From Jon Frederickson, ISTDP Practitioner and Trainer
Where are we going in therapy? Therapists and patients both ask, “Where are we going?” In one sense, we could answer that with one word: nowhere. Why? Because defenses are always designed to take us away from reality and our feelings about it. But no matter where we go, reality shows up. Thus, defenses help us take imaginary “journeys” away from what is, this moment. But we really can’t go anywhere, since we are always here, now. And yet, as we let go of defenses, there is a sense of movement. Even the word emotion comes from the Latin e-movere, to convey the sense of something inside moving outward. We often think of therapy as moving toward an agreed upon conscious goal. And that is true on the conscious level. But a therapy that touches our depths does more. It reaches toward something unknown and unlocatable in space, the inner you. Where are we going? Toward the unknown of the patient and the unknown of the therapist. And because we do not know the unknown, we can’t know in advance where we are going. And even when we touch on the unknown in ourselves or the patient, it remains unnamable, unsayable, never to be captured by a concept or sentence. Just as music cannot be reduced to words, neither can the inner life of you and your patients. (https://istdpinstitute.com/) The universe is always speaking, they say – we just have to be open to hearing it. “The experience often is characterized by […] guests who come calling, but who swiftly retreat unless they are recognized and greeted” (Coppin & Nelson, 2017). Even in silence, it is speaking. Psyche is the Greek word for “soul”, and it has twin roots - the mysterious “butterfly” and the verb “to breathe” (Hollis, 1996). We breathe it in, that “…breath of life [which] connects us to [the] world, each time we breathe in or out, [enabling] us to be speaking beings” (Downing, 2000).
As Edward Whitmont put it: "one cannot encounter the Self through introversion only. Human fullness requires the actual meeting with a Thou” (Coppin & Nelson, 2017). In the “meeting with a Thou” – in the work of speaking, sharing, relating - of being with – the Self may be experienced, through feeling, and importantly, through all feeling, whether those feelings are desirable, tolerable, or not. The problem has always been that “to know oneself profoundly can be extremely upsetting” (Bettelheim, 1982) – because it means feeling into “the shadow part of the psyche” (Le Grice, 2016), which can mean feeling painful feelings. In this case our task is simply “…to live through them, not repress them or hurtfully project them onto others” (Hollis, 1996). It is here that talk therapy can provide us critical assistance in doing so. To “…experience some healing within ourselves, and to contribute healing to the world, we are summoned to wade through the muck from time to time” (Hollis, 1996), because only “…after the full acknowledgement of the loss […] does there really arise the possibility of turning to other as other” (Downing, 2000). As Rilke said, only one “…who doesn’t exclude any experience, even the most incomprehensible, will live the relationship with another person as something alive and will himself sound the depths of his own being” (Coppin & Nelson, 2017). Therapy can facilitate self-understanding, allowing us to connect to our deeper values, aspirations, and beliefs; it can also bring us closer to the experience of the numinosity of which we are both apart from, and a part of, and which holds us in protection wherever we go - the ocean of which our consciousness is but a drop - though, as Coppin & Nelson (2017) note, even that metaphor is inadequate since, unlike an ocean, it “…is fundamentally immeasurable and therefore impossible to quantify or fully define […it is] a wilderness that cannot be tamed.” As Camus (1965) said, “I don’t know whether this world has a meaning that transcends it. But I know that I do not know that meaning and that it is impossible for me just now to know it. What can a meaning outside my condition mean to me?” One answer might be: nothing, if that condition is restricted to the cognitive. It seems to me that true inquiry cannot “be unyoked from the complex emotional life of the body” (Coppin & Nelson, 2017); for me, the felt sense is the ‘why’ and the ‘what for’ of inquiry itself – my connection to and experience of that which lies beyond my individuality. Psyche, Self, spirit, soul: these are all interchangeable terms to me; their number indicates that what they point at is beyond intellectual comprehension - but not experience. The mind looks for explanations, but the body knows better; it simply receives what is given, and what is given to me - is feeling. It is not one but all feelings that bring such communion. As Nietzsche said, “All feeling suffers in me and is in prison: but my willing always comes to me as my liberator and bringer of joy.” This I understand as meaning: the will to feel - the will to attend to the entirety of the felt sense, no matter how painful. Suffering “is an ineradicable part of life, even as fate and death. Without suffering and death human life cannot be complete” (Frankl, 1984). It seems to me that the felt sense is the live wire through which the current of life travels, that feeling is the immanent experience of the one in all, and that thought is but a shadow cast upon the wall by that singular flame. It follows then that when the mind is not put at service of the heart, but instead learns to dominate it, that many of the difficulties that lead us to seek therapy result. Bettelheim, B. (1982). Freud and Man’s Soul. Vintage Books, Random House, NY. Camus, A. (1965). The Myth of Sisyphus, and Other Essays. H. Hamilton, London. Coppin, J. & Nelson, E. (2017). The Art of Inquiry: A Depth-Psychological Perspective. Spring Publications; Thompson, CT. Downing, C. (2000). Sigmund Freud’s Mythology of Soul; the Body as Dwelling Place of Soul. In: Slattery, D. P. & Corbet, L. (2004). Depth Psychology: Meditations in the Field. Daimon Verlag, Einsiedeln, Switzerland. Frankl, V. E. (1984). Man's Search for Meaning: An Introduction to Logotherapy. Simon & Schuster, NY. Hollis, J. (1995). Tracking the Gods: the Place of Myth in Modern Life. Inner City Books, Toronto, ON. Hollis, J. (1996). Swamplands of the Soul: New Life in Dismal Places. Inner City Books, Toronto, ON. Le Grice, K. (2016). Archetypal Reflections: Insights and Ideas from Jungian Psychology. Muswell Hill Press; London/NY. Nietzsche, F. W. (Translation by Hollingdale, R J., 1977). Thus Spoke Zarathustra: A Book for Everyone and No One. Penguin Books, Harmondsworth, England. What does it mean to ‘work with the unconscious’? For me, working with the unconscious in therapy means noticing what is not being attended to but is still manifest, in the room, in the relationship, in the client’s behaviour, in their body - in my own behaviour, and in my own body too. A starting point for doing so is will, or perhaps, openness - to that which is greater than myself and the client, that which holds us both and silently guides us in our work together.
