Life in a Bind – BPD and me

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


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Therapy, choice, and our internal fight

I think this is the most important thing I’ve ever written. I think it’s also the most inward looking, the most esoteric, the least relatable – unless you happen to be in a very similar place to me. Albert Camus wrote that “bad authors are those who write with reference to an inner context which the reader cannot know”. Bad or good – it will depend on how much of my inner context, you know from your own experience.

***

Tucked at the back of a pocket in my purse, I have a small piece of paper with the following words: “We suffer at our sense of loss, we are frightened by her rage, we are guilty in the face of her rejection, we are hurt by her choice of isolation, and we are confused by her message”. It’s a reminder of what I don’t want to become, of what I don’t want to be said of me.

The words are from the eulogy at the funeral of Christine Chubbuck, an American TV news reporter who took her own life live on air in 1974.  I watched the powerful film of her life a few months ago, and then read an in-depth article written shortly after her death, which contained descriptions of her from family, friends, and work colleagues. Like the manner of Christine’s death, it was haunting and disturbing, and made for uncomfortable reading, not least because of the implication that Christine’s death was a choice that amounted to a denial of the support available around her, a rebellious message to those she felt had rejected her.

No one knows exactly how she felt in the lead-up to her death, or what the complex mix of factors and motivations was – conscious and unconscious – that led her to take her life, in that way. My own response to the film and the article, what I take from them, are only my personal attempt to derive from them that which will be most helpful for my own journey. They should not be taken as my own interpretation of what was going on for her. All I can say is that for me, what is most helpful at this point in my own therapy, is one word above all others, in that extract from Christine’s eulogy – it is the word ‘choice’.

***

At a certain point, when we are far enough down the road of reflection, self-examination, and recovery, I think that long-term therapy becomes a moral matter. I had begun to believe that before I watched “Christine”, but the film and article brought that message home with a vengeance.

I think the phrase ‘moral matter’ needs some explanation, so that it is not misunderstood. I don’t mean morality in its religious, cultural, or judicial sense; I mean personal morality, the way in which we choose to live our lives – ‘the place from which we act’, as my therapist would say. Eventually, when you’re no longer in mental crisis day after day, when you’re no longer in deep despair more often than not, when you’re no longer self-harming, or suicidal, or living constantly with the ghosts of projections; when you’re ‘well enough’ and understand enough to see your patterns of behaviour and to know where they come from – at that point, a greater awareness of personal responsibility for recovery starts to set in, and decisions from the small to the large become much more consciously about choosing to act from a place that is not ruled by past patterns, a place of freedom and integrity.

***

This is a difficult topic – you might even call it offensive, in some ways. It was offensive to me when my therapist first started suggesting I could choose how I felt about certain things. I would insist that I couldn’t help feeling sad or depressed, that I couldn’t help, for example, dwelling on the pain that came from feeling excluded from her life. Yet she would keep telling me that I had a choice about how much attention I paid to those feelings, and how much room in my psyche, I allowed them to take up. I was upset and offended by the implication that I was choosing pain and depression over thankfulness and joy – a subconscious choice, perhaps, but exhibited consciously in the overt belief that I had no control over my emotions. And yet we all have more choice than we think we do, and others, particularly our therapists, can see that in us, before we are aware of it.

I remember the first time I came starkly face to face with this in session. My therapist and I had been discussing some difficult self-sabotaging behaviour, and I’d identified a pattern in the behaviour, and an explanation for it. My response was to simply affirm that now I understood what the behaviour was about, I could see how and why it would continue to occur.

Sometimes it really is the case that one has to be cruel to be kind, and my therapist left me in no doubt of the seriousness of my statement and the threat it represented to the therapeutic process. If I’d identified a pattern and understood its origins, I was no longer powerless or without choice. It was not a fait accompli that the behaviour would continue – I could work hard, take responsibility, and try and stop it. It might take me a long time, and progress might be slow; but there is a crucially important gulf between turning one’s face and one’s heart towards progress and committing to change, and deciding to stare only at one’s feet, and where they are currently planted.

My therapist didn’t put it this way, but retrospectively I would say I was faced with a choice of personal morality. Do I move with integrity and responsibility to make a change and act from a different place, or do I continue to act in a way that is damaging to myself and others, and allow myself to believe that that’s just how things are, and that I have no choice in the matter?

