The training that qualified me as a psychologist treated the mastery of the practice of psychotherapy as a science. I was instructed that I should feel pride in striving to become a “scientist-practitioner”: someone who could encounter a patient, decided what is wrong with them, then carefully plan and deliver an intervention based on "evidence-based models" that follow a linear course, in a particular time frame, and could be tracked and monitored along the way using a variety of measures and questionnaires.
I sometimes wonder now whether anyone who truly aligns with this idea has actually met a human person.
I tried. I really did. I read the books, and printed out the worksheets, and did the planning. The Universe knew, though, from the beginning, that this was not what I was meant for at all. I used to joke with my colleagues about the fact that whenever I printed out a worksheet or formed an agenda for a particular session, my patient would always cancel. It was this way from the very beginning.
The first patient I ever saw at my university clinic was one such person I prepared diligently for. I followed this very nice seeming manual I had found, and used a whiteboard and made lists of all these things she could do to manage her struggles. I was kind and prepared and delivered this material with care. She was compliant and motivated and did all the things I asked.
As we were doing some such busy whiteboard related thing one day, I noticed that all the activities on her own lists were things other people had told her were a good idea. Before I could check whether this fit with where we were supposed to be in the book, I blurted out, “What do you do that’s for you?” Not a particularly genius inquiry, but it was literally the only spontaneous comment I had made the whole time I was with her. She looked at me, firstly kind of baffled and then, with an increasing brightness that spread slowly across her face. I could almost see the little cartoon light bulb illuminated above her head. She had so clearly spent her life never having paused to consider what she might like or find important.
She returned only one more time, to tell me that this comment shifted things completely for her, that she didn’t need to come to therapy anymore and that instead, she would get about the business of doing things for her. She felt healed by this invitation to align with her own heart, the only thing I remember saying that was truly aligned with mine.
I have been instructed in the course of my yoga practice and training around the concept of adhikara. This is a Sanskrit word with no clear English equivalent. It can be translated as studentship, entitlement or as our qualification, our rightful true role or position in the world. My favourite translation of adhikara is as being a student of one’s own heart. Adhikara, to me, encapsulates practices of tuning in and deeply listening to who we really are, where we really belong and what we are really for. As a student of a healing modality currently under the rule of the scientist-practitioner model, it would be easy to believe that one’s own heart is not just irrelevant, but even dangerous to one’s patients.
My initiation into psychology was within a post-graduate clinical training program. It endowed me with many treasures, and was one of the most challenging, important and meaningful experiences of my life. However, it also instilled in me the fearful notion that any orientation to my own instinct or intuition as a means of guiding a patient’s treatment was a fairly sacrilegious, risky alternative to “evidence-based practice”. I was also taught that too much of my self in the room was demonstrative of laziness or a lack of skill at best, and a dangerous boundary aversion at worst.
Since then, a mix of luminous teachers, my own treatment, and patient, containing clinical supervision have demonstrated to me that in actuality, good therapy is both art and science. In the words of Esther Perel, “Science seeks an evidence base, but art is an encounter with the unknown.” In the practice of the healing arts, we encounter the unknown every day - in our patients, in ourselves and in the alchemy we create in each therapeutic relationship. These encounters demand the unique artistry within us - it is not only not dangerous, but the essential ingredient in potent, vital therapeutic work. Only in repossessing the artistry of our intuitive, real selves can we really find our place as useful healers to the people we seek to help. The best way you can invite your clients into alignment with their own hearts is to embody alignment with your own.
This is a place you have always known, and it is your entitlement, your adhikara, to enlist whatever guidance, teaching, and love that you need to support your journey back home there. Rediscovering yourself in your work is not just a tokenistic gesture, but a powerful means of returning to the weighty, unique gifts you have to offer your patients, and the world.