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The power in therapy of ‘talking to yourself’

One of the revelations that many who enter therapy experience is that the process becomes not just talking to the therapist but also, in a deeper, way talking to themself.

This was highlighted recently by artist and cultural commentator Grayson Perry, in the BBC Radio Four programme Start the Week. (see link at bottom of this post).                                                                                                                                  

Grayson Perry

Perry, who went into therapy in his late thirties because of anger issues that were threatening his close relationships, says that up until then he was suspicious of therapy: “I used to take the mickey out of it and I found it a little bit irritating but then gradually I met a lot of my wife’s therapist friends and thought ‘these people are really nice to talk to’.”

Once he began the process, he says, he found the sessions cathartic: In a way you’re doing therapy on yourself. I used to say I’m going to therapy now to talk to myself.”

This made me think about how part of the power of therapy is not getting the observations or thoughts of the therapist, but actually hearing yourself speak out loud the thoughts that have been rattling around your head in an often unformed way.

Clients often say to me: “Having this space once a week, where I can speak all this out loud, makes things seem clearer in my mind and I get to see more of what’s really going on.”

But while therapy may be, in some ways, a conversation the client is having with themselves, I strongly believe that this also depends on the presence of the therapist. It is the fact that there is another human being, who is interested in your experience and who is listening, that helps create the conditions for the client to really open up.

And when we have the space to open up we are often able to see patterns of behaviour in our lives and may ask ourselves, ‘Why did I make that choice?’

Through the relationship with the therapist the client is able to gradually deepen his relationship with himself. He learns that his feelings are important, that there are often deeper emotions he may not be in touch with and that much of his behaviour is underpinned by unconscious patterns.

Start the Week, BBC Radio 4

 

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Couples

Why detaching from conflict can kill a relationship

Many people believe that fighting is bad in a relationship and of course that’s true if the arguing is toxic and non productive. However, for a couple therapist the worst indicator for the relationship is  when one of the partners seems to have given up.

This partner may have got to the stage where everything seems to hopeless that they detach from the relationship – they no longer even care enough to get angry.

This roughly equates to what couple therapist and researcher John Gottman describes as stonewalling and he argues it’s the most damaging pattern in a relationship.

It is when one partner withdraws from interaction with the other, as he or she is feeling overwhelmed or hopeless. When there is a problem in the relationship the woman will sometimes insist on long talks late into the night to try and resolve it but this can leave the man feeling drained. If he withdraws emotionally in this situation, his partner can then feel she is not being valued and she in turn begins to withdraw.

I’ve seen this pattern often in couple therapy, especially if there has been a betrayal by the man and his partner wants to go over the details again and again. She has a need to try and understand as much as possible about what happened but he feels interrogated and is afraid of not remembering something important and getting into worse trouble.

According to Gottman’s research men are much more likely to stonewall than women. They may try to avoid arguments, perhaps because they don’t believe the arguing is helping, but the net result can be that the woman begins to detach and this can be a major indicator that the relationship is dying.

When one partner is angry about something in the relationship it shows that that person at least cares, even if it is uncomfortable for both partners. When one partner emotionally checks out it is far more damaging because it suggests that they have given up believing that things can change.

Part of the answer to this conundrum is not to remove conflict from the relationship – as if that were possible – but to learn how to handle conflict differently.

Couple therapy can help the partners learn ways of expressing their thoughts and feelings in a way that the other person can truly understand. It can help the couple express underlying feelings, such as vulnerability or grief, rather than sticking to anger and judgment. Allowing in these unacknowledged emotions can shift the dynamic. 

Couples can also be helped to understand whether there is anything in the current situation that echoes what may have happened in their childhood. Frequently, we unconsciously bring unresolved issues from the past to our adult relationships and untangling this knot can help lessen the emotional temperature.

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John Bradshaw – championing your inner child

This is a great talk by psychologist John Bradshaw about the inner child, in which Bradshaw talks about the importance of “championing” that part of ourselves. This idea is developed in his book Homecoming, published in 1990.

Bradshaw, who died in 2016, was from Texas and has the style of a Southern preacher in his public talks.

In this talk Bradshaw talks about the importance of doing what he calls, the “original pain” work in order to move on from the the pain of the past. In other words, we need to grieve it.  By grieving our past pain we can begin to reconnect with the inner child and then to champion it and parent it.

Part of this process of personal growth, says Bradshaw, is often finding a support group. For him it was a 12-step group. This group is almost an alternative family but it needs to be a non-shaming place.

