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My New Therapist

Jade is 19 and is training to be a Therapist. She had previously written a piece before for this site entitled “My Therapeutic Introduction” which expressed her unease about seeing a therapist for the first time, with whom she felt uneasy and uncomfortable with. Here is Jade’s second account of Psychotherapy with her new therapist.

By Jade

Beginning therapy is a tricky business, walking to that front door, knocking discreetly, looking to see if anyone can see where you are going too. All part of the journey I suppose. I had no idea what would be in store for me until the door closed, I sat down and the therapeutic relationship started to form.

After leaving the therapy room I felt like an ant being put onto an atlas globe. So vulnerable and weak against the world, so much space to explore. I felt like I had been opened up to things that I had kept hidden for so long. I felt like I could explore myself and the world and not feel threatened, it was such a strange but surreal feeling. How this one therapist, after one session, can make me think and feel for so long without me cracking (until I got out of course). I felt like I wanted to go back in there and re-live the whole thing over again. Not that it’s nice feeling the pain and upset and the happiness, but having the opportunity to feel something, to see it as what it is, then that is beautiful. It’s like an addiction to chocolate or prescription drugs; you want more of what you think will make you feel better.

I had on and off feelings about it as I was driving home, maybe it was to much to feel all of this after just entering therapy, maybe im not stable or ready enough, but by hell this lady threw it at me. I had gone back and re-lived some of my childhood that I had forgotten, some deep and dark feelings that now I would much rather forget, but I felt and explored them safely with my therapist. Death had a big part to play in my first session, I spoke about my mum having secondary cancer and she came right out and said “is she going to die”?

I sat back in my chair, looked at the floor and felt like I had been punched in my stomach repeatedly. That’s the first time anyone has asked me that question and it was really the first time I had even thought about the fact that I could loose my mum to cancer.

Im very excited that I have 39 more sessions with her. Imagine what i’ll be feeling after 40, obviously I know their will be some rocky paths ahead of me, but I like this feeling of (feeling), expressing, smiling. I wonder what this year is going to have in store for me, I hope it is many good things that I can share with other people – sharing feels awesome.

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Leaving Therapy

By Will

I will always remember these words from my first therapist “You begin to live when you leave therapy.” I like to think that you can also live when you are in analysis as well, but if you are like me, you may carry your therapist around in your pocket some of the time. So how does that enable you to be free? Having this little thinking and reflecting ‘action man’ with you at all times can be both comforting and irritating. If you have experienced some extremely emotional situations with your therapist, and you have felt comforted by him, you may tend to elevate your analyst to a God like status as they become the Master, the Knower or the Buddha. This can put you in a juxtaposition and in day to day situations you may be influenced by your therapist, and you may judge many of your actions and thoughts with him in mind.

The thought of leaving therapy can be daunting. What will happen to me when I leave? Will I be able to cope? Is our work really finished or is my ego forcing me to end the relationship? Is my therapist trapping me? You may be reluctant to leave therapy as you do not want to hurt your therapists feelings. These are vital issues that require working through and together you both may reach a better understanding. It is almost impossible for both Therapist and Patient to collectively feel that therapy is over simultaneously, so one person as in all relationships, may feel at a loss. When we leave therapy knowing we have not addressed all our problems we may be mindful that we will always have problems and issues to solve as this is part of being human. We can cling to all sorts of illusions and justifications in regards to ending the theraputic relationship but I guess the obvious reason for leaving therapy is that you want to.

We may sometimes loose sight of the fact that therapy is self-centered and your therapy is about what is good for you. After all, your therapist has worked on themselves and should be able to digest the loss and work through it alone or with supervision.

“Intimate knowledge creates vulnerability. Where intimate knowledge is asymmetrical, vulnerability is also. Whoever is known most about is usually the vulnerable one, for multiple reasons. In psychotherapy, this vulnerable one is the client.”

