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The Existential Moment: On Caring

Mike was a 34-year-old single, white male with a history of “one-night stands.” He came to therapy down, feeling lonely and unfulfilled, despite being professionally quite “successful.” Anxiety was a chronic issue, pervading relationships and performance. Mike’s father was “a spoiled child trained as a marine.” Mike’s mother was “pretty much a Puritan, but I knew she loved me.” Mike insidiously avoided, withdrawn emotionally and in his daily life.

Stop reading for a moment and consider Mike. How do you feel?

Mike’s therapist, Riccardo, felt nothing. Mike was the model client – dependable, amiable, etc. One day, however, after years of therapy, Mike popped into Riccardo’s head. Riccardo realized he hardly ever thought about Mike, very rarely. He thought, “if he left therapy, I might never think of him again.” He felt a wave of sadness, then got curious. Finally, he realized he liked and cared about Mike a lot. He then felt guilty, like a failure having let him down.

Riccardo raised some of this the next session, even boldly discussing his fear of never thinking of Mike again if therapy ended. At one point, Mike said, “…I get it. I pay you to help.” But, Riccardo said, “you can’t pay me to care about you.” That struck Mike. Maybe Riccardo wouldn’t judge and hurt him like everyone else. And the therapy deepened from there.

Existential-Humanistic therapy is relational and experiential. Care is a critical therapy component: letting our clients matter to and influence us.

In many cases, caring is pretty straightforward. We love our clients. Unconditional positive regard is easy. The only risk is maybe what we do with that affection. Alternatively, we might genuinely dislike our clients. That’s hard. Can we show care by simply being curious, allowing their life to matter? Can we accept and validate when we don’t want to? Then there are the detached and avoidant, like Mike. That’s tricky. We might not even realize we are in a protective cocoon of detachment.

A focus on care has several benefits. Most importantly, it deepens the relationship. Showing care in our actions can bring us closer to our clients. It can also offer therapeutic transformation in a moment. Considering the nature of our care (or lack thereof), guided first by an inner searching process, also deepens our understanding of our clients. Finally, by being open, we grow and hopefully become better therapists, maybe better people.

Links to Related Blog Posts:

Read more posts about the relational and interpersonal on EHI’s blog.

Read more posts about the Therapeutic Relationship in the Existential Moment series.

Read more posts about how E-H therapy is experiential on EHI’s blog.

Read all the Existential Moment series posts on EHI’s blog.

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The Existential Moment: Micro-skills: Reflecting

Reflection is a bit like the work of the Spirits of Christmas Past, Present, and Yet to Come. We mirror or reflect our client’s experience—the content presented, the process or experience in the moment (e.g., nonverbals, tone, pattern of speech, etc.), self and world constructs (e.g., “I am…”), protective patterns and inner tensions, and core vulnerabilities or wounds.

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