Learning about pluralistic therapy: Living with uncertainty
Kate Smith, University of Abertay
One thing that I am pretty sure about is that, in life, it takes confidence to not be certain for any length of time. The idea of pluralism relies fundamentally on an acceptance of equally valid ‘other truths’ which must be accommodated in to the life of the therapeutic relationship.
This presents a particular challenge for students of pluralistic counselling and psychotherapy. As a culturally defined pastime, education tends to be reduced to the attainment of knowledge or the adoption of practices which are an advancement of our current knowledge and skills. For most people it is about the recognition of questions, and the provision of appropriate answers to these. For instance, if a client is anxious, the reason for this is given by the counsellor’s theoretical approach: perhaps that unhelpful cognitions led the client to incorrect emotional responses, that there is incongruence between what is desired and what is imposed by their external world, or maybe that their ego is under assault rendering their defence mechanisms suboptimal. These explanations are slippery in the hands of a pluralist; we must acknowledge that, rather, than the provision of explanation, the outcome of the developmental process for pluralistic therapists is to create a tolerance for the unknowing and recognition of the merits in building understanding from within the relationship.
Because we do not provide our students with fixed explanations, but rather a selection of theories and ideas which flow across schools and interventions, we must acknowledge the demands of this breadth. At one time, students may recognise and define cognitions as unhelpful thoughts which are linked to negative emotions, and in the same breath be asked to recognise that all emotions could be a natural response to our environment and should be cherished as helping us become more aligned with our true desires. As we turn from the objective evaluation of ideas we move our target from the elucidation of truth (and thus from the idea that, with truth, we can ascertain effectiveness), to a more fluid pursuit of the client’s subjective sense of understanding and direction: trusting the client to collaborate in defining the meaning of the process of therapy and the outcome.
Few things would empower counselling students more than providing them with an initially simple frame, with an associated list of ‘dos’ and ‘don’ts’, like ‘don’t ask questions’, ‘only use the client’s frame of reference’ ‘if your felt sense is persistent, reflect it back to the client’, and ‘trust the process’. These are comfortable positions to sustain while expertise in any approach to counselling is developed. But this is also one which infers ‘right’ from ‘wrong’ in the way therapy is done. Students of pluralism are required to step in to a world without these sureties, taking a position alongside theoretical knowledge rather than consuming it: to question the process, and ask the client to question it too.
As a result of this the developmental trajectory of a pluralist is unsurprisingly unique and, with luck, personally congruent, with each nascent therapist becoming their own unique practitioner. There are a few things which I feel I have learnt while accompanying students on their journey, the first is that each student will bring a rich, deep understanding of the world as they experience it – and this is where we should start; that they too will hold their own truths and beliefs which should be respected and understood, and that rather than using an educational approach of ‘from-to’, we should allow them to grow confidently fat with uncertainty.