Life in a Bind – BPD and me

Borderline Personality Disorder, Generalized Anxiety Disorder, and my therapy journey. Listed in Top Ten Resources for BPD in 2016 by goodtherapy.org. I write for welldoing.org and for Muse Magazine Australia, under the name Clara Bridges.


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Let it grow

flower in iceI am going to start by owning up to the fact that this post has nothing to do either with the film ‘Frozen’ or with gardening. So for those hoping for some insight on either topic – I am sorry to disappoint. Having said that, if you have any interest in the subject of therapy, or if you are in therapy yourself, I do hope that you read on.

A couple of months ago I had one of those ‘revelatory’ moments through therapy, that it is easy to live for, but hard to come by. It was a significant realisation for me, as it challenged my assumptions about the nature of therapy itself. Those assumptions had affected both my engagement with the process, and also my relationship with my therapist. The ‘revelation’ had an enormous impact on the way in which I approach therapy, on how I relate to my therapist, and on the expectations I have of what ‘should’ happen in session. (“There is no ‘should’, there are no rules”, I can hear my therapist saying….).

In ‘A matter of choice – BPD and self-worth’, I started by saying that therapy has twin tasks – to reveal the ways in which we really think about ourselves; and to ‘make up for’ what has been missing, and that those tasks can be more broadly described as dealing with content (or process) and with relationship. In that post, I said that both of those tasks were important – but that wasn’t the position I started with, several months ago.

So much of what BPD is about is concerned with relationships, and my absolute desire for connection had led me to place the therapeutic relationship at the centre of my therapy. It was my primary interest, and I thought it should be my therapist’s primary interest too. All the reading I had done had pointed to the fact (or so I thought) that the key vehicle for change, particularly with a ‘condition’ such as BPD, was the transformative power of the therapeutic relationship. I thought about it, and I talked about it, endlessly –it was my key preoccupation. Those with BPD are often said to have an ‘all or nothing’ approach to life – and this was certainly the case with how I thought about therapy. The therapeutic relationship mattered – and in the context of sessions, it mattered to the exclusion of all else.

Whenever my therapist suggested that content  and process were important too – or that her task was also to uncover my unconscious thoughts about myself – I argued that that was not possible until the ‘re-provision’ of what had been missing in my life, was well under-way. If the ‘patient’ has not already forged a rock-solid relationship of trust with the therapist, and has not yet been ‘re-parented’, how will they be in a position to cope with the potentially devastating realisations surrounding how they think about themselves? Nothing could have shifted me from that position (or so I thought) – and any attempts by my therapist to try and ‘re-focus’ me, I simply construed as rejection.

My husband often grumbles that I listen to my friends but not to him. He can make a point over and over again, but it’s not until I hear it from an ‘independent source’ (whatever that may mean!) that I actually take it on board, and trust it. In this case, it was only when I read the point my therapist was trying to make, in two separate books by Irvin Yalom (a well-known American psychotherapist and author), that it truly hit home. It grabbed me, in only the way that something can when it truly makes its home in the innermost parts of your being. It made both intellectual and emotional sense and I felt it as a conviction at the deepest level.

In his book ‘Love’s Executioner and other tales of psychotherapy’, Yalom describes his work with a client who, amongst other traumas, had suffered sexual abuse by her father. In that context of that tale, Yalom writes the following (the highlighting for emphasis, is my own):

When I first began to work as a therapist, I naively believed that the past was fixed and knowable; that if I were perspicacious enough, I could discover that first false turn, that fateful train that has led to a life gone wrong; and that I could act on this discovery to set things right again…..But over the years I’ve learned that the therapist’s venture is not to engage the patient in a joint archaeological dig. If any patients have ever been helped in that fashion, it wasn’t because of the search and the finding of that false trail (a life never goes wrong because of a false trail; it goes wrong because the main trail is false). No, a therapist helps a patient not by sifting through the past but by being lovingly present with that person; by being trustworthy, interested; and by believing that their joint activity will ultimately be redemptive and healing. The drama of age regression and incest recapitulation (or, for that matter, any therapeutic cathartic or intellectual project) is healing only because it provides therapist and patient with some interesting shared activity while the real therapeutic force – the relationship – is ripening on the tree.

