Meaning-Focused Therapy

What Makes Therapy Therapeutic?

George Kunz
Seattle University, Seattle, WA

What makes therapy therapeutic? Is it transference and counter transference? Is it the therapeutic alliance? Is it unconditional positive regard? Yes! All these are therapeutic. However, we need to ask deeper philosophical questions about the nature of this relationship, this unique face-to-face encounter between client and therapist. With careful reflection on psychotherapy, I will make the extravagant claim that it is ethical responsibility that makes therapy therapeutic.

We need to reflectively dig deeper into this relationship to understand what makes therapy therapeutic. While ethical responsibility may not be sufficient, it is necessary for healing. More than ethical responsibility is needed for therapy, but without it, therapy won’t work. Furthermore, I will claim that simplicity, humility, and patience are the expressions of ethical responsibility. Simplicity, humility, and patience are the ethical conditions that make psychotherapy therapeutic. I will eventually claim that this relationship is sacred, and could be called religious.

When I claim that simplicity, humility, and patience are therapeutic, I don’t mean they are the necessary skills of the therapist. They are not qualities that can be developed for use as techniques. A therapist can’t practice the skill of simplicity, or train herself in humility, or develop the proper habit of patience. They are conditions of this unique relationship between client and therapist that we call psychotherapy. They begin in the appeal of the client asking the therapist to not harm and to help her with problems. They are fulfilled by the therapist’s response to that appeal.

Simplicity, humility, and patience are gifts. I don’t mean gifts as talents or special sensitivity of the therapist. They are gifts in the sense that they are the freely given condition between the client and therapist in this unique relationship. The client gives her gift by appealing to the therapist to transcend his role as a therapist, to transcend even himself, in order to be responsible. In return, the therapist gives his gift by responsibly responding to the client, and by appealing to her to transcend her role as a client, to transcend even herself, to be responsible toward others.

The Germanic word gift is close to the Latin word gratus. Gratus is the etymological root for the words gratuitous, and gratitude, and gracious. Psychotherapy ought to be understood within the mode of gift-giving rather than in the business model of economic exchange that grounds much of the field of counseling. As gift, therapy is closer to the notion of grace than to the notion of contract. Grace is the unexplainable and unmerited gratuity of a good relationship

Briefly, simplicity is the gift when the therapist, in his effort to understand the client, is asked by her uniqueness to not reduce her to one of his convenient psychological labels; and then he responds with respect to this request. Humility is the unmerited gift when the therapist, having the skill and opportunity to change the client’s behavior, is asked by the client’s vulnerability to not manipulate her; and then he does not apply a technique on her. Patience is the gratuitous gift when the client’s suffering asks the therapist’s compassion to not suffer her suffering, but to suffer her. Suffering her is therapeutic.

Let’s conduct a phenomenological analysis of the straightforward face-to-face encounter in the therapeutic relationship. When we do a phenomenological analysis, we hold back any interpretation or explanation and describe as carefully as possible what shows itself. When the client reveals herself in pain, she wants to be understood; she does not want some explanatory interpretation

Let’s describe these three gifts of simplicity, humility, and patience in order to understand how they each make therapy therapeutic. At the cognitive level, simplicity can be understood from a phenomenological description of what it means to know another person. At the behavioral level, humility can be understood from a phenomenological description of what acting for the good of another really is. At the feeling level, patience can be understood from a phenomenological description of suffering another.

Our phenomenological reflections will respond to the following three questions. The first question asks about knowing another. What does it mean for a therapist psychologically knowledgeable about pathology, to acknowledge that he does not know the client; that he cannot reduce her to a category and make clinical judgments about her; that he cannot ethically assign a pathological label to her distinctive behavior? What is therapeutic about this paradoxical condition of knowing, and yet not knowing? What makes simplicity therapeutic?

The second question asks about acting for the good of another. What does it mean for a skilled practitioner trained in the techniques of therapy to recognize that the vulnerability of the client asks him to not act on her, to not apply his technical skills to manipulate her behavior? What is therapeutic about this paradoxical condition of acting, and yet not acting as the agent of her change? What makes humility therapeutic?

The third question asks about suffering for another. What does it mean when an empathic and caring counselor faces the suffering of a client, to know that he must not be drawn into feeling the same emotional suffering the client feels, but must, however, suffer her? What is therapeutic about this paradoxical condition of not suffering and yet suffering? What makes patience therapeutic?

