Re:Utilization with Highly Critical Clients

I once had a very critical client - my most critical in 30 years. I told him that he would not be an adequate client for therapy and there was no need to return.

He criticized this point.

I insisted. We repeated the conversation with minor variations of words for about 10 minutes. As we this happened he of course focused in on what would make a good therapy client and I replied with less and less vagueness that: 'a good client could handle ambiguity'. This contest was very important. He tried to beat me in the issue of him not being a good client v. him being a good prospect for therapy.

Of course, he wanted further detail. I explained in this vein. 'People who are demanding as you are will expect exact answers from me for your money and you will complain after 2 or 3 weeks that you did not get what you paid for...I gave you nothing of value. To anything I say you will either say you already tried it and it didn't work or that it is stupid and you won't even do it...or I'll talk you into it and you will return and say 'nothing happened' or it was of no values, etc. That is why you are not a sufficiently good therapy prospect/client. And...since you are not, there is no need to pretend and go thru the paces wasting you time and mine."

He disagreed. He said he could handle ambiguity.

I agreed. But added that he could not or would not learn from it.

He disagreed. He announced that he COULD most certainly learn from it.

I disagreed. He would have to do his own thinking of how my incorrect ideas and ambiguity could apply to him. Then he would tell me that and I could gradually improve the accuracy of what I say...but still with ambiguity...he would have to modify it and make it apply to him...tell me how it could or did fit...back and forth until we get very helpful to each other. But he could not do that. He could not use ambiguity like a successful therapy client.

He disagreed. He said he most certainly could.

I admitted that I am wrong sometimes. And I would happily admit that if you really could.

He said he could.

I said okay. I will have to think about what is a good beginning for him and either mail it to him or tell him when I saw him the next week.

I decided to mail him 7 ambiguous assignments. More than 1 per day before I saw him next (and his getting the mail).

----here's a glimpse of what one was---

He was to drink water with every meal until I saw him again. And the water was to be in a glass filled largely with marbles. (I cautioned him to not swallow any for legal purposes...).

He returned with a 17 page written! summary of his experience with the many assignments.

Regarding the water and marbles he stated: "At first it was of not consequence but then this was very interesting because the thirstier I became the more frustrating it was. And I guess you had me do this because you wanted me to realize that this must be how it is for my wife; The more she needs me the more frustrating it is for her." Etc.

This indeed became an easy case. He did all the work. Can you imagine my joy that in the second session he is tell me that he frustrated his wife and that is not a good behavior? To this day I am in contact with the x-client. He refers others to me and publicly proclaims that most therapy is 'b*$L s*$t' but that I really know what I am doing! And I did very very little.

What I did do was let him defeat me in the concept that he would be a terrible therapy client and would not learn and should not come.

That's utilization, if I do say so myself.

Replies:

Re:Utilization with Highly Critical Clients, by Harlan D. Kilstein, 08/20/01

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