Compare and Contrast, Part 2
The “less-good” internship
When I started my second internship at a community clinic, each of us four interns (the other three were in PhD programs from a different school) had to choose a supervisor.
My father: “I hated Dr. B, but I learned a lot from him.” At the time, I still listened to my father’s advice. I picked (who I’ll call) HB, a choice that became a nightmare for both her and me.
This Dogma Won’t Hunt
HB ran what was a de facto psychoanalytic clinic within a community mental health center. The rest of the counseling staff was either onboard, cowed, or indifferent to her role as self-appointed mother-superior. She was only the intern supervisor but lorded over the clinical staff meetings.
My first year of training was free of explicit clinical theory. That would change. During an initial conflict between HB and me, she made it clear: we speak psychoanalysis and only psychoanalysis here. And as I learned, for better or worse.
Case presentations are a mainstay in medical training. They put difficult clinical problems in front of multiple eyes, which can help the clinician find a new path. Case presentations have been adopted in many counseling clinics, but at this clinic, rather than provide help, they were rituals designed to absolve clinicians of responsibility for their work. Discussion of a client’s issues invariably concluded with excuses why the counseling was getting nowhere. Invariably, the clinical case presentation ended with HB expressing empathy for the clinician: “This is a very difficult client.” In absence of useful ideas, another clinician would fill dead air with, “how do you see this person diagnostically?” If you can’t help them, label them. Label them as unqualified to benefit from the church of Freud.
If I had to characterize my first internship with one word, it would be respect. Our professor supervisors respected us student interns and we in turn passed that respect to our clients. If I had to characterize my second internship with one word, it would be contempt. HB and her minions displayed contempt towards non-submissive interns (well, me) and contempt for the clients who refused to get better, despite our most excellent clinical efforts. But they saved their most profound contempt for the process of learning that thrives on curiosity and questioning.
And yet, regardless how I felt at the time, those two internships were complementary to my development. I’ve had to relearn that lesson, repeatedly, that there’s no such thing as an experience you don’t gain from. For the last twenty years, I’ve practiced either Aikido, karate, or Tai Chi. For short periods, I’ve had instructors I’ve found wanting. Those experiences let me appreciate the excellent ones. When I learn of a possibly interesting book, film, or TV show, my first inclination is to read the negative reviews. When I’m attracted to a new idea, I look for the criticism.
Contrasts help you discern, help you think. Without letting contrast into your awareness, you end up living in a presumption bubble, where you filter out everything you don’t already believe. We know how well that’s working for our culture.