The Mummy at the Dining Room Table provides many examples of unusual and difficult cases, and assures the reader that there is hope for every situation. One of the most helpful aspects of the book is that it can be used to prepare for a patient and condition, for which the therapist in not familiar. . While every patient is different, the book provides the consistent message, which therapy is helpful and people can grow and change and succeed. The book gives a large number of examples and treatment strategies that can be helpful to any clinician.
Reading about the experiences of experts such as Albert Ellis, William Glasser and Jay Haley is like seeing the theories and techniques in action. The book has use for the clinician as well as the patients. It points out what clinicians learn from their clients, and how they grow as clinicians, becoming more expert and insightful. The clinician learns more about human emotion from every client in which they come in contact.
One of the aspects of this book that can be intimidating to the new therapist is the creativity and expertise of the clinicians in the book. Each therapist has a unique and dynamic personality. They are interesting people. Someone new to the field, without the experience and confidence may find the case example and techniques intimidating to some degree. Reminding oneself that everyone started out as new and tentative in the field can help overcome that intimidation.
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These are well-known and highly successful therapists talking about their most memorable clients and situation. The book tells the stories in a dramatic, interesting and at times funny way. It is so helpful to read the behind the scenes accounts of the therapists preparation for these unusual case scenario. Even the most expert of therapists are always learning and researching. We learn that power of the therapeutic relationship cannot be underestimated and that even the most unusual patients and problems can be treated. Hope is an important part of treatment. With insight, an open mind and hard work, success often comes. The cases situations, therapists, clients and therapeutic techniques are fascinating.
The books make it clear that fieldwork, videotaping and supervision are so important. It is a reminder that our patients are real people and not subjects of an experiment. The therapist has a responsibility to be prepared and well trained. Many of the therapists in this book have done extensive research on their techniques. These therapists take a journey with their clients and are able to help them develop solutions to their problems.
In Chapter One, “The Man Who Wanted His Nose Cut Off”, the new therapist, Jeffrey Kottler was inwardly shocked by his client’s confession that he had been having a sexual and somewhat romantic relationship with a cow. Kottler only saw this client twice but learned an extremely valuable lesson for a therapist. He learned that the simple act of listening, in a non-judgmental way is actually therapeutic. He listened and reflected back to his client and did not judge or attempt to change or analyze anything in these two sessions.
He simply listened and by the second session, it seemed that the client Manny had come to his own solution. While Manny’s solution was not what Kottler would have though was ideal, for Manny it was apparently a fine solution for Manny and he never returned to therapy. Clients will not always complete the journey or the goal that we as therapists have in mind.
My personal preference and belief system is most congruent with humanistic an existentialism. This approach to therapy is open minded, flexible, client centered and believes in the goodness of the client and of humanities ability to change and grow. Existential psychology grew from the writings of such well-known philosophers as Kierkegaard, Sartre and Camus. Much of their writings talked about the ability of human beings to come through adversity.
They focus on self-reliance and responsibility and come out on the other side with a philosophy that focused on self-reliance, authenticity, responsibility, and mortality. Rollo May, is one humanistic psychologist that translates the philosophy to psychology. His therapy focuses on the here and now and a clients freedom to choose. Existential psychology focuses less on the person’s genetics, experiences as a child or family or origin and more on the person’s perceptions, responses and conscious choices in the immediate. The existential believers see the motive for behavioral as the rift between existential anxiety and freedom.
In the case of Manny, a therapist could easily be entrapped in the reasons for his sexual behavior with a cow and his apparent attraction to the cow. The therapist could look at his family history and try to determine if something led him to this behavior. Another therapist may be inclined to believe that he simply never had proper sex education and so was finding it difficult to relate to human women. Perhaps all Manny knows is how cows have sex. No matter what the reason, the treatment is to relieve Manny of his unhappiness. He came in complaining about his nose and then quickly began to talk about the cow.