I changed my behaviour in the way I needed to back then, but it wasn’t the only time my therapist has had to remind me of the weight of that responsibility for change, and of the implications for therapy, of refusing – whether actively or passively – to bear the weight of that responsibility. She reminded me again, only a few weeks ago, when I seemed adamant that I simply could not see a way forward towards a happier, more fulfilled life, and towards an image of myself that was even remotely positive. It’s almost as if I was saying – do something, because I can’t do it, or I won’t’. But of course without my agency, she has no agency to help me; she cannot do her work without me doing mine.

***

I’m sure I read somewhere that Carl Jung said that people in therapy are far more willing to confront the skeletons in their closets, than to face the good inside themselves. I’ve seen it often enough within myself, and it makes intellectual sense – resisting recovery is natural, because change, even for the good, is frightening, and the familiar feels safer and more predictable. Encouraged by my therapist, I’ve tried to turn this ‘head knowledge’ into an active struggle to try and identify what advantage those resistant parts of me gain, by remaining stuck in old patterns. The parts of the picture come slowly, small pieces at a time, and even thoughts that feel like revelations are sometimes only one aspect of a much bigger whole.

If remaining with old patterns feels safer, what do we gain by refusing to remain stuck? The difficulty is that the skeletons in the closet have a habit of breeding – we add to them – when we refuse to confront and own their ugliness as our own, and also at the same time refuse to accept and own our goodness and our ability to change. We act from a place of fear, and shame, and defensiveness, and in ways that are damaging to ourselves and others. We act from our unconscious without an awareness of what drives us; we act through the fog of projection, rather than from a clear vision of who we and others are. We act from fear of loss – of so many different kinds.

There are many examples from my daily life. In therapy, this action is made manifest in behaviour that negatively impacts my process and therapeutic relationship, whether that is shutting down in a session because of resentment at not having a perceived need met, or intruding into my therapist’s space in some way, because of a need to feel close. It is made manifest in many, many different ways – many human ways. Because at this stage in my therapy, I’m there less because I am ‘ill’, than because I human, and all of us have circumstances and hurts that we are trying to get to grips with in order to live a life of greater freedom and depth. For me, a key part of that is learning to deal with loss in a way that doesn’t frighten, destroy, or overshadow everything else in my life. It means learning to accept that I am significant and loved purely for who I am.

***

After a difficult therapy session this week, I posted on Twitter that I was sitting in a café rather than going home to be alone with my self-harming thoughts. As I was sitting there, I kept thinking, ‘I need to feel better, I need to feel better, I need to feel better’. A kind and thoughtful therapist suggested I reframe these thoughts as ‘I would like to feel better and I can, I have before and I can again’. She suggested that words such as ‘should’ and ‘need’ put too much pressure on myself, and that there is a difference between motivating myself, and pushing myself too hard. The encouragement towards self-compassion is an important one, particularly when it comes to my emotions, and to how I feel about myself. But when it comes to my ‘internal orientation’, to the direction in which my heart and mind are set, to my actions and to what I do, I realised that I need more, even, than self-motivation. I need determination, utter commitment and resolve, a sense of importance and urgency. I realised, as I was still pondering the matter a few hours later, that what I needed to keep uppermost in my internal struggles, were the words ‘I can and I must.

‘I can and I must’. Does this constitute putting too much pressure on myself? At first glance, it looks like it. At first glance it seems the very opposite of what had been suggested to me. But I don’t believe that it needs to be. I wouldn’t apply ‘I can and I must’ to the desire to feel better – accepting and sitting with my feelings, whatever they may be, can be a positive thing. There is no contradiction between feeling despairing and hopeless for a while, and staying in my integrity. But feelings don’t happen in a vacuum, they happen within a worldview, within a locus of control, bounded by action or inaction. I won’t tell myself that I ‘must’ feel better. But when it comes to trying to face and fight my inner resistance to feeling better, my internal saboteur who wants to keep me stuck feeling bad, and who wants me to stay in the pit of despair – that’s when I need to say ‘I can and I must. I can and I must stand and fight. Choosing not to fight, postponing the fight, ignoring the fight, telling myself the fight doesn’t matter, or will be won another day – that’s not staying in my integrity.

As I continued to think things through many hours later, and tried to see the ‘I can and I must’ aspect of the situation I was in, the following became abundantly clear. Every time I choose to confront the part of me that wants to stay stuck, every time I make conscious efforts to feel better rather than accepting my place in the pit of despair and closing my mind off to other possibilities – I am actively accepting, all over again, the inevitable truth that I am changing and that therapy will end. Every time I fight my internal saboteur I am affirming my walk on a path that ultimately leads to readiness to say goodbye, physically at least, to the dearest, most important adult in my life, and to the one who has shaped me these last few years and will continue to do so internally, for the rest of my life.

