Professional-Client Relationships Approaches and Power Dynamics Essay Example

those affected. Nevertheless, the roots of the patient-doctor relationship can be traced back to ancient Greece through Cicero.

Cicero opted to assess the mentally ill by conducting interviews, where he gathered information about different aspects of the person such as their social class, emotions, clan, and interests. Galen, another figure from ancient Rome, expanded on this initial approach by emphasizing the importance of studying and experimenting on patients in order to comprehend diseases.

In the mid-16th century, the term "patients" replaced the derogatory term "lunatics" when referring to the mentally ill. This change in language demonstrated a shift in how mental illness was perceived, especially during the 18th century when it became recognized as a treatable condition. Instead of being seen as morally weak, those with mental illnesses were now regarded as individuals who could be cured through research and treatment rather than being isolated from society.

Advancements in the treatments, care, and relationships surrounding mental illness occurred during the 19th and 20th centuries. However, despite these advancements, certain types of treatments still had misconceptions and errors. To improve the patient experience, efforts were made to create a more welcoming and comfortable environment. This included constructing larger hospitals to accommodate more patients and provide suitable housing. Furthermore, rooms were decorated and patients were given permission to display pictures, transforming their appearance from prison cells.

During the mid to late nineteenth century, there was a significant shift in the relationship between medical professionals and patients. Previously, the relationship had been distant and impersonal. However, during this time period, the focus shifted towards providing optimal patient care. This approach aimed at fully curing

patients so that they could reintegrate into society as productive individuals leading normal lives.

Furthermore, there was also an increasing recognition of patients' human rights during this era. Although efforts were made to uphold these rights, appropriate measures were not effectively put into practice.

During the 1930s, various theories arose concerning the causes of mental illnesses and proposed treatments that violated human rights. These treatments included tooth extraction, removal of large intestines, lobotomy, and bath treatments. The film 'One Flew over the Cuckoo's Nest' portrays a typical mental asylum from this era, depicting these themes. In the film, nurses and doctors enforce a strict routine that all patients must follow.

The routine for patients is considered crucial for their sense of self, so any modifications can be unsettling to their lives. This repression leads patients to think that they must depend on the routine for their well-being. However, this belief is incorrect since the ultimate objective should be to heal the patient, and this routine does not enhance mental health. Consequently, patients are unable to reintegrate into society after treatment because life in a hospital is more manageable.

The film portrays a distant and impersonal connection between the nurse and the patients, which has traditionally been seen as the most successful method. The therapy sessions are held in groups, making it challenging for patients to openly express their insecurities and discuss their issues. As a result, individuals are seen more as numbers or problems rather than unique individuals. Additionally, the main treatment emphasized in the film is lobotomy, along with medication given at specific times every day.

The belief was

that lobotomy could heal mental illness by fixing damaged nerves in the brain. Nonetheless, in actuality, lobotomy led to a personality alteration where individuals became more tranquil but less passionate. Despite patients' apprehension towards lobotomy, medical professionals conducted the procedure on anyone considered a danger to themselves or others.

The film mentioned depicts the main character's reaction to his friend's suicide, resulting in him undergoing a lobotomy. Prior to the operation, he was an energetic individual, often referred to colloquially as the life of the hospital. However, post-lobotomy, he became devoid of energy and enthusiasm, his personality damaged. The effects of lobotomy sparked debates regarding the ethicality of subjecting individuals to such treatment, regardless of their mental illness. Ultimately, these discussions led to the treatment becoming obsolete due to its violation of human rights.

Compared to "One Flew over the Cuckoo’s Nest," "Good Will Hunting" offers a distinct interpretation of the therapist-patient relationship. The connection between Will and Sean is defined by care and nurturing, which is more common in modern times. While certain therapists still adopt alternative methods, there is a preference for cultivating a caring and nurturing bond. In certain instances, the therapist also assumes the role of an absent figure from the client's childhood, serving as both a compassionate friend and parental figure.