The key to treating many was in the relationship between the therapist and the client. As Kottler learned I believe, easing the anxiety may have been the real key to treating Manny. Relieving some of the anxiety through acceptance began the treatment process for Manny. The end result, which seemed to give Manny the freedom to pursue this bovine relationship and simply cover up the smell. This may not have been the best outcome at all and I believe there is a lesson there as well. With several more sessions, Kottler may have been able to address the anxiety Manny feels regarding relationships with humans.
This certainly may have required some sex education as well as some exploration into family dynamics, but it would also have required a discussion on what he wanted in terms of a romantic relationship. He may have moved to discuss the issue of existential angst and the desire for meaningful relationships with humans
Kottler talks at the end of his chapter, about another patient who was distressed by his desire to dress in women’s clothing. Kottlers reaction and apparent acceptance relieved the anxiety for this man. The man was disturbed by his thought but had difficulty managing them, that was is reason for coming to treatment. Ultimately, with therapy, the man's disturbing thoughts subsided to a level he was able to accept. I believe Kottler’s examples speak about the importance of the therapeutic relationship as the major tool in therapy.
With both of these patients, therapy could have, and may have helped the person examine their relationships and make conscious choices that would relived the anxiety and fear that exists without a meaning to ones life. Manny’s future therapy might have moved him towards self-discovery and reflection that he has the ability and freedom to develop meaningful, fulfilling human relationships that result in happiness. He may have been able to discover why he was at the time, using cows for sexual gratification and how he might ultimately, and move to fulfilling intimate relationship with a human.
Carl Rogers, with his humanistic focus, believes that humans are good, and desire to be the best and do the best person possible. People do not always accomplish this desire easily, which is where therapy becomes important. Manny, given the freedom to talk and lead the conversation to some extent, could have worked towards self-actualization. If Manny is disturbed by his current relationship and want to move towards relationships that he will find more fulfilling, therapy can be the key. The therapeutic environment can allow him to explore anything in a safe environment and then he can make choices for his life. Manny may have been able to understand the concepts of “real self” versus “ideal self”, meaning what he is and what he wants to become or move towards.
The many case examples in this work all speak to the hop and powerfulness of therapy and relationships. My belief in the humanistic approach is even stronger as I read these examples. People with such disturbing problems including the woman who hanged herself to test her husband and the family with the mummy at the table, all can have a positive ending. Though not perfect, and perhaps not what the therapist would want, but progress can be made.
In the chapter by Carlson, with the same title as the book, a family had mummified a female member of the family. We actually learn about this because the main character of the chapter, Trina is seeking to understand herself better. She feels it is important to establish contact with her family, which we are aware is somewhat dysfunctional. As it turns out, Trina’s aunt has been mummified because the family felt that it would ease their grief. The woman died at home and so with the help of a friend in the medical field, the woman was embalmed and mummified.
The family would actually sit her at the dining room table .It seems that the entire family, including her husband and children are involved with the caretaking of the mummified woman. This example, and this family is probably the most bizarre of the books many odd cases. As a humanistic therapist, this family, if they were in treatment, would need ample time to o talk a process the decisions they had made and the reasoning behind the decisions.
Addressing grief, the loss of a close personal relationship and perhaps acknowledging that many people may feel the same way about the loss of a loved one. Most people however, do not have the resources to embalm and mummify. As with the case of Manny, the behavior is odd and troublesome and probably illegal. However, it is possible trough understanding, flexibility, a non-judgmental attitude and hope, that the family can have a successful outcome.
Each example case in the book is real and each saw some measure of success. Each therapist, no matter what he level of experience at the time of the particular case, learned something from the treatment process. While these cases are shocking and interesting to read about, their treatment process and the relationship with the therapist is not really that different from treatment with other patients.
It is important for therapists to understand and look for the uniqueness in each individual and not to just seek out the unusual or overlook the more typical. Even the most seemingly straightforward problems, can be complicated and unusual once unraveled. This was so with the case of Trina, who began in treatment to address a standard marital issue. The key to treatment is the training and understanding of the therapist, the belief that treatment is possible and then the therapeutic relationship.
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