***

I can continue to delude myself that I am at risk of losing my therapist’s care, or her good opinion, or that I don’t matter to her as much as others, or that I don’t belong in some way in her life; and I can continue to seek reassurance and try and build up a store of as much concrete comfort and as many wonderful words as I can, before therapy ends, in the hope that those things will sustain me afterwards. Or I can stop deluding myself and just accept what she shows and tells me. Accept that I am loved and wanted and significant, and that I belong.  And if I accept those things, I have no reason to seek reassurance, or to seek ways to keep adding to that externally sourced, concrete ‘store’.

I can delude myself that that concrete ‘store’ is vital to my survival, or I can open my eyes to the fact that I have been neglecting my ‘internal store’ of my experienced and lived relationship with her  – indefinable, not concrete, impossible to capture in words, as it is – and I have been minimising it, making it vulnerable, weak, and small, in order to provide myself with a reason to keep stockpiling my external store. And that is far outside my integrity, and a cruel act against myself. I can and I must stop doing that. I can and I must stop bankrupting my internal relationship so that I can keep adding to my memory bank.

It seems to me now that I can choose to focus either on being, or on remembering, but I cannot give equal attention to both. My heart has to be turned toward one or the other. The more I focus on gathering memories, the less I focus on immediate relating, and the less I’m able to internalise her. Ultimately, my deepest desire is for the therapy and the relationship to be something that I am, not just something I remember. And for that I need to accept that the remembering may consist primarily in seeing her and hearing her in who and what I am becoming, knowing that what I’m seeing is her influence, and what I’m hearing is her voice, woven into my thoughts.

***

This is the hardest, most brutal, most challenging, most exhausting thing I have ever done. I had not the slightest idea, when I started, that this is what therapy would mean for me. That I would reach a point when this wasn’t just about feeling better, but about being better. It’s so easy to take umbrage, in the days of fighting expectation and perfectionism, and accepting that one is ‘good enough’, to the idea of being ‘better’ – but there is no contradiction between being ‘good enough’ and still striving to be more fully human. Who wouldn’t, in the final instance, say that they were living, in some form of another, to serve love (for themselves, for others, for their passions); and which one of us wouldn’t say we would like to better and more fully give and receive love. We are all either advantaged or disadvantaged to a varying degree in that capacity to give and receive love, depending on our nature, our nurture, and our past and present experiences. Growing in this area, getting better at giving and receiving love, can be a tremendous joy – therapy can be a tremendous joy. But it is by far the hardest thing I’ve ever done. It really has been, and continues to be, both the worst of times and the best of times, both the season of darkness and the season of light, both the winter of despair, and the spring of hope.

***

I’ll end very near the place where awareness of this ‘moral journey’ started for me, even before I saw the film ‘Christine’. As well as with the words and influence of my therapist, it started with this extract from a book by Ann Belford Ulanov, a Jungian analyst, and what ties it to the quote from Christine’s eulogy, is once again the word ‘choice’:

“In the world of neurosis and psychosis there inevitably comes a time in treatment when moral choice presents itself to the person involved. The terms come clear. Choose life – being, bits and pieces of goodness – or choose to fall away into illness, into non-being. This is a choice one lives toward. It does not come quickly or all at once. It is certainly not something manufactured ‘for the good of the patient’. The choice cannot be hastened, nor produced at will. But if the psychotherapeutic treatment achieves any success, sooner or later this choice will present itself in the most intimate of personal terms to the person involved and demand a response. Side with goodness, the patient will be told from within, even though it is a shadowed goodness, an ambiguous goodness; side with it or turn away from it’.

 

[Though not mentioned explicitly, I am also grateful for Brene Brown and her books on vulnerability and shame which I have been reading and listening to over the last few months, and her own emphasis on courage and faith and acting from integrity.]

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Therapist – client boundaries in the online world

I wrote this article for welldoing.org more than a year ago, but didn’t post it as I was concerned in case it was seen by the person who prompted it to be written. However, I had cause to think of it again recently, and I believe enough time has passed that it is ‘safe’ to now share it here. I am still passionate in my belief that therapy is a sacred space, and that we have an ethical responsibility to honour that space, including in our interactions online:

https://welldoing.org/article/what-boundaries-therapist-acknowledge-social-media


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Summer therapy break – it’s almost over…..