*Quote by ~ http://sleightmind.wordpress.com

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Beyond Words

By Will

Silence is golden in the therapy chair that I have now moved back to. Far beyond the realms of any text book spouting analysis and theory, we sit in silence, engulfed by the nothingness of being. If pins did drop you would certainly be able to hear them dropping like fine rain in this open space. How can I explain how many times lately I have felt the ordinary things so deeply and shed tears “the silent language of grief.” How can I explain the moments of mindfulness having stared at a daisy like I have never seen one before, in awe of it’s transient beauty, the back of the flower just as beautiful as the front. The little moments, the little things, are not little. They are everything.

This is not therapy, this is far more than that word. It is a soulful fire and water life, shared with another human being, cloaked in 21st century attire. It is a meeting of tragedy, realisation, joyfulness and nothingness, and just like the weather, it is everything and nothing at the same time. Whatever it is, my physical body turns up to it twice a week, and often walks out from it swaying with dizziness. My Dad, my Son and my best friend are all losses and painful gains at the same time. The paradox and tragedy of death and life so much alive under the same fine umbrella that we collectively hold.

Things are not what they appear to be: nor are they otherwise ~ Surangama Sutra

Inspired by: Karin L Burke.

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The Depth of Wounds Vary

By Will

“I think his symptoms are likely to be stress related. He has no typical symptoms of colon cancer, though of course, colon cancer often has no typical symptoms.”

As I sit and read this letter, from a digestive specialist to my doctor, I am once again struck by the severity of the power of thought and matters of the heart. Was my body able to produce the same symptoms as my Father who died from this cancer nearly 2 years ago. Can stress really do that?

Unresolved issues bubble underneath unnoticed, often for decades like a volcano, until one day when they finally erupt. What also struck me is the term “typical symptoms” as with the mind and the body we are all so different. According to Freud’s early theory, “painful memories and feelings were repressed by the unconscious and found expression in patients physical symptoms.” Although I have suffered panic attacks and depression in the past, my current physical symptoms seem more physical than mental. These intense emotions and feelings that were repressed may have something to do with my movement around my analysts room, from one ‘place’ or ‘space,’ to another. It is as if I am unable to stay in one place or rather unable to stay with the pain and the wounds for too long so I have to move around.

My therapist was speaking today about Masud Khan who had  fifteen-years of analysis with Winnicott and mentioned the phrase “A hard nut to crack” and that “All nuts can be cracked eventually” and I immediately thought that he was refering to me and our 3 1/2 years of analysis. Whether this was actually intentional or a Freudian slip or even transference from my therapists own analysis, it did not matter. I knew my own interpretation very well which is a belief that I should have worked things out by now, that I should be sorted and more aware of my unconscious drives and desires. It, whatever that is, takes as long as it takes.

Robert S. Boynton wrote “Is the aim of psychoanalysis to “cure” or merely to comfort? Should analysts maintain a clinical, professional distance and respect the “boundaries” between themselves and their patients (as classical analysis insists upon)? Or should they strive for a so-called “real relationship,” eroding the boundaries in order to heal the patient?” I liken this to the earlier phrase “typical symptoms” as I believe that in Psychotherapy there aren’t any, it depends on a multitude of complex factors but mainly on what suits the patient and therapist. For me, the relationship is paramount, for others a more clinical relationship may be what is required. I am unsure if I will ever be “cured” but I am sure of my need for some more of that beautiful connectedness and truthfulness that penetrates deep inside, as these wounds are deeper than I thought.

My sense of identity broke down and was replaced by something that is very hard to put into words ~ Eckhart Tolle

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Musical Chairs

By Will

My current course of therapy began with my therapist and I sitting facing one another. Man to man discussions involving facial expression, eye contact and movement. After a year like this I finally plucked up courage and we began to discuss the couch, which sat far away in another corner of the room. I wondered who lay on there, I wondered what would happen if I lay on there. The couch was discussed for quite sometime and eventually it seemed to take on gargantic and magical proportions. The day came when out of the blue I stood up from my chair and lay myself down. The resistance was startling. I could not see my therapist anymore and I felt isolated, watched and extremely uncomfortable. After a few weeks, lying on the couch became second nature, and I could not imagine sitting back on the chair again. Our therapy changed at that point and I was no longer as conscious of what I said or how I said it. Unfettered speech flowed and I became surprised how open I was without eye contact.

