Monthly Archives: September 2014

How does Therapy Help — The New

In my last blog, I considered psychoanalytic theorizing and its core understanding of repetition.  Today I’d like to consider the uniqueness of the therapeutic situation itself and the ways that it is different from whatever we presume happened between mother and infant, toddler and parents, etc.

For it may not be, as we largely assume, that parents have not had the ability to contain/digest/understand/empathize with what our client has brought to us to deal with.  Perhaps, they haven’t been given a chance.

For there is a profound difference between infanthood/childhood/teenagerdom and what happens in a therapeutic situation:  the client has chosen to be there, however ambivalently and reluctantly.

Even if our clients arrive expecting magical understanding or advice, they must, after some time, recognize that what we offer is more modest – the chance to think about and re-explore their lives and history, a chance to reinterpret events.  If they persist beyond this initial stage of disillusionment, they are choosing to go on a journey of understanding with us.

When the client continues to come, they are saying, however ambivalently, “bring it on.” And this may well be something that they have never been in a position to say, or think, or do, before.  It makes for an entirely new situation.

I don’t believe we have adequately thought through what this means and how it makes therapy essentially different from that of a child/infant with his/her parents.

A client who persists with therapy says “I choose you to be the person with whom:

  • I will attempt to feel and think things I have always avoided,
  • go to places no right-minded person will go,
  • share experiences that drive me  (and will probably drive you) crazy,
  • and if you prove understanding and trustworthy enough, to whom I will say things I have never said before.

It’s very likely our client has never said/done this before.  It is new, and will have profound consequences in enabling our client to find resources within themselves which they had never previously had cause to discover.

Though this new situation may inevitably involve repetition (for our behaviour/thought and feelings are not starting from scratch), it is profoundly different from what occurs with our parents, who are there, as a given, from the beginning.  If we’re lucky, they’re loving and thoughtful and mean well.  If we’re even luckier, they have some sense of what they have taken on in this most impossible of jobs, and are, in most ways, adequate to it

But I believe what parents sign up for is fundamentally different from that which analysts offer.  And so retrospectively understanding parents as inadequate analysts is a profound mistake.

If this isn’t obvious, there are a number of things that should make it more so:

  • It’s simply out of order for parents to “interpret” their children. I speak from experience here:  my daughter bristles (rightly, I’m afraid) whenever I’m tempted to do so.  She simply has not given me permission to do so, in the way a client gives a therapist.   Interpreting, in the words of Jay Haley, is a “power tactic,” and not one parents should use. I have permission to be her parent, but not her therapist. Thus the fundamental activity of therapists is denied to parents.
  • Of course, much of the “containing” that analysts feel parents haven’t done would be pre-verbal, from the earliest days, months and years of an infant’s life. But even here, I’m not sure we’ve adequately thought the difference between containing/digesting feelings which are formed before significant contact with language (what early mothers have to do) with containing “early” feelings of adults who are swimming in the sea of language, which is what therapists, at their best, do.
  • If being a good parent was simply a question of being an adequate analyst, you wouldn’t find many children of therapists who are messed up. Unfortunately, it is quite easy to do so.

Of course, I am not saying that there aren’t many ways bad or inadequate parents or even good parents in bad moments can’t mess up a child in ways they will still be struggling with years later.  In many of these cases, there will be a clear line of causation which it is possible to make:  for example, if a parent physically/verbally/sexually abuses a child, the scars which the adult bears years later can be traced back to the abuse, and what it meant to the child.

But a great deal of what analysts do, or take themselves to be doing, is dealing with  feelings/thoughts/perceptions/fears that are pre-verbal.   For example, Klein and Bion talk about the primitive fear of dying, which is attributed to the earliest months of a person’s life.   Such feelings may indeed need to be contained/digested/processed in a good analysis.

But here we are in quite different territory as far as causation goes.  We have no way of knowing whether this client’s early mother couldn’t deal with/contain/digest, his early hatred/fear of dying, etc.  This is true even if there is evidence the mother was depressed, preoccupied, grieving – absent in some major way.

All we really know is that there is work to be done, and if we, and the client are fortunate, we will be able to do it together, in a way that has never proved possible before.  But my suspicion is that a big part of why we are able to do that work is because the client has walked into our room under their own steam, sat in our chair (or laid on our couch) day after day, and has continued to do that until what they want/need has been accomplished.

For our clients, in our consulting room, everything they do/say/feel is understood as part of the work they have come to do.  This is an ennobling understanding. What has previously been understood as pathology is seen as attempted communication, as co-operation.  Even when clients seem to be working against us (resisting in its many forms), it is our belief as therapists that this is essentially working with us, presenting us with what we need to grapple with to help them.

All this makes for a unique situation, a proper “job” that clients can find themselves able to do however much previous “jobs” have been beyond them.  Being able to work with someone, in such a difficult situation with such difficult “material,” again, may be new for a client.  The sense of achievement they get from this and the support they get from being party to discovering the “truth” about themselves, may, and I believe is, much more important in their “cure” than the explanations in terms of repetition which we provide for them.