For a while I’ve been fascinated by the therapeutic material that can be provided through encountering the practical parameters and circumstances of therapy – for example, how we pay (which I wrote about here), and what we wear (which I wrote about here and here). In my latest article for welldoing.org, I wrote about what we learn through our response to the time-limited nature of a session, and the 50 or 60 minutes that circumscribe it. I enjoyed reflecting on this, and on how my response to the clock changed as trust and my therapeutic relationship developed. The article can be found here:
This process happens repeatedly during therapy. Even after three, four, five years, the breaking and the remaking happens. The shattering and the putting back together.
After time, it becomes a little easier to bear. Familiar in its recurrence, less shocking in its predictability. Maybe a little less painful – as if the pain has had its edges knocked off by repetition.
If only it were the mirror that could shatter and by putting itself back together could show me a different me. Instead the mirror stays steadfast and it is I who must repeatedly break and reconfigure until what I see reflected bears more resemblance to the truth. Or at least, what my mirror tells me is the truth – my breaking is far from finished.
The mirror flashes back at me all the different shards of myself; the ugly, jagged parts which I have to hold gingerly, but firmly, like infant selves, to fit them back into a whole.
The trouble with being broken in order to be righted, is that it can feel like the old breaking – the one that left us scarred and misaligned. The solution can feel a little like the cause, until we see that it’s the presence of the mirror, waiting to show us our true reflection, that makes the difference between the two.
It never fails to hurt me, this breaking. It never fails to amaze me, either.
Though I’ve written extensively over the last few years about my experience of open ended psychoanalytic psychotherapy, I’ve never really described my brief experiences with Cognitive Behavioural Therapy (CBT), the first of which occurred more than ten years ago, and the second of which occurred around six years ago. As with the many other different modes of therapy, I think it works well for some people and some situations, and less well for others. It was successful for me the first time, but utterly unhelpful the second, and I believe I now understand the reasons for that difference.
I recently wrote a couple of brief articles for the site Health Unlocked, about these two experiences of CBT. The first details my positive experience, and what I found valuable about the process, and can be found here:
I recently encountered the second person, over the lifetime of my blog, who has had a less than complimentary view of what I do and how I approach life. I feel very fortunate to have had so little criticism; in fact the individual I just mentioned believed that their comment would not be published because they couldn’t see any negative comments and therefore assumed I simply deleted them all. That is not the case – I’m very happy to have an open discussion with anyone holding views either similar or very different to my own, and I’m happy to be challenged. But I believe that that conversation should be respectful, and always mindful of the fact that while differing views on therapy abound, no one knows really knows a therapeutic relationship apart from the two individuals engaged in it, and I believe strongly in choosing words carefully such they uphold rather than undermine that relationship. On the couple of occasions I haven’t published comments, it was because they were not made respectfully, but aggressively, and because I believed that they had the potential to undermine not just my own, but others’ therapeutic journeys as well.
On this occasion, the commenter said (amongst other things!) that they were concerned that my posts would encourage readers to live in a fantasy world and not try and make any changes to their lives; the fantasy world in question, was the way in which I see my therapeutic relationship. Though I disagree with the individual’s point of view, I think it is, in part, understandable. It’s impossible to gain a complete picture of my therapeutic journey, even if one were to read every post I’ve written over the last four years; not just because one cannot capture the essence of a relationship, in writing, but also because I write about only a fraction of what takes place either within session, or outside it. Someone reading a handful of posts without the context of what came before or after, might gain an inaccurate or partial picture of what I believe, what my life and therapeutic process are like, and how (or whether) things have changed. I have written posts when feeling hopeful and optimistic, but I have also written posts in the midst of suicidal ideation or profound despair and grief. Drawing broad conclusions about my beliefs, attitudes, or worldview, from these snapshots into my life, is like opening the pages of a book at random, and making assumptions about the characters and the ending of the story, based on what happens in a single chapter.
I would be saddened and mortified if I thought that what I’ve written implies that change in therapy isn’t vital or necessary. It isn’t a point I make overtly, or in a directive way, because I believe that everyone has to take change at their own pace. We cannot force ourselves – let alone others – to be open to the enormous shifts involved in therapy, before we are truly ready. For my own part, I believe that I have made significant progress in therapy over the last few years, and I hope that that is evident in at least some of what I write; some of the comments I have received, indicate that that is so. But this particular commenter’s barbed remarks did prick my conscience, and brought again into the foreground, the uncomfortable feelings I sometimes have when I think about how my blogging has developed over time.
It’s a pattern that I see not just in myself, but in a number of others who write about their therapeutic journeys. And it’s fundamentally a positive pattern, indicating recovery, growth, and a necessary deepening of relationship and trust within therapy. But how does that pattern impact upon others?