I’m nervous about going back to therapy tomorrow. You would have thought after five years and numerous therapy breaks, that I wouldn’t be wracked with anticipation, that I’d know what to expect. And, I guess, the problem is that I do. I know returns are difficult – the last week leading up to a return has always been particularly challenging, and this time has been no exception. My #therapybreak tweets from the final third of my five-week summer break, show that unfolding:

https://wakelet.com/wake/1f7fe065-a5ae-4110-9ae8-8a021506bc9a

One thing that has changed over the years has been the speed of adjusting after the return, of reconnecting, and of working through the vestiges of resentment and anger that inevitably bubble up, however accepting I’ve consciously felt of my therapist’s need for a break. But I haven’t yet found a way of avoiding the clouding of vision, and turmoil of emotion that makes an appearance in the lead-up to the ‘reunion’, however things have gone in the preceding weeks. I think that part of the reason, at least, is an inability to completely let go of expectations.

Without wanting to or planning to, or even realising that it is happening, as the end of the break approaches my head starts to fill with imagined conversations and imagined scenarios of how the first session back could go. Those scenarios involve both the ways in which I’d like, and not like it to go, along with my possible responses. But either way, positive or negative, there are fears and expectations involved. I would like to be able to approach the end of the break and the first session back, with complete openness and curiosity, with excitement and gratitude for what has been and what is to come. But I find it so hard to release those thoughts of how I’d like her to be, what I’d like her to say, how I’d like the atmosphere to be. I know that I’m restricting both of our freedom, imprisoning us both, in a dynamic enforced by my expectations. I want to work on that – but I don’t yet know how.

 

 


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I have a mother – when things shift in therapy

[This post talks about the uniqueness and importance of ‘mother’, and for me, that has a particular meaning. But for others it may be more appropriate to invest this word with a different meaning – it may relate to a father, grandparent, or adoptive parent, or any other primary caregiver. I don’t mean to exclude by my use of the word; but it is so intrinsic to my own experience and what I’m writing about here, that I cannot avoid it.]

“You can hear something over and over again, but until you hear it at the right time, in the right context, in the right frame of mind and with the right understanding, it makes no impact. You can hear words and you may comprehend their meaning, but it may still not be clear what the words are meant to change, and how . “

That’s a paragraph from a post I wrote two years ago called ‘A new experience of mother – Part 3’. It was one of five posts on the same theme. It continues to surprise me, the way that therapy returns over and over again to the same topics, to the same ground, but in subtly different ways. The return is an indication that there is more to think about, more to say; an indication that there is still something unresolved, and something hidden to unearth. It continues to surprise me that the merest fraction of a degree in the angle at which we look at an issue, can make an enormous difference to our perception, and can lead to a revelation. And that the ‘revelation’ can be both so close in content to what we already knew, and yet so far from it in terms of its impact, that it seems both ludicrous and impossible, not to have seen it any earlier.

Elsewhere in the same post, I wrote the following:

“My therapist often made the point that she was different to my mother, and she made it in numerous ways. She made it by actually being different; by responding in ways I didn’t expect and then drawing my attention to the fact that I’d been anticipating the reaction my mother would have had. She was understanding when I expected judgment; caring when I expected criticism; comforting when I expected shaming. She made the point quite explicitly by saying that therapy offered me  – she offered me – a different experience of mothering. I heard the words, and thought I understood them.”

And so I never expected to come back, two years later, and write what is effectively Part 6 of my series of posts on ‘A new experience of mother’. But I’m returning in order to add something absolutely vital to the things I realised then. Something that arose directly out of thinking about the distress I felt when my therapist did not answer my question about where she would be going on holiday this summer. I wrote about that incident in my post ‘Why therapists frustrate their clients’, but I wanted the realisation that came out of it, to be part of a separate post – this one.

***

When my therapist asked me to think about why it mattered so much to me that she had not answered my question, I said that it wasn’t so much the knowledge itself that was important, but what it would mean if she told me. I told my therapist that “it would mean a little less exclusion. It would mean feeling trusted. It would create a deeper feeling of relationship, and strengthen our bond. It would create another memory. All of those things seemed self-evident, natural, and in need of no further explanation. And yet she still seemed to think there was more to discover.”