For two years our seating arrangements remained like this, until recently, when I began to feel a compulsion to sit on the floor. It felt a little crazy but I had to bring this up and for a few weeks we would discuss the possible meanings of my desire to get down on the floor. Again, one day out of the blue, I made the leap and there I was sitting cross legged in front of my therapist on the floor. This only lasted a few sessions, as it was quite uncomfortable. The next time I entered the room I took another seat next to the desk opposite my therapist. We looked at each other and we both beamed naively. Neither of us knew what was going on with all this movement, but it just seemed right.

Once again our relationship changed. We started to laugh more together and we stayed away from theory and debate. We talked about politics and art and a whole rainbow of things, and although our professional relationship remained, a new friendship seemed to begin to flourish. I started to feel a new sense of equality with him and for the first time we talked about the possibility of separation and what that meant. Later on we realised that my movement around the room mirrored the internal movements and shifts that were taking place within me. Each view point around the room gave me an alternative perspective, a new way of seeing things. It also highlighted the need to escape the pain of uncomfortable feelings and emotions. Rather than staying with these feelings I needed to move away and escape from them like a fight or flight reaction.

Often the hands will solve a mystery that the intellect has struggled with in vain ~ Carl G. Jung

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An Interview with Peter Wilkin

An Interview with retired Psychotherapist Peter Wilkin.

During this interview, I have attributed my own gender to the ‘therapist’ & the female gender to the ‘patient’, purely & simply to try & reduce any possible confusion. I have also used the term, ‘patient’, to refer to the person in therapy, though neither this label nor any of the other common alternatives have ever sat that comfortably with me. However, ‘s/he who has come to explore & make sense of his/her difficulties’ is just a tad too cumbersome to repeat throughout an interview.

I once said, “I sense that Peter is one who has been fully analysed, and is therefore able to analyse others” A while after writing this I came to the conclusion that it is not possible to be ‘fully analysed’ or ‘fully enlightened’. What are your thoughts on this?

I agree entirely. I did enter into therapy before I began my psychotherapy training, purely to comply with the course requirements. Although I did not feel to have any huge issues that needed addressing I was aware of several recurring problems that I intended to share & work on with my therapist. You probably won’t be surprised to learn that those problems went a lot deeper than I had anticipated. My therapist, who worked psychodynamically, was a very astute man who always knew if I was avoiding facing up to difficult feelings and, although he was gentle enough, I knew there were no real hiding places.

Once the course of therapy had finished (2 years) I felt the benefit both as a practitioner and in general. However, I still experience difficulties in certain areas of my life, just like we all do – but if I were to enter therapy for the rest of my years I would never come anywhere near being ‘fully analysed’. Nor would I want to. There are certain little foibles and defence mechanisms that I would prefer to hold onto.

Do you believe that in order for a therapist to help someone, the therapist has to be ‘helped’ during the process too?

Yes I do. I strongly believe that to practice as a therapist without receiving regular supervision from an experienced and qualified supervisor is both irresponsible and potentially dangerous. All therapists are susceptible to reacting back to their patients’ *transference reactions (*transference in psychotherapy is an unconscious process where the attitudes, feelings, and desires of our very early significant relationships get transferred onto the therapist) and it is vital that there is someone whom they can trust who is capable of identifying and interpreting such reactions. As therapists, we all carry our own agendas & we are all susceptible to projecting them onto our patients. Additionally, we are also prone to accepting & carrying our patients’ projections. Supervision provides a safe and confidential space where the therapist can sit and analyse his work whilst also feeling supported.

How did you deal with frustration, in regards to the time spent with a client, where the client was unable or reluctant to change. Do you feel that your frustration should be voiced during the session, or does this depend on the person?

That’s a really good question. I think I learned to deal with such frustrations much better as the years rolled by. In a way, this question links to the previous one. In reality, there is no logical reason to feel frustrated if it is our patient who is resistive or reluctant to change. But, of course, we still do – which can result in us either feeling angry with our patients or, alternatively, over-sympathetic & desperate to ‘make things better’ for them.  All such feelings are fine if we remember to sit & work out where they are coming from – but we do not always do that. Instead, we fail to separate our own issues from our patients and become embroiled in a messy and unproductive relationship with them.