The biggest difference between Freud’s psychoanalytic approach and the modern one can perhaps be generalized as the difference between good science and bad. In bad science the scientist observes the object but never actually accounts for themselves as a variable in the equation. Good science, though, does, and modern psychodynamic therapies do this by pivoting from Freud’s one-directional method of practice - with the therapist as an all-knowing observer, and the client as object of observation - to an awareness of the importance of the therapeutic alliance, where the presence of both people is an equally meaningful part of the process, and the mechanism of change is ultimately found in the relationship between the two.
Freud’s one-directional approach to practice can perhaps be said to reflect the hierarchical, patriarchal model of thought that continues to dominate today - the one-up and one-down - whereas we can but hope that the focus on the therapeutic relationship is indicative of a differently structured future. That’s the direction psychoanalysis seems to me to have taken – a strong therapeutic alliance is widely accepted as being a critical mechanism of action in the psychotherapy, and so much can be learned from our unconscious reactions to being an active participant in one. In therapy there sometimes comes what is called a moment of rupture - a moment in the therapeutic relationship where the connection is threatened, or even damaged. Such challenging moments are quite possibly inevitable, given that out in the world of daily life they occur, relationally, all the time. Our job as a therapist and client dyad, working together, is to be as open and attentive to these moments as we can, because they provide significant opportunities for growth. Such moments can leave us both with no choice but to fall back again on our own resources, and (hopefully) from there to return to one another - having been reconfigured by our individual understanding of what happened, and what it meant, and from this emergent way of being and understanding - rather than backing out - to continue inching forward, toward each other, and ultimately, toward our own selves.
Something good can come from difficult moments; it can almost seem at times as if the unconscious of both therapist and client have colluded to create such an opportunity. If consciousness is a stream, and behaviour and conscious awareness of its determinants are what we see at the surface of the water, well, then - the deep flows just as incessantly. Many clients come to therapists wanting guidance, and tools – ultimately wanting someone to tell them what to do, and how to do it. While I can fully sympathise with this wish, I also can’t help but think this stance arises out of painful experience – that it is a learned response, a reaction in which people shut down their own valid emotional reactions, have an external locus of value and of judgement, lose all sense of their own agency and ultimately lose the knowledge that everything they need is already inside them.
The issue of “wanting tools” is often a barrier to the work a client is there to do. “Wanting tools” often means wanting a shortcut, a way of bypassing the unconscious obstacles between a person and the life they want to live – such as unconscious anxiety, or unconscious, attachment-related behaviours. As a practitioner dealing with this wish requires stepping out of the shoes of an omnipotent, all-knowing expert, and focusing instead on the collaborative effort, the shared effort where the client and I put all our skills together, put our hearts and minds together to try to achieve something good for them. It requires being honest and transparent about the limits of my powers – that I cannot know for sure what the client needs, that I may have some ideas about what might be good for them, but that ultimately only they can know. This means accepting their reactions in response to this, encouraging them to fully embody the feelings that then arise in response to me, and ultimately leaving the space of knowing what they need free for them to step into and claim once again. Transference is perhaps not a widely known term. It can be thought of as when a pattern of interacting with an early attachment figure becomes a blueprint for later relationships. Nat Kuhn, in "Intensive Short Term Dynamic Psychotherapy: A Reference" (2014), describes transference as the tendency to "bring aspects of problematic relationships with early attachment figures into therapy". For example, a client with a highly critical mother may tend to feel that the practitioner is being critical towards them and become hostile in response. Working in the transference, which is a key mechanism of change in psychodynamic work, involves focusing on these feelings towards the practitioner, perhaps in the hope of clarifying their origin and thus allowing the client to work through this unresolved emotional content in the context of a secure attachment. It can be differentiated from projection in that it isn't necessarily something you are disowning from within yourself and then projecting onto another, but more the echo of a learned pattern of interacting. There is overlap between the two - there can perhaps be projection in transference, for example. But what is important here is the willingness and the ability to discern between old feelings about past, painful experiences, and new feelings about present experiences. Without this discernment our reactions in the present will never be just our reactions to the present, but instead be forever clouded by echoes from the past.