Sometimes ideas occur to you in a way that is more like a voice speaking in your head, than your mind thinking a thought. That’s what it was like when all of a sudden, completely out of nowhere, I heard an answer to my therapist’s question about why it mattered and what it would mean. “It means I have a mother”, the voice said, “and that is the most important thing”.

***

I was at home at the time, and it was a couple of hours after session. I stopped, utterly taken aback. What was going on? On the one hand, it immediately felt as though there was a weighty truth in the statement the voice had made. And I already knew I had a therapy-mother – my therapist had been using that terminology (and also the phrase ‘therapy-daughter’) for some time. But on the other hand, there was something not quite right about the statement. The voice said “and that is the most important thing” -but how could that be true? That, right there, seemed to be the voice of my biological mother, who insisted that she was and always would be the most important, the only truly trustworthy person in my life, the person who would love me in a way no one else could ever love me. This seemed to be the voice of the person who elevated mothers, and specifically herself, above every other person and type of relationship I might ever encounter. And I already knew, in so many different ways, what a negative effect on me her narcissism had had. So how could the voice be right, if it seemed to agree with her?

***

The next morning I awoke having had three dreams that felt clearly linked to each other, to the question I had been thinking about, and to the ‘answer’ I’d received. In various ways, the dreams drew attention to three aspects of the mothering I’d received when growing up. They showed me that I had a mother who wanted intimacy with me but at the same time couldn’t cope with it because she could not deal with her own emotions, let alone my own. She left me, therefore, with the sense that she was afraid of me, and that I was a threat to her. They showed me that I had a mother who never wanted me to grow up and was full of nostalgia for the days of my childhood, not seeing or wanting to see who I really was and was growing into. They showed me that I had a mother who wanted to appoint herself as the most significant person in my life, and wanted to exclude others from my affections.

But very importantly, the dreams also showed me something that I could never consciously have accepted as a possibility. They showed me that at one time in my life, even if I couldn’t remember it, I had wanted that intimacy and that exclusivity too, even though I knew that the former would lead to rejection and invalidation, and the latter would be poison. I didn’t always reject my mother and everything she stands for, as forcefully as I have done for the last twenty years or so. I didn’t always reject completely out of hand, any idea that came from her, or any association with her. And I didn’t need to reject everything that sounded like her voice, now. It was possible that she could speak some truth about mothering, even if she herself had not been a good-enough mother.

***

I grudgingly realised that my mother was right – and I never thought I’d say that about her! Having a mother is the most important thing. Mothers are unique, and there is no other relationship like it. Wrong though she was in the way that she interpreted that relationship, its meaning, and its implications, I now believe that she was right about the importance and uniqueness of the relationship. And I’ve read enough articles over the years, about the impact on individuals of losing their mothers, to know that for many people, the importance and uniqueness of that relationship continues well into adulthood, and up to death and beyond.

Two years ago, I came to understand that my therapist was providing a new experience of mothering. I knew my therapist was very different to my mother and I was grateful and full of joy to have a type of mother-daughter relationship with her. But what I didn’t understand until a few weeks ago, was that for the last two years I’ve been holding two somewhat contradictory positions alongside each other. Because while accepting that I had a therapy-mother, I also believed that my mother was wrong about the importance of the mother-daughter relationship. I believed that I didn’t really need a mother, and had never needed one. I knew I had a therapy-mother, but I still thought of myself as being without a mother. On numerous occasions I had caught myself thinking ‘if I had a mother…..’, as if my biological mother were dead, rather than me being emotionally estranged from her.

In placing such an emphasis on my therapist’s difference to my mother, and in deriding so strongly the very concept of the uniqueness and importance of the mother-daughter bond, I was inadvertently preventing the experience I was having with my therapist from becoming a fully healing and transformative experience. She was providing something wonderful – but I couldn’t see it as being the very thing I had lacked for so long, while I still refused to acknowledge the importance and the necessity of what had been lacking. Inevitably, my therapist was providing what I had lacked in a rather different, and a more intensive and more concentrated way to that in which it would have been given through the longer period of childhood and growing up – but she was providing it nonetheless.

***

When I saw my therapist the morning after my ‘answer’ came, along with my dreams, I told her that it finally felt as if something had shifted, and that I had been missing a vital puzzle piece that had now fallen into place. More than that, I had been missing something vital, and things had shifted internally so that somehow I now felt more complete. She said she was very glad the ‘penny had dropped’! I kept repeating to myself, inside my head, ‘I have a mother, I have a mother’, and every repetition was full of joy. Whenever she or I made reference to it, I couldn’t help smiling; I still can’t.