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Developing a healthy ‘internal leader’

My way of working with clients involves seeing them (and myself) as made up of different parts. While we may think that we are unified, coherent personalities, when we pay attention to what is going on inside us we often discover a collection of many different parts, or sub-personalities.

These may include a part of us that criticises or judges us (the inner critic), a vulnerable yes often playful part (the inner child), a part that tries to win approval from others (the pleaser), a part that can feel defeated or powerless (the victim) and many others.  These sub-personalities are connected to the idea of archetypes (universal patterns of behaviour and being) developed by psychologist Carl Jung.

But what kind of internal leader do we have who is in charge of these different parts?

According to therapist Stacey Millichamp, in her book Transpersonal Dynamics, our personalities can be compared to political regimes. We may have an internal ‘dictator’ who orders the rest of the psyche to behave in a certain way.  These kind of clients tend to be very controlled, even uptight. 

Milliband says: “Honesty is suppressed and freedom from the regime must be found through covert, secretive means…[there is a] fear of punishment, disallowing spontaneity and creativity.”

Such clients can be hard to work with because they often keep secrets, fearing that if they are honest in therapy it will be used against them in some way.

A different client may have a fragmented psychological regime in which there is a lack of internal leadership that can create a frightening and chaotic internal world for the person.

Part of the therapist’s role is helping such clients develop a strong internal leader who speaks to them in a firm but compassionate way. Such a leader can allow the difference parts of ourselves to be expressed in an appropriate way.

The internal leader is a bit like having an ally who we can rely on, who is on our side but who will also tell us the truth about ourselves. 

So, how do we develop such an internal leader or ally?

According to Milliachamp, there are several ways:

  • think about a historical or present day leader who inspires you and describe in detail what you admire about that person
  • develop self-talk that is evidence based and encourages getting reality checks about situation’s in your life.  This is because often we have fantasy scenarios in our heads that are based on negative ways of seeing the world and our place in it.
  • spend time with people who embody the leadership qualities you are seeking. This may be in person but could also include attending workshops or reading books. 

The client may also look to their therapist to model positive psychological leadership and I have had clients who have said things like, ‘When I found myself in that situation I heard your voice in my head and that helped me decide what to do.”

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Is there a hierarchy of grief?

I recently attended a talk given by Julia Samuel, a grief psychotherapist and author of Grief Works, Stories of Life, Death and Surviving.

Julia Samuel

She talked about a ‘hierarchy of grief’, in which certain kinds of loss are deemed to be worse than others. For example, when someone dies we mostly assume that those most affected will be the person’s close family – especially spouse and children.

But this can sometimes end up with others who were very close to the deceased not feeling they have the right to feel bereaved or to grieve.

 For example, Samuel worked with the brother of a young man who died suddenly. In that family the mother claimed that she was the person most affected by the death. The brother, who had a very close bond with the deceased, took it as his role to support his mother in her grief and downplayed his own feelings.

Even worse, in that particular family, was the that surviving brother was expected to step up and take a more active role in the family business, following the death, which made it even more difficult for him to allow himself to grieve.

That is why siblings are sometimes known as the ‘hidden mourners’, says Samuel. 

She added that sometimes we can try to get over grief too quickly and that this can cause its own problems. She worked with a woman, who had received the message from her mother that it was important to ‘forget’ and ‘move on’ from major losses. So, when her mother died this woman tried to do just that. 

After being encouraged to bring in something of her mother’s to the counselling session, she brought a scarf. Holding the scarf close to her, she became very emotional as it still smelt of her mother. Her body’s reaction put her in touch with all the grieving feelings she had repressed because she’d thought she ‘should’ be over them.

Counselling can help people who find themselves in a stuck place when dealing with grief, she argues, because when you are on  your own, or even in a couple, you find yourself circulating the same old thoughts ‘like a washing machine’. Having a third person present can bring in new ideas and help introduce new strategies.

Samuel points out that , as a society, we still don’t talk much about death. This is despite the growing media coverage of celebrities, such as Gary Barlow or ex-footballer Rio Ferdinand, who have experienced the unexpected death of a close family member.

In a kind of magical thinking we seem to believe, she says, that if we talk about death we will somehow hasten its arrival for ourselves or someone else. “We think that if we deny it, it won’t happen. But then when it does happen it is much worse [for having been denied].”

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Discussion Individuals Uncategorized

When staying positive can become a negative

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We live in a ‘think positive’ world, in which people are encouraged to hide or deny their vulnerability.