In his book ‘The Gift of Therapy’, Yalom puts the same point in this way:

But it is not the content of the intellectual treasure trove that matters but the hunt, which is the perfect therapy mating task, offering something to each participant: Patients bask in the attention paid to the most minute details of their life, and the therapist is entranced by the process of solving the riddle of a life. The beauty of it is that it keeps patient and therapist tightly connected while the real agent of change – the therapeutic relationship – is germinating.

As Yalom also states, “In practice, there is a great complexity in the link between the intellectual project and the therapist-patient relationship”. And he does not deny that the key therapeutic force is the relationship itself. So my focus on this aspect was not misplaced – but my focus was certainly too narrow and too exclusive. The therapeutic force  – the relationship – needs feeding in order to maintain its momentum, and its food is both process and content. Its food is ‘the hunt’, ‘the intellectual project’.

I have a tendency to want to ‘do everything right’ – and therapy is no exception. It would be easy for me, therefore, to substitute an exclusive focus on ‘getting the therapeutic relationship right’, with an exclusive focus on ‘getting the content and process right’ – or to try and do both. But I think that would be to both misunderstand the nature of therapy, and also to misunderstand what Yalom is trying to say. In the same chapter in ‘The Gift of Therapy’, Yalom writes that he discovered that what he and what his clients remembered and valued about sessions, were very different. He tended to value intellectual interpretations, whereas they tended to value small personal acts that were relevant to the therapeutic relationship. The precise intellectual interpretation was not what made the crucial difference. He writes that, instead, “…the search for explanation kept us engaged and our engagement ultimately made the difference”.

I take that to mean that it is not necessarily the precise content of sessions that is most important, but the process of talking about the content, and indeed that it what Yalom said when he talked about the ‘treasure hunt’ being more important than the contents of the ‘treasure trove’. And I have seen this borne out in my own therapy. Recently we discussed a difficulty in a friendship, for which I felt a failure and was blaming myself entirely. My therapist kept offering up suggestions for what might have been going on with my friend at the time, and when I thanked my therapist in my next session for the fact that I had since felt much better, she said she had been trying to give me a different perspective. However, what I took away from that session was a sense that she was on my side. Without that sense, I would have been unable to get through my distress and take on that different perspective. The intellectual interpretation and the personal act: two different views on one session, in which our relationship was made stronger through our shared endeavour and exploration.

What I learned from my reading, and from experience itself once I applied that reading to my sessions and ‘widened my focus’, is this: therapeutic alliance is central to change, but it doesn’t have to be central to the conversation.

I was ‘majoring’ on our therapeutic relationship, but in doing so, I wasn’t giving it room to breath or grow. By constantly putting the spotlight on it, I was freezing it in time. By neglecting the importance of content and process, I was completely missing the fact that the relationship grows, in the background, using the process and the content as its sustenance. I was not feeding our relationship – I was stifling it, and starving it of oxygen. I was expecting a flower to grow, in an expanse of ice. I wanted, desperately, for my therapist to care about me. But what was I giving her to care about? What was I telling her about myself, or my life? We all know that our best and deepest friendships are based on shared experiences, and a shared journey (emotionally, even if those friends are not physically present). My therapist and I need to go on a journey together, and to get to know each other through the things we encounter. If we only encounter each other, in isolation from the world around us, there is not enough ‘grist for the mill’, and there is no way to deepen the relationship.

I still have the urge to spend most sessions talking about ‘the relationship’, just as I spend so much time thinking about it. But when I do leave room to talk about other things, it’s amazing how often and how naturally ‘the relationship’ comes into it, whether that’s through the interpretation of  a dream, or the way I reacted following a session, or some other situation. But it comes up in a way that is not forced, and which provides continuity and a deeper understanding between us.

So for those who are also struggling with what to expect of the therapeutic relationship and who find themselves constantly engaged in thought or in talk about it, my suggestion would be – take your eyes off it for a little while. It will grow – if you let it. But it will do so in the background. It will germinate, it will ripen on the tree, while you are engaged in turning over and ploughing other fields. And when you turn your attention back to it again, you will have a rich harvest of shared experience, understanding and mutual caring. You relationship will have matured, and it will be beautiful to behold.


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Five Things You Always Want to Ask Your Therapist but are Afraid To Ask

I can really relate to this post, and I have so many of my own questions that I could add to the list – I think many of us in therapy probably have our own ‘top 5’ (or ‘top 20’!) questions. And the amazing thing about therapy is that through the process, and through the therapeutic relationship, I am very gradually gaining the confidence and finding the trust to ask my therapist some of those questions, without as much fear of rejection. The responses may not always be what I would most like to hear, or my question may be answered with another question – but doing the asking, continues to build trust and relationship, and that’s the most important thing….


