10. Hope - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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Therapy may be about hope.  Individuals, couples, and families may invest in therapy to find hope and create a sense of a future together.  Sometimes, an individual, one or both partners, or one or multiple family members are invested in therapy to find the hope that they have lost from years of dysfunction.  Others never lost hope, but are alarmed that their attachment has diminished or pain and turmoil has increased to a breaking point.  These may be core issues for Carson and Vee that they have never consciously expressed to each other.  To find, build, or recover hope, they invest in therapy to build skills or the relationship or make it stronger.  Although some individuals, couples, or families have given up real intimacy and connection, they come to therapy to search for a reason or more reasons to stay together.  Trying to stay together for the children but getting into too much conflict, some individuals or couples without hope for intimacy strive for a better working relationship.  Some individuals come to therapy so that they can say they tried the one last thing before giving up.  The therapist can offer these possibilities for clients to choose from, including whether they have come to therapy to kill the last bit of hope so they can give up.  Sometimes, an individual will admit he or she has little or no hope, but want to have done therapy to finalize decisions, including separation.  Without admitting this, some individuals reveal themselves with their body language and other non-verbal communications. It becomes clear that they are not invested in therapy or do not expect it to be beneficial.  This will inevitably be a self-fulfilling prophecy.  Bringing the minimal investment into the light of therapy improves the integrity of the process.  Individuals who more invested in couple or family therapy may be conscious to completely ignorant of the other's negative outlook on therapy and the relationship.  This may be purposeful, that is the individual may be in denial about another's disconnection.  Proceeding with various therapeutic strategies and intervention may be ineffective as a result.
  
Carson and Vee's sense of hope was significantly different from another couple.  They were conflicted, hurt, and confused, but they both had hope to be able to heal and grow- that is, to stay together.  And as such, the prognosis and direction of therapy was quite different as well.  In contrast, Kadee was there to build hope and Kim was there to extinguish the last bit of hope.  One was trying to build and the other was trying to leave.  Kim had all but physically left.  Kadee was trying to get help and guidance from the therapist to build and Kim was trying to get permission to quit.  The therapist needs to reveal and clarify that the goals of therapy between the couple are mismatched.  The lack of matching goals may well mean that one partner, probably Kim, has already made a hidden decision.  The therapist should reveal that decision.  If the mismatched goals include one that is clearly more negative and hopeless, then the therapy should initially facilitate the articulation of the process that lead that member to reach such a position.  In doing so, therapy may be able to get Kim to reveal the pain and desperation underlying the position.  Often the process that led to quitting was done quickly or abruptly out of fear.  The therapist should honor the position, but make Kim articulate her process.  The therapist can check what this does to Kadee who is the more hopeful member.  She may experience Kim's lack of hope in itself as a betrayal.  Does it create a change in her goals?  Sometimes, one member of couple is desperately ready to leave the relationship, but has some cultural inhibition or sanction against leaving.  Kadee may be seeking therapy in order to have someone in an authoritative permission- the therapist to give her permission to leave.

Working with less invested partners on their reasons for loss of investment and hope would be more productive than proceeding with communication work or family-of-origin work, for example.  If there is hope, then the therapist's skills and effectiveness working successfully with the couple confirms and increases the hope in the couple.  Working sensitively and successfully with less invested partners in the early sessions may build upon their limited hope.  Couples may not have confidence that they will stay together or if they can improve their dynamics effectively enough. However, hope increases when they can at least believe the therapist is sensitive and competent.  Individuals, couples, and families with marginal hope may gain confidence in therapy if the therapist recognize and draw out their underlying emotions and hunger for attachment- or other key psychological issues.  Low investment and hope may come from anxiety or insecurity that their needs can ever be accepted or met… by anyone.  Sensitive acknowledgement in of itself, that they may have marginal hope increases hope.  Their secret is not a secret from astute the therapist.  "EFT clinicians and researchers… envision the couple relationship as an attachment bond whereby distressed relationships are viewed as insecure bonds... It has been suggested that these insecure bonds do not allow for the satisfaction of each partner's attachment needs for comfort, security, and closeness because of compelling negative emotional responses and constricted interactional patterns that arise and block emotional connection and engagement between partners.  Thus the main focus of the EFT approach to couples therapy is on underlying emotional patterns and on relational interactions with the goal of reorienting, resolving, and transforming negative interactional patterns which will then allow for the fostering of a secure attachment between partners" (Peluso and Macintosh, 2007, page 254-55).

If the therapist is aware that a less invested or less hopeful individual has endured a distressed relationship (perhaps, for years), the therapist can direct energy towards him or her to address the insecure attachment bond.  While someone may have only a little bit of hope left, that hope gets amplified when an astute therapist acknowledges his or her distress.  The individual may experience or think, "Someone gets it… gets me!  Maybe, the therapist can get my partner or family members (or help me get others) to get it… get me!"  Sometimes, the tenuous hope is that the therapist can make a difference after years of enduring negative dynamics.  If the chosen therapist responds knowingly and sensitively, then that hope is strengthened.  For example, many men who resist coming to therapy for themselves or in couple or family therapy and are only reluctantly attending because of threat or coercion, nevertheless may hold hope for the therapist to get them… and to protect them.  "For men, negative statements made by their partner were a consistent negative predictor of all dimensions of therapeutic alliance.  These results seem to indicate that men expect therapists to provide a refuge from what they see as a barrage of negative statements from their partners.  Therapists who fail to provide this protection for men effectively contribute to the lack of therapeutic alliance" (Thomas et al, 2005, page 31).

