7. The Seventh C- Clarity - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
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7. The Seventh C- Clarity

Therapist Resources > Therapy Books > Therapy Interruptus

Therapy Interruptus and Clinical Practice,
Building Client Investment from First Contact through the First Session
by Ronald Mah

• The ultimate goal of therapy is for an individual, one or both partners, one or all family members to gain clarity about himself or herself, or each other, and/or the relationship.
• Client clarity directs the individual, couple, or family to subsequent processes, decisions, or behaviors.

The ultimate and practical goal of individual, couple, or family therapy may be achieving clarity.  Clarity supercedes all other goals.  As the therapist attempts to move the individual, couple, or family forward in confidence and competency in capacity, success or failure, progress or lack of progress will increase clarity.  Individuals, couples, or families often come to therapy to get clarity about if there is hope, is there a way, what is the capacity, and so forth.  Often, they know what can and cannot happen.  In some cases, the couple relationship had ended emotionally years before, but doing "the one last thing" is important.  Being sure gives them permission, direction, and the next steps.  Setting aside any other goals, including therapist's prejudices (i.e. romanticism that they should live happily ever after), therapy is successful if one or both of the couple is clear.  When there are sixteen (eight plus eight) definitive and clear "Yes" answers or one definitive and clear "No" answer to the capacity questions, clarity is achieved.   Negative clarity can lead to terminating the relationship.  However, ending a marriage may not fit into the cultural expectations or desires of the clients.  Individuals from certain cultural backgrounds, especially women often remain in relationships or marriages despite negative clarity about the partner.  Or, individuals who do not feel they have any options or are psychologically disempowered due to abuse or trauma may also remain in relationships.  They remain despite clarity that their partners or themselves cannot or will not change in the relationship or they do not have a sense of worth or the courage to work it through.  The therapist may or may not be involved in the next step or steps: closure, communications work, grief work, etc.  Clarity about oneself or the other person's personality, capacity, will, etc. may be all that an individual or the couple really needs.  It is appropriate to offer to be a part of the next step at times but not necessarily.  Clarity may be the goal of an individual relative to a relationship: romantic, family, friendship, business, academic, vocational, or other one that presents confusion or uncertainty for him or her.  There may be an important decision to make.

Jacque had worked for several years in the accounting department of a large marketing firm.  He had done well and progressed in the company.  The company had decided to relocate his entire department half-way across the country.  He was up for promotion to a well-compensated high status position that required him of course to relocate with the department half-way across the country.  He had grown up and had deep roots in his community.  Jacque had gone to college only a few miles away from where he grew up.  His college friends had merged easily with his childhood friends and his work colleagues.  Fantasy football and the local professional and college sports teams facilitated old and new relationships, professional and non-professional, and mixed ethnic and cultural backgrounds become a great group of friends.  Jacque was married to Abigail who had become very rooted in the area since coming initially for college.  Abigail had been teaching for several years at one of the local elementary schools where she was well liked and respected.  His income however was several times greater than her income, so financially his transfer/job offer was very compelling.  They had two children: one 10-year-old boy about to enter and one 13-year- old girl already in middle school- a neighborhood school.  Both children were involved in local sports, arts, or other community activities.  He used therapy to help him decide what he should do: take the promotion and move or turn it down and risk unemployment while seeking another job.  Eventually, Jacque decided to pass on the offer and seek new employment.  In the process of therapy, he balanced the offer along with his ambitions and financial goals against the importance of his and his family’s deep roots in the community.  The therapist had no vested interests in either course or action, but worked with Jacque to help him uncover what was most important to him.  Over the course of a few sessions, Jacque became clear that the community, friends, and roots for his entire family were the most important to him.  He also came to see that his anxiety about finding another job was based on older childhood experiences of unpredictability from difficult family-of-origin times as immigrants, as opposed to his high marketability in his field and in the economy.  With clarity, he made the decision and move onto problem-solving the consequences of the decision.

