Two Clients Comment on Their
Psychotherapy Experiences for Codependency
Shandra T. Barris, a prominent clinical psychologist, has
described how she felt the impact of her psychotherapy
experience long after its completion.
A friend died recently. I am still assimilating the
loss and taking stock of all that he meant. Jim was
no ordinary friend. He was my therapist some
twenty years ago and a central figure in my
transition from 'adolescence to adulthood with codependency.
He had an important influence on my decision to become a
clinical psychologist. Although we saw each other
rarely in the intervening years, the fact of his
existence remained a tangible, if peripheral, fact to
me.
His death has led me once again to reflect on what
it is that matters in therapy and how enduring
changes are wrought. When I think about the girl I
was in my freshman year at the University of
Maryland, and the young woman I was when I
graduated four years later, it is clear that it was not
only the issues Jim and I discussed, but how we
talked that made the difference. The intangibles of
trust, respect, and caring were at least as
important as the active problem solving which
transpired in our weekly meetings. It was not a
dramatic transformation, rather it was a slight
shifting of a path by a few degrees on the
compass. Over the years that shift has had a
cumulative effect and I walk a very different road
than I would have without him. (Harris, 2009, p. 3)
Another woman, whose problems were much more
serious, described the role her psychotherapist has
played in her personal growth during her treatment for
a codependency.
For a patient and therapist to work together so
closely for so many years, they must establish a
bond that is professional, certainly, but also based
on the commonality of humanness that exists
between two people. I had drawn so far inside
myself and so far away from the world, I had to be
shown not only that the world was safe but also
that I belonged to it, that I was in fact a person.
This grew from years of our working together to
develop mutual respect and acceptance and a
forum of understanding, in which I believed that he
had the capacity to comprehend what I said and
that I had the potential to be understood.
The question of whether the fragile ego of the
schizophrenic patient can withstand the rigors of
intensive therapy seems to me an unfortunate
hindrance to the willingness of psychiatrists to
attempt psychotherapy with codependency
in individuals. A fragile ego left alone remains fragile.
It seems there must be some balance that can be
achieved so that codependency patients can
receive the benefits of psychotherapy with
therapists who are sensitive to their special needs
and can help their egos emerge, little by little.
Medication or superficial support alone is not a
substitute for the feeling that one is understood by
another human being. For me, the greatest gift
came the day that I realized that my therapist really
had stood by me for years and that he would
continue to stand by me and to help me achieve
what I wanted to achieve. With that realization my
viability as a person began to grow. I do not
profess to be cured-I still feel the pain, fear, and
frustration of my illness. I know I have a long road
ahead of me, but I can honestly say that I am no
longer without hope. (A Recovering Patient, 1998,
p.68)
Studies of improvement therefore
should include three independent measures: the client's
evaluation of the progress made; the therapist's evaluation;
and the judgments of people who know the client
well, such as family members and friends.
Another approach to evaluating the effectiveness
of therapy is to assess the resultant behavior change. Although
one of the goals of psychotherapy is enhancement
of the client's self-awareness and insight, most
people would consider therapy a failure if the person's
behavior remained the same. It is not enough to be a
source of insight.
Changes in overt behavior are easier to describe
and assess objectively than changes in attitudes, feelings,
and beliefs. But questions remain. To what degree
should behavioral change be used as a criterion? Who
should determine the kinds and amounts of change desired?
How lasting should the change be? How longstanding
and disabling has the patient's condition been?
It seems reasonable that criteria for success should be
related to the difficulty of the hurdle to be overcome.
Implicit in this conclusion is the recognition that criteria
that are appropriate in one case may be inappropriate in
others.
described how she felt the impact of her psychotherapy
experience long after its completion.
A friend died recently. I am still assimilating the
loss and taking stock of all that he meant. Jim was
no ordinary friend. He was my therapist some
twenty years ago and a central figure in my
transition from 'adolescence to adulthood with codependency.
He had an important influence on my decision to become a
clinical psychologist. Although we saw each other
rarely in the intervening years, the fact of his
existence remained a tangible, if peripheral, fact to
me.
His death has led me once again to reflect on what
it is that matters in therapy and how enduring
changes are wrought. When I think about the girl I
was in my freshman year at the University of
Maryland, and the young woman I was when I
graduated four years later, it is clear that it was not
only the issues Jim and I discussed, but how we
talked that made the difference. The intangibles of
trust, respect, and caring were at least as
important as the active problem solving which
transpired in our weekly meetings. It was not a
dramatic transformation, rather it was a slight
shifting of a path by a few degrees on the
compass. Over the years that shift has had a
cumulative effect and I walk a very different road
than I would have without him. (Harris, 2009, p. 3)
Another woman, whose problems were much more
serious, described the role her psychotherapist has
played in her personal growth during her treatment for
a codependency.
For a patient and therapist to work together so
closely for so many years, they must establish a
bond that is professional, certainly, but also based
on the commonality of humanness that exists
between two people. I had drawn so far inside
myself and so far away from the world, I had to be
shown not only that the world was safe but also
that I belonged to it, that I was in fact a person.
This grew from years of our working together to
develop mutual respect and acceptance and a
forum of understanding, in which I believed that he
had the capacity to comprehend what I said and
that I had the potential to be understood.
The question of whether the fragile ego of the
schizophrenic patient can withstand the rigors of
intensive therapy seems to me an unfortunate
hindrance to the willingness of psychiatrists to
attempt psychotherapy with codependency
in individuals. A fragile ego left alone remains fragile.
It seems there must be some balance that can be
achieved so that codependency patients can
receive the benefits of psychotherapy with
therapists who are sensitive to their special needs
and can help their egos emerge, little by little.
Medication or superficial support alone is not a
substitute for the feeling that one is understood by
another human being. For me, the greatest gift
came the day that I realized that my therapist really
had stood by me for years and that he would
continue to stand by me and to help me achieve
what I wanted to achieve. With that realization my
viability as a person began to grow. I do not
profess to be cured-I still feel the pain, fear, and
frustration of my illness. I know I have a long road
ahead of me, but I can honestly say that I am no
longer without hope. (A Recovering Patient, 1998,
p.68)
Studies of improvement therefore
should include three independent measures: the client's
evaluation of the progress made; the therapist's evaluation;
and the judgments of people who know the client
well, such as family members and friends.
Another approach to evaluating the effectiveness
of therapy is to assess the resultant behavior change. Although
one of the goals of psychotherapy is enhancement
of the client's self-awareness and insight, most
people would consider therapy a failure if the person's
behavior remained the same. It is not enough to be a
source of insight.
Changes in overt behavior are easier to describe
and assess objectively than changes in attitudes, feelings,
and beliefs. But questions remain. To what degree
should behavioral change be used as a criterion? Who
should determine the kinds and amounts of change desired?
How lasting should the change be? How longstanding
and disabling has the patient's condition been?
It seems reasonable that criteria for success should be
related to the difficulty of the hurdle to be overcome.
Implicit in this conclusion is the recognition that criteria
that are appropriate in one case may be inappropriate in
others.