Let’s begin with a phenomenological description at the cognitive level, at the level of knowledge. What is known, and what is not known in the therapeutic encounter? At this point, we are not concerned with the content of their discussion, what is spoken about during therapy, but what meanings are expressed to each other simply by their facing each other. “Speaking in psychotherapy is primarily speaking to another, and secondarily speaking about something.”

I call this a phenomenology of the faces of the client and therapist facing each other, speaking to each other.

The client’s face says to the therapist, “here I am.”

This message, “here I am,” is the most powerful expression of human existence. Even before my client opens her mouth, her face facing me says, “I am here.” Before she speaks about her situation, her face says, “I am the one before you. I am here and others are not here. I am here, and this suffering I suffer, these problems I will tell you about are unique.” Her face does not say, “I’m here to represent that group of people called depressives.” She does not say, “My suffering is just like the suffering of others.” The face of the client says, “It’s me. You see me here. You do not see a client in pain. You see me in pain. I am the only one here, and I’m here in pain.”

The face of the good therapist says in response, “Here I am. I’m not only here with you. I am here for you.”

The client’s face says more, “I am more than just here. I am here and I am vulnerable. I am more vulnerable here than when I’m out on the street. In here I tell you my story. I’m opening up my life to you. I lay bare my suffering. In here I lower my defenses. I trust you will not abuse me. I have no one here to protect me. I am more vulnerable than you. This is not an equal situation. You’re secure. I’m vulnerable.”

The face of the good therapist responds to her fear, “I will not harm you.”

The face of the client goes on to say, “I am here bearing my own witness to my own suffering. No one is here but me to tell you that my story of pain is real, that I’m not lying to you. No one is here but me to tell you that I and my story have dignity and worth simply because I exist.”

Even if the client tells the therapist that she does not have any value, that her mother always told her that she was worthless, that her father beat her because she was stupid and ugly, her face says to me, “Here I am; I am good; I do have dignity.”

The good therapist’s gift to her conflict is, “I see you and I witness your goodness and dignity.”

The client’s face goes on to say, “I see you seeing me before you. I see you witnessing me as the one before you, witnessing that I am the only one telling you about my suffering. As I speak about my suffering, I see you as the one here hearing my problems. I want to believe your face when it expresses back to me, ‘I am here. Yes, I hear you. I’m not only with you but for you.'” Her face says, “I want to see your face expressing to me that you will not harm me, you will not reduce me to one of your categories. You will not use me simply to practice becoming a skilled therapist, not use me to feel good about yourself.” This appeal by the client, and the responsible witness by the therapist to the client’s witness of herself is what makes this ethical and what makes it therapeutic.

With this phenomenological description of the cognitive condition of the therapeutic event, let’s look again at the first question: What is simplicity? What does it mean for a therapist to both know and not know a client’s pathology? What does it mean to see her behavior and hear her story about problems, but not reduce them to symptoms? How does one not know when one knows? How is this paradoxical simplicity therapeutic?

To get started, there are a few embarrassing difficulties. Good therapists hold two cognitive dissonant bits of knowledge. They know that their academic education about pathology helps them as therapists. They also know that equally good therapeutic healing can take place through the help of untrained people, for example, relatives and friends, even strangers. People without trained knowledge about the signs of pathology often give more help than do therapists. On the one hand, therapists know that their own expert knowledge helps them understand clients. But, on the other hand, they are also haunted by the sense that something beyond their knowledge of pathology, something transcending their skills, ultimately brings healing. Good therapists know that there is something within the face-to-face relationship itself, this speaking to… is what heals.

Unlike other scientist practitioners, such as a car mechanic or a cardiac specialist, the psychotherapist must know that right here facing him is an individual whose singularity, whose distinctive uniqueness questions his use of general knowledge about pathology. The face of the client asks the therapist to place his general knowledge in the background, and to place her in the foreground.

Psychotherapy is unlike medical practice. For example, I am very happy that my cardiac doctor relies primarily on his expert knowledge of the structure, function, and operation of the heart in order for him to examine and treat my particular heart. While I am pleased that he treats me as an individual, it is his general expert knowledge of human hearts that gives me the confidence that he will do the right thing with me.

