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...it is the qualities that we
hide from ourselves that we will project onto others in some form or another.
Transference and counter-
transference are about emotional responses and feelings.
Projection and
counter-transference can feel very real. They can feel stronger than reality.
Many people in Britain grow up not having talked about sex...
There has always been the pain and
suffering of sexual abuse; it just has not been talked about.
There's tremendous power in the use and misuse of words.
...I am struck by the arrogant and dictatorial stance that
Hahnemann took and am curious as to how his position has filtered down and
affected us all.
Let's question sexist, abusive, patriarchal, imperialistic
language within our profession.
When a patient is actively involved in their own process of
cure, they do respond better.
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The Flaws of the Practitioner
As alternative practitioners, we have a tendency to smugness. We think we are
better than orthodox doctors because we have better tools. What we can do,
however, is make different mistakes – mistakes that can actually be equally
as distressing. Working with people will bring up feelings for the
practitioner at times. We need to be able to deal with our feelings so as not
to affect our patients and their healing. Suppressing our feelings will lead
to our damaging ourselves, and this in turn makes us vulnerable to projecting
that damage back on to our patients.
We've all got our flaws. We need to acknowledge them and deal with them
rather than ignore them. If we suppress them, this will create a blind spot
which will affect our own ability to see clearly and ultimately will prevent
us from finding the right remedy. If you are having difficulties finding the
remedy, it is always useful to look at the relationship itself and your part
in it, and to ask yourself whether your visibility is flawed. And. . . there's
a problem with blind spots. We can't see them! It is difficult (if not
impossible) to understand our unconscious on our own. We all have blind
spots, and we all need someone else to help us to see them. Our growth and
our healing and especially our self-awareness occurs mostly in relation to
others – those close to us, if we are willing to listen to them, or, of
course, a counselor or psychotherapist.
It is important to deal with our own flaws. Those patients we find difficult
to deal with, who upset us or make us feel angry, those who fascinate us or
even inspire us are the ones to watch out for. We need to look inside to see
what or why we are projecting onto these people. Because it is the qualities
that we hide from ourselves that we will project onto others in some form or
another. And, our disbelief in the face of apparently unbelievable stories
may reflect damage of ours that is unresolved.
Projection
I interpret situations and events based on my own past experiences. I project
an experience I have had onto the experience I am having now. Or, I project a
person I have known (who is similar) onto the person who is with me now. Or,
I can project onto a person in the present my past experiences with them. Or,
a patient can project onto me based on how they perceive my role (rather than
who I am).
Projection distorts the vision of the person who is projecting. I make up a
story about another person based on my reality, on an experience ! have had
or a person I have known who is similar. I interpret situations and events by
reading into them my own experiences and feelings. Projection keeps me from
looking at and owning parts of myself. I project unconsciously onto other
people parts of myself I am uncomfortable with.
The positive outcome of projection is pain relief! If I hit my finger with a
hammer, I can blame the hammer, or anyone else who happens to be in the room,
to ease the pain. Patients can project onto us the all-knowing, all-seeing
healer, or the reverse depending on their previous experiences. The same
homeopath may be experienced as warm, sympathetic, cold, or aggressive, all
by different people. We need to be able to recognize when there is an element
of projection going on and acknowledge our own feelings so that we can put
them to one side (to be dealt with at a later date), so that we can be open
to the person we are treating.
Transference
Transference and counter-transference are about emotional responses and
feelings. A patient has a feeling response to a practitioner based on any
similarities between how he looks or behaves and someone the patient has
known, usually a parent figure. The patient brings or transfers emotional
responses (feelings, attitudes, behavior) from a past relationship into a new
one. Transference is about feelings and unresolved issues that are activated
by the roles other people are in, as well as the work that is being done.
There's always an element of projection in transference.
Transference distorts the person who experiences the transference and his
perception of the person he is transferring onto. Unknowingly I may remind a
patient (unconsciously on her part) of her depressed mother because of how I
look or behave or even a small mannerism. She then treats me in a similar way
to the way she treated her mother. She may feel persecutory and cut off
emotionally and find it difficult to trust me, to talk freely. Or she may try
and rescue me, being concerned about my feelings, and not want to
"burden" me with her troubles.
