To put it simply, I’m always working on how to make sense of what I’m seeing and experiencing when I sit with clients. From early in the first meeting, I’m building a working explanation of what coping strategy the inner mind is trying to follow and how it might be limiting or interfering with life. Sometimes, I have no idea, so I keep watching for clues. More often, by the end of our first or second meeting I do have a tentative idea of what issue the inner mind might be stuck on and how it seems to be trying to make things better. I hope the language doesn’t bother you, but I call that a “working hypothesis.”
The beauty of having one of those is that what follows is an exciting story. Is my hypothesis right? How might it be incomplete or even wrong. It’s exciting because the purpose is to help my client come to a better life by healing, growing, or both. Having an idea makes me a better observer because I’m tuned in to things that might confirm, disconfirm, or add to what I already think. It’s like being at a sports event and rooting for your favorite. You watch that one much more closely.
A client shared that daily chores took away from quiet time to herself. It was a casual comment that would have been easy to miss. But I already had an idea that her inner mind had from her earliest years, been concerned with growing and developing properly, so that comment clicked. The fact that she volunteered that information said it was important. Time to be in her own thoughts was an essential part of how her inner mind (and her conscious mind, too) were imagining the conditions needed for proper growth and development. The comment seemed to confirm what I had thought, but it also gave a more detailed hint about what she needed. It also suggested a new question. Were there things about her own coping that kept her from having those personal times? Were there outside factors getting in the way? It made me curious about the pull of daily chores. Why didn’t she have the time her inner mind seemed to consider vital.
That’s an example of how carrying an idea as you go. Wondering about deep concerns and blockages will automatically set your own curiosity up to ask good questions, wonder about important things, and listen intently to meanings that come out seemingly “between the lines.”
One more thing, It’s critical to hold these ideas with a very light touch. Being ready to be wrong and go back to the drawing board is critically important, otherwise, you will find that you are no longer listening to the right things and have lost attunement. Don’t get too attached to what you think.
This subject is taken up in Chapter 1 of the new book, How Psychotherapy Works: Navigating the Therapeutic Space with Confidence. And, by the way, making a practice of always forming hypotheses and testing them helps us accumulate knowledge of the inner mind and that makes us better therapists, counselors, and coaches!
Jeffery Smith MD

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