Unlike the medical doctor, the psychotherapist is confronted by an individual whose psychological singularity is unique in every way. The client’s social and environmental conditions may be like others, but they are unique. Her interpersonal relationships may be analogous to others, but they are unique. Her suffering may be like others, but it is quite unique. The therapist should not say, “Oh, I know what you mean.” He does not know what she means. When he says, “I know what you mean,” he is reducing her meaning to a common meaning that he knows from himself and others. He is not called to know what she means. He is called to understand (stand under) her, but not know her meanings as she knows them. Her experiences are singularly unique.

Let’s proceed a little deeper with our philosophical excavation of psychotherapy. This mental task of moving the client’s individuality into the foreground and the therapist’s general knowledge of pathology into the background is a philosophical maneuver. It’s an epistemological choice to attend to individuality rather than commonality. Aristotle taught us this trick centuries ago. This epistemological maneuver assumes, however, that the person is “nothing more than”…a thing among things, a being among beings containing both individual and general characteristics, and the knower can choose to attend to the person’s individuality or to her commonality, depending on his particular interest. Psychotherapy, however, should not involve an arbitrary philosophical exercise, an epistemological strategy, a mind trick. Psychotherapy is a concrete, lived-out ethical event based on the ultimate goodness of the client, and an ethical obligation to that goodness by the therapist. He is called to understand (stand under) the client. His face should say, “I am here, standing under you, to be for you.”

In psychotherapy, the face of the client does not call into question the therapist’s general knowledge, nor question the therapist’s skill in cognitively moving between knowing individuality and knowing generality. The face of the client questions the therapist’s ethical judgment about reducing the client to fit a general category. Therapy is an ethical event, not an epistemological event. The singularity and uniqueness of the person does not threaten the therapist’s general understanding of pathology. Her singularity commands his ethical behavior. Attending to this singular client appealing for singular understanding and help is an ethical reality.

The meaning of the primordial first word, “Here I am,” expressed by both client and therapist facing each other makes this ethical reality therapeutic.

The good therapist knows that it is the ethical that makes therapy therapeutic. He experiences that her self-revelation, “Here I am,” makes her uniquely singular, and uniquely responsible as the one telling and owning her story, and his hearing this revelation makes him uniquely singular, and uniquely responsible as listening and receiving that story. Not only was singular pain lived, and a singular story about that pain told, and that story was told in person by the person who lived that pain, and that story is owned by that person, but also that story of pain is heard only by that therapist, witnessing back to the client that he is alone in the therapy situation hearing her unique story and testifying to her that he hears her revealing her story. This witnessing of the client’s witnessing makes the therapist uniquely responsible. The therapist does not disclose the client’s meanings. The client reveals herself.

Let’s look at these two words, disclose and reveal. When the therapist makes his detached diagnosis searching for symptoms that will disclose the meanings of the client, he is trying to make her fit his pre-established categories. Picture the analogous miner with the head-lamp searching to disclose the ore. He is not only looking for what is there, but his light is also bringing the oar into light, out of darkness. In disclosing, consciousness not only knows, it opens up the reality it wants to know. Picture the therapist with his theoretical head-lamp illuminating what he is looking for in order to disclose symptoms to fit his theory. His consciousness not only knows the client, he also opens up for himself the reality that he wants to know.

On the other hand, when the client reveals herself, she is the one who bears witness about herself. To reveal has a different meaning than to disclose. In contrast to the self-fulfilling search of a therapist, the client’s revelation of her story is more like a prophetic manifestation, an epiphany. Her life is sacred. Her revelation of her life with all its pain and confusion manifests the sacred. This is a religious act.

The singularity of the client facing the therapist makes him singularly responsible. There is no other person seated before the client at this moment. The therapist cannot retreat from his place before the client. He cannot escape from his own skin, from his embodied presence before this client, here in this place and now at this time, witnessing her presence as the one who is revealing her suffering. The face of the client, her eyes looking at the therapist, her ethical command to him as she reveals her story says, “you cannot escape by acting as if you are only a representative of the group called therapists.” At this place and time before the client the therapist is not a general therapist before a general client. The simple statements from each to the other, “here I am; there you are,” are gifts of simplicity, gifts of therapy. The Greek word Therapeutikos means “one who cares for by paying attention to reality as it is given.” Therapists must be phenomenologists rather than scientists. They must pay attention to the person as she or he gives herself or himself, rather than searching for evidence to prove their hypotheses.