The therapist who is aware of gender differences, especially of male stoicism combining with vulnerability can fulfill such unexpressed hope.  The therapist can both fulfill the hope and show he or she "get it" or get him.  The man such as Carson may be or appear reluctant but available.  Resistant but in the room.  Some men in this circumstance may simultaneously have hope that the therapist will understand him, while feeling hopelessness from repeated prior interactions with his partner (or from previous failed therapy).  Flaskas (2007) sheds light on these apparently contradictory stances.  They identify hope and hopelessness as related but also separate experiences.  The experiences of hope and hopelessness are not just opposites and in inverse proportion to each other: when hope is high, then hopelessness must be low, and when hopelessness is high, then hope must be low.  As a kind of psychological yin and yang, Flaskas presents hope and hopelessness as coexisting experiences rather than opposites.  This creates the possibility of simultaneously having strong hope and strong hopelessness.  Subsequently, an individual, couple, or family that experiences abuse, crushing loss, or tragic trauma, may draw upon their resiliency and feel hope while still feeling intense hopelessness (page 189-90).  "Hope and hopelessness can be powerful lived experiences.  The dynamics within intimate relationships can be complex, and individual and family experiences of hope and hopelessness are often embedded in family history, and in wider community and social contexts and circumstance.  Engaging with, and being engaged by, the family's constellation of hope and hopelessness presents challenges for the therapist and the therapeutic relationship" (page 186).

The therapist can offer the co-existence of hope and hopelessness to clients.  Rather than hold hope and hopelessness as internal emotional experiences, the therapist can promote the idea and practice of thinking and doing hope or hopelessness.  Clients may feel that thinking, feeling and doing form a unified process from individual, family, or cultural experiences of hope or hopelessness.  The therapist introduces to clients that they can feel hopeless, while still doing hope.  Or, clients or couples may act negatively, but still have hope in the relationship (page 190). It is often difficult to alter emotions that have been embedded by years or generations of despair.  However, acting "as if" or "doing it anyway" can be therapeutic directives to get clients to do hope regardless of low hope or high hopelessness.  The practice and behavior of hope can include: going out on a date with each ones partner; spending time together; sharing breakfast; giving small tokens of caring, and so forth.  Each person's and their family experience of hope and hopelessness occur in wider contexts, including generational history that can either encourage or discourage hope, and encourage or discourage hopelessness.  "Poor housing, impoverished neighbourhoods, family poverty, racism, and abuse and adversity across generations are all contexts that make it much harder for families to hold hope" (page 191).  

The therapist needs to elicit individual, couple, or family's formation of hope and hopelessness.  Adversity, generational experiences of despair and abuse, and other experiences may create the possibility or expectation of new tragedy. Couples and families often develop various complicated patterns of hope and hopelessness, affected by social context and various resources.  Different members may experience hope and hopelessness differently depending on position and roles in the family.  Some individuals may be better at holding on or bearing hopefulness.  Also, some individuals in the family may be better at doing hope as opposed to feeling or thinking hope.  Still other members sustain beliefs holding hope and a feeling of hope, but are not particularly good at the concrete and pragmatic practice of doing hope (page 191-92).  Within a relationship, if only one individual holds and does hope well, another person may experience it as deeply unfair.  This harms their relationship, as his or her experience seems to be invalidated by the other's position.  "…psychotherapy could be framed as an act of hope on the part of both family and therapist.  Yet all families do not approach therapy with the same capacities to hope for change, all families do not request therapy in the same way and, within families, the constellation of hope and hopelessness means that different family members have different relationships to hope for the therapy itself" ( page 193-94).

Flaskas reminds the therapist that he or she may tend to gravitate to the high hope partners.  Their high hope confirms the explicit hope of human services professionals that growth and change is possible; and, that work as the therapist can facilitate it.  High client hopelessness implicitly threatens the therapist's self-definition and self-worth.  "Managing to hold hope, in the face of witnessing the family's hopelessness and carrying our own hopelessness, can be a difficult task" (page 195-96).  The therapist who tends to be very sensitive and empathetic may absorb the energy of clients, especially any negative energy.  "…coming to be stuck on either side of the polarity is likely to lead to anti-therapeutic sequences, which are patterns of relating between therapist and family that are not in the interests of therapeutic movement… Hearing yourself defaulting to sounding falsely hopeful with a family, or alternatively taking up a routine position of warning against a family's hope ('yes, but . . .'), are two ways in which we may find ourselves heading towards antitherapeutic sequences.  These kinds of patterns in our own relating are fuelled by our own counter-transference, our reaction to the family's constellation of hope and hopelessness, and our involvement with the family" (page 196-97).

The profession of psychotherapy may be quite vulnerable to holding hopelessness.  The therapist regularly hears tales of trauma and hopelessness that may cause personal doubt the existence of healthy or functional couples or families.  A frustrated therapist may feel hopelessness in the work with highly difficult clients. At the same time, the therapist can be inspired by the resiliency, heart, determination, and redemption of amazing individuals, couples, and families who persevere despite horrific experiences.  If the therapist can find a balance between conflicting perspectives, it can make them more empathetic and tuned into individual, couple, and family's hopelessness and hope.  This is an essential task for the therapist.  If the change agents- the therapist does not have hope, what do clients have?  If client's hope is tenuous and hopelessness is high, he or she needs something to hold onto.  Sometimes, the therapist can tell clients that if they do not have hope right now, then they can use the therapist's confidence, experience, and hope that "This can work," for the time being until they find hope.  The therapist needs to address their fundamental experiences, both cultural and family-of-origin about hope and hopelessness in order to be effective for clients in therapy.

ADDRESS:
433 Estudillo Ave., #305
San Leandro, CA 94577-4915
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
CONTACT INFORMATION:
phone: (510) 614-5641
fax: (510) 889-6553
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