As well as being accepting and validating, I have a mother who is not threatened by me and is not afraid of me; a mother who sees, values, and enjoys the ‘adult me’ as well as the ‘child me’; and I have a mother who does not want or need exclusivity and is confident of her position in my heart. Unconsciously, that was the type of mothering I associated with my therapist feeling comfortable enough to talk to me about her holiday plans, and that is why it was so distressing to feel that that experience was being withheld. But if it hadn’t been, I may not have realised the things I did.

I may not have realised, finally, that in my therapist I have not just a new experience of mothering, but a good-enough mother – and absolutely nothing can take that away from me. I have a mother. The relationship I thought I didn’t need, is in fact vital. The relationship I had been missing, I now have. The experience I thought I would always have to do without, is now a part of me. I know that I will lose her, as the majority of mothers are lost, at one time or another, to their children. And that will be devastating. But not even that can take away from me the fact that what I was missing I am no longer missing, and will never miss again. That is indescribable. I have a mother. It is the most important thing.


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Therapy break update and thoughts – not over yet!

While most of those I know in therapy are already back in session, I have another [insert own adjective] couple of weeks to go until I see my therapist again! I’m a little over two-thirds of the way through, and have put together my #therapybreak tweets for the middle third of this long summer break:

https://wakelet.com/wake/867ff092-2c48-4478-bfad-76fe4f5fca62

The first third can be found here and the final installment will be published on 23 September, the day before my return to session.

My thoughts are with those who have recently returned to session – going back involves such a mixture of states and emotions, and whatever happens in those first couple of weeks back, it is rarely straightforward. But I am grateful to a lovely Twitter friend and our chat earlier tonight, for the opportunity to remember and reflect on something very important about the return. She is seeing her therapist again soon, after a gap of a couple of months, and wondered if her therapist would remember what she was like, and how to work with her. And in replying to my friend, it was as if the last five years of working with my therapist were all present at once, and I grasped in one moment how I would have answered that question and felt in that situation a few years ago, versus how I feel now.

I said that yes, her therapist would remember what she was like and how to work with her. But at the same time, her therapist wouldn’t know how the last couple of months had been, until she was told, and working together changes all the time, so it is never completely the same. Her therapist will care and know her as before, but she will also be human and will not ‘get things’ straight away, and may not remember everything my friend might expect her to. But if that happens, it says nothing about how her therapist feels about her, or her desire to understand what’s going on. I said to my friend the things that I wish I could have said to myself – but I hadn’t realised them yet –  a few years ago, in the early days of my therapy.

I hope my answer was helpful to my friend, but her asking the question was also a blessing for me. In replying and in reminding myself of what I knew, I felt a great sense of security and of knowing and being known. I remembered one or two sessions over the last few months when it was clear my therapist did not quite understand how things were for me, but it also evident that she cared deeply about understanding, and was trying hard to do so. I remember how powerful it was to realise that I’d reached the point where the fact that she didn’t understand, did not upset me; and the fact that she was committed to trying, was infinitely more important and moving. I smiled inside at the thought that she is human; I was grateful for it. Even though I could probably only recall one or two examples, the felt memories of her ‘human-ness’ permeated me, and I felt hugged by her presence. I no longer need to be ‘intuited’ -one of the changes that therapy has wrought. I just need someone to bring themselves as they are, to be there, to care, and to try. How much simpler; how much more precious. What a gift…..


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Why therapists frustrate their clients

“It feels as though you want me to learn through deprivation” I tried to argue through my tears. “But why can’t the same lesson be learned through positive means? If I ask a question, why not answer it first, and only then ask me to think about why I asked, and what it means to know the answer? That way, all the distress and disconnection of not receiving a reply can be avoided; we can start thinking about the matter, from a place of confidence and trust”.

“It’s a good theoretical question”, my therapist replied. “But sometimes I think it’s necessary to frustrate, to really get at what might be going on”.

***

Not just frustration, but distress. Distress that cut me off from her and immediately caused me to switch from a fairly adult mode, to a hurt child just wanting to protect herself. For the second time in the last few weeks I asked my therapist where she would be going on holiday, and for the second time, she did not answer. Instead – no prizes for guessing the stock therapist phrase that came next – she asked, “What does it mean to you, knowing where I will be going? Why is it significant?”