Let’s do another phenomenological reflection on what is often given. Clients lie. They tell therapist things that are not true. Clients can believe something that is not true, so when they tell the therapist this untruth, it is not really a lie. A lie is when the truth is known and an alternative is spoken to another. When the client tells a story that is not the reality as it happened, she is still testifying that that story is her story. She says without speaking, “This is my story. This is the way it happened. This is how I felt.” She may in some way believe her own version of the situation, or believe that this is what the therapist wants to hear and believe. The therapist may conclude that her lying, or her false belief, is part of her pathology, and therefore the truth of the story is not what is important, only that she believes this story. The client’s experience is what is important. It is the client’s reality, and the therapist must accept it as her reality.

This raises another reflective question: is the therapist more like the reader of history whose desire is to have truth disclosed as it happened, or is the therapist more like the reader of fiction whose desire is to have truth disclosed as if it happened? Both historian and story-teller disclose truth about the human condition. The historian has a legitimate claim that his truth is a truth beyond the truth of fictional themes. The fiction writer has a legitimate claim that her truth is a truth beyond the truth of factual history. Both can claim from their own perspective their ethical responsibility to tell their truth about the human condition.

To which truth should the therapist be committed? The truth “as” it happened, or the truth “as if” it happened? Neither. The truth to which the therapist must be committed should be neither the truth of the historian nor the truth of the fictional storyteller. He must be committed to the client herself as the truth. In psychotherapy truth first and foremost comes from the most real of reality, the concrete person before the therapist. There is nothing more real than the existing person in her concrete presence, even when she is lying. The real person’s existence is more real than any spoken reality. She is not only there; she is there with her own infinite worth, simply because she exists as a human person. (Later we’ll discuss the ontological thereness of the client.) If her lies are a part of her pathology, then the therapist must be interested in, and open to, both the story as representative of an historical reality, and also the story as if it happened, because he is committed to this first reality, this first truth, the concrete person there before him.

The therapist wants to understand how the client believes reality happened. The therapist also wants to know how the client distorts reality away from the way it actually happened. The therapist must believe that if the client is to challenge her own pathology she must come to a clearer understanding of what happened. The therapist must believe that the client would serve herself better were she to stop distorting reality. The therapist must believe that the world of reality, as it gives itself, is a co-therapist, or better, is the primary therapist. It is the real world that heals. The real world must be allowed to heal in therapy, even when that reality is the source of pain. Facing reality must in some way be therapeutic. The therapist has an ethical obligation to help the client face reality while also respecting the client’s beliefs about reality.

The therapist must use this hard reality precisely because he values the client more than he values either the historical truth or the fictional truth, simply because that real person is the first and last truth. The therapist has an ethical obligation to respect the client’s story as one that, at this time, preserves her dignity. Therefore, the therapist must be committed to the truth both as it happened, and the truth as if it happened because the client is the first truth. This is the therapist’s paradoxical ethical charge.

Let’s consider the temporal progression of therapy. At the beginning, before they have met, before the actual facing takes place in therapy, the therapist does “know” the client as if she were a member of a classification, as one member of a group labeled depressive, or obsessive-compulsive, or whatever. The therapist reads the file on the client; he reads her history. Someone else at the intake session possibly wrote this history now on file. This history is a disclosure of a person as a member of a classification with her own particular characteristics. So the therapist, at the beginning of the process, knows a disclosed client. While it is a picture of the actual client (after all, it is her history), it is, of course, not a picture of the actual client. Over time the therapist comes to know both more and less of the client. As the client reveals herself, she reveals that there is much more to her than disclosed in her history. Even in the midst of therapy, what she speaks about not only reveals, but also conceals. This is not a deliberate concealment. Whatever reveals simultaneously and inevitably conceals.