Aimee, a young woman in early pregnancy came to therapy with her boyfriend Dragan trying to decide whether to keep the baby.  They had been dating for about four months.  She was twenty-three years old and in her first year of law school.  Dragan was twenty-three years old and about to graduate with a degree in electrical engineering, computer science.  They had been having fun dating and had not gotten into any discussion of a future together as yet.  They were still in the early stage of something- they would not even had characterized it as a relationship.  They were exclusive- sort of, although neither had brought it up and no decision or boundaries had been made.  Whether or not she had the baby, Aimee intended to finish law school.  She had wanted to become a civil rights attorney since she became politically aware in high school.  Dragan had come to the United States from Bosnia for college.  He was looking forward to an exciting career in the high tech world.  Sooner or later, he wanted to have his own start up company- perhaps, doing something in both the United States and Eastern Europe.  A baby was not something either had anticipated.  Aimee was torn about keeping the baby.  There were so many unknowns.  Law school was a given, but little else.  Will her boyfriend Dragan be there for her?  He said it was her decision.  Dragan said that he would support whatever she decided.  If she decided to have an abortion or carry the baby to term and then give up the baby for adoption, that was ok with him.  If Aimee decided to have the baby, Dragan said he would there as the father whether they stayed together or not.  As Dragan is talking to the therapist about his post-graduation plans, he unknowingly revealed that being tied down wasn't part of his life plan.  Despite his promises to be an involved father, everything he spoke of doing involved the first person pronoun "I."  Never did he refer to "we" or "us" in his aspirations.  Dragan was so involved in weaving his charming dream for the therapist's approval that he forgot Aimee was watching him.  The therapist "heard" the tone and direction of his plans and they did not involve a baby- much less a partner.  Aimee sensed this too.  She heard it and could see it in his eyes.  With this clarity, Aimee knew if she kept the baby, she'd be on her own.   She had no illusions that Dragan would be a co-parent must less a partner as a consequence her choosing to keep the baby.  Did she decide to keep the baby?  The therapist never knew because this was the only session.  The therapist knew however that Aimee had the clarity she needed to make an informed decision.  Have the baby or not, she already had enough information to know that she was not going to stay with Dragan (the lying narcissistic jerk!) who was ready to abandon her and the baby.  If Aimee decided to have the baby, she knew she would be raising it as a single unattached mom without the biological father Dragan.

It became clear to Pia that despite her wanting to work on the relationship, despite her continued love and hope, her husband Rivera was done trying.  It was far too foreign to his self-definition.  How he saw himself as a man... as a husband came from his family-of-origin models, male cultural standards, and his religious background.  The changes Rivera needed to make just challenged him far too much.  Try as he might, he became like a dancing dog that stands up on two legs and prances about for a few moments.  Try as it might, the dancing dog always eventually drops down to all four legs.  Try as he might, Rivera could not subjugate his needs to be in control and experience a mutually reciprocal relationship as him being less of a man.  Whenever he tried to negotiate as the therapist had thought them, Rivera felt a strain and resentment at what he felt was Pia disrespecting him.  Pia could see how foreign this process was from the look on his face.  "Whatever" became his standard dismissive response.  "Do what you want."  When Pia or the therapist asked what he wanted, Rivera would sigh, "It don't matter what I want.  She's not going to be satisfied anyway."  It didn't matter that Pia was not ready to stop.  When Pia became clear that Rivera would not try anymore, she moved on from trying to make a two-person process work by herself.  Therapy was successful.  No doubts were left.  Clarity however painful was achieved.  Rivera was clear he did not want to work on the relationship anymore.  Pia was clear that Rivera was done.  As Pia moved into her loss and grieving process, and dealing with divorce and child custody, she could have chosen to continue using therapy for these different issues or goals.  Incidentally, Pia didn't use the therapist for this, but decided to move back to her hometown where she had extended family support and a network of close friends.

Often more identifiable in individual therapy, in couple or family therapy it may become clear that one partner or both have significant emotional and psychological issues that need attention.  This may have relevant for Rivera as it lead to his resistance to further change.  Or for Pia if she may have continued to deny the clear messages of being done that Rivera had been giving her for months.  It may be significant trauma, abuse, cultural rigidity, attachment issues, loss not yet grieved, and so forth.  The therapist may refer out an individual in a couple to another therapist for therapy, or may do the individual work with the other partner observing.  In doing individual work with one partner, the observing partner often sees for the first time the depth of pain and symbolism-the partner's existential cultural framework.  The observing partner can be so immersed in his/her own emotions and grievances- his/her existential cultural framework, that he or she previously lacked a clear perspective of the desperation the partner comes from.  From this clarity may come compassion needed for healing and greater connection.  Individual work may be indicated for someone such as Aimee if she had deep issues compelling to "make a family" with an unwilling partner and/her attraction to charismatic narcissistic men.  In working with narcissistic personality as in the case with Dragan, the therapist can engage him or her, so the other partner (in this case Aimee) can watch.  When immersed with the narcissistic personality who is very quick and intense intellectually, the partner will often fail to be aware of how the narcissistic partner continually asserts superiority, grandiosity, entitlement, and/or entitlement over and over.  Seeing him/her do it with the therapist, however can be very revealing.  As an observer of the dynamic rather than being the target of the narcissism, the partner (Aimee) sees much more clearly what the narcissistic partner (Dragan) is doing and who he or she really is.  If the partners are willing and invested in deeper therapy, it may further reveal the family-of-origin experiences that lead to the narcissistic personality and other personality disorders.  Or, therapy may uncover relevant cultural/social experiences that can lead to the narcissistic personality and other personality disorders as well.  In either case, the partner's fog of being the object of the narcissist's charisma and manipulations can be lifted in therapy by a skilled therapist as it was for Aimee.