The distress was very real but it also felt predictable – it was a case of ‘here we go again’. I knew that precious time would be lost while I clammed up and found it impossible to speak. Whatever it was that I had come to session wanting to talk about, would be waylaid and sabotaged by that one question. It seemed to me that it would be a mark of progress if I could just put the distress to one side, and carry on – as if the question had never been asked. I wouldn’t let my internal saboteur win this one – my therapist had encouraged me to be wary of him, often enough.

But unusually, (as she tends to let me lead), my therapist seemed to want to steer me back into conversation about the question. She has an acuity of judgment that seems to be able to differentiate between the saboteur, and an altogether more straightforward, vulnerable side of me, even though the two often sometimes look the same. I think she saw the question not as a distraction, but as hiding something important. And she wanted us to work on getting to the bottom of it.

***

Years ago, her comment about frustration would have lit my internal touch paper and I would have seen red. It would have felt uncomfortably close to the idea that suffering can be good (which makes my skin crawl) as opposed to the idea that good things can inadvertently result from it. I would have wondered at how she could choose a path that she knew would lead to distress, when it seemed to me there was a perfectly suitable alternative. But I know her better than that now. I trust her vastly more than that. I know she cares deeply and will do what she believes is right and in my best interests. When I asked her why I needed to learn through ‘deprivation’, I couldn’t yet see why she was right. But I was willing to trust that she might be, and willing to work with her, to see what we could find.

***

It’s very easy to settle for the obvious, simple answers. I think it’s what I tend to do, when the time isn’t yet ripe for other answers. I said that in many ways, knowing the place where she would be on holiday was not in itself a hugely significant piece of knowledge. It meant that I could look up a picture of the place and envisage her there; it meant I could use that picture as the home screen on my phone, and it would be a helpful way of connecting with her during the summer therapy break. I said that much more significant than that piece of knowledge, was what it would mean if she told me. “And what would it mean?” she asked. It would mean a little less exclusion. It would mean feeling trusted. It would create a deeper feeling of relationship, and strengthen our bond. It would create another memory. All of those things seemed self-evident, natural, and in need of no further explanation. And yet she still seemed to think there was more to discover. That we hadn’t yet got to the bottom of it. She didn’t quite understand why the withholding of what still seemed to her a fairly insignificant piece of information, could create the level of distress that she was observing.

***

The pain lingered between sessions. Her belief that there was more, the fact that she still didn’t quite understand what was going on, troubled me. I wanted, desperately, to understand. Despite myself, her curiosity became my curiosity, fuelled by my despair. I’m not sure whether I thought that an answer to my question would ever be forthcoming, but the desire to know the answer was soon completely eclipsed by my desire to understand what was going on.

Why did it matter so much that she should tell me? Why was it significant? What on earth did it mean? My mind buzzed with the questions; I was taken over by them. In the car, at home, carrying out tasks, moving about. And quite suddenly, an internal voice – definitely me, but appearing out of the blue, somewhat like free association – gave me an answer. And it stopped me in my tracks. It was blindingly true, but also difficult to swallow, as it ran counter to my ‘natural’ way of thinking. It was unexpected, staggering, and it put not just one thing but many things, into a completely different light.

***

I went to bed shortly afterwards, my mind still buzzing, feeling blown away. It’s fairly rare for me to remember dreams, particularly in great detail, but that night I had three dreams which I remembered vividly, and which I knew the minute I woke, were inter-related. I usually struggle to interpret my dreams and to link them to the work of therapy, but as I drove to session that morning, the meanings started unpacking themselves with startling clarity. I was awed by the way in which our minds can put together images with purpose to help meaning float up out of them. I felt fortunate that a couple of weeks before that, I’d had a similar sequence of three dreams in which I realised that what was important was to pick out what was consistent across all three sequences, rather than pondering the meaning of each detail. Sometimes the details were there purely in order to demonstrate that the details didn’t matter – what mattered were the themes.

The dreams added further layers of understanding to the flash I’d had the night before. I’d come to a surprising realisation, and the dreams helped me to see the different ways in which it was true. The dreams showed me the less self-evident, and vitally important ways, in which it really did matter that my therapist talked to me about where she would be going on holiday.*

***

What followed was a session that was both very moving, and deeply joyful. It felt as though something had finally clicked into place; as though a missing piece had been found. There was a clarity of vision I rarely experience, but which always feels striking and humbling when I do.

