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What Are Psychotherapists Doing To Their Patients And Their Practice With Their Offices?

The unconscious mind becomes manifest in the physical world through the nature and placement of external, physical objects surrounding us. Could this transference or countertransference present in your office be effecting your patients?

When a client enters your consulting room, the space itself communicates to them a myriad of messages. How your client interprets and reacts to the psychotherapy setting may be thought of as transference. Do you know what messages you may be sending unconsciously via your setting?

Every setting constantly and silently tells a story, a narrative constructed by the elements of the room, their placement, their associations, and their symbolic meaning. It is right there for all to read, and each person will interpret it differently. The consultory is a room of stories. It acts as a container for the stories told by clients and by the therapist. However, like an ancient vase, the container itself tells its own story. Do you know how your clients are interpreting the stories conveyed by your setting?

Charged with the psychological and emotional health of their clients, mental health practitioners would do well to consider all elements positive and negative in the psychotherapeutic environment that possibly could contribute to the therapeutic process as a whole. Yet, the psychological literature and interviews with psychiatrists, psychologists, and psychotherapists indicate that the room in which therapy takes place is rarely discussed. Can you identify if or how your office contributes to or detracts from your clients psychotherapeutic progress, your professional or personal achievements? Archetypal psychologist, James Hillman writes, "As long as the world around us is just dead matter, Eros is trapped in personal relationships. And transference, by the way, just confirms that, hour after therapeutic hour."

Hillman cautions therapists about the design of the consultory:

It's not enough to be in a tastefully decorated room. White bread therapy has all along secured itself in well-appointed consulting rooms, with comfortable chairs and artistic ornamentation. "Good" design can lead to the mediocrity of normal adaptation rather than into the depths of soul.

James Hillman (1982) invited psychotherapy to attend to the world of things--things that are empty, wrong, ugly, or brokenby moving with the heart toward the world. In the analytic setting, if the analyst became "thing conscious," they would awaken to how uncomfortable they are in their poorly built, "chemicalized" chair. Hillman proposed that psychotherapy might conceive of itself as an aesthetic activity rather than as a science, and ask questions about "what things are, and where, and who, and in which precise way they are as they are, rather than why, how come, and what for". He rhetorically asked if this meant that psychotherapists would analyze their couches, or tell their office-ventilating machines that their cold monotone interrupts conversations.

Hillman looked at setting itself through various lenses, in addition to looking at a settings content. Lamenting the ceiling as "the most neglected segment of our contemporary interior," he posited that "the ceiling is the unconsidered, the unconscious". "[It is] the place of images to which imagination turns its gaze to renew vitality". He wondered, as one might wonder about all the facets of the psychotherapy setting, "What statements are these ceilings making? What are they saying about our psychic interiors?" What statements are the file cabinets, the wall hangings, the rugs, the lighting, the window treatments, the furniture making? Hillman contended that our ordinary rooms are the places in which soul change can take place if we attend to these places "where these interior faculties of the human mind begin."

By better understanding their countertransference and its effect on their patients, our mental health clients enhance the therapeutic experience for both the patient and themselves.

Helping You Help Your Patients And Your Practice

The office itself acts as a feedback loop, answering the questions:

1. Does your setting reflect your unconscious personal psychotherapeutic beliefs? 2. Is your setting congruent with how you feel about your patients? 3. Does it mirror how you feel about yourself, personally or professionally? 4. Do you know how your consultory affects your clients? 5. Does your setting encourage or stifle patient communication? 6. What unconscious signals in your setting are affecting your fiscal health?

How Is Your Office Affecting You, the Practitioner?

Understanding the aspects of your countertransference as manifested in the physical setting of your office will allow you deeper insight into yourself, which in turn enhances the therapeutic process for your patients. For the mental health professional, symptoms of negative countertransference may be experienced as fractured focus, indecision, wanting to escape the office, feeling "disconnected" from patients, depression, feeling professionally unfulfilled or unsatisfied, lack of energy or creativity.

How Is Your Office Effecting Your Fiscal Health?

Mental health professionals usually have practical concerns that parallel the desire to help clients achieve emotional and psychological balance, since their practice often defines their fiscal health. A mental health practice is also a business. The consequences of negative or unidentified countertransference can manifest as low or declining patient retention, a sense of business being stuck in a rut, unrealized advancement of their practice or professional recognition, or fiscal decline or "flatline."

Katherine Grace Morris, Ph.D. is the Founder and President of Psychology of Setting Associates and is the "Environmental Therapist." She has a doctorate in depth psychology, and is the pioneer of a new field of psychology, called the "psychology of setting." She uses a client's setting -- home, business, etc. to solve clients' problems with themselves or with their employees. Change is easier when the body leads. Changing the setting leads the body and the head follows. http://www.psychologyofsetting.com

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