The front side of an object reveals that front side and conceals the backside, which can be disclosed by turning the object around. The narrative of a client both reveals what is spoken and conceals what is left unspoken. While that which is hidden can then be revealed, it in turn conceals more. The reality of the client is infinitely more than can be revealed by any multiple turning over the life of the client in an extended narrative. As the therapist comes to know more of the client, he comes to know less. He comes to know that there is always more of the client. The client is infinitely more than what a therapist can know. The therapist knows there is always the unknown. The therapist is always in the condition of unknowing. This unknowing is therapeutic because it respects the infinite privacy and solitude, the infinite Otherness, of the client. Right within her revelation is the truth that the client cannot be fully known. She is always more…

The gradual disclosure of an object is an epistemological act. The gradual revelation of the infinite otherness and dignity of the Other is an ethical event. The Other reveals not only unseen sides, she reveals that she is infinitely sided, infinitely Other. Her infinity is not just uncountable characteristics. Her infinity is expressed in her existence as a human person, whose infinite value is a first principle. Let me correct that: the value of a person is a first principle that is not a principle. It is a concrete fact. She is a person whose face says, “I am infinitely unknowable and mysterious.” And further says, “I have infinite value. Do not do violence to me. Do not reduce me to a principle. Do not make me into an idea of a client whom you think you can know.”

Let me sum up this phenomenology of knowing the client and her pathology. The gift of the client is her revelation of her unique and sacred self, and her appeal to not be violated, to not be reduced to pathology, but to be acknowledged as infinitely worthy. “Do not do violence to me. Do not violate my integrity and worth.” The gift of the therapist is his response to her revelation and appeal. “I will not reduce you.” This situation of mutual simplicity is therapeutic.

Here is my first charge to students. Study your pathology. Know symptoms. Learn their etiology. But most importantly, listen to your client as she or he says, “Here I am. Don’t violate me with your labels of pathology.” Say back to the client, “I see you. I am listening to you.”

Let’s discuss the second question, the one at the level of behavior. What does it mean to work with a client, and yet be asked to not use technical skills to manipulate the client? What does it mean to act, and yet not act in a way that engineers the client into predetermined outcomes?

Again therapists hold a cognitive dissonant set of beliefs. They know that they can use methods to change the client’s behavior for the better. They also know that therapeutic healing can take place with the help of untrained others without the use of techniques? Healing can even happen without any intervention. The therapist believes that his training in therapy can help clients change behavior. He also recognizes that what is therapeutic is beyond his skill as a therapist. He is haunted by the recognition that healing transcends whatever he does. What takes place is bigger, more profound. Her request, “be here,” and, his response, “Here I am,” are prophetic revelations.

Let us again conduct a phenomenology of the relationship between client and therapist. The first message from the client’s face says, “Do not violate my freedom.” The second message is, “serve my needs.” She says by her presence, “Do not violate me by manipulating me. Help me with my difficulties.” Helping without manipulating is humility. Humility is the service of another’s freedom. The client says, “Help me regain my freedom. My problems keep me from acting freely. I am investing in you, therapist, the freedom to help me with my lack of freedom.” The client’s previous bad judgments and behavior have reduced her freedom. Her loss of freedom asks for the therapist to use his freedom to help her regain her freedom. The client’s troubles and neediness says, “I’ve been hurt. I’ve been sabotaged. I sabotage myself, and I cannot regain freedom on my own. I’m investing in you the authority to help me overcome my self-sabotage, in order to be free again.” The therapist is asked to help her regain health. The client does not say, “Help me regain capricious freedom, help me with my self-centered freedom, with that freedom I use to sabotage my freedom and health, and to hurt others.” Her face says, “Help me regain responsible freedom.” The therapist must be obedient to the freedom invested in him to be used to serve the need of the client to regain her responsible freedom.

Let me make another extravagant claim: the therapist is responsible for the responsibility of the client. This claim that one is responsible for the responsibility of another goes against our precious individualism. We tend to understand the concept of responsibility as belonging only to the individual. Our usual thinking goes like this: If the therapist is responsible for the responsibility of the client, then the client must no longer be responsible for herself. Or, if the client is responsible for herself, then the therapist must in no way be responsible for her. The therapist is responsible only for himself. The client is responsible only for herself. No one is responsible for another.

This isolating individualism of Western civilization is pathogenic. And it sabotages the therapeutic of therapy. Accepting the gift of responsibility for the client’s needs is the therapeutic humility of the therapist. The client’s primary need is to be responsible to others. Her pathology is, in some sense, her tendency to be egocentrically needy and not responsible. Her therapy, therefore, is to become more responsible. Certainly, the client has been abused by others. She has been harmed. She has harmed herself. She has harmed others. She turns to the therapist in her search for responsibility. The therapist is responsible for the responsibility of the client.