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Book Review: Psychodynamic Counselling in a Nutshell

I am very grateful to Dysthymia Bree for writing this excellent review of an excellent book, which I can heartily recommend to anyone interested in the process and nature of psychotherapy. I read it a couple of months ago, and it was one of the few books which I wanted to pick up straight away and re-read, the moment I had finished it.

It was an interesting, informative and thought-provoking read, and for me, it played a crucial role in helping me to overcome some big obstacles I had been struggling with in my own therapy. Before starting with my current therapist, I had spent five months working with a psychodynamic psychotherapist to whom I formed a very deep and idealised attachment, despite the fact that I knew from the beginning, that our work was time-limited. For me, she came to define ‘the perfect therapist’, and the way in which she conducted therapy became the model I looked for in my subsequent experience. In consequence, my commitment to, and my relationship with my current therapist suffered, due to constant comparisons and very particular expectations on my part. I did not feel cared for or understood, and that fact led me to seriously consider leaving therapy (or at least therapy with her) on a number of occasions.

Reading ‘Psychodynamic Counselling in a nutshell’ had a profound impact on me, in that it really brought home to me, two key points about therapy.

Firstly, when my therapist withholds reassurance, she is not doing it because she is evil, difficult, controlling, or because she does not understand or care for me. She is not rejecting me or abandoning me, however much I may not understand the reasons for her withholding. Withholding reassurance can be immensely difficult for therapists, who may long to provide what they know is being sought from them, and who know that the implications of not providing it, may be that the client (temporarily) hates them or withdraws from them. Sometimes, providing reassurance may be the easy path, but not the one which has the longest-term therapeutic benefits. In those situations, far from acting uncaringly, the therapist is acting more like a loving parent, ‘holding’ the client in their distress while at the same time acting for their long-term benefit in order to try and teach them how to trust and to reassure themselves. Realising that not always rushing in with reassurance may sometimes be as difficult for my therapist, as it is for me when I don’t receive that reassurance, helped me to have a much more ‘human’ view of her, when I might otherwise be tempted to view her as callous and uncaring.

Secondly, the nature of short-term therapy is very different to the nature of long-term psychotherapy, and therapists use different strategies in each case. Some of the things I remembered and valued most about my ex-therapist, were the statements that she made which ‘bound us’ and ‘bonded us’ together (for example, talking about how we both recognised that we worked well together), and the things she said that made me feel cared for (for example, worrying about whether she had hurt me with something she had said, or offering me a ‘metaphorical hug’). I remembered the statements, and criticised my current therapist for the absence of similar statements, but what I never considered was WHEN those statements were made and WHY.

How quickly and successfully a therapeutic alliance can be made, is key to the success of short-term psychotherapy. My current therapist had the freedom to allow an alliance to develop gradually (which was particularly difficult given my attachment to my ex-therapist), whereas previously, a relationship had to be forged quickly, and my ex-therapist had to lead that process. As for the statements I treasured because they made me feel cared for – they may have occurred ‘only’ fourteen sessions in, but my fourteenth session was also my penultimate session. So although those statements felt as though they happened ‘early’ or ‘quickly’, it’s not the time elapsed that is significant, but the fact that they happened at the very end of our therapy together. The time-scales in long-term work are very different, and things unfold and develop at a very different pace and in a very different way. Direct comparisons between the two can be very unhelpful, and they certainly held me back for a long time, in terms of trusting and committing to my current therapist.

I am grateful that I came across this book recommendation when I did, as it contributed to changing the course of my therapy, and the view of my therapist. I hope that it may be similarly helpful for you!

Living Well With Depression

Readers often ask me about psychodynamic psychotherapy; the whole concept of a therapist who works hard to be unobtrusive can seem strange – as my mother once exclaimed, “So he just sits there and listens?!”

What a psychodynamic therapist actually does is far more than listen, and  Psychodynamic Counselling in a Nutshell offers a readable yet rigorous introduction to the field for patients and even professionals reading about psychodynamic therapy for the first time.

Susan Howard walks the reader through both the theory and practice of this style of counselling, and also addresses ethical issues, its history, and potential pitfalls for the both practitioner and patient. The pitch and tone of the book are accessible without being condescending.

