Do We Unconsciously Invite Gifts?

With Christmas upon us, gifts from our clients can become an issue. I have posted on this earlier but was just revisiting a great paper on this by Helen Spandler and others. This paper is now free online.

The Spandler et al paper is a great one and covers the issue of gift giving in psychotherapy extensively. In rereading this, of particular interest to me, was the section on whether we as therapists unconsciously elicit gifts from our clients. Money quote:

It would appear that therapists generate their own specific gift patterns. While one respondent reported being offered what were the two ‘biggest’ gifts in the study, most respondents reported receiving gifts rarely. There were a number of examples of therapists reporting no gifts. One retired female therapist claimed she received no gifts after thirty-five years of therapeutic work, and another only twice in twenty years’ practice. Yet, on the other hand, some therapists reported a number of examples of gifts. We could speculate: are therapists who receive many gifts ‘better therapists’? Alternatively are therapists who rarely receive gifts those who are able to ‘contain’ the therapy so that the therapy itself is ‘enough’? As one therapist asked: ‘Do we unconsciously invite gifts?’ Clearly, such matters depend on the particular ‘take’ or interpretation of therapeutic approach, which in turn may relate to the personality/background of the therapist. However, responses highlighted other factors involved in evaluating the gift, including the mobilization of gender dynamics.

This can lead to complex unconscious patterns when groups of therapists work together. The person receiving the most gifts in the group practice can feel guilty, the rest can feel envious.

While we are on the topic, one of my favourite Christmas gift stories. I can remember one year receiving a book of crossword puzzles from one of my client’s prior to leaving for a three week Christmas holiday. Although we had explored the issue of how she felt about me being away she denied being angry at me. It took me a number of minutes to understand the real meaning of her gift: cross words = angry words.

Comments

[The Relaxed Therapist]

...or maybe she was just "puzzled"?

One Christmas, seven clients each gave me a bottle of wine. As I don't drink alcohol (and never have), I'm not sure what I did to invite this...I'd never been given alcohol before and haven't been given any since!

[Doctor X]

I believe that we can only understand offers of gifts by listening to patients on a case-by-case basis. The latent meanings symbolically represented in the patient’s communication are of the utmost importance in terms of understanding the trigger for the gift, the meaning of the gift and the possible meanings of our responses to the offer of the gift.

When we listen to multiple levels of communication in a session, the underlying meanings of these 'acting-in' phenomena may be represented quite clearly, but your crossword puzzle example serves to remind that the gift itself is a communication. The symbolic expression of latent meaning in a gift of crossword puzzles is one of those unforgettable and extraordinary things that can occur in psychotherapy. The patient may have manifestly explored her anger with you, but apparently still felt some anger that was defensively disguised as a 'gift' of 'cross words.' As a 'puzzle,' the gift also seems to contain an invitation for you to decode the patient's cross words.

Unconscious processes are ingenious. I've got to hand it to you for letting the meaning of the gift get through to you as quickly as it did. This is the kind of meaning that can easily elude recognition even as it stares us in the face. We all know that what seems obvious in retrospect is often not on the radar of our awareness as we try to understand what is happening in a session. Yet once we see the meaning, the pieces fall into place. It's a great story. Thanks for sharing it with us.

[Chris]

I am always delighted the way another therapist will look at a gift and its interpretation and provide another or deeper interpretation to the one already made. This is a nice observation by Dr X that the crosswords were also a puzzle to be decoded. Wish affect and conflict.

However Relaxed Therapist’s seven bottles of wine may have just been seven bottles of wine. Would we make a different interpretation however if all seven clients knew the therapist liked wine or even more interestingly if all seven knew he didn’t drink :-)

Regards
Chris

[psychoa]

And what of the patient who gives the therapist who's thumb is anything but green, not just a plant but a minature evergreen? I think she's always wondered if I could keep her alive...

[Nikeroo]

I agree that gifts can be symbolic. I know of a patient that once offered her therepist a gift of a box of tissues. There had been none in the room and she was worried that his other patients needed them.