Recently, I saw two actors present a Russian folk tale for an adult audience. Without props or costumes, the actors had us with them every step of the way. The man was a bear in his movements, the woman was a little old grandmother, weak-sighted and hard of hearing, and they were standing dangerously close to each other. They transformed themselves and we were transformed watching them.
A performance like this one has something to tell us about therapy.
Back in the 70s, anthropologist Edward Hall included a chapter called Space Speaks. His paperback, The Silent Language, sold well because many people shared his curiosity about the biological and cultural effects of settings for social experience. I think his ideas help us understand why therapy that "should" work does not always go well.
Counseling or therapy, like any performance, occurs in space. I know I have sometimes felt uncomfortable in the space surrounding me when I have gone for counseling. I literally feel the walls are closing in on me. In our culture, we learn to assume that five feet from someone else is about right for social conversation, closer implies intimacy, and farther means we are speaking so anyone can hear. I prefer sitting a little farther than that in a counseling room, probably because the room itself is likely to be small. More often than not, I have felt "too close." At the usual distance, my senses tell me that instant intimacy (at least on my part) is expected, that I should tell all as if I had known the counselor all my life.
In Milan Kundera's novel, The Unbearable Lightness of Being, the hero says he cannot abandon the good manners he learned as a child. Even when he is interrogated, he feels impelled to answer the interrogator's questions. Therapists, who, like an interrogator, are on their turf, are in a somewhat different situation. As therapeutic interactions become routine, they find ways to control the degree of intimacy in a situation. But for the patient or client, the speaking distances many therapists set up may contribute to a sense of premature trust even when the client can't put a finger on the reason.
It's also possible for a client or patient to sense an office as too large, too much like an ordinary living room. I feel most comfortable in a space about where the furniture is placed in a fairly close grouping but with space left between the furniture and the walls. That way I feel a congruence or comfort, close enough to talk personally without feeling closed in. The extra space around the edges makes a difference.
If all therapists (like good actors) had the strong kinesthetic sense of good actors, the setting might not matter. But the strong belief counselors are trained to have in talk therapy may drown out the sense of other influences on the patient. A classic example is the word-oriented therapist who stares at the floor when a client says he would rather sit on a hard chair instead of a soft sofa.
Many of us have accustomed ourselves to physicians who monitor physical illness in small windowless spaces. I go to two physicians, both excellent communicators who seem comfortable talking with people. They can sit or stand close to the person consulting them but let the discussion flow easily between both people. I believe they both have a strong sense of their bodies in space as well as being competent in their work. Somehow they manage to give their patients a sense of shared space.
The idea that the setting has a more powerful effect than often assumed can be overlooked by people concerned with other issues. A friend of mine goes for counseling to a psychologist sharing a suite with several other professionals. About six years ago, a patient with a gun walked in and shot a psychiatrist. This tragedy was succeeded by a less obvious tragedy. The professionals, concerned for their safety, decided to have the receptionist's office sealed off from the waiting area by a shield of bullet-proof glass with only a small opening for exchanging information with patients. When my friend told me this, she had an almost pleading tone in her voice as she said, "Can you imagine how this makes me feel, to have to talk through a bulletproof shield to get in to see my therapist?"
I think she has a point. Even in less dramatic settings, different impressions co-exist. I recently heard someone tell of the mistake she made sizing up a psychologist. The person had experience being in therapy but this was her first experience of psychological testing. She and the tester were in a pleasant office where she felt very much at home because of the array of colorful, amusing folk art sculptures set along the window sill. Right away, she felt comfortable. Fairly early in the appointment, thinking she was with a kindred soul, she spoke frankly about something she did not like in the process.
In the middle of the testing appointment, the two took a break. Just before they began working again, the client said, "I'm enjoying the folk art you have in here." The tester said, "Oh, this isn't my office. I'm just using it for the day." The client, who was enjoying most of the tests, felt a twinge of uneasiness that proved to be justified. The psychologist, whose perception of the room may not have extended beyond her own convenience, wrote a report describing the person she tested as "disinterested and rebellious."
As a person trained in culture and behavior, I believe that perceptions of space make a very good topic in therapy, particularly when the therapy is not going well. If you are a therapist, consider bringing up the subject of the space and the furnishing that makes up the setting for your time together. You may be surprised at which patients share your interest. It's true, one or both people may sense a painful mismatch which has always been covered over before.
But there's a more than even chance that talking about turf may give a productive new direction to your therapeutic work.
Rochelle Cashdan, Ph.D., is a cultural anthropologist with an interest in therapeutic issues.
Last reviewed: By John M. Grohol, Psy.D. on 27 Jan 2007
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