Obviously this does not mean that the therapist is to take away from the client her responsibility and take it on himself. He is not responsible to make the client’s choices and act for her. He is responsible for the client’s responsibility.

Just how the therapist fulfills that responsibility to help his client become responsible is learned in practice and good supervision. Analogous to the question about whether the therapist is like a history or a fiction reader, we can ask if the therapist is more like an engineer or a confessor. The engineer changes future behavior toward a predetermined outcome. The confessor accepts and forgives past behavior, and witnesses the restoration of love from the community or God. The therapist is neither an engineer nor confessor. He is responsible to the client’s psychological health. If her health depends on overcoming her egocentric needs and developing responsibility, then the therapist is responsible for her responsibility.

Let me sum up this phenomenology at the behavioral level about working with clients. Don’t say, “I can change you.” The gift of the client is the revelation of herself and her appeal for the therapist to not try to change her with techniques, but to help her regain her responsible freedom. She says, “Respect my freedom. Help me respect my freedom.” The gift of the therapist is to respond to this appeal. “Your responsible freedom is sacred.” These mutual expressions make up the gift of humility. This humility is ethically therapeutic.

Students, my charge to you is, become skilled! Develop styles that help. But most importantly listen to your client say, “Here I am. Don’t manipulate me.” Reveal back to the client, “I am here for you. Your well-being and responsible freedom is what is important from this encounter.”

Finally, let’s conduct a phenomenology at the affective level, the feeling level, to respond to the third question: What does it mean for a caring and empathetic therapist to suffer the client but not suffer the suffering of the client? What does it mean to emotionally respond to the client and yet not feel the client’s feeling?

Again the therapist holds dissonant beliefs about his own emotions. He knows that his affective detachment from the client helps him be therapeutic. He also knows that compassion is needed. He also knows that healing can take place with the help of emotionally involved others, such as family and friends. Those emotionally involved family members know that only the client can suffer her suffering. Their love for the client together with their experience that they cannot suffer the client’s suffering makes them suffer. Healing can happen only if another suffers. The therapist suffers because he values the infinite goodness of this suffering person. She is good. Her suffering is not good. He suffers because she suffers. The therapist cannot love the client as the family loves her. But his concern for the client must be like their love by wanting her to not suffer because she is good and her suffering is not good, and he is willing to suffer her. His interest must be a disinterested interest. He wants her to not suffer purely for her goodness, not for some benefit back to himself. He must be committed to the client without any need for reciprocal pay-back toward his interest. Of course he enjoys and celebrates her relief from suffering. But he is not motivated for this benefit to him. He is motivated for her goodness.

The therapist suffers patience. Patience is suffering the Other. It is not re-suffering the Other’s suffering. I should not say to the client, “I feel your pain; I have felt that same pain you feel.” When the therapist tells the client that he has felt her pain, he disrespects her pain by making it a generalized pain, one that can be shared, one the therapist and others have felt. But the client’s pain is distinct; it is unique; it is singular. Only she feels this pain. The therapist may have suffered a pain like the client’s, but he cannot feel the client’s pain; and he cannot tell her that the pain she feels is common. That would be a lie, because her pain is unique.

The client is not asking the therapist to suffer her pain. The client is asking the therapist to suffer her. The therapist must be patient, not compassionate by trying to suffer her suffering. The therapist does not suffer empathy or sympathy by trying to suffer her suffering. He does not suffer as the client suffers or with the client. He suffers the client. The client asks the therapist to be patient, to suffer her, to be responsible to her pain. She is asking the therapist to suffer the responsibility of being responsible for her. This request is her gift for the therapist to be patient, to transcend his own feelings. This gift can be therapeutic if received and suffered by the therapist. The client’s suffering asks, “be here, suffer because I suffer,” and, his response, “Here I am,” is a sacrificial rite.

The face of the client and the story she tells say, “Here I am. My suffering is unique. I cannot detach it from myself in order to give it to you. As much as I would like to rid myself of this pain by giving it away, only I can suffer my suffering.” The client does not explicitly ask the therapist to suffer. But the client’s suffering says, “I want you to suffer me. When I know you suffer me, when you care enough to sacrifice me, when I experience that your suffering is suffering me, then will I know your ethical responsibility is authentic. When I experience you suffering me, I know I am infinitely worthy. I know my existence, as disturbed and troubled as it is, has a dignity worthy of your suffering.”