It seems to be, that as we get better, and as we bring more of ourselves into therapy, we put less of ourselves out there in our writing. Sometimes this is a conscious decision; often it is not. Some like to claim that suffering and creativity go hand in hand – I don’t necessarily agree, but it’s certainly true that I wrote most, when my mental health was at its lowest point. Another way of looking at it is that writing can be a coping mechanism, a way of releasing and processing powerful emotions, particularly when there is no other mechanism for release. It can be a source of comfort and solace, a means of expression. It can be many things, that is, that therapy can also be – which is why in many ways, it can be a helpful companion to therapy. But it also runs the risk of taking the place of some of those things that therapy should be providing instead, potentially diluting both the process and the relationship, or at least circumventing some of its lessons and the bonding quality of spontaneous relating.
It seems to be that we write less as we recover more, and as our therapeutic relationship deepens. We want to take things to our therapist, rather than to the page. We want our therapist to be the first to know what we’ve discovered; perhaps the only person to know, for a little while, about some important aspect of us that has changed. It is a private, bounded, intimacy – not just because of the vulnerability present within it, but because it is so precious, and many of us keep our most precious things, close to our hearts. Many of us do our growing up within the context of our therapeutic relationship; we grow into different people, or at least, whole people, living life from a different place. Who wants to do all of their growing up in public? We want to share aspects of our stories, we want to give and receive support; but we also want to cherish the safety and privacy of our intimate therapeutic relationship, as others might cherish the safety and privacy of family.
There is so much I haven’t written about over the last couple of years. Significant therapeutic ruptures, and even more significant repairs. Many lessons learned, but few written down. Important milestones, and even more important small, ordinary steps towards wholeness. And an absolute confidence and trust – not yet in myself, that is a huge work still to be done – but in my therapist, and in who she is. Projections still get in the way sometimes. Sometimes I still react as if she were like my biological mother, rather than reacting from a place of knowing who my therapy mother is – and she is very different. But I’ve reached the point where I feel there are no walls, and no fear – just a deep trust that I know her and can tell her anything, and we will be okay.
And so the picture that I’ve put forward in my writing, is incomplete. I can remember avidly reading blogs in the early years of my diagnosis and therapy, and that wonderful feeling when you find someone who seems to see right into your head, and puts down on the page the very things you’ve thought and felt. Comments from readers of my own and others’ blogs, shows how common this experience is. And so sometimes I feel guilty that I’m not offering up to someone who might need it, the encouragement of knowing that for every difficult and painful time I wrote about, there are many other moments of precious connection and progress. And there is a constant – sometimes bizarrely and frustratingly meandering, but still life-giving – thread of change and growth. And for my own part, I feel worried that if I need something to look back on, I will be missing, in words, the very best bits of my story. But that is part of my inner work that has still to be done – to develop trust in myself, in recollection, and in the presence of this experience, lasting through time, sustained internally and eternally, without the need for an external reference point.
And it occurs to me, too, that just as I have written less over the last couple of years, I have also been reading less about therapy, and about others’ experience of it. Honouring the precious intimacy of the relationship means not just keeping cherished moments within the bounds of the space, but to a certain extent, keeping other influences out of it. I don’t mean that therapy is a bubble, apart from the world – that would be to reinforce the commenter’s criticism about living in a fantasy. It is to say that therapy is about authenticity and finding our own way through the process – and that it is very easy to be influenced by others’ stories, and even to use them as vehicles for saying something about ourselves, thus circumventing tougher but ultimately more useful and personal forms of expression.
It is also true, I think, and demonstrated throughout life, both within therapy and outside it, that people don’t really hear or see what is being said, until they’re ready to do so. Many of us know that when on the very edge of despair, having someone meet us where we are, can sometimes be more encouraging than being shown the person who has already made it through. It’s difficult to relate to who we might be in future, when we cannot envisage a future; but relating to someone who experiences a similar present, helps us to feel another’s presence, and to feel less alone. In my earlier years of therapy, I would have found it very difficult to envisage and accept that things would change in certain ways; just as I find it difficult to accept even now, that the eventual end of therapy might be less traumatic than I currently imagine it will be.
And so perhaps it does not matter that I haven’t written much about how things have changed over the last couple of years. Perhaps this guilt and unease that the commenter triggered in me, is misplaced. Perhaps my posts are meeting people where they are, at a particular period in their therapy; and when that period is over, they no longer seek the same sort of meeting. My story is presented incompletely, and it is still incomplete – as all of our stories are. And if you don’t see change in its pages, perhaps that is because you have dipped into it at a point when change is moving incrementally slowly, inching its way into my being. Or perhaps you missed the lightning flash of revelation that came a couple of pages before, or that awaits you in the next chapter. I’m awaiting that one too – but who knows how things will unfold…..
