addicted. We become addicted to drugs including alcohol, to sex, to gambling, to compulsive overeating or restricting. We become addicted to dramas, to spending money. We become addicted to more.

I may sound paranoid but I believe that there is a cultural conspiracy that undermines the development of our true, spiritual self. We are encouraged to abandon our true-self and become an idealized version of it self-riddled with our culture’s proscription of who we should be. We sell out, but deep down inside we know something is wrong.

The fact that we aren’t satisfied with our false, self-solution, that we become “dis-eased,” means that something is “right” about us not that something is wrong with us. Jung described the alcoholic as having a “spiritual thirst.” It is our spiritual self or our real self that is reaching out to find itself, to be actualized. It is like an alarm clock that will continue to ring despite the number of times we hit snooze. So it’s what is right about us that doesn’t allow us to completely abandon ourselves to the nonsense in our culture.
Recovery helps us find our lost, true self. It helps us reconnect with who we really are. Recovery is about “being,” not “having.” It’s an incredible journey that begins with shattering our false self. This opens the door to discovering our true spirit.

Every spiritual discipline is concerned with “being” not “having.” That’s why the 12 Steps work. They facilitate a spiritual experience based on a pedestal of hopelessness as Bill Wilson noted.

In recovery we experience a 180 degree shift in our attitude and perceptions.  This is a remarkable personal transformation. Recovery is paradoxical, which means that it is beyond belief. We shift from an obsession with “having more” to a focus on “being,” and living a life guided by spiritual principles. This breaks the trance and cures our cultural sickness. We become like Alice in Wonderland, realizing that what is isn’t and what isn’t is. What an amazing journey.

For the purpose of the online CE Course, the article objectives are:

• To understand our cultures influence of personal development and the role it plays in the etiology of addiction.
• To understand the effects of a culture focused on Having vs. Being.
• To explore how we have become a society that is addicted to more.

Introduction

If you have worked with addicts then I am certain you have confronted the so called “difficult patient” and said something like, “You don’t want to get well! Your disease is in control.”

Many well intentioned therapists and counselors have accused patients of “being resistant” and “not wanting to get well.” I have too, unfortunately. Today I look at what we label as “resistance” from a radically different and more useful point of view. I no longer think of people in these terms and because of this shift in my thinking I am a better therapist.

In this article I want to share my current understanding of resistance. Before I do, however, I think it will be useful to discuss the evolution in our understanding of resistance.

Psychoanalysis and Resistance

The concept of resistance was first discussed in Psychoanalysis. Simply stated, the process of analysis involved helping a patient work through their resistance to experience repressed memories. Here’s what Freud said:

“It is hard for the ego to direct its attention to perceptions and ideas which it has up till now made a rule of avoiding, or to acknowledge as belonging to itself impulses that are the complete opposite of those which it knows as its own.” Sigmund Freud (1926/1959).

According to Freud resistance manifested itself in five different forms: 1) Repression resistance – which is denial and avoidance; 2) Transference resistance – which is essentially projection; 3) Epinosic Gain – which occurs when one is getting a secondary gain from one’s illness; 4) Repetition Compulsion Resistance – which is acting out the unconscious; and 5) Sense of guilt or need for punishment – which is feeling unworthy of success or happiness.

Psychoanalysis employed three therapeutic processes to deal with a patient’s resistance: recollection, repetition and working through.

A Shift in Thinking

Humanistic therapists objected to the psychoanalytic deterministic view of human nature or what we can call “painting the patient dark.”

Humanistic therapists posited that a desire for resolution, growth, and wholeness existed in our psyche and that this force was constantly nudging us forward in our emotional and spiritual development. This was a major shift in the thinking of the time. It was in stark contrast to the psychoanalytic notion of a pathological resistance that was keeping us stuck and sick.

This new perspective argued that it was what was “right” about us that manifested through our symptoms. It wasn’t pathology. Being depressed or anxious or becoming an alcoholic or addict meant that something was “right” about us. A wonderful example of this can be found in Carl Jung’s letter to Bill Wilson where Dr. Jung described alcoholism as a “spiritual thirst.” Our symptoms were calling attention to our spiritual or true-self: That Ebby was ignoring his need for spirituality, growth and maturity.

So now a counselor’s or therapist’s task shifted from “removing resistance” to “unlocking potential.” This is an incredibly important change in the therapeutic process. You can imagine the different climate this would create in therapy. Family therapists provided the next important contribution to the process of therapy.

