From the perspective of the therapist, the role of therapists in society is to use their knowledge and craft to decrease the amount of human suffering and pain through interventions at the individual and family level. From the standpoint of individual members of society, therapists fill the role of the clergy in an increasingly agnostic world, are a surrogate supportive community for those without, and stand in as parental figures for people whose parents can no longer parent them: they are the holders of wisdom and help about seemingly intractable problems, from existential issues to difficult children.

Humans inevitably experience pain and suffering in their lives.  Pain, whether physical or emotional, is fairly straightforward. It hurts. If you break your leg or if your mother dies, it hurts. If you break your leg, you go to a doctor, and if you lose your mother you go to a therapist, but the role is the same: comfort the client (“Yes, this hurts, but I am here with you, and rest assured you will heal.”) and catalyze the healing process.  Suffering is more complex. It is like meta-pain, pain about pain. This realm belongs to the therapist. If you feel guilty about feeling pain over losing your mother, for example, the therapist can recognize the rules you are playing by (“It sounds like you don’t believe you should feel pain over the death of your mother”) in the meta-perspective, help shift those rules (“Sadness is a natural and healthy reaction to loss, and you are a good and brave person to feel it”), and then deal with the pain (back to “Yes, this hurts, but I am here with you, and rest assured you will heal”).

Family therapists specialize in suffering that maintains itself through patterns of behavior in relationships. Suppose you and a friend are pinching each other, but somehow neither of you recognize it. Humans are often in this position, metaphorically: unconsciously collaborating in their own and others’ suffering. Family therapists know about and can recognize the invisible-pinching patterns people can get into, can teach the pinchers to recognize it too and help them learn how to unpinch. The first two basic steps are the same: recognizing the rules (“It looks like you are pinching each other, with the rule ‘the more I hurt, the harder I pinch’”) in the meta-perspective, help shift the rules (“Let’s try a new rule, ‘I use pain to remind me to check to see if I am pinching’”).  The third step, dealing with the pain that may remain, may or may not be necessary, and the degree to which a family therapist is equipped to do so depends on their preferred model and their interpersonal style.

In general, family therapists are more concerned with second-order change – change in the patterns of behavior that perpetuate suffering – than the suffering itself, much less the pain. Still, their role in society is basically the same as the role of other kinds of therapists: to reduce the amount of suffering that exists and that flows into the next generation.



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