Counter-transference
I (the practitioner) respond to my patient's transference (feelings) as if
their feelings were real. My feelings, in response to the patients reaction,
get in the way of seeing clearly who they are. My own unmet needs and
unresolved issues will make me vulnerable to counter-transference.
Counter-transference distorts my perception of the patient. I
"displace" feelings onto my patient that don't belong, and this
distorts my perception of what is happening in the here and now, and gets in
the way of healing.
I remember a patient I treated unsuccessfully for a time. She was bright and
cheerful, and we both liked each other a lot. She kept coming because she
felt so good after seeing me, because she had such a lot of positive
transference onto me, but her symptoms remained. And I remained stuck in
positive counter-transference, until I had to make a house visit for one of
her children. Then I saw how she interacted with her family. She was snappy
and demanding and irritable. I was then able to prescribe effectively.
CAUTION!
Projection and counter-transference can feel very real. They can feel
stronger than reality.
I'd like to share with you a technique that I use for checking out my
projections. I clarify what it is that is bothering me about a patient and
then I personalize it. If I continue to feel that it's nothing to do with me,
if I feel resistant, then I know that I'm projecting something. I have to own
my projections and take them back so that I can begin to see that person
clearly, uncontaminated by my unconscious emotional bias. This makes me a
better homeopath and less vulnerable to abusing my patients.
Sex in the Consulting Room
Three-and-a-half years ago I talked about taking sex out of the consulting
room [2]
and about the various ways in which the homeopath could unwittingly abuse his
patients, sexually. This had an incredible effect. Some people were shocked,
confused, angry, and anxious; others were grateful and relieved.
My motivation for giving this talk was the unbelievable number of tales I was
hearing of professional sexual abuse, ranging from the mundane to the gross.
From people who had been asked intimate questions about their sex lives at a
first visit, without any warning, sandwiched between urination and
respiratory complaints, to patients who had their breasts examined when
they'd gone with tonsillitis, to others who had become sexually involved with
their homeopath.
Our sexuality is a most private and vulnerable part of who we are. It
deserves a special attitude. We do not in general socialize our sexuality; we
do not discuss it over the kitchen sink – not really discuss it. Many people
in Britain grow up not having talked about sex and never having heard their
parents talk about sex, having heard it talked about only within the
framework of smutty jokes or the cold, biological facts of mating from a
biology teacher. Some people have never talked about sex. They may never have
discussed "it" with a lover, husband or wife.
We have a fine tradition in the UK of intimacy; it is swept between the
sheets, at night, with lights out and eyes shut. You don't ask for anything,
and you don't complain. This is not the only sex we have in our country, but
it makes up a significant proportion. Just imagine a patient who has never
talked about sex, and let's put him or her in a consulting room with one of
us, and imagine how they will feel. Shocked? Distressed? Turned-on? Lacking
in confidence in us? Patients do feel uneasy about being asked if they've had
gonorrhea or syphilis, if they masturbate, how long they'd been doing it for,
what their fantasies are, what their sexual preferences are, whether they've
ever had or wanted to have a sexual relationship with someone of the same
sex, and so on, when it isn't put into a context, when it comes, apparently,
out of the blue. I actually believe that people who do not experience it as
an abuse are the ones with a problem. People are generally more sensitive
now, more aware of their own personal and sexual boundaries. We must respect
those boundaries.
We can sexually abuse our patients by touching them inappropriately:
- by asking intimate
questions about their sexuality inappropriately or stupidly or
needlessly, without first putting our questions in a professional
context.
- by projecting our
sexual values onto them.
- by assuming or
implying that they should be having sex if they are not; that is to say,
if they have chosen celibacy.
- by assuming or
implying that they should be having sex with another person if they are
not and if they have chosen to have an intimate relationship with
themselves; i.e., have chosen masturbation.
- by suggesting that
they should be having sex with a person of the opposite sex if they are
not; i.e., if they have chosen someone of the same sex.
- by having sexual
fantasies about them when they are in the consulting room (or out of it
for that matter).