A good example is the patient who has brought an issue of loss to therapy but who seems to be avoiding and sabotaging all attempts by the therapist to help her develop insight and move on. The therapist begins to feel frustrated and begins to lose patience with the patient. Having taken the issue to supervision, the supervisor discovers that this therapist suffered a broken relationship that he had never recovered from. He had never managed to accept the break-up & still grieved for the loss of his partner. Consequently, he had been projecting his own frustrations at not being able to work through his grief onto his patient.

As for voicing such frustration during the session – yes, I think that’s fine … but, of course, there is a particular way of doing it. The rule of thumb is that any such frustrations should be aired in a way which is likely to help the patient develop insight. The other rule, just as important, is always be tentative – in other words, always give the patient a ‘way out’ if they are not ready or unwilling to accept your hypothesis.

For example, the therapist might say: ‘I’m very aware that, whilst you were explaining to me about your partner’s reluctance to talk about his illness, I began to feel my stomach tightening … I can actually feel a huge knot of tension in it … right here *points to his stomach & taps it with his fist* … you know, I could be entirely wrong about this, but … I wonder if I’m feeling some of the frustration that you felt when your partner refused to let you in … you being unable to tell him how that made you feel?”

If the patient is ready to hear the tentative interpretation, a response might be: “I desperately wanted to let him know how frightened I was about losing him … but he just didn’t want to hear. I used to feel so angry with him (begins to cry) … & so wound up that I couldn’t eat.’

What are your thoughts on individual and creative therapy, which may be quite unorthodox, in terms of extending the 50 minute hour or adults taking part in play therapy or even switching seats with the therapist?

Ah! Well, if the therapist is practised in such ‘alternative’ techniques (e.g. in Gestalt therapy) & the patient has been fully briefed about the mode of therapy, then I am all for it. I used to employ similar strategies myself when working with families. I remember a specific session of ‘couples’ therapy when I asked one person to turn her chair round & direct all her answers to the wall. She was baffled at first, until she realised that this was how it felt for her partner when he tried to talk to her, as she never seemed willing to listen to him.

So such creative switches in therapy can work well, although I’m not sure about extending sessions beyond the agreed ‘hour’. For me (working within a very structured timetable) it would have caused problems & inconvenienced people with later appointments. And I believe an hour is ample time at one sitting to address the issues that need to be discussed. Giving a time boundary helps to contain a session by informing the patient that she has a specific amount of time to go wherever she needs to go. If the patient is inclined to wait until the last few minutes before ‘dropping a bombshell’ then this needs to be addressed by the therapist, as it most likely represents a ‘boundary’ problem that needs working on in therapy.

Do you feel it is necessary to share your personal experiences with the client, or again do you feel that this would depend on the person?

Generally speaking, no. I believe the more a patient knows about her therapist, the more that information is likely to pollute the therapy process. To illustrate, if I were to disclose a particular faith or religion, that might prevent the patient from sharing a negative feeling towards that faith or religion. Or if I was to highlight a particular personal difficulty (an illness, a relative’s struggle, an anxiety), that might generate concern & worry for the patient. I know that some person-centred counsellors do share certain personal experiences as a way of empathising but, for me, I think it is inappropriate to do so. There are surely better ways of demonstrating empathy as opposed to revealing personal details.

How important were your initial instincts on first meeting with a client?

Extremely important for two reasons:

Firstly, I trust my instincts. Almost thirty years of clinical practice has honed them to a point where they are pretty sharp at forming an accurate profile of a person.

Secondly, they are a wonderful source of counter-transference for me to explore, either on my own or with my supervisor. Instincts always surface from the unconscious and, on occasions, I will be unwittingly projecting my own beliefs onto the patient. If the therapist is able to identify these counter-transference reactions it can provide him with a rich source of information about himself and his patient.

For example, I may feel inexplicably cool towards a patient in the first assessment session. The reason might be a very simple one, in that she reminds me of someone I know – & if that’s the case I will surely work that out quickly. But at the other end of the spectrum there may be no discernible reason why I should harbour such a negative feeling. So, I would have to explore my instinctual feelings until an explanation surfaced.

