"Yes", "No", and "I Don’t know" -Helping Clients to Express Themselves
“Why do they keep coming if all they say is ‘Yes’ or ‘No’ as answers to my questions?”
“How am I expected to get to know them when I hear ‘I don´t know’ over and over again?”
“Will I be able to find more topics to raise before I start shrugging my shoulders in indifference as they do?”
Therapists may sometimes experience this kind of frustration and ask themselves similar questions.
I believe that it is important to acknowledge that frustration.
I believe that therapists who feel this kind of frustration are therapists who care. They care about their clients and they care about the therapeutic process. The frustration arises in the gap between what they would like to give their clients and what it appears the clients are receiving. Moreover, many times the frustration they feel is echoing a frustration felt by their clients.
When a therapist shares this kind of frustration with us, colleagues, I often hear other therapists trying to support them by sharing their own way of dealing with the frustration. They say things like:
“We (therapists) should not work harder than our clients!” or -
“We (therapists) can’t do the job for them (clients).”
As a therapist I do not feel comfortable with these statements and I would like to suggest another approach to this issue.
This approach entails perceiving the therapeutic encounter as a space where we, both therapists and clients, make our best efforts to help clients to clarify their needs and to work together towards therapeutic goals.
In line with this view, I see a client that keeps coming to therapy as a client that is already making an effort.
However, many of our clients come with doubts. Some question themselves and some question others in their life. Perhaps their short replies mean that their questions are bigger than the answers they can come up with at that time.
And when they say that they don’t know, that’s exactly what they mean. They do not know.
This might mean that they do not feel as if they know, or maybe they just don’t know how to share the things they do know with us.
So when their shoulders are lifted, it is not necessarily a sign of resentment. It can be a sign of helplessness, of frustration, of their hope that we will find a way to help them take the weight off these shoulders or to support them in leaning towards the therapeutic relationship.
Being therapists, I believe that we have the responsibility to do exactly that. Moreover, I think that we should make an effort to enrich our toolbox so that we can offer clients a variety of ways to express themselves and to benefit from therapy.
The following are two ways to do it:
A - Offering Clients a Non-verbal Channel of Communication
When a client finds it difficult to put an experience, thought or feeling into words, to elaborate on an issue or to answer a question - we can invite them to choose an illustrated card that can describe it for them. They can then work with that card using nonverbal techniques such as art, music or movement. To encourage this, the therapist can say:
“Choose one card that can represent a positive moment you have experienced since our last session and another card that can represent a low point. Place these two cards on a blank piece of paper and draw an environment that can contain both of them. Can you point at the place on the picture that describes your current state?”
“Look for a card that can describe our usual sessions. Besides the card, draw metaphorical things that could help both of us make this scene more suitable for your needs and goals.”
“Play a song that you like to listen to during this period (or - play a song that accompanied a meaningful period in your life). Search the deck for a card that evokes similar feelings as listening to this song. Draw freely around the card, move around in the room or copy words from the song’s lyrics that you find especially empowering/ unclear/ hopeful.” The therapist chooses the guidance according to the goals.
Many times the visual anchor of the card and the therapeutic activities that accompany it will serve as prompts for conversation. However, the therapeutic process can also take place through the nonverbal channels themselves.
The therapist chooses the type of intervention according to the issues that come up during the session.
B – Using Projective Techniques
Another way to facilitate communication could be to use projective techniques when clients find it difficult to answer direct questions or to speak freely about real-life events.
Thus, for example, when a client raises an issue related to their family, and keeps responding with “I don’t know” to follow-up questions regarding it, the therapist can invite them to choose a projective card that can represent the current atmosphere in the house. Once the card is chosen, the therapist can ask questions regarding the images that are illustrated on the cards: How would different items illustrated on the card describe themselves and the overall atmosphere of the card? How does each of the illustrated objects contribute to the atmosphere depicted in this card? What do they need from each other?
Or - What do you like about this card? Where would you like to be in this picture, if you could? What part of this card don’t you like? What would you add to the picture to align the atmosphere closer to what you would like it to be?
This kind of work can be followed by role-playing. Here, the therapist and client play the roles of the various illustrated components in order to help the client express feelings and practice communication skills.
Therapists should modify these activities to suit the specific needs of their clients as well as their preferred mode of expression.
To learn how to use these cards and others, please join one of our online workshops
Written by Gali Salpeter - Story & Therapy
Expressive Therapist. Spec. Drama and NarrativeTherapy (M.A.)(NFKUT)(I.C.E.T)