The Family Therapy Revolution

Family therapists were iconoclastic. It’s hard to imagine that just sixty years ago a therapist was violating the rules of therapy when they interviewed and treated the entire family. This out of the box thinking contributed to the next major shift in therapy. From this point of view the focus of therapy was on what was occurring between people rather than within: behavior was determined by the interactions or sequences of interactions in the family. Therefore psychological problems were understood as necessary to maintain the family’s homeostasis.

The patient was no longer the individual. It was rather the entire family. The person with the presenting problem was not the sole focus of treatment; it was the interaction of the family. The person with psychological problems was referred to as the “identified patient” or the person saying “Ouch – I have a pain in my family.” Therefore, it was necessary to interview the entire family together to see how they interacted to find a solution and understand the problem.

This redefined our understanding of the therapist’s impact on the therapy. Harry Stack Sullivan, one of the first interpersonally oriented therapists, viewed the therapist as a “participant observer.” This meant that the therapist was no longer the cool objective professional making the “immaculate perception.”  Instead the therapist was understood to be actively involved in the dynamics of the family, either in a helpful way or in a harmful way. As Minuchin and Baracai (1972) stated, “The family therapist operating as a change-agent is not in the position of the ‘cool’ professional, aiding a system from outside. By his intervention he forcibly enters a system, becoming a participant member, thus inducing change from the within”.

The family therapy perspective teaches that we each have the ability to influence each other in either a positive or negative way. We are either a part of the problem or a part of the solution.  If a family is not responding to the therapy – blaming the family would be harmful and make the therapist a part of the problem. Instead of blaming the family the experienced family therapist would focus on how he or she is contributing to what he or she needs to do to shift the dynamics.

The Myth of Resistance

From the family therapy perspective labeling a patient as “resistant” or “not wanting to get well” is a cop out. It is an interpersonal maneuver designed to blame the patient for the therapist’s incompetence. Family members do this to each other all the time and as therapists we label their behavior as dysfunctional. However, when we do this we justify it because we are of course making a “professional judgment.” Bullshit! A wolf in sheep’s clothing is still a wolf.

In 1961 Carl Roger’s hypothesized that “…resistance to counseling and to the counselor is not an inevitable part of therapy, nor a desirable part, but it grows primarily out of poor techniques in handling the client’s expression of his problems and feelings. Insight is an experience which is achieved and not experience which is imposed.”

We readily encourage patients to be authentic and honest. Yet many therapists do not hold themselves to this same standard. Are you willing to admit to a patient that you are incompetent? If you are, good for you! If you aren’t, you might want to take a look at what would stop you.

Here is how I currently integrate the ideas previously discussed in my current thinking: It has been helpful to know that each of us wants to grow, to mature, and complete unfinished business. This is the part of each patient that I engage in therapy. If a person is not honoring this part of themselves then this becomes the focus of our session. If I can’t reach that healthy part of a person then it is not their fault, it is mine. Carl Withaker, M.D., a pioneer in family therapy once said, “The family is responsible for their life, while the therapist is responsible for the therapy.”

I have mostly stopped labeling a patient as resistant and lacking motivation. Instead, I now face my incompetence. This has helped me become a better therapist because I focus on what I am doing that is contributing to the impasse we are experiencing in therapy. I focus on what goes on between us rather than blaming the patient. I have also discovered that discussing my dilemma openly and honestly creates a very valuable dialogue.

This new approach is responsible for opening up the door to learning how to be therapeutic. The results speak for themselves. Today I am able to help many clients that I would have failed 20 years ago.

References

Freud, S. (1959). Inhibitions, symptoms, and anxiety. In J. Strachey (Ed. & Trans.) The Standard Edition of the Complete Psychological Works of Sigmund Freud (Vol. 20, pp. 75-175). London: Hogarth Press. (Original work published in 1926).

Patterson, C. H. (2000). Resistance in psychotherapy: A Person-Centered view. In Understanding Psychotherapy: Fifty Years of Client Centered Theory and Practice. PCCS Books.

Rogers, C. (1961). On becoming a person: A therapist’s view of psychotherapy. Boston: Houghtin Mifflln.

Minuchin, S. and Bracai, (1972).  Families and family therapy. New York: Norton Books.