The formation of a client and therapist relationship relies on the acceptance of nurturing and caring friendship offered by the therapist. This acceptance can manifest in various ways, with finding common ground being the most common method. In 'Good Will Hunting', Sean's memories provide Will with glimpses into what his life could have been like in

a stable family, illustrating the use of Transference and Countertransference techniques employed by therapists. The movie prominently explores these themes throughout their therapy sessions. Transference and countertransference were originally developed by Sigmund Freud to explain the reciprocal impact both parties experience during psychotherapy. Freud examined his own reactions, emotions, and identification with certain clients as part of his exploration of transference.

Transference is when a client's emotions about their issues are unconsciously projected onto the therapist. These emotions are believed by Freud to stem from childhood and transferred without awareness. On the other hand, countertransference refers to the therapist's unconscious emotions transferred onto the client. In some cases, therapists may share their own traumatic experiences to establish trust, find common ground, and create a connection. This can also be seen in the movie 'Good Will Hunting'.

Will's pain from his abusive foster parents is transferred to Sean, triggering Sean's own memories of abuse. By sharing his own experience, Sean gives Will hope and assures him that he can overcome attachment issues. In the end, Will leaves Sean a letter using the same words Sean used when he met his wife, demonstrating countertransference in action. It is important to consider power dynamics in psychotherapy, where psychologists have more power over their clients, leading to mistrust and hindering the professional-client relationship. Some scholars view the therapist-client relationship as similar to a parent-child dynamic, with the client feeling helpless and lacking control over decisions concerning them.

Many authors believe that the power dynamics between the professional and client persist even after the end of the psychotherapy relationship. Despite efforts by psychologists to balance these power

dynamics, there are limitations. Some clients are too vulnerable and weak to handle certain power, so it is crucial for psychologists to assume some of that power. This is because psychologists may need to make decisions that patients might not initially understand or want, but these decisions can have beneficial effects.

The vulnerable clients include patients who suffer from anxiety, young people, depressed clients, and clients who have been or are hospitalized and imprisoned clients. The theory of power differential has been developed and sustained by three resources. The first support comes from discussions of transference, which renders the client completely helpless to the therapist's influence. The second source that gave life to this theory is feminist psychology.

DeVries (1994) views power issues as theoretical concern, suggesting that power differentials, particularly with regards to gender, transfer from society to psychotherapy. Within feminist psychology, there are two approaches. One approach focuses on equalizing power between therapist and client (Proctor, 2002), aligning with the practices of many modern psychologists. On the other hand, the second approach argues that rejecting power differentials can result in significant negative clinical consequences (Brown, 1988).

The third reason for supporting this idea is the act of crossing boundaries, which can result in increased boundary violations and exploitations. This can cause psychological harm to the patients, as therapists who cross therapeutic boundaries place their clients in uncomfortable positions, as they become completely reliant on the therapist's power. However, it is crucial to note that a certain relationship must be established between the therapist and client.

Extensive clinical data supports the healing power of touch and the humanity of gifts,

which can lead to certain boundaries being crossed in a professional-client relationship. It is important to consider the various powers within this relationship, especially those that may pose a threat. Coercive Power involves compelling someone to act against their own will.

In situations where a client's hospitalization against their will is determined, the therapist possesses the power to assess their sanity and make such decisions, thereby exerting coercive power. It is crucial to acknowledge that certain patients, especially those with sociopathic tendencies, may also possess coercive power as a result of their illness. The movie "The Unsaid" provides an example of this dynamic, as the patient manipulates their therapist by resembling the therapist's deceased son.

The use of coercive power can create an unequal distribution of knowledge between two individuals, particularly when the therapist holds more extensive knowledge about the client. This gives the therapist an advantage, as they have access to information such as vulnerabilities, criminal activities, and feelings of shame stored in the client's files. Clients are aware of this power imbalance and may opt to withhold information or conduct their own research on therapists to level out the knowledge gap (Zur, 2007, 2008).

Sharing personal information between therapists and patients helps to balance power dynamics. It is important for therapists to always fulfill their fiduciary role, regardless of the clients' or therapists' powers. Yet, in some cases and with certain clients, openly discussing power within their relationship can be advantageous for therapists.