She has been in treatment for seven months. Her sensitive caregiver has long felt that the patient is avoiding, moving away. Every time you go back to her, she backs away. Any attempt by the caregiver to touch, ask, find out, is repulsed; Sometimes in thunderous silence, sometimes in the diversion of the subject, and sometimes in a clear and blatant statement – “Leave it … give me peace.” And as the treatment progresses, the therapist, with her sharp senses, feels that her tormented patient’s past dictates her present. “I wish,” the caregiver tells herself, “I wish she could have closed her past in silence, just ‘locked’ him up and moved on; but he is there, active, and overwhelming.”
The current meeting begins with a casual chatter about what happened last week. The therapist lets the patient talk, over and over, until she “runs out.” “This is it,” says the patient, “I have nothing more to tell you …”. Silence surrounds the room. Severe silence, of “no talking.” After about a minute, the therapist says: “There is distress here … in the room … a common distress of the two of us …”. The patient nods. “Unpleasant distress …”, the therapist continues. “Yes?”, The patient asks, “Do you feel that way? Do you feel distressed?”. “Yes,” the caregiver replies, “I feel distressed … but I feel that not only do I feel distressed … but that there is, here in the room, distress … that is ours.” The patient has the courage. “True … there is distress here in the room … and it belongs to both of us.” Again, silence. “Is it difficult for you? …”, the patient asks the therapist. “Yes … I’m having a hard time … I’m not comfortable … but it’s okay … I understand that this is my job … that it’s important to take care of … I understand that in order for something to happen here in the room, I have to hold on to this difficulty “. And again, silence. “Thank you,” says the patient, “the fact that I know you are holding it helps me feel safe … I feel I can touch difficult things …”.
The Matrix is a tool that allows us to characterize movements that take place in psychotherapy. In fact, the matrix examines two significant parameters for each speech segment in psychotherapy. The first parameter is “who is it about”, that is – who is the subject of the section. Since each section can talk about the patient, the therapist, or the connection between them (which we call dyad), to the first parameter, “is this about?” There are 3 options: the patient, the therapist, or the dyad. The second parameter is what the character of the section is, “what is he talking about.” Here, too, there are three options. Sections can talk about the content of an experience, about something you feel, for example – when a patient says: “sad for me” is this section, “sad for me”, is about the content of an experience. The second option is a ratio, something that happens between content. When a patient says, “I’m in a dilemma whether to tell you how I feel … on the one hand, it’s important that you know; on the other hand, I’m ashamed,” the passage he quotes contains a relationship between experiences. The extraction of the section is not in the content, but in something more complex, something that happens between experiences. This is the second option, content ratio. The third option concerns the potential to experience. This possibility does not touch on “what is the experience” (this is what the content is about), nor on “what happens between experiences” (this is what the relationship is about), but on the question “what can be experienced”. When a patient says, “My head is locked … I just can’t think of anything,” he is not talking about something he is feeling or a relationship between experiences, but about not being able to feel. And when that patient, a few sessions later, tells his therapist, “You know, all of a sudden my head opens, I have a million thoughts and feelings.” He is no longer talking about a specific experience or relationship between experiences, but about something in his potential being released.
The power of the Matrix is that it refines our therapeutic action. A bit like a microscope, it observes what is happening at a very high resolution, allowing us, therefore, to move during it in a more calculated, sensitive, and safe way.
We will return to the patient you started the conversation with, and try to analyze the movement in the session with you through the two parameters that make up the matrix; That is, we will examine the conduct of the conversation with reference to two questions: who it is about each of the sections, and what it is about (content, the relationship between content or potential to experience) in each of the sections.
At the beginning of the conversation, the patient brings up trivial content. In this section, the answer to the question “who is it about” is the patient and the answer to the question “what is it about” is the content of experiences. Then, “She’s over,” and she falls silent. The therapist says: “There is distress here … in the room … a common distress of the two of us …”. The answer to the question “who is it about” varies: it is not about the patient, but about the connection between the therapist and the patient, about “what is happening in the room”, about the dyad. The answer to the second question, “what is it about”, is still content, since the therapist is talking about an experience (distress) that is in the room. Then, the patient asks the therapist: “Do you feel this way? Do you feel distressed?”. This question conceals a fundamental change, since the answer to the “who is it” question is not the patient (as at the beginning of the conversation), nor the dyad (as in the statement made by the therapist about the distress in the room), but the therapist herself. The patient asks the caregiver how she is feeling. The therapist is not satisfied with telling the patient how she feels (she says: “Yes … I have a hard time … I do not like it …”), but adds after describing the experience as an internal occurrence with her, an internal process. She explains: “I understand that this is my job … that it is important to take care of … I understand that in order for something to happen here in the room, I have to hold on to this difficulty.” This explanation is a relationship between experiences (“Because I know it’s important, I stand by it!”). Then, after this all-too-elegant move on the part of the caregiver, the patient moves forward. She thanks the caregiver and then adds that thanks to the caregiver’s ability to hold, something happens to her, to the patient. She suddenly manages to feel something she has not felt before. Suddenly, “I feel safe … I feel I can touch hard things …”. This statement refers, of course, to the patient, so the first parameter in it (“who is it”) is the patient. The second parameter of this statement (“what is it about”) is not experience. The patient does not tell how she feels but says that suddenly there is something she can do (touch hard things). He says that her potential to experience has expanded, and therefore, the second parameter of the statement “I feel I can touch difficult things …”, is the potential.
And now, in the bird’s eye view, one can appreciate the movement made by the therapist, the movement that led the patient to expand the range of her experience and touch on difficult content from her past. The movement began with the transfer of the focus of the meeting from the therapist to the dyad, and from there to the therapist herself. Following this shift, the patient invited the therapist to tell more about what she was going through (she asks her: “Is it difficult for you?”), And then the therapist shares an internal process she is going through, which is all devotion to the patient (“I understand that for something to happen here in the room, I need to Hold this difficulty “). This movement “does work.” The patient thanks to the therapist, and reveals how, thanks to precise movement from the patient to dyad, and from there to the therapist, her potential, of the patient, opens up. And here, she can feel safe and tell.
