All posts by ahrp-therapy

Thinking-Out-Loud

On Metaphor

There is nothing quite so satisfying as finding the perfect metaphor to describe a complex thought or experience. A good metaphor brings with it a kind of settling feeling, as if you’ve finally found a permanent, but unobtrusive space on the shelf for that old vase your grandmother gave you, that you don’t much like, but also don’t have the heart to throw away.

It’s finding the perfect parking spot right by the elevator in an otherwise totally packed parking lot. Or putting in the last piece on the edge of a large and complex jigsaw puzzle—you know you’ve a lot more work to do, but you feel real accomplishment at having made a good start.

Familiar and Easy to Understand

In therapy, the main value of metaphor is this feeling itself: it allows you to take abstract, and difficult-to-explain thoughts and emotions and turn them into tangible, familiar objects and processes. You give yourself something to grab onto, and you finally get to feel like you actually understand something about yourself.

For example, self-esteem is a hopelessly ill-defined concept. Almost nobody knows what anybody else means when they use the term, because self-esteem isn’t a thing you can point to. It’s a non-physical idea that refers to a psychological orientation towards the world that allows you to feel confident while making both decisions and compromises, so that you get what you need while retaining your self-respect.

But if I say that self-esteem is the “seat” of a stool with three legs, you can immediately get a sense of what it comprises and how the parts relate and interact. And if we name the three “legs,” social connection, agency and productivity, and philosophical/spiritual/religious engagement, the picture becomes even clearer.

Of course, self-esteem doesn’t literally work like a stool with three legs does. Furthermore, you could argue that the stool should have 4 legs and a backrest, and maybe a bit of padding for you to sit comfortably on.

Which is exactly the idea: as you build the image, you refine your understanding of the system it represents. In other words, creating a metaphor helps clarify the aspects involved and how they relate.

Clarifying and Refining Our Understanding

This clarifying and refining function makes metaphor and analogy incredibly powerful tools in psychotherapy.

One of the hardest parts of managing and healing emotional and psychological suffering is how confusing and overwhelming it all is. Metaphorical thinking doesn’t “cure” our overwhelming emotions, but it does allow you to take break from them for a while. And, more importantly, you start to move towards understanding yourself, rather than running away from the frightening things within you.

Even the smallest understanding of how it all fits together is enough to give you the feeling that you’re starting to get a handle on things. You can understand it all.

And if you can understaind it, you can fix it.

Creating More Confusion?

The two main arguments against metaphorical thinking are:

  1. It leads to misleading over-simplifications.
  2. It allows us to invent facts and events that make for a pretty picture, but which don’t actually reflect reality.

Both of these can be an issue in therapy, because, indeed, the emotions we struggle with are often very complex. And secondly, a big psychological challenge for many people is establishing what is actually true, and what is imagination and/or projection. And so, it might seem that thinking and speaking metaphorically will only confuse things more.

Somewhere to Start

But, nobody who wants to learn math would ever start with calculus; the first book all of us read in school was definitely not War & Peace; and no pianist ever had their very first lesson on stage in front of 20,000 people.

In other words, learning a new skill requires you to start simple and move at a pace that works for you.

As with the metaphor of three-legged stool of self-esteem, it’s never going to be a perfect match, and there are lots of ways to change the diea, but working with a simple image helps you identify the core features of the thing you’re trying to understand. It’s somewhere to start.

Secondly, identifying all of the places where a metaphor doesn’t match reality is just as helpful as creating it in the first place. There are many ways in which learning to manage emotions is utterly unlike learning the piano, or being on stage in front of 20,000 people, for that matter.

Teasing these things apart helps you create a more nuanced understanding of your emotions and your experience, and therefore of yourself. Which is the major goal of psychotherapy in the first place.

Of-a-Piece with Yourself

First and foremost, therapy is about learning that you don’t have to be afraid of your emotions. Even though you can’t control them directly, you can influence your emotions, and you can decide whether or not to act on them. So although it sometimes feels like it, you are not locked in a stagecoach being dragged towards the edge of a cliff by a team of wild horses. Which is to say, you are not a mind trapped in a runaway body that you can’t control.

We are not buggy and driver, nor are we horse and rider. We are like the centaur or the sphinx, half animal, half rational; a complex system consisting of two seemingly incompatible aspects which somehow combine well enough for us to think, to feel, and to be active, intentional agents in the world.

But we are also not two separate creatures magically joined at the waist. Our thoughts explain our emotions, and our emotions respond to our thoughts. We can separate them metaphorically, but in reality they are of a piece and inseparable. Metaphors are incredibly helpful, but they’re also not the whole truth.