“Tell me, what is it you plan to do with your one wild and precious life?” Mary Oliver
For those in the US trying to get through this Mother’s Day ♥️
There is both a weighty and a light-hearted point to this post.
The weighty part is this. The way in which we are cared for in therapy, if we have a deep and trusting relationship with our therapist, changes our cells. It protects us in the sense of keeping us connected to our selves and to a richer and more complex understanding of the world. Though I haven’t thought of myself in terms of my diagnosis for a long time, this quote reminds me of Marsha Linehan’s words, that “people with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement”. Being cared for in therapy gives us a protective, emotional skin. The world has less power to hurt us – not just because our greater sense of self and self-worth can withstand it, but because the way in which we see the world has changed. We see it through the eyes of someone who loves us and sees the ways in which we add to the world and are at home in it, rather than through the distorted lens of those who could not validate us and never really knew us.
As an aside, I find the image of my therapist’s caring being ‘in my skin’, particularly poignant. It is a way of experiencing her touch – something I have often wished for, but which, in its physical sense, is outside our therapeutic framework.
The light-hearted point is this. I discovered this quote because I finally got round to starting Harry Potter (having watched the films but never read the books). My therapist has, on a number of occasions, used examples or metaphors from Harry Potter, and she has often encouraged me (particularly for the sake of my kids!) to try the audio book versions, read by the wonderful Stephen Fry. But it was the recommendation of a different audio book, from another wise someone (you know who you are!), at the start of the Easter therapy break, that finally convinced me to try audio books, having previously had my reservations about them. I love reading – looking at words, absorbing them and savouring them in my own time, immersing myself in them – and it was difficult to imagine having the same experience listening to a book being read. I was right in one sense – it is not the same experience – but it can be a fantastic one nonetheless!
Having listened to a handful of other books, I took up my therapist’s recommendation (though for myself, rather than the children!) and started listening to the first Harry Potter. I’m moving through the books and loving them – not just the stories and words themselves, but the wonderful way in which Stephen Fry conveys them, changing voices for all the characters, and moving (seemingly) effortlessly between them.
But even this light-hearted discovery has a weighty side to it. In discovering audio books, I have discovered something that I think will be vital not just to recovery, but to ongoing well-being and looking after my mental health. The Easter therapy break ended up being incredibly fruitful for me, in terms of new realisations, internalisation of new ways of seeing,and deepening of my relationship with my therapist. It felt as though I made numerous small but very significant shifts in my understanding and perceptions. Looking back, I believe that without realising it, I gave myself a break from rumination and down-spiraling thoughts for long enough that I was able to remain on a fairly even keel emotionally. The lack of ‘distraction’ from negative emotions and perceptions, then allowed a period of growth to take place. And the key way in which I gave myself a break from rumination and down-spiraling thoughts, was by filling the time and space when I would usually be engaged in those ‘activities’, with listening to audio books instead.
I tend to think of driving and cooking as being my ‘processing periods’ – but in reality, there is little ‘processing’ and much ruminating going on during those times. By giving my mind something else to do and concentrate on, I am essentially trying to rewire my brain so that the well-worn pathways of rumination and negative thoughts have a chance to start to ‘grow over’, and new pathways can begin to be laid down instead. My therapist likened it to walkers wearing a deep scar into the face of a mountain, by treading the same ground that has already been visibly worn down. It’s much easier to stick to the (literally and metaphorically) down-trodden paths, than to carve out new ones. However, if traveled on enough, the new paths become easier and easier to tread, and the old ones lose their visibility and appeal. I’m not sure there is enough Harry Potter (even with the later books!) to take me through that rewiring process, so I will have to find a new literary immersion, later. But for now, they are a great joy, and I can thoroughly recommend them! Metaphor and stories are great allies in the work of psychotherapy, and particularly in the later books, it is clear that J.K. Rowling has a deep and nuanced understanding of the demons of the mind….
Last week I attended an event in which Susie Orbach, the well-known British psychotherapist and writer, talked about her latest book, ‘In Therapy – the unfolding story’, based on the very successful Radio 4 programme of the same name. In conversation with author Jill Dawson, and in response to the audience’s questions, Susie talked honestly about the therapeutic process, and her own experience of it. It was a fascinating and inspirational evening, and I wrote about it for the therapy website welldoing.org:
If you have the opportunity to hear her talk, don’t miss it!