While there are other books about psychodynamic psychotherapy I’m fond of – The Science of the Art of Psychotherapy (Norton Series on Interpersonal Neurobiology), for example, provides a more rigorous…

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A matter of choice – BPD and self-worth

People come to therapy with a variety of issues, and with their own individual goals. But whatever the particular difficulty, at the heart of therapy there are often twin tasks: to reveal the ways in which we really think about ourselves; and to ‘make up for’ what has been missing. Or, to put it in even more general terms, the twin tasks of therapy are concerned with content (or process) and with relationship – and both are important.

But even when it comes to content, and uncovering the nature of our thoughts and assumptions about the person we thought we knew best – that too, at heart, is about relationship. But in this case, it is the relationship we have with ourselves, that is being explored.

In my experience, and on the basis of reading numerous blogs by others with BPD, there is nothing more likely to elicit feelings of embarrassment and wanting to run away (fast), than talk of self-love and self-acceptance. And yet self-love seems to be the cornerstone of any and every therapy or process concerned with recovery, growth and personal development. A recent article in PsychCentral, says that “Learning to feel your own flow of love energy inside, without detaching or exploding, is critical to your own healing journey“. And in discussing the difficulties of communication within relationships, the same article goes further, and says: “Truly, the biggest obstacle to cultivating the authentic intimacy you desire with the special person in your life has to do with the part(s) of your self that you do not love, accept, value, and that, as a result, stays hidden, disowned, rejected out of fear, shame.

However, the challenge for many of us, before we can even begin to contemplate self-love and repairing our relationship with ourselves, it to identify those parts of ourselves that we do not love and accept. In some cases, we actually need to try and see through the protective veil of self-deception that we have created, in order to realise that we don’t, in fact, love ourselves at all. The deeper I get into therapy, the more I am starting to realise the ways in which I actually think about myself  – and it’s a big shock. It seems almost unbelievable that I can have come this far through life, without realising how radically different my actual self-perceptions are, from the way I like to think that I think of myself.

What is becoming clearer is that the way that I like to think that I think about myself – is actually a defence. What I’m seeing is a false self, but it’s so convincing that it has completely pulled the wool over my eyes. Perhaps this is an incredibly early example of the BPD tendency to adopt another’s identity, or in this case, to adopt an expected and acceptable identity – that of a confident, competent, happy and carefree person. Or perhaps this is connected to the psychoanalytic concept of a ‘false self’ in which an infant builds up a false sense of identity and false relationships, based on the overriding and encroaching importance of its carers’ expectations.

Until recently, I believed that for much of my life, I thought I was an ‘okay’ sort of person; that I didn’t dislike myself; and that I had relatively healthy levels of self-esteem. I thought that my ability to get through bullying, criticism or lack of acceptance, was to do with strength of character and not caring what others thought, rather than an expert ability to compartmentalise, to ‘put on a face’, and to suppress negative thoughts and emotions. But that circle seems impossible to square with the things I am now realising about myself.

I have a big desire to please, and an equally enormous desire not to disappoint. I hate to let people down and to be anything other than what they expect me to be or what I think I should be. I will sacrifice anything to the fear of offending, and to the need to ‘do things right’. In therapy, I am constantly putting myself down, saying that what I think or feel is ‘stupid’ or ‘silly’ or ‘nonsensical’ or ‘not important’. I expect my therapist (and others) to disapprove or think the worst.

When in conversation with my therapist, I am quick to defend others, to excuse them and to try ‘not to paint them in a bad light’, regardless of how they may have hurt me. I defend my parents’ invalidating behaviour; my husband’s hurtful comments; my friends’ insensitivity. In my head, I defend the behaviour of the school bullies and of the boyfriend who intimidated me into having sex. I try and minimise their behaviour and suggest that they had reasons for doing what they did; reasons that were understandable and that I had given them, because of the ways in which I had behaved.

Conversely, every time my therapist makes an interpretation that is sympathetic towards me and paints me in a ‘good light’, I am quick to try and show her how she has misrepresented me, and how I’m not ‘as good as she thinks’. I know that this is at least partly rooted in my desire for her to know ‘the worst of me’ and to still accept me. In my mind, ‘seeing the best’ gets conflated with ‘not accepting the worst’, and that is a big trigger for me. But all in all, whether I am defending others or belittling myself, I constantly end up as my own worst critic and invalidator of my emotions.