My understanding is that this often-confused process involves the outward projection of feelings coming up in me (but which I deny myself the experience of) onto another person. I might be denying myself the experience of these feelings perhaps because I learned that to experience them was intolerable (I never learned to self-soothe and thus regulate these feelings), or that to experience them was unacceptable (a caregiver perhaps never learned to self soothe or regulate themselves in response to me having these feelings when I was a child) – and so now, when this intolerable or unacceptable feeling comes up in me, it causes unconscious anxiety, leading me to the unconscious defensive manoeuvre of projection; instead of feeling my feeling, I believe the person in front of me is feeling it, not me - I "project" it onto them, I believe they are the ones feeling it, and then I behave accordingly in response to my belief about what the other person is feeling. The point here is that I am not interacting with reality, but instead with my belief about reality, and that this whole unconscious manoeuvre is occurring to enable me to not have to feel my own feeling – a feeling experience has taught me to deny myself.
There is an important distinction to be made between feeling something and acting upon it. You can inadvertently communicate so much through your face and your presence when you are just feeling something, but the words you choose to say involve a conscious choice, a path of action. How do you stop the words you say from being a reaction to what you’re feeling, rather than an expression of it? How do you make sure you are being fully congruent and genuine, and not just reacting to the discomfort your feelings or thoughts create inside you? Through integration, I think; through maintaining a connection between your heart and your head, your attachment and your detachment, being clear on what is yours and what is not yours, and ultimately, by ‘doing your work’.
The self-awareness that you will foster by ‘doing your work’ can create enough space inside you to allow you to attend to what is really going on for you before you interact with the world - can allow you to really recognize what your genuine feelings are in response to the events in your life and not just discharge the anxiety you feel because of them. By ‘doing your work’ in this way – by getting closer to who you are and what you really feel – you can begin to step out of the collusion in unreality which we all, it seems, engage in as part of the social contract: the unspoken agreement to all be living inside our own heads and forever interacting primarily with only our own ideas and beliefs about the people around us, instead of being real and authentic with one another. There are legitimate concerns about the medical model and the capitalist logics that have bled into and shaped this area of work over the last century - and the othering potentialities therein. The counselling and psychotherapy industry can, as a result of its inescapable rooting in the capitalist structure of society at large, tend to focus on symptom reduction as a goal rather than exploring causes, with an aim to just get you functioning again – to get you back to work, essentially. And this is why I love psychodynamic work - because it makes space for the question why are these symptoms occurring - what is making them occur?
You can hack away at weeds with all the energy you are able to muster, but unless you get to the roots they will be sure to grow back, time and again, and without getting at those roots you risk being left dealing with the problems they represent for a lifetime. When I first arrived in this country I realized I had become complicit, just by virtue of my being here, in the ongoing genocide of the First Nations people that belong to this land. One of the reasons for my becoming a therapist was to make some kind of sense of my being here, on this land: the intention was, from the beginning, to ensure a significant percentage of my work is with the people who belong to this land – here in Vancouver, this primarily means the people of the Squamish, Musqueam, and Tsleil-Waututh First Nations.
Both sets of my grandparents were born colonized subjects, and I know all too well the internalizations that result; how heavy sits the Crown. I have to work in opposition to that; it’s the only thing that makes sense to me, to work with these and other marginalized populations and facilitate the undoing of the internalization of external forms of oppression, the undoing of all the frozen moments of trauma that creep into the body and contort it. Sadly, many of the systems in place that provide support to Indigenous folks also function under the oversight of the same enterprise that has its boot on their necks. Coping with the consequent feeling of incongruence this creates in me means keeping my eyes, ears and heart open in order to learn how this enterprise operates - so that I can make better decisions about how to be of service to this demographic and thus be a useful part of the healing journey being undertaken by the communities here. My personal history is the reason I became a therapist. My earliest experiences led to damaging internalizations which therapy was able to allow me to understand and to begin to heal from, and this same facilitation of healing is what I aim to bring to others. This impacts the way I approach therapy; I operate from a psychodynamic lens - the way of working which provided the best framework for understanding my own self. I bring the strength of my own experience as a client to my work - I have moved through that process all the way to the experience of love for myself, inside my own body. It was both a life-changing moment to feel this feeling, and one filled with grief - to realize that in all the years before that moment, I had not. I believe this is of critical importance for a therapist - to have been on the path too, in your own way, in order to be able to gently encourage others to traverse the path that lies before them.
|
Thoughts on Counselling, Therapy, and Mental HealthArchives
August 2024
Categories
All
|