A possible explanation might go something like this: the patient lost her mother when she was only a child. She had no father figure to turn to & this caused a multitude of problems for her. Throughout her adult life she has had a string of very brief relationships & only one longer relationship that lasted just over two years. Whilst she insists that she yearns to be in a loving & caring relationship she is also frightened of ‘losing’ any figure that she may get close to. Consequently, she unconsciously projects a rather austere persona that is inclined (& unconsciously designed) to deter people from trying to get close to her.

During therapy, how important are the unconscious or the darker sides of the Psyche. For example, with my analyst, we have adopted a name for the part of me that seeks drama, darkness etc?

What a wonderful question! Very important, I would say. According to Jung the Shadow is an archetype that reflects deeper elements of our psyche. It is, by its name, dark, shadowy, unknown and potentially troubling. It tends not to obey rules, and in doing so may discover new lands or plunge things into chaos and battle. It has a sense of the exotic and can be disturbingly fascinating.

We may see the shadow in others and, if we dare, know it in ourselves. Mostly, however, we deny it in ourselves and project it onto others.

In therapy, if we face up to our shadow side it can help to vitalize our lives. Those fears & anxieties that we suppressed many years ago, when confronted & understood, can lead us to places that we would, otherwise, never have discovered. The negative messages we receive in childhood all contribute towards constructing our shadow sides. If a person is told that they are stupid, or clumsy, or even unlovable, those messages live on in the dark side of the psyche. Shining a light on them is usually perceived as a fearful & risky thing to do. However, exposing them to the light in therapy provides an opportunity to see them for what they really are (hurtful and inappropriate comments) whilst, also, unwrapping potential that, otherwise, would have laid dormant.

For those who would like to learn more about their shadow, there is an excellent article by Denise Linn entitled: ‘Facing your Shadow

Have you ever given a client advice?

Within a contracted course of therapy, never (as far as I can recall). For me, doing so goes against the whole ethic of offering the patient ‘cues’ (in the form of interpretations & hypotheses) so that she may find her own way through her difficulties. Offering solutions by way of advice disempowers the patient by taking away her potential for finding her own answers.

Of course, if the patient asked me: ‘Is there a train station nearby if I’m ever unable to travel by car?’ then I would answer their question. But suggesting various coping strategies runs against the grain of psychodynamic therapy & may even imply that you have no faith or trust in the patient to find her own way out of her difficulties.

Many thanks for giving me the opportunity to address such thought-provoking questions, Will. Having been retired for several years I had to put my thinking cap back on in order to provide what I hope will be satisfactory answers.

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Down Time

By Will

Today is one of those days where I find myself leaning heavily on the phrase ‘This too shall pass’. In fact, I have relied on that phrase ever since my last therapy session 4 days ago. The clouds above seem real low. I guess what is difficult at times like this is bearing with the nothingness and the lack of meaning. I know my last therapy session was emotional. I had to sit up on the couch with my therapist in view, which I only do when I am struggling. The crazy thing is that I can’t remember what we touched on and discussed, or rather, I have probably suppressed it. I keep thinking about a child sulking but I am unaware of the sulks reason.

It is also one of those days where I have gone to call my therapist for reassurance and then decided against it. I feel that I need reflection. Someone to tell me that I am going through the ‘X’ phase which is because of ‘Z’. Do I pick myself up and do something and rise above the grim feelings, or let them be and embrace them fully so that real healing can take place. My worry is that prolonged depression can intensify and gather moss, I need a break from this dark limbo land. My head is awash with theory. Look after yourself I hear myself whisper.

This is sadly one of those times where no manual, no self help book and no positive quote has effect. Fragments of me are being blown around by the wind. I inhale one cigarette after another and exhale each fag with a deep sigh. I think about what I do have and try to be grateful. I think about my losses and try to have empathy for myself. I think about time and how a moment can seem like a lifetime and a lifetime can seem like a moment. Maybe this is a time not to think and a  time to breathe. I think about whether to publish this post or not. However, if the premise of my site is about ‘experiences on the couch’ then this is one of those experiences that I am willing to share.

Every little thing counts in a crisis ~ Jawaharlal Nehru

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