Even more uncomfortably, I am starting to uncover the assumptions I make about my friendships. The feelings I have of being an outsider in a group; of surprise when  someone I’d known for eight years told me I was a ‘good friend’; my sense of wonder when another friend painted my nails one afternoon – they all come down to a difficulty in accepting that I actually matter. I am slowly coming to realise that I believe that my friendships are not just the product of chance, of circumstance and of being thrown together (in terms of how the friendships started) – but that this is their ultimate basis.

Fundamentally, I do not believe that I have been chosen. In a circle of friends, I believe that others ‘put up with me’, but would not seek me out or choose me. I see no reason why it would be any other way. And in some ways, that is not surprising. My relationship with myself is clearly far from healthy. To quote another article on ‘Self-love’ from PsychCentral: “If you do not love yourself for all you are (and are not), is it reasonable to expect the other can do so?”

The difficulty with therapy bringing to light my unconscious self-beliefs, is that now the mask of self-esteem is paper thin. The gradual erosion of my compartmentalisation means that I can no longer just bury painful feelings and pretend that I don’t care. I have been going through a difficult situation in a friendship recently, and with the grip of my ‘false self’ having been loosened, it has left me feeling attacked, rejected, and completely worthless, to the point of suicidal ideation. And as was the case a couple of months ago, when I had similar feelings, the two motivators of my suicidal ideation are linked to the twin tasks of therapy. They are to do with uncovering a powerful self-belief of worthlessness and nothingness, and a belief that what I need in terms of relationship, love and acceptance, will never be realised.

The difficulty is, that I know, in theory, how to square that circle. It’s with that ‘flow of self-love’ and with a belief that only I can provide what I need, in terms of acceptance, and that that will feed into a greater sense of self-worth. But that belief still seems counter-intuitive – or at least, ‘adult-intuitive’, and I’m very much stuck in ‘child-intuitive’ mode, where the most compelling principle is “to matter is to be loved“. And to be loved not because of biology, obligation, or through chance –  but by choice.

Sometimes life feels like a throw-back to the playground. It feels like wanting to be chosen for the sports team because I have something to offer and somebody wants me on their side – and not because I am the last one left in line.

 


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A different kind of inner view: World Mental Health Day

Nightminds final

In some parts of the world, 10 October – World Mental Health Day – is already over. In other parts of the world, the day is only just gathering momentum. But for as many as 450 million people around the world, it will be mental health day again tomorrow. And the next day. And the next.

For those 450 million people, today’s spotlight on mental health hasn’t made their darkness any lighter. Their hope is that it’s made the depth of that darkness more visible; its character more evident; its blackness more tangible; its presence more acceptable.

The world is changing  – but slowly. Stigma and ignorance are gradually being chipped away by greater knowledge and understanding – but will they be eradicated? Maybe not in our lifetime. And maybe not in the lifetime, gone too soon, of those 1 million people every year, who let go of the ledge from which they are hanging. The world is changing – there is a World Mental Health Day – but it won’t change in a day. It won’t change because of a day.

It will change because every day, those who share our nightminds, reach out and share their darkness with each other. Those who share our nightminds see us brightly and embrace us warmly. And that embrace enables us to open up a little of our darkness to those who do not share it, and to risk being truly seen. And the more we risk being truly seen, the less alien our nightminds seem. The world will change because 450 million people can’t be wrong – though they may feel like ‘wrong people‘ to their core.

If you’re not one of those 450 million people, do go out and do on World Mental Health Day -on this one, and the next. Read about mental health; learn about it; talk to someone with mental health difficulties; raise awareness; give generously, in whatever way you can.

But for the other 364 days of the year – just sit with me and share the view. Let me show you what I see, in the hope that one day, I can learn to see the things that you do.  Let us share the view, if not the sights. Let us see together, if not as one. Let my darkness be a revelation and let your acceptance be my light. That’s how we turn World Mental Health Day into every day. Until we no longer need a day in which to try and understand that we’re all living life on the very same ledge, but with a different vantage point. Until we realise that it’s not the colour of our souls that differentiates the darkness from the light – but just the axis on which our world is spinning.

 


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You know you’re borderline when….

.……you take automated WordPress emails personally and feel criticized and upset by them….

Yes, at the risk of seeming to take BPD lightheartedly – sometimes you just have to laugh after you’ve cried – this was me, a few weeks ago.