Engaging with the Process

Ultimately, it doesn’t matter what the final product looks like, the important thing is the process of creating it. Therapy is about engaging with your emotions and memories in a way that takes the fear out of the equation so that you can be honest with yourself and the people in your life.

And so, creating metaphors is a way of disarming the emotions, thoughts, and memories that scare us. It is a way of playing with our experience, and rearranging our feelings into patterns that feel right and true, and above all, that make sense. Even if nobody else understands, we do, and that’s the whole point of starting therapy in the first place 🙂

Articles

Psychodynamic Therapy: Some Thoughts and Ideas

Thoughts and Ideas Related to Psychodynamic Therapy

The following are some concepts which might be helpful as you begin your psychodynamic therapy process, or if you are still unsure about what it is, how it works, and why you might want to start.

The Psychodynamics of Personality

The psychodynamic approach to therapy begins with the idea that our personalities and actions are the result of the changes and movements (the dynamics) of psychological energy. This means that our personalities and experiences are fluid, adaptable, and ever-changing.

At the same time, this energy flows in patterns and along pathways that are partly natural disposition, but also the direct result of learning and life experience. Most importantly, because of this tendency to do things as we are used to doing them, we often seem to get stuck in a rut, and our attention and efforts can become fixated on particular events in the past, particular interpretations of words and actions, and specific self-protective behaviours. This often leads us to responding to new events as if it was the past, ie. in ways that don’t line up with what is actually happening.

At its simplest, this is how psychodynamic theory understands emotional distress and unhealthy coping. Common experiences like depression, anxiety, and even our strangest fantasies are understood as patterns of thought and action which contain, limit, and protect us from our emotions, and block our ability to adapt flexibly and feel safe with the fact that everything in life is always moving and always changing.

Self-Protection

Emotional pain is real pain, and we don’t like pain. As simple as that is to say, and as silly as it may sound—pain is bad. This is by far the most important and helpful idea in the psychodynamic approach: our problematic and “crazy” habits and behaviours are actually ways of

  • protecting ourselves from emotional pain
  • expressing the fact that we are in pain or that we feel unsafe

In other words, the famous “defence mechanisms” like denial, repression, and projection are psychological tools we use to manage our emotions and stop ourselves having to endure experiences which cause pain. In particular, the actions we take towards other people can be understood this way, too. “Oversensitivity” and erratic behaviour, clinginess and neediness, lying and cheating, controlling and micro-managing, avoidance and dismissiveness.

We also do this towards the world more generally. Anxiety and hyper-awareness of danger, apathy towards things you know you should care about, as well as greed, hoarding, and acquisitiveness—these are all ways of protecting ourselves from the pain of abandonment, rejection, disappointment, and all of the other things that make us hurt.

Psychodynamic theory argues that everyone uses these tools all the time, and that “mental illness” is not illness per se, it’s simply that we’ve come to rely too heavily on only one or two of these tools. This means that emotionally, we spend a lot of life trying to eat soup with a fork, and wondering why we’re so hungry all the time.

As the old saying goes, if all you have is a hammer, everything starts to look like a nail…

Striving for Health

The upshot is that most of the time, even the weirdest and most frustrating “bad habits” are actually the person trying to help themselves, but not knowing how to do it in any other way. So they are not “exhibiting maladaptive behaviours,” they are striving for health.

The goal of psychodynamic therapy, therefore, is to help you strive in a way that fits better with both your own personality and the reality of world you live in. This means managing events and emotions in a way that makes your life better, not worse.

Starting from this perspective, then, my approach to psychodynamic therapy works towards finding the answers to the following questions:

  • What are you suffering from?
  • What emotional tools are you using to help yourself?
  • Why do you use that particular set of tools?
  • Where or from whom did you learn them?
  • How well are they working?
  • What tools would be more effective?

Talk Therapy

Talking these things through might seem like ‘just talking’ but there is a lot more going on than you might think. Speech is not the only way of exploring these questions, but talking allows us to express thoughts and emotions in a way that others can clearly understand, or figure out why we might not be able to express or even feel them in the first place. It also helps us:

  • feel safe in our surroundings
  • signal empathy and understanding and establish trust
  • confirm that we are percieving people and events correctly
  • make sense of confusing or painful memories
  • prepare for future experiences we’re not sure how to handle
  • normalize so-called ‘weird’ thoughts

As a psychodynamic therapist, I always try to use the emotional power of speech not simply to help you understand yourself, but to soothe distress and resolve anxiety, to encourage mental and emotional flexibility, and to support and maintain the development of new emotional tools, new ways of thinking and feeling. Most importantly, it is in itself healing to have someone non-judgemental to talk to about things that frighten you or which you fear might push other people away.