The therapist, who is aware of and meets clients' needs in the initial contact experiences becomes much more likely to work successfully with the individual, couple, or family.  Establishing connection, credibility, and control with the individual, or each partner and the couple, or key family leader are the first three key goals for the therapist.  These are sound foundations to clinical practice.  They create the context of therapy by facilitating trust in the therapist so that the client is more likely to consider and cooperate with his or her subsequent therapeutic interventions and interactions.  The sense of connection enables clients to believe the therapist offers interventions in line with their emotional core.  Clients are more likely to try unfamiliar or uncomfortable things suggested if they hold the therapist as credible as opposed to inexperienced, unprofessional, uneducated, or just plain weird!  The individual and especially the couple or family often need the therapist to control their communication and behavior that is hurtful and destructive.  An individual or family member may need help expressing his or her feelings without raging.  In a couple or family, another individual when expressing hurt needs the therapist to keep the other member's vulnerability under control, so the whole process does not get waylaid.  The therapist is needed to control or help control unchecked cycles of arguing and fighting eroding the relationship.  The relationship may be duplicated in session as a couple or family or be experienced in the greater community of the client.  The therapist must create and maintain the environment or context of therapy through these three therapist goals for successful therapy.  Therapist focus on information gathering and avoidance of "doing therapy" during the initial contact and first session decrease the likelihood of the client committing to therapy.  Much of what has been presented in this project has been discussed in the context of "doing therapy"… later in the therapeutic process.  The therapist would be well served to use therapeutic and theoretical insights and skills immediately with the client.

Once or as the therapeutic foundation is established, there are assessments that need to be covered: communication, container, and capacity.  Assessing for communication, the couple or family container, and each individual's capacity helps reveal the overall condition of the relationship, and directs therapy to a significant degree.  These processes along with other experiences in and out of therapy eventually lead to the ultimate therapeutic goal of clarity.  If the therapist fails to create a productive context for therapy by attaining initial goals, and make the initial assessments, therapy will tend to be erratic and/or lose direction, and fail to meet the ultimate goal of clarity.  Client clarity, whether it is for an individual, for one partner or both in the couple, or among family members allows one or more individuals to make decisions about continuing to work on the relationship or end the relationship.  It allows them to see themselves and other participants in relationships, which enables them to understand what is possible, probably, improbable, or impossible.  By facilitating client clarity, the therapist maintains his or her ethical mandate not to advise or make decisions for clients.  Therapy becomes the relationship mirror facilitated by the therapist for an individual, each partner and the couple, family members and the family to see themselves at their best and worst… and everything in between.  Each person can see if individually and as a couple or family... or in a work or social community whether he or she can grow or change, or have grown or changed.   Each individual can see if he or she likes or still cares for the partners, family members, or colleagues.  And whether he or she likes or still cares for him or herself.  Therapy may become a crystal ball for a look into the future.  Can an individual see him or herself with the other partner, in the family, or in the work or social community in the future?  If he or she can see oneself with another or others growing old together or cannot stomach more of the same as a couple or in a family or at work or in a community, a decision becomes clear.  Even if a client decides he or she cannot tolerate remaining in a couple for example, the decision to terminate the relationship and perhaps, also terminate therapy, it will not be therapy interruptus but the consummation of the therapeutic process through achieving clarity.  When the therapist can create client clarity, he or she has accomplished success in the therapy without giving advice or making recommendations.  The client or clients have made their own decisions which is sound clinical practice following principles of therapeutic integrity for client self-determination.

When the therapist articulates any part or all parts of the process of therapy, including the Seven C's of Therapy, the client is more likely to gain confidence in the therapist that he or she can fulfill their needs.  In that sense, many parts of the discussion in this book is not only for the therapist's consideration and development, but also offered as conceptualization of therapy.  Effective and productive therapy may be conducted instinctively.  Conceptual clarity does not only enhance therapist's work, but it can also suggest language the therapist can use to communicate rapport, expertise, wisdom, and credibility to prospective clients.  This constitutes a “selling” or “marketing” of therapy to clients that enables them to attempt the process.  Hence, the theoretical and practical process of therapy can also facilitate more committed clients.  This is important in agency situations, but is of particular relevance to the therapist's development of private practice.  Good therapy can be good business as well.

3056 Castro Valley Blvd., #82
Castro Valley, CA 94546
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
office: (510) 582-5788
fax: (510) 889-6553
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