I was in the middle of my six week break in therapy. I was feeling pretty terrible, as I tend to do during therapy breaks. I was messing around in WordPress, and when I next checked my email, I saw this:

wordpress2

I was gutted and furious at the same time. F**k WordPress. How DARE it call me vain? Oh WordPress, how can you do this to me, and make me weep on the inside?

I hadn’t even realised I’d clicked on a ‘Like‘ button  – why are they so bloody impossible to find on other people’s sites when you’re looking for them, and so apparently easy to mistakenly click on, on your own? SORT IT, WORDPRESS!

I was seriously upset. I was mortified at being called vain. WordPress was EVIL.

It wasn’t until the next day that I actually understood the joke.

Of course I think ‘Swallowing up the storm – BPD and anger‘ is about me. It IS about me – it’s my post.

Ha ha WordPress. You’ve actually got a sense of humour you mischievous son-of-a-b***h. You’re actually rather funny.

But I’ll be damned if I ever ‘Like’ another post of mine again.


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What happened in therapy when life was too busy to make plans

Unusually, I turned up to my last therapy session without a Plan B. Even more unusually, I turned up without a Plan A either.

A couple of weeks ago I came across an excellent blog post by Dawn Friedman, a counsellor working in America, entitled ‘When you have nothing to say’. Dawn is a family therapist and as well as writing about parenting and children’s issues, she writes about the experience of therapy, both from her own professional perspective, and from her experience as a client.

This particular post struck a chord because it described exactly, the way that I plan and prepare for my therapy sessions. I make lists, in my head, of topics or events to talk about. I order the lists –and make sure that the order is logical and will flow appropriately from one topic to the next. I prepare ‘opening lines’ and follow-ups to opening lines. I think about what we could talk about if I get through the list. Or which topics I will leave out, if we don’t have time to go through the list. I visualise the scene; I imagine the conversation. And since the day, a few months ago, when my therapist ‘caught out’ my sub-conscious trying to flirt with her by wearing short skirts, I also think about what I’m going to wear.

The post made a very interesting comparison. Dawn wrote: “Therapy is a lot like writing. Sometimes you come to the page with a plan and sometimes you don’t. Sometimes you have it all outlined and mapped out and sometimes you’re free writing whatever comes into your head no matter how messy and disorganized and ungrammatical it might be.”

When it comes to my blog posts, I generally come to the page without a plan. I may have thought of an opening or closing line – I may even have drafted out a paragraph in my head – but in essence I’m happy to write freely, and see where it takes me. Why do I find it so difficult to apply the same approach to therapy? I suppose it’s because the blank page and I can sit in companionable silence without me feeling as though it is expecting me to write something. I’m not worried about boring the page, or disappointing it. I don’t wonder what the page is thinking, or whether it’s judging me. I don’t worry about wasting the page’s time by filling it with meaningless, therapeutically insignificant trivia. And even if I do, I can press CTRL-X and ‘take it all back’. If what I write on the page is messy and disorganized and ungrammatical, I can tidy it all up afterwards.

Nevertheless, despite my doubts about my ability to treat therapy in the same way as writing, and largely due to a short time between sessions and a busy time at work and at home, I decided to listen to Dawn’s reassurances that it is okay to just show up without a topic prepared. And so I did. No script, no Plan A, no Plan B (or C, D….).

I sat down in my usual chair and my mind ranged over the numerous topics I could mention, none of which seemed to grab me emotionally at the time. In desperation, I started with a couple of small events from the night before, and then, not quite sure how I would ‘get into’ those, changed tack and moved back onto an item we had discussed during the previous session. The conversation was interesting, but it seems to me that even more significant than the content of our discussion, was my reaction to the situation I found myself in.

It may be okay to just show up, without a plan, but it does not yet feel okay to me. As well as making me feel lost and uncomfortable, it brought some entrenched anxieties and thought patterns to the fore. Looking back on the session, I realised that having a plan is about more than being organised, not wanting to forget anything, or not wanting to bore or disappoint my therapist. Having a plan is a strategy for avoiding two things I find acutely uncomfortable about therapy – silence, and the possibility of ‘doing it wrong’.

