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From: Ellen-Marie
Date: 10/10/01
Time: 7:46:53 AM
Remote Name: 172.133.44.200
Judy, you asked me to identify signs that the Rescue Game is being played. Lack of participation and resolve on the part of the client would be clear indicators along with concommittant anger and resentment at this lack of cooperation on the part of the therapist. It takes two! And, for the therapist to notice there's a subplot afoot, it often takes experience playing the Rescue Game through to the end and experiencing the uncomfortable feelings of "failure" before the early signs of involvement in future games are readily identifiable. But knowing that participating in the Game is a possible reality in a therapy relationship and that it is, at the very least, an unpleasant experience for both parties, the therapist can practice being proactive.
How? First, by engaging in an honest examination of personal motives for doing the work. Identifying the absolute bedrock impulse for working as a therapist. If it is to Rescue the consumer rather than help the consumer help himself/herself, confident that the consumer is capable of doing so with some guidance, then the seeds of the Rescue Game as a matrix for therapist-consumer interaction are present. Second, if the therapist believes the consumer wishes to play the Game, then the therapist who believes the consumer has the potential to take personal responsibility and work in partnership with the therapist, can learn to negotiate a Therapy Contract and to respond verbally and nonverbally to honor the contract throughout the treatment encounter. The contract emphasizes that the participants are equals with shared responsibilities to bring about desired change.(Games People Play by Eric Berne, a classic transactional analysis presentation is a wonderful reference book, and a good basic textual resource.)
There really is no substitute for self-examination as the first response and a continuing activity while working to recognize the emergence of the Rescue Game. Noting personal motives for doing the work, carefully observing thoughts, feelings, and emotions, while doing the work, reflecting deeply on thoughts and behaviors that lead to surprising and unpleasant encounters . . . Some therapists do journaling to keep themselves more deeply aware of what they actually do in therapy sessions and what they are thinking and feeling at those times. This knowledge helps them learn what they believe about therapy and themselves as therapists. And that awareness provides a basis for changing. Sometimes we can not help others change unless we ourselves change!
Too little speech-language pathology course work even suggests self-examination as necessary activity. Some early versions of Van Riper's Clinical Practices and Procedures did refer to necessary therapist qualities for success. But the sincere therapist soon discovers that meaningful interactions are the bedrock of therapy and that these require thoughtful attention.
I hope this helps you begin to see how to know whether a Rescue Game is underway. Your question is an excellent one, a basic one. Thank you for asking it.
Now, about relating to "Steve" when he requests stuttering therapy: Being aware of one's own personal motives for wanting to work with him would be a good place to start. Then ascertaining his would be the next. Steve underscores the importance of entering into therapy relataionships with adults fully aware of the motives involved. Because he has been hurt by participating in therapy with other speech therapists who haven't helped him realize the life he has dreamed of having for himself and because he wants to punish subsequent speech therapists for the failures of those he knew before, doesn't make Steve a bad person. His motives and behaviors, however, are not helping him. A therapist who gains his attention may want to help him realize that "Then is not now!" Now he is an adult and can make personal choices. As a child he was expected to do what he was told by adults. Now, as an adult, his own choices have real consequences. Is he prepared to live with the consequences is a question that may be posed at the outset. Does he want to use his valuable time and energy to change or bascially remain where he is in life? By answering this question honestly, Steve will know whether to proceed with speech therapy or not. If he chooses not to answer this question at all or honestly, then the therapist has a clear indication of the likelihood her/his expenditure of time and engery on Steve's behalf will be helpful to them both.
"Steve" will be a wary consumer at best, so it will be important to set a series of sequenced goals with him and to help him apprerciate his role in achieving each one of them. "Steve" will benefit from learning about human learning, how it isn't always linear or at a quck pace, etc.
Again, Judy, how to relate to "Steve" is a core question. I hope I have given enough information to underscore the importance of recognizing and relating succesfully to our own and our consumer's humanity, i.e., fears, hopes, motives. Doing so I think is the key to successful therapy for all our clients and to satisfying work for us.
Best,
Ellen-Marie