But this can come at a cost, as shown in research published this week by the charity Macmillan Cancer Support*. The research showed that this ‘think positive’ attitude among people with cancer, espcially those with a terminal diagnosis, was preventing honest conversations about end-of-life care.

More than a quarter of people surveyed said they found it hard to talk honestly about their feelings around cancer and a similar number said they felt guilty if they could not remain positive or portray themselves as a ‘fighter’. Health and social care professionals were generally reluctant to bring up the subject of end-of-life care with patients, the survey found.

The result of this was that many people with cancer were not having vital conversations until far too late and were dying in hospital against their wishes.

I believe this research has wider significance and shows the down side of an excessive focus on ‘thinking positive’ or being a ‘fighter’.  There is an important place for these qualities in life, but when taken too far it can become denial and a way of avoiding vulnerability.

When we adopt a think positive attitude too rigidly, we can easily slip into viewing ‘negative’ emotions such as vulnerability, fear, sadness and anger as somehow wrong or things to be battled against.

Miriam Greenspan talks about this in her book, Healing through the dark emotions. By ‘dark’ emotions she she doesn’t mean they are bad but rather that as a culture we have kept these emotions in the dark.

“In the throes of grief, fear, or despair, we generally believe that giving feelings like these too much space in our psyches is a sign of emotional weakness or breakdown,” says Greenspan.

She describes this attitude as ‘emotion phobia’ and says that while we can push these feelings away for much of the time, sooner or later we experience a major loss, shock or trauma and our habit of pushing away dififcult feelings no longer works.

In my work as a psychotherapist I often have clients who have got the message, usually from childhood, that their feelings (and particularly their ‘difficult’ feelings like sadness, vulnerability, fear or anger) are not okay.

These are the clients who want me to make such feelings ‘go away’. Instead I encourage them to try and name the feelings they are struggling with, to locate where in their bodies these feelings live, to see if they can allow these feelings to be present and to trust that there is a purpose in these feelings.

My experience is that there is always a reason for particular feelings in our life. If we can shift our perspective away from judging the feeling (and ourselves for having it) to being willing to experience it we can begin a different kind of ‘conversation’ with the feeling.

We can then begin to explore what this feeling is trying to draw our attention to in our life, or pehaps to  something in our distant past that needs to be given a place.

* https://www.macmillan.org.uk/aboutus/news/latest_news/fighting-talk-can-leave-cancer-patients-unable-to-talk-about-death-and-dying.aspx

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Couples

The Distancer-Pursuer Dynamic

You may have noticed, in your own relationship, that often one partner really wants something from the other partner and becomes extremely frustrated when they don’t get it.

I have had many couple clients who bring this kind of problem and I have seen it at work in my own relationship – and it can be very painful!

The way it works is one partner pushes for something and the other partner won’t give it, or won’t give it in the way that the first partner wants it. This is called the distancer-pursuer dynamic.

The pursuer is the one wanting something and the distancer is the partner who is not giving it. Usually both partners end up feeling that they are being unfairly treated.

Here are some common things that people caught in the distancer-pursuer ‘dance’ may say:

Him (pursuer): “Most of the time, when I want sex, she knocks me back.”

Her (distancer): “He’s always wanting sex – it makes me feel pressured and even less in the mood.”

Or:

Her (pursuer): “Whenever I try to have an intimate conversation, he seems more interested in watching TV or checking his phone.”

Him (distancer): “She’s always trying to have deep conversations – I feel like I don’t have time to just chill out.”

The more the pursuer makes demands or vents his or her frustration, the more the distancer feels under pressure and even less likely to give the pursuer what they want.

The object of the pursuer can be one of many things – sex, attention, affection, emotional intimacy, appreciation. But the actual thing being pursued is less important than the dynamic that is being played out.

The important point to realise is that the distance between the two partners always remains the same in this behaviour pattern, so as the pursuer tries to get closer the distancer moves away. Uncomfortable as it is, in my experience it is often the case that both partners unconsciously make sure that they stay stuck in the pattern.

But why would the couple make sure they stay in this painful pattern, even on an unconscious level?

Basically, it is because the distancer-pursuer dynamic enables both partners to avoid some of the challenges of intimacy, while blaming each other.

The dynamic regulates the emotional closeness within the relationship. While we all may say we want a close relationship with our partner, in reality we move between a desire for closeness/relationship and a desire to autonomy or independence. This is one of the fundamental challenges of being in a relationship.

In their book Sex, Love and the Dangers of Intimacy, Nick Duffell and Helena Lovendal argue that the distancer-pursuer dynamic is a way for the couple to try and manage the conflict between closeness and autonomy.

