John Suler's Teaching Clinical Psychology
I use this exercise as a way to help students understand what it's like for clients in psychotherapy to reveal personal information about themselves, why they may keep secrets, and the reasons for showing "resistance" to the therapeutic process of exploring their intrapsychic world.
I start by telling the class that anyone can choose not to participate in the exercise. Then I instruct them to write down on a small piece of paper something important and personal about themselves that they have NEVER told anyone else - a secret wish, fantasy, feeling, belief, or something from their past. If they can't think of anything, I suggest they write down something they have told maybe only one or two people who are close to them.
I give my promise to the students that NO ONE will see what they have written. When they are finished, I tell them to fold the paper up several times, very tightly.
Then I walk around the room and ask some students, one at a time, if they will hand me the paper. A few do so with little worry, a few refuse, most will comply but with some hesitation. For those who do agree, I take the paper and do the following, usually in a humorous way:
- ask them if I can open it (I never actually do)
- hold it to my head and pretend I can mind-read it
- "carelessly" toss it into the air
- ask if I can give it to someone else (I never do)
- stick it into my pocket and pretend to forget it's there (I always give it back)
- take one person's paper in my right hand, another in my left, wave my arms back and forth over each other, and pretend that I have confused whose secret is whoseOnce I finish and have handed each paper back to its owner, we talk about the reactions to the exercise. We discuss how they would have felt if the paper was read by someone: anxiety, anger, embarrassment, shame, helplessness - the same feelings that clients struggle with in psychotherapy, and that may account for their "resistance." How would the therapist react to your revealing such information? I note that while what they wrote on the paper was a conscious secret, clients in psychotherapy also must contend with unconscious "secrets" that may be even MORE sensitive. We then discuss how the various ways that I handled the papers might be metaphors for real or fantasized situations in psychotherapy:
- do clients sometimes think that therapists can see right into them, or read their minds?
- might a client worry that the therapist might treat lightly or carelessly something personal that the client reveals?
- what if the therapist told someone else about the client's disclosures (this raises the practical and ethical issues about confidentiality)?
- what if the therapist forgot something important the client told him/her, or confused that information with another client?
Michael Loft describes the how, why, and outcome of using this exercise with his social work team:
How? Basically, I followed the steps to the letter. First, I condensed the steps to their essence - I made even shorter "key" notes (or cue cards) to permit a natural, personal presentation. (In spite of this, I was still nervous presenting in front of my peers).
Second, I had to "take charge" because a couple of social workers were jeopardizing the process. They, inadvertently, couldn't resist trying to "problem solve," what I was trying to present. Basically, I had to ask them to stop this and "Go with the flow."
Once we got through this piece, things went smoother.
Why? We needed to rejuvenate our clinical meeting. They meeting had become more "business-like" and needed a shaking up, so to speak. The exercise brought us all back to the roots of "why" we are trying to help people.
Outcome? My peers thanked me, in person and in e-mail, for stirring them back to their roots. From my vantage point, the exercise struck deep. My peers were moved to greater understanding of themselves in their work. I hope to do more of the same in the future.
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