Payment in kind

When I teach psychotherapy to my colleagues who are psychiatrists or psychologists, I am careful to stress the importance of not only mastering techniques to perfection, but also paying the utmost attention to patients’ needs. This may mean handing them a box of tissues when they are on the verge of tears, even before they begin looking for them. Or speaking to them gently and reassuringly when hidden sorrows resurface. Or making sure, after an emotional session, that patients are in a condition to drive, and, if not, staying by their side a little longer.

I point out that it is quite simply a matter of being ‘kind’, since the kinder we are with patients, the more progress they make. Besides, there are no undesirable side-effects: nobody has ever complained of being too well-treated.

Still, kindness doesn’t always get high marks in psychotherapy. When I recommend it, I am told that I may be using the wrong word. ‘Benevolent neutrality’ is enough, they say. ‘Kind’ sounds a little soft. Yet kindness is exactly what is intended.

Kindness is, all by itself, a tool of therapy. A powerful one, too, particularly in everyday relationships. At the end of a group-therapy session I was running, I was advised to use an exercise that seemed slightly ridiculous to me. A blank sheet was supposed to be taped to the backs of the eight participants and two therapists, on which each of us was to write down what he considered the other person’s best quality. After 12 weeks, I knew that not everybody thought very highly of every-body else.

Nevertheless, the exercise was a resounding success.

It is striking to see how something positive can always be found in any individual, even if you don’t intend to form a friendship with him or her.

It is even more surprising to observe the effect when the person is told about it. All the participants had a lump in their throat as they took leave of each other, full of gratitude. Kindness had done its work. A remarkable book by psychiatrist Roger Walsh, 'Essential Spirituality', tells a similar story dating from the 1960s. In a particularly difficult class, a schoolteacher used the technique of the blank sheet pinned to the back of each child to try to change the way the children related to each other. Each child left the school with his sheet of paper listing the compliments, which the teacher had rewritten so that they would remain anonymous. Silly? Perhaps.

Years later, that same teacher was attending the funeral of one of her pupils, who had died in Vietnam. The boy’s mother came up to her. ‘Do you remember the letter you gave Mark? He hung it over his bed when he came home that night. It was in the inside pocket of his uniform when he died. I wanted to thank you for what you did for him.’ Why don’t we all carry a letter like that?