They say: “We can establish lifelong patterns of one wanting more and the other less, one wanting closeness and the other space. We can play these games till we die and many couples do.”

The dynamic may go both ways, so that in certain areas one partner is the distancer while in a different area it is the other partner. A common pattern is for men to be the pursuer when it comes to sex and women when it concerns emotional intimacy.

John Welwood in his book Perfect Love, Imperfect Relationships,  highlights how the dynamic reveals the early wounding we may have experienced with parents. One partner may have experienced an intrusive parent and thus fears engulfment in adult relationships, while another may have had a parent who was distant and so felt abandoned.

He says: “Many people suffer from some of each, resulting in a ‘push-pull’ relationship, where one partner pursues when the other is pulling away, but then retreats when the other comes forward.”

In a future post I will go into this dynamic in more details and talk about how we can respond, when we find ourselves caught in it.

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Discussion Individuals

The truth about family holidays

I’ve noticed  that two of my busiest periods for new clients contacting me – both individuals and couples –  is the end of the summer and the beginning of the year. Both of these are times when people have spent significant periods with their families and/or partners, without the usual distractions of work, school, etc.

In this post I’d like to focus on the family holiday and the ambivalent attitude many of us have towards it.

A bit like having a new child, having a holiday with our family or partner is something most of us look forward to and we project lots of positive expectations onto it. But, also like having a child, we can often fail to anticipate the downside – the stresses it can place on relationships.

We tell ourselves the holiday will be relaxing, it will give us a chance to bond with children or re-connect with partners, it will be a break from work and the humdrum. All this may actually be true but it is also the case that holidays can bring to the surface tensions within the couple or family relationship. And unlike most of the year, there is little escape from these stresses when you’re spending nearly all your time with these people.

Balancing needs

My own experience gives me an insight into why so many new clients seem to contact me at the end of the holiday season.  I nearly always look forward to a family holiday and it is usually a  genuine break from work and I return feeling refreshed. But at the same time I sometimes struggle with balancing my own needs and wants with those of other members of the family.

At home it is easier for achieve this balance because I have time away from my partner and children, I have other activities such as work or other social contacts. On holiday we are all thrown together for a week or two and that can be challenging.

I find it helpful looking at this through the perspective of the inner child. The inner child is a metaphor for the part of us that can sometimes feel vulnerable, afraid, angry and is very sensitive. It is also the part of us that can be playful and joyful. Being aware of, and acknowledging the needs and wants of this inner child is very important, but we must not let it rule our lives.

I have an internal ‘little boy’ who can sometimes feel overlooked or unwanted.

Neglecting our own needs and wants

On holiday much of the focus is on what my children need or want, or my partner, and the danger is that I neglect my own needs and wants. This leads to my inner child feeling neglected and I begin to feel irritable and run down. This is all made worse because we tell ourselves that on holiday we are “supposed” to be enjoying ourselves and so if we’re not we can feel we’ve failed in some way.

On the other side of all this, of course, is that family holidays do also help me feel more connected with my partner and children because I get to spend more time with them and can share that time without the usual distractions of work and routine.

I don’t believe the tensions or arguments that surface on holidays are necessarily a bad thing because I see them as inviting us to look at elements of our family or couple relationships that may need attention. In that sense, tensions on holiday can play a positive longer-term role in our relationships.

It can also be helpful to adjust our expectations of holidays and to begin them with our eyes wide open. If we remind ourselves that some tensions are likely and have an idea where these tensions may emerge, we can prepare ourselves for them.

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Discussion

What does our psyche want now?

I recently attended a talk by the American depth psychologist and author James Hollis, whose books I had long admired.

James Hollis
James Hollis

“I often ask my new clients if they they think they have a soul and what it may be asking of them,” he said. That made me think. Hollis did not mean soul in the Christian sense, but rather the part of us that is separate from our ego, that is part of our unconscious and that has a connection to something larger than ourselves.

In the traditional religious meaning, soul is opposite to body, but in depth psychology soul refers to the Greek word psyche. Rather than being this ethereal, floaty thing that many of us imagine, in this sense soul is closely connected to our human experience, particularly our deep emotions, our longings, our joys, our mystery. This was an idea developed particularly by the archetypal psychologist James Hillman.

By ego, I mean the part of ourselves that we are aware of and which we think of as ‘us’, but which is only the tip of the iceberg and does not encompass our unconscious. It is our ego that tries to control our lives, and our environment, and which is constantly on the lookout for threats.