The client, in the midst of her suffering, knows that the therapist’s suffering her is an ethical and noble suffering. Feeling his love-like suffering, his suffering disinterested interest, makes therapy therapeutic. Suffering others heals their suffering.

Let me sum up this phenomenology at the affective level of suffering of both client and therapist. This gift of the client appealing to the therapist to suffer her because she is infinitely and uniquely worthy is the condition of patience. Suffering the client’s appeal for suffering without suffering the suffering of the client is patience. Patience is ethically therapeutic.

Students, my third charge to you: suffer your clients when they say, “Here I am. I am asking you to suffer me. Your suffering will show me that I am worthy.”

Let’s do a little more philosophical reflection on the ontological thereness of the client. It is the ethical condition in any interpersonal relationship that establishes the ontological status of the participants, answering the question: What kind of reality do humans have while in relationship? What kind of beings are these beings? First of all, they both exist as human persons, not simply as beings among beings. Because each has consciousness and freedom giving witness to and owning their own being there, their reality is more real than the reality of things. Each is there and expresses that he or she is there, “Here I am.” This is the kernel insight of existentialism. Human reality is pre-eminent reality. Our thereness is doubly there. Let’s call the reality of each person “hyper-reality,” “super-there.”

In psychotherapy the client’s thereness is more than doubly there. She does not present herself as one whose reality is based on her expressing some social position or title, or based on her skills or talents. In therapy her reality is stripped of these qualifications. She is not there behind the cover of a social class or individual capability. She is there simply as the human person she is. Her reality is bare or naked reality. It is a reality that is truly pre-eminent reality. Her reality is not a reality propped up by personal or social qualities. The naked reality of the client makes her not less real, but more real. Her reality is hyper-hyper reality, or triple reality, if you allow me to continue to use these weird superlatives to describe the ethical and therefore ontological condition of the client.

In psychotherapy the client’s thereness is more than triple reality. She not only is there naked without being clothed by credentials or social position, but she is also there giving witness that she hurts. Her vulnerability exposes her as if her raw nerve endings were turned inside out, powerless, unprotected, susceptible to pain. Hers is hyper-hyper-hyper reality. The more she reveals herself in her suffering, the more she stands exposed as raw reality. She is self-revealing. She is raw, naked without honors. She is there as pain. Her thereness is infinitely there.

Correspondingly the therapist’s ontological existence is defined not only as the one who is there as responsible for other persons, but also as the one whose bare and naked reality without the props of personal or social status makes his thereness hyper-hyper-hyper responsible. The pre-eminent existence of the client as raw thereness gives the therapist his pre-eminent existence as responsible thereness.

Summing up, therapy is therapeutic when client and therapist offer to each other the gift of simple reality as bare and naked before each other, without the complexity of social status, or ideology, or psychological theory. They are two people standing toward each other with nothing but themselves to present their reality.

Therapy is therapeutic when each offers and accepts the gift of humility. Neither has an agenda beyond helping the client regain her responsible freedom. The therapist serves this good without any disguise or deceit. He is simply there as servant. The client’s otherness and freedom is infinitely beyond his manipulation. His freedom is invested in him by and for her, and committed to her good.

Therapy is therapeutic when they offer and accept the gift of patience. Each suffers her and his bare and naked existence. Patient suffering is the infinite emotion that heals.

Finally, let me return to the word religion to describe therapy. Religion is etymologically derived from the Latin religare, which means to bind in obligation. Our ordinary understanding of the notion of religion refers to denominations, or to doctrines, or rituals. The more primitive meaning of the word religion is from the prefix re- meaning again and again + -ligare, meaning to bind. Religion means to continually transcend ourselves and bind in obligation to others. The therapeutic relationship is religious. When the word religion is understood as the ethical bond toward others, an obligation which can be refused, but which is freely chosen, and therefore an obligation to which one can fully commit, then we can call the therapeutic encounter a religious bond.

Students, you are entering into a religious profession, a sacred profession. Make it holy!!

*An address delivered at Orientation Retreat for the Graduate Program in Counseling Psychology at Trinity Western University on September 14, 2002