Nobody enjoys giving bad news

In ACT, creative hopelessness is often a dreadful moment for therapists. It is at the heart of a many supervisions because it is often the therapist who interrupts the process before it has achieved it’s goal, which is to develop acceptance.

It is important to recognize that creative hopelessness is not the easiest or lightest part of therapy (compared to values work, for example). Indeed, it means giving someone bad news: apparently there is no definitive method to make the difficult emotions for which the patient has sought support disappear totally, or that does not deprive him of anything essential to him. How do we know? In touching on the patient’s experience. Each time he finds a method to alleviate his devastating emotions, it turns out to be temporary and involves being constantly re-implemented, or only works somewhat, or even takes away from what matters to him. Sometimes, even, the solution he finds to mollify his emotions ends up adding other just as devastating ones (drinking alcohol, for example, to no longer feel alone, leading to feelings of guilt).

In regards to this goal of controlling painful emotions, the therapist is also just as destitute. In this context, it is not shocking that the job seems daunting. If given the choice, the therapist would prefer that a method to ease these difficult emotions exist. However, this method does not exist, and the therapeutic movement towards a fulfilling life seems to involve abandoning the search for this miracle solution.

In this situation, echoing what the patient is experiencing, the therapist experiences certain discomfort and feels somewhat trapped. They become the bearer of bad news and dread that the messenger will be confused with the message, that is to say that the patient might judge the therapist as incompetent, although a miracle solution simply does not exist to put an end to the emotions of which the patient is battling. Surreptitiously, without realizing it, the therapist is pushed to look to alleviate that which they are feeling about having to give this bad news, at the risk of compromising the therapeutic relationship, or more directly, to fail to develop acceptance. For example, the therapist might try to cut this phase of therapy short and, instead, move towards values work in order to swap this announcement of a difficult diagnosis for the promise of well-being, and thus feel better about himself. He could also take on the tone of a doctor (“You will never be rid of your suffering”) or an academic (“You have no alternative but to accept your emotions”) thus dropping out of the game by pretending to be the one who knows what to do. Another way to avoid this type of feeling of incompetence/abandon of the patient is to push off the work on creative hopelessness to the next session, and then the next one, and the next one, because the client would not be ready for it, or could be harmed from it.

There is a reoccurring theme here. Both the patient and the therapist are confronted with these emotions that they would prefer to get rid of. However, the best way for the patient to get to the point of acceptation is through the guidance of his therapist, and this guidance can only be helpful if the therapist is not trying at the same time to avoid his own emotions. The therapist could be supported in this diagnostic announcement by remembering that the inability to control the emotions that cause us pain, sustainably and without cost, is not about this particular patient, but all of humanity, including the therapist. He is not really giving bad news, he is describing (sometimes painfully) the reality of the human condition. More certainly, the path to development of acceptance for the patient go through the development of acceptance for the therapist, simply because the therapist does not know how to solve this emotional ‘problem’. That which therapists know, on the other hand, is how to help the patient construct a fulfilling life, independent of these difficult emotions. Neither against them, nor in spite of them, more like, next to them. By applying this to himself, the therapist progressively develops the capacity to live a fulfilling professional life independent of his doubts, his worries, etc. Neither against them, nor in spite of them, in a wise coexistence.

Translated with the help of Chelsea Davis-Laurin

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