As a preface to this post, I should say that I don’t like to refer to the people I work with in therapy as patients or clients. Patient is typically associated with a medical context and we have free healthcare here in Canada, so client doesn’t make sense for that. However, I don’t use client either because I feel like that makes the relationship about the exchange of money for service rather than the therapy. So, when referring to the people I work with in therapy, I usually call them ‘my people,’ ‘the people,’ or ‘person.’
When you’re learning to be a therapist, they teach you to try an understand the person you are working with on a deep level. In order to help them, it is important that you understand their mindset, their thought processes, and their subjective reality as well as possible. You don’t have to agree with it, but it helps a lot to understand it.
My primary therapeutic modality is Cognitive Behaviour Therapy. This is a therapeutic modality built upon the very idea that people can experience the same reality differently, or have differing thoughts and feelings about the same reality. Look no further than the example of the number 6/9 drawn on the ground. One person says it’s a 6. The other person, standing on the other side says it’s a 9. Neither are ‘wrong’ per-se. Each is experiencing a different perspective of reality. This is a very simplified example, but it does extend into far more complex examples.
The reasons why two people may experience two different perceptions of the same reality has a lot to do with each person’s genetics and lived experiences. I won’t go into detail about this at this time as that is an entire post all to itself. For now, I will say that it is important to understand your person’s subjective reality.
Without getting too philosophical, there is debate as to whether there even exists an objective reality at all. There are subjective realities, and there are realities that are common amongst many people. I am musing about this topic today because in almost every other profession, we are concerned with the shared common reality and not an individual’s subjective reality. I have had to appear in court a few times now in this role. I have had to speak to numerous parents, caregivers, social workers, teachers, and other care providers about the children, youth, and people I work with and explain to them how this reality works and why it is important.
The legal system is perhaps the most difficult because that is almost exclusively concerned with the common reality – the reality that was observed and shared by the most people. However, in therapy, a person is going to act upon and operate on their subjective reality, not someone else’s. In fact, we all do!
Let’s say I have someone who was involved in a motor vehicle accident. They have PTSD from a previous accident and they were not the driver. There were three other people in the vehicle. No one was seriously harmed. When you ask everyone about the accident, you are likely to get three people saying something like: “It was a minor accident. No one was seriously hurt.” But the fourth person who has PTSD will probably say it was a terrifying experience, they had completely lost control, and it was a significant crash.
The legal system is going to be most interested in learning the details of the accident as it was experienced by the majority of people. Yes, they will be able to use other evidence to tell them what happened, but that’s not what I’m concerned with right now. That is how the legal system decides what reality is. However, if I am now working with that one individual who has aggravated PTSD, then no one else’s reality will matter – at least not starting off anyway. If I start out by telling this person that their experience wasn’t as bad as they thought, that the other people involved said it wasn’t that bad, and that they are safer than they feel they actually are, I won’t be doing anything for that person except causing them to doubt their own judgements and feelings of safety, downplaying and denying their experiences, and making them either not trust me, or not trust themselves.
I’m not saying that the common shared reality is not helpful. There is a place and time during therapy to bring it in, but only when the person is safe enough to be challenged with it. You must first restore their feelings of safety and security. You must also restore their trust in themselves and establish the trust with you as their therapist. When you have created some doubt and curiosity, and the feeling that you have their best interest at heart, you can start bringing in the common shared reality of others as a means of challenging the subjective reality of the person.
This is not only important for things like PTSD and traumatic events, taking the time to learn and understand how people perceive reality and why they perceive it the way they do can offer much insight into the person’s lived experiences and inner thoughts. It can even reveal important things about a person’s core beliefs and sense of self, but those are topics for another day.
Even according to science, reality is not fixed. Albert Einstein’s Theory of Relativity proved that aspects of reality are relative to the observer. The notion that each of us can have our own unique perspective of reality that differs from others in slight but meaningful ways is not a stretch of the imagination. On the contrary, it is something that should be considered every time you work with someone in therapy.
Thanks for reading,
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