Chapter 4 · Language and the Clinical Encounter
Check yourself
Two questions on this chapter. Pick an answer to see the reasoning, and retake it as often as you like.
A client adopted as an infant told you two weeks ago that she'd been thinking about the woman who gave birth to her, and that she felt angry. You said, warmly, "She must have loved you very much to make that choice." She said "yeah, maybe" and changed the subject. Last week's session was flat and stayed on practical topics. She cancelled once since, and today she's here, pleasant and slightly far away. What's the most useful move?
The comment supplied a meaning she never asked for, and it did it while she was telling you she felt angry. "She must have loved you very much" is one of the most common sentences in the culture's script about adoption, and hearing it from a therapist can land as one more person needing the story to be gentle. She said "yeah, maybe" and left. That's usually all you'll get.
A is the most tempting option, and it mistakes your uncertainty for neutrality. You can't know for sure, which is exactly why you ask instead of wait, because she is very unlikely to raise it herself. C is well intentioned and it makes the moment yours: a thorough apology hands her the job of reassuring you, which is the same dynamic she has been in her whole life. B is short, names the moment without deciding what it meant, and leaves her free to say it was nothing. Either answer she gives moves you forward.
Lin is 29, adopted from China at fourteen months by white American parents. She's been your client for four months for work anxiety and stress about a recent move. Adoption came up on her intake form and has never been clinical material. Today she's describing a hard week at work. Mid-session, still talking about a stressful day, she says, "I had been crying that morning anyway. It was my birth mother's birthday, or what I think her birthday might be. I always feel a little off on that day." She keeps going with the workplace story without pausing. What do you do?
The way Lin placed it, mid-sentence, no pause, on her way somewhere else, is often a client testing whether the topic belongs in this room. She gave you the information and an exit at the same time. A takes the exit for her and reads as not noticing; for someone who learned not to mention the biological family unless asked directly, that's an answer about what's welcome here. B honors the material but takes the choice away, and interrupting her actual concern to pursue what interests you can land as the counselor deciding what matters. C keeps both: you follow her where she went, you show her you heard it, and you leave her the agency. Something like "You mentioned your birth mother's birthday earlier. Is that something you want to come back to, or something you wanted me to know?" That question makes the material welcome without requiring anything of her.