Tuesday, September 11, 2012

Crossing the bridge

It's 2 A.M. and you're driving on the Tappan Zee Bridge in the pouring rain when you get a flat tire. You try to pull out your spare, but you don't know where to go from there. The bridge is swaying in the wind, and it's very dark. You're wet, tired, and hungry, and it seems like you'll never get off this bridge.

All of a sudden, a lone pickup truck pulls up behind your car. The driver gets out, pulls some worn but sturdy tools from his trunk, and proceeds to change the tire in practically no time at all. You thank him profusely; to you, he's an angel sent from Heaven to get you off the bridge. You shake hands, get back in your respective cars, and continue off into the darkness, hopefully towards home. The entire way, you're praising the kindness of a stranger.

Fast forward: a few days later, you're with your family, enjoying some quality time. Your cell phone rings; it's an unfamiliar number. You answer the call to discover that it's the fellow who helped you that dark rainy night on the Tappan Zee. He's calling to check up on you, make sure everything is okay. He asks you if you need any help with anything, or maybe if you want to talk. For some reason, you feel uncomfortable - why is this guy calling you? Sure, he helped you off the bridge when you really needed it, but now his attention just seems odd...eerie, even. 

After all, once you finished relating the story to a few people within the next day, you forgot about the stranger. 

And, you presumed, he forgot about you...

"And that," my newest graduate professor exclaimed triumphantly, "is how you must look at the 'relationship' you share with your patients."

Pacing at the front of the classroom, he waved a bony finger. "I see this all the time - don't get involved. The therapeutic relationship is a farce. It must be so. It is a facsimile, an uncanny resemblance to an authentic relationship, and quite possibly the closest thing to an honest healthy relationship that your client has - or will ever have - experienced. But make no mistake, it is not real." Looking at each one of us in the eye before continuing, he said "When your patient is sitting in front of you, he or she is the only person who exists - but once they leave the room, it must be out of sight, out of mind. And once you have finished the treatment plan, sever all ties!

"There is no relationship, no dyad. You had a job to do and now it's done - you helped him get off the Tappan Zee in the middle of the night, no more, no less."

I appreciate the necessity of maintaining some professional distance; there are legal as well as moral reasons, and an overly involved relationship can quickly become inappropriate and damaging for both individuals involved. But my professor's opinion advocates an approach that flies in the face of why I - and I believe many of my colleagues - got involved in the mental health field in the first place. Of course, we want to help, to make a difference in the lives of people who need understanding and empathy - and this stems from a deep compassion for one's fellow human being, far beyond a utilitarian goal of forming a better functioning society. Certainly as far as Jewish values go, we are exhorted to share in the burden of our suffering brothers and sisters (this is a theme we have visited several times in the past; it is a fundamental element of how the Torah guides our interpersonal dealings, no less).

I hope that I can maintain a balance between my professionalism and my concern, in order to ensure that neither overpowers the other. But I cannot accept the directive to perceive my client as a "consumer" whose only relevance is in the immediate context of the therapy session, give or take a few moments consideration just prior to the meeting and reflection following afterward. If I was treating Jewish patient, for example, how could I not find out their full Hebrew name in order to pray for them? In my eyes, that would be as egregious an oversight as any basic part of the therapeutic process.

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