- by ignoring or
doubting or denying what they tell us, especially what they tell us
about their own abuse.
- by playing sex therapist,
without telling them that is what we are doing, especially if we do not
have the training to do so.
- by becoming involved
sexually.
It seems that within every walk of life the issue of sexual abuse is being
thoroughly examined in the family, within the medical profession, the
teaching profession, the church, and so on. There has always been the pain
and suffering of sexual abuse; it just has not been talked about. It has been
locked away in peoples' bodies where it has formed an abscess which has now come
to the surface. We did not know it was there and now we do. Any professional
involved in a one-to-one relationship with a patient, which is, by
definition, an intimate relationship from the patient's perspective, is
capable of abuse, because we have enormous power and because we are
vulnerable – only being human.
There are no degrees of sexual abuse. All abuse has an effect. There are only
degrees of effect. It is the breaking of trust that affects a person's
self-esteem and his/her ability to trust that creates a deep wound. People
who suffer abuse feel helpless, inadequate, worthless and guilty as they
blame themselves in an attempt to rationalize the experience. And they
question their own experience, finding it hard to believe and harder to understand,
whatever their age. They take a feeling of there being something wrong (or
bad) with them into all their relationships, and then events tend to confirm
their feelings as they are attracted to similar experiences, to similarly
abusive relationships.
We need to make sure we don't reinforce their negative self-image. People who
have been abused lack self-definition and are often unable to validate
themselves because they didn't receive validation from others. We need to
respect the trust our patients offer us, and treat it with great care.
Disbelief and denial are genuine life-savers; we need to know how and when to
shatter these boundaries.
Penetrating the Case?
When Dr. Chapman asked me to speak here, I was delighted and honored. When I
received a letter from him suggesting that the topic for my presentation be
"Penetrating the Case," I was genuinely and thoroughly shocked! I
rang and asked Ted whether it was a tongue-in-cheek title, or whether he
wanted something particular from me. But when the shock had subsided. I
realized what a marvelous gift he had given me. Because it led me to think
about an area of homeopathic practice that I hadn't paid a lot of attention
to – our language.
There's tremendous power in the use and misuse of words. Edward Whitmont came
over and spoke to us last year. [3] He said, and I quote, "Words
embody spirit. As we speak, so we also think. As we think, so we also
feel." I have never penetrated a case in my life, in or outside of the
consulting room. It's not what I do. Do I embrace a case? I don't think so.
You know, most words have double meanings, but some are more double than
others. Penetration has a lot of sexual energy. l believe we need to consider
carefully the words we use to do our job. To reduce a person to a case
interests me. Are we distancing ourselves? What from I wonder? Our own fears,
our own trauma? Where's the respect here? I wonder if it enables us to do
things we might not otherwise do. I suspect it is one of the ways we
"rise above" patients' traumas and side step our feelings, the
effects our patients have on us.
Also, in the UK we are currently debating this issue of confidentiality with
regard to "cases" presented in colleges and at conferences and seminars.
I wonder how some patients, especially those who have suffered from sexual
abuse, would feel about their "cases" being paraded in front of
hundreds of homeopaths and then published, albeit anonymously.
. Because it is through respecting these processes in ourselves that we
will be able to respect them in our patients, and then we can heal.
References
[1] Miranda Castro, "Supervision: A Homeopath's
Perspective," Journal of the Society of Homeopaths 9 (Spring
1989)
[2] Miranda Castro, "Sex in the Consulting Room," Journal
of the Society of Homeopaths 11 (June 1991)
[3] Edward Whitmont, "Opening Doors" seminar given to
the Society of Homeopaths, 1991.
Homeopathic Organizations
European and International Councils for Classical
Homeopathy
Stephen Gordon M.C.H., R.S.Hom. (General Secretary), Brandon House, West
Church Street, Kenninghall, Norfolk, NR 16 2EN. England. Tel: 0953 87521,
Fax: 0953 878163
Society of Homeopaths
2 Artizan Road, Northampton, NN14HU, England. Tel: 0602 21400, Fax: 0602
22622
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