We need our ego to run the business of life, but if its needs dominate then our psyche/soul may need to make itself felt through neurosis and painful symptoms.

Writing in his book What Matters Most, Hollis says soul is a metaphor to describe our essence: “It is the energy that blows through us, that enters us at birth, animates our journey, and then departs, whither we know not, at our passing.”

Soul, by its nature, is actually impossible to fully define. While it lives in the unconscious it is constantly making itself felt in our conscious lives, through our emotions, dreams and imagination.

The reason Hollis asks his clients if they think they have a soul is because he is wanting to get away from the assumptions many people bring to therapy; that they have a ‘problem’ and that it is somehow the therapist’s job to get rid of this problem.

Depth work is not about solving the problem but about recovering the life we’ve somehow lost along the way, he says. Clients often come with a symptom, such as an addiction, a depression, an anger issue or a relationship problem, and they want the therapy to eradicate this symptom.

But depth therapy does not “cure” people or eradicate symptoms. “We don’t solve these problems, we outgrow them,” says Hollis. But to outgrow them may mean exploring what the meaning of the symptom is, what is our psyche trying to get us to pay attention to in our lives?

Mostly we are governed by our egos and we think we know what we want or what we need. But the psyche/soul may have a different idea of where we need to go. It is our ego that desperately wants to get rid of the symptom.

Some approaches, such as cognitive behavioural therapy (CBT), try to get rid of the problem the client brings. CBT can help, and I use some CBT  approaches in my integrative therapy. But my experience is that often CBT can seemingly get rid of the symptom, only for it to re-appear in another form. If the underlying issues are not dealt with this is always a risk.

But how do we know what our psyche is asking of us? One way of exploring this is through therapy with a practitioner who has experience in working with the unconscious. Other ways in include noticing our dreams and what they may be telling us.

As palliative care doctor, and therapist, Michael Kearney says in his book Mortally Wounded: “My own personal and work experience has [shown me]…that soul is connected to depth, to death, to the imagination, and that it brings with it a sense of meaning.”

 

Further reading

By James Hollis:

Swamplands of the Soul, Inner City Books, 1996

What Matters Most, Gotham Books, 2010

By Michael Kearney:

Mortally Wounded, Morino Books, 1996

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Couples

Why couple therapy won’t ‘fix’ your relationship in the way you expect

“Be patient towards all that is unsolved in your heart and try to love the questions themselves…the point is to live everything. Live the questions now. Perhaps you will then 9504443699_d6effb8b17_zgradually, without noticing it, live your way some distant day into the answers.”

  • Rainer Maria Rilke

The quote above, from the Austrian poet Rilke, says something about the couple therapy process and how changes in a relationship are often achieved not by applying a new technique but rather by a gradual shift in awareness and perspective.

Many couples who are struggling in their relationships come to therapy to be fixed. Or, more accurately, they come to get their partner ‘fixed’. They hope that the therapist will tell their partner what he or she needs to do differently or what techniques the couple needs to put into practice in order to solve the problem they come with.

While there is a place for techniques and tools in helping couples tackle their problems, it is naive to think that these alone will lead to sustained improvements.

In my experience couple therapy is more of a stuttering, unpredictable process than a linear improvement. Over time I would expect a couple’s relationship to improve but it is often a case of two steps forward one step back. There may be periods where nothing seems to be improving at all.

But if the couple is able to stick with the process and hold a little less tightly their desire for a solution to their problem, something different can emerge.

Often that something different comes from each partner being willing to feel their pain, and sometimes to share it, without immediately blaming the other person.

Frequently one of the things that needs to happen in couple therapy is for each person to understand how they have contributed to the stuck place the couple finds itself in. Once we begin to recognise our own responsibility we can then stop pointing the finger so quickly at our partner. This takes the pressure off them a little, which can open up a space for something new to enter the relationship.

In my own relationship I’ve found that, when I’m unhappy about something, the simple act of being heard by my partner can make a difference. It often means that the thing that was annoying me so much doesn’t seem quite so difficult any more.

As couples we can sometimes get stuck in an “I win, you lose”  mentality, in which power struggles take over and we feel that unless we get our way it will be unbearable. The reality is that it is always going to be difficult for two people to share their lives and that we need to find ways of making space for the differences but still allowing each person to have their feelings acknowledged.

John Welwood, one of my favourite writers on relationships, says in his book Journey of the Heart, : “Techniques rarely have any impact when used as short cuts, to bypass letting a difficulty affect us, work on us and move us to find our own genuine response to it.”

(Photo courtesy of Tom Blackwell, creative commons, at Flickr.com)