What Was Old is New Again: Psychotherapists Making House Calls
January 21, 2009Posted by pamela |
Marin Mommies is pleased to present another great guest article, this time by Mill Valley psychotherapist Lisa Nave, MA, MFT. Lisa specializes in working with parents, children, and families, and works from a holistic, integral psychotherapy model, which combines the best of western psychology with the best of the eastern wisdom traditions.
Today, we live in a technological society where much of our communication is virtual. Our society is more socially fragmented than it has ever been, with high divorce rates, disconnected suburban communities, and a lack of common values or even cultural rituals that keep us closely tied. In my private psychotherapy practice many of my clients have spoken of these issues over the years, and it is due to their distress that I decided to offer house calls as an optional service, if appropriate.
For issues such as parenting and child development, house calls may be the preferred method. There are several reasons for this:
- Working directly with clients in their homes allows the therapist to provide “on the job training”, that is, the therapist can work more directly and experientially with the client.
- The client often feels more comfortable and natural at home, and can be more authentic with the therapist.
- The therapist can often see more family patterns, dynamics and challenges in the client’s home than in the office, and can utilize these insights in their work together.
- Parents of young children often feel isolated, and the therapist visiting the family at home is experienced as the community reaching out to them.
- Many parents are unable to find a babysitter for weekly office sessions, or can’t afford a babysitter, or both – and house calls can be a great service to them.
House calls can also be helpful for mothers with postpartum depression who find it difficult to get to a therapy session in the office. Oftentimes, these mothers don’t get the help they need because they feel helpless and isolated at home, and don’t know where to turn for support.
Psychotherapy is fairly new to society. Freud brought psychoanalysis to the world stage in the late nineteenth century, and since then, the role of the psychotherapist has gone through a number of metamorphoses. Freud’s psychoanalysis creates a psychic space for the client, and requires the therapist to act as a blank slate. And although this method is certainly effective in many cases, it may not always be so. For instance, when it comes to the issue of building secure attachments between parent and child, and developing stronger relational skills, the therapist as blank slate may not be very beneficial.
The role of healer changes throughout the centuries with the needs and conditions of the times. In Freud’s time, during the Victorian era, people were largely repressed, and did not have an awareness of their emotions. Though bringing awareness to our emotions is an ongoing and necessary focus of work, the role of healer may require another shift to meet the needs of people and families today.
New research in neuroscience reveals the importance of forming secure attachments in childhood, and that our interactions with others actually sculpt our brains and psychological development (Siegel, p.102). In light of the fragmented conditions in our culture today, combined with the pioneering new research in neuroscience, the role of healer may need to adjust again. Today’s psychotherapist will need to be mindful of the ways in which people’s brains develop, and have an understanding of how to facilitate the development of secure attachments and strong relational skills with their clients.
Because most families today don’t live near their extended family, they do not have the benefit of receiving help from their parents, grandparents, siblings or cousins in caring for their children. This lack of social connection and support leaves a number of gaps in the family system, often resulting in a great amount of pressure on the nuclear family unit. Humans evolved as interdependent, social beings, and we have not changed biologically in this regard. A therapist can help to fill some of these gaps left by modern changes in our culture by joining with the family and helping them to develop stronger attachments that will endure for generations to come.
House calls are not appropriate for all clients or issues, however. For example, when a client has experienced a trauma, or requires secure boundaries from the therapist, it would be in the client’s best interest to meet the therapist in their office. It is important to talk to your therapist about your specific issues and needs before you both decide upon the method of therapy and the location of the session that will be best for you.
The role of healer in society began as a medicine man or woman who was a member of the tribe, who was integrated into the community—and has transformed over the centuries into the role of priest, or doctor. The latest incarnation of the healer, the psychotherapist, has largely remained hidden behind a blank slate for the past century, a la Freud, and has generally not integrated into the community. But perhaps now, into the community is exactly where therapists need to go, when appropriate, to help children and families more directly, and to become agents of social change. Perhaps what was old is new again.
Reference: D.J. Siegel, Parenting From the Inside Out , New York: Penguin, 2003
Lisa Nave is a psychotherapist with a private practice in Mill Valley, CA. She works with individuals, couples and families, and offers both office visits and house calls. For more information please see heer website at www.lisanavemft.com.