Monday, September 19, 2011

Personal Space?

For the first time, I'm working at a clinic where I have my own office. It's exciting after years of competing for space, and carrying my supplies and paperwork around like a nomad, to have my own space. I have a bookshelf where I can keep my professional books, resources, toys and art supplies. I have a clock (two actually). I have a windowsill perfect for plants (which I can't keep at home, because the cat won't leave them alone).

I also have four white walls and a lot of desk, bulletin board, and empty desk and shelf space. What to do with it?

There's disagreement amongst clinicians about what "should" appear in an office used for therapy.

Some clinicians would never use overhead lights, preferring the indirect lighting of floor or table lamps to create a more intimate space for conversation. I prefer to have the overhead lights on - it makes me feel more awake.

Some clinicians hang their diploma or license, while others do not. I did, only because I didn't have much else to hang on the wall. However, I hesitated, self-conscious about the privilege of my education in contrast to so many of my clients. I ultimately figured that all of my clients already one has to have a graduate degree to be a therapist, so it's not like I can pretend otherwise by NOT hanging the diploma. I've noticed that some clients feel comforted by it (as sign I might know enough to help them), while others seem mildly curious, or completely unaffected. No one has seemed to react negatively.

Some hang abstract art or prints of nature on their walls. I have some photographs of nature to use as examples of "safe space" imagery. These are pretty neutral and unassuming.

I have a whiteboard for making lists, drawing diagrams, or just writing quotations. I also have a bulletin board where I keep important phone numbers, and little cards and pictures. Lastly, I have some knick-knacks or personal significance - a few photos, a stress ball, a few cat things, a rubber duck, a plaque with a quotation on it. These things have been given to me by colleagues, friends, or family.

The things listed in the last paragraph are quite a bit less neutral. I would guess that old-school therapists or analysists would not approve of any of these things: quotations, cards and drawings can all suggest a particular perspective (and in fact I use them that way intentionally, as a kind of cognitive restructuring), while personal objects and photos influence the client's view of who I am, and therefore, their transference to me. I obviously don't use these objects to shape transference intentionally - I like to have them at work because they are soothing and grounding for me. However, it bears careful consideration how this might affect the content and process of therapy.

The possible impact of my knick-knacks came to my attention after a client I see at my other job (where I'm in someone else's office) shared with me that he had attacked a cat. As I worked through my reactions to this disclosure after the session, I started to think about the cat things I have in my own office, and wondered if he would have been able to tell me what he had done in that setting, and if he did tell me, how the experience would have been different for him.

I had thought that being a cat person was a pretty inconsequential part of me, that wouldn't be of much clinical significance. However, I'm beginning to think that any aspect of who I am could be clinically significant, depending on who walks through the door. So the question becomes, do I remove as much of myself as possible from the office to minimize the impact of the environment on the clinical work as much as possible?

I considered doing so, and at least for now, have decided to leave things as they are. Why? Because I've also learned that any little thing can be seen by clients as a piece of who I am. There's no way to predict and prevent everything. None of my clients have commented on the cats. They HAVE commented on my water bottle or a coke can from lunch, the kind of tea I drink (from the tea bag wrapper in the trash), a piece of jewelry or clothing, my pen. Things that seem innocuous, and which would be hard to avoid (short of not having any liquid, food, or writing implements visible anywhere).

It seems much more feasible to take clients' reactions to the environment as grist for the proverbial mill - information about who they are, or transference material that can allow entry into important personal dynamics. However, a small part of me wonders if it's possible for a client to have such a strong reaction to something in the environment that they can't or won't work through it, and feel the need to stop our work instead. So, I'm wonder what others think about this topic. Do you try to keep everything in your office neutral, or do you have a few personal things? How do you see real or perceived elements of the environment impacting your work, and what do you do about or with this dynamic?

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