And part of that clarity was the slightly reluctant but unequivocal realisation that my therapist had been right. Of course it’s a matter of conjecture, but I tried to think honestly about what I thought might have happened, if my therapist had answered the question first, and asked me to analyse, second. Much as I wanted to believe that the outcome would have been the same, I knew that I didn’t really believe that.

I had been very distressed, and I wish that there had some way around that. I imagined how good it would have felt if she had replied to my question straight away, and I imagined turning my attention to thinking about why my question was important, with a joyful heart, and feeling close and connected. And yet lovely though that picture was, it lacked the all-consuming motivation, the fierce curiosity, the absolute drive to understand so that I could somehow try and make sense of my pain, even if I couldn’t make it go away. I can’t honestly say that I think the same outcome would have been achieved if I had had her answer first. In fact I believe the opposite – that it’s unlikely the breakthrough would have happened – at least, not at that time. And I’m very glad that it did.

***

As my therapist is prone to reminding me, ‘good therapy sessions’ aren’t defined in terms of whether I go away from a session feeling uplifted and joyful. ‘Good work’ in therapy is very often painful, very often involves distress. I know that my therapist does not like seeing me in pain; I know that she would never cause it intentionally. Sometimes, pain is the unintended consequence of her being just as human as I am; sometimes, it is the by-product of a sound therapeutic judgment and the decision to withhold and frustrate rather than to provide and satisfy. And all these situations are absolutely compatible with wholehearted caring and commitment, which is what she continues to show to me, five years down the line.

I didn’t ask her again, where she would be going on holiday. She did tell me, in a subsequent session, and I thanked her, without asking her why. I know that withholding the information was never a matter of principle, the information was never a secret. I think she told me because it felt straightforward to do so. I don’t think there was an ‘agenda’, or a particular reason. I think it probably just felt like the right thing to do at the time, and there was no good therapeutic reason for not doing it.

For both of us, therapy is hard work, and very often involves sifting and working through a great deal of non-straightforward conscious and sub-conscious ‘stuff’. But sometimes it doesn’t. Sometimes things just are. Sometimes, we just are. But to get to ‘just be’, we often have to bear with the frustration of not knowing quite how, who, and were we are at, and why. At those times we need to try and trust that even though it may be our therapist ‘doing’ the frustrating, they are not the same person as the many others who may have frustrated us in the past, for quite other reasons. They simply know that we will be more likely to gain insight into our pain and to heal, if we can stay inside our predicament and our hunger to understand our dilemma, rather than observe it from the sidelines, from the perspective of satiation.

 

*[Interestingly, when I proof-read this post I realised I’d written ‘where we should be going on holiday’, instead of ‘where she would be going on holiday’, transposing the ‘sh’ and w’ of ‘she’ and ‘would’. A Freudian slip? Perhaps it was the echo of my therapist’s light hearted comment that unlike Freud, she didn’t take her patients on holiday with her!].

**I haven’t given the details of the realisation I mentioned here, but only because it will be the subject of another post in future.


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Summer therapy break 2018 – one third of the way through

Somehow I managed to completely miss the fact that Storify disappeared in May, and along with it all my previous compilations of #therapybreak tweets! However, I’ve discovered Wakelet, an excellent alternative, and this is installment 1 of 3, of my #therapybreak tweets from my current break, which started on 18 August and will end on 24 September:

https://wakelet.com/wake/13b05313-b87e-4724-ae16-1dcdfab1b6cf

As usual, it’s been lovely sharing stories of therapy breaks on Twitter, with others who are also in the midst of their own breaks. It’s also been lovely seeing the steady presence, #therapybreak after #therapybreak, of those whose stories I do not know, but who ‘like’ tweets, whether or not they comment, and who by those actions show their support and let me know they are thinking of me.

Some aspects of therapy breaks have become a little easier  – for example, I no longer have to fight an internal battle to maintain a clear perspective on who my therapist is and on our relationship. However, life has got harder, and so despite feeling close to my therapist, I still spent much of every day of the first ten days or so of the break, fighting despair and the feeling that I did not want to be alive.

I’m glad that as has happened in the past, my #therapybreak tweets have captured the beautiful, grateful, moments that have struck me, in amongst the more difficult feelings, as in this way they function as an act of self-care, as well as a means of connection.

A couple of others are also using the hashtag #therapybreak to share their stories – it would be lovely to build up a collection of experiences in this way!