Ever since starting psychotherapy, I have worried about ‘doing therapy right’. I think that attitude is deeply entrenched, in a great many aspects of how I approach life. I like to do things ‘properly’ and well. My assumption is that there is a right way  – or at least, a ‘best’ way – to do most things. Although I’m incredibly sensitive to feeling controlled, and don’t like feeling restricted, I’m also reassured by rules and knowing how things should be done. Rules help me to feel in control because I know what I need to do in order to get things right. Rules also mean that I know what I need to do in order to please others, and that has always been important to me.

My therapist has repeatedly told me that there are no rules in therapy, and that there is no ‘right way’ to do things. By this, she does not of course mean that there are no boundaries – only that I do not need to worry about how to be, what to say, or whether to say anything at all.  I hear it, over and over. Sometimes, I even think I really ‘get it’. Very occasionally, I even think I really manage to do it. Until I realise that there being ‘no rules’ in therapy, has just become another rule, and I feel anxious if I think that I am failing to obey the ‘there are no rules’ rule.

And so I started to read a lot of books about therapy, and they are incredibly interesting and illuminating. I really feel as though they are helping me to understand therapy (and my therapist) better, and therefore to be less resistant to certain parts of the process, and to gain more from it. Until my therapist pointed out that my desire to learn about the process of therapy may just be another way of trying to learn ‘how to do therapy’, and how to get it right.

I had begun to think that one of the ways in which I was slowly starting to ‘do it right’, was my reaction to silences in therapy. At the start of my work with my current therapist, I found even the briefest silence intensely uncomfortable. If it took place when I was in any way distressed, it verged on the excruciating. Initially, I saw this as an external issue – a fault with my therapist, for not talking enough. My therapist helped me to see that there was an internal issue that merited examination – why I found the silences so incredibly difficult and painful to deal with.

I realised that I felt silence as abandonment – abandoned by a person, and abandoned of my perception of that person. I felt cut-off, and left alone with my despair. I felt that words would have reached out to that despair, but they would also have reassured me of my therapist’s benevolence, and let me know what she was thinking. Without those words, I felt as though her mind was cut off from me, and I could not trust in who she was. Was she judging me? Was she condemning me? Did she understand me or care about me?

Bearing the silences has become easier over time, partly through positive change, and partly through defensive coping mechanisms. I started to try and cope with the silences by staring hard at a certain point on the carpet or at my therapist’s shoes, to focus my attention on something other than the intense internal discomfort. These days, I find myself staring off into space, and having the sense of drifting. I can sit with the silence without feeling that excruciating discomfort – but instead I end up ‘zoning out’ from the session and tuning into my thoughts. I’m in my own little vessel, wrapped up in my own head, and drifting away from shore. But my therapist and I are getting to know each other better, and I think that she senses my drifting. Recently, instead of letting the silences go on for too long, she has been ‘pulling me back’ into the room by asking me a question. And rather than the silence meaning I lose trust in who she is, it is my trust in who she is that is gradually helping to strip the silence of its negative associations.

Going into therapy without a plan, brought me face to face with my anxieties over ‘doing therapy right’ and dealing with silences. The discomfort of not knowing what to say, plunged me headlong into the discomfort of feeling as though as I was rambling, and therefore ‘getting it wrong’.

I think that session taught me a valuable lesson – that I need to practice turning up without a plan. I need to learn to sit with the discomfort that it brings, which invariably will also mean continuing to work through my anxieties over silence and the need to follow rules and to please others. If I can turn up to this page without a plan, and get from ‘Unusually’ to here (albeit by a rather longer route than I had hoped!), I can try and apply that same approach to some of my therapy sessions. My therapist is not a blank page – luckily. My blank page may not judge me for my lack of inspiration, but neither can it help me to regain my inspiration. In her post, Dawn talks about trusting your therapist to help you to figure out what you would like to say. Working with the blank page  – filling it – is essentially a solitary journey of discovery. Whereas, as Dawn writes, “You and your therapist are working in collaboration….The two of you will discover what it is you’re working on through the course of your conversations.”

I have reached the end of this post with a number of CTRL-Xs, and a fair amount of tidying up. It occurs to me that although I cannot delete whatever messy, disorganised and ungrammatical material comes out in therapy when I turn up without a plan – I can still ‘tidy it up’ afterwards. Not in a manner that shuts it away or tries to sweep it under the carpet – nothing said in therapy is irredeemable – but in a manner that helps to make sense of it, and to show where it fits in.

So I will endeavour to more often turn up to session without a plan. Now that sounds like a plan…..