Process Focused Therapy

To use another old expression, the proof of the pudding is in the eating. The same is true of psychodynamic therapy: the most important part of the process is the process itself.

A science-like approach using measurements, prediction, and goal setting can sometimes seem helpful and enlightening, but more often than not it interferes with the actual mental and emotional healing of therapy—ie. it reinforces already problematic defence mechanisms. Which is to say, most people are already experts at setting expectations that are too explicit, to high, and too rigid, pushing themselves to the breaking point to achieve them, and then punishing themselves harshly for “failing” to live up to these impossible demands.

This creates what is effectively a self-fulfilling prophecy of failure and low self-esteem. By setting all of these expectations aside and allowing the conversation to go as it goes, and focusing on the things you are actually feeling right now, the emotional work itself becomes much easier and more effective—because you are not continually interrupting yourself with judgements and criticisms.

As mentioned, most unhealthy and problematic defences are exactly this, our best attempt at living up to unachievable expectations while also trying to prevent ourselves from failing. The only way to resolve this emotional paradox is intentionally learning to tolerate ambiguity: talking about what you need to talk about, without worrying whether it’s the “right thing,” “important enough,” or contributing to your “forward progress.”

Long-Term Repetition

There are exceedingly few people who can learn to play piano in 12 weeks. The same is true of learning to tolerate and manage thoughts and emotions. Building confidence is not easy, and the ability to tolerate bad feelings is a complex skill that cannot be learned in one or two sessions. Every stage of any learning process needs many repetitions and many variations in order for the new ability to become an automatic part of our everyday experience. This is why the psychodynamic approach is considered a long-term therapy. It takes time and it cannot be rushed.

You won’t be on the hook for the rest of your life, but there is no way to predict how many sessions you will need. A large part of my job as a therapist is to try and make our work together efficient and effective, but, ultimately, it takes as long as it takes. As mentioned above, having rigid expectations interferes with your ability to do the emotional work you need to do. Beating yourself up and stressing yourself out for “taking too long” will only make the process take longer.

Working Through

Many people find that they need to talk about the same person or event over and over again, and worry that they’re being boring or obsessive. In fact, this is a natural and expected part of the process, particularly when they have experienced trauma and/or neglect. This stage of the process is called “working through” and many therapists and theorists consider it the heart of all effective therapy.

The most important thing to remember is that the impulse to repeat is a sign that whatever it is, it’s important for you. There’s something there that you need to figure out, and so that’s what you need to talk about, whether it’s once, or a thousand times.

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Psychodynamic Psychotherapy

The psychodynamic approach to therapy begins with the premise that our personalities and actions are the result of the changes and movements (the dynamics) of psychological energy. This means that our personalities and experiences are fluid, adaptable, and ever-changing.

At the same time, this energy flows in patterns and along pathways that are partly natural disposition, but also the direct result of learning and life experience. Most importantly, because of this tendency to do things as we are used to doing them, we often seem to get stuck in a rut, and our attention and efforts can become fixated on particular events in the past, particular interpretations of words and actions, and specific self-protective behaviours. This often leads us to responding to new events as if it was the past, ie. in ways that don’t line up with what is actually happening.

At its simplest, this is how psychodynamic theory understands emotional distress and unhealthy coping. Common experiences like depression, anxiety, and even our strangest fantasies are understood as patterns of thought and action which contain, limit, and protect us from our emotions, and block our ability to adapt flexibly and feel safe with the fact that everything in life is always moving and always changing.

Self-Protection

Emotional pain is real pain, and we don’t like pain. As simple as that is to say, and as silly as it may sound—pain is bad. This is by far the most important and helpful idea in the psychodynamic approach: our problematic and “crazy” habits and behaviours are actually ways of

  1. protecting ourselves from emotional pain
  2. expressing the fact that we are in pain or that we feel unsafe

In other words, the famous “defence mechanisms” like denial, repression, and projection are psychological tools we use to manage our emotions and stop us having to endure experiences which cause pain. In particular, the actions we take towards other people can be understood this way, too. “Oversensitivity” and erratic behaviour, clinginess and neediness, lying and cheating, controlling and micro-managing, avoidance and dismissiveness.

We also do this towards the world more generally. Anxiety and hyper-awareness of danger, apathy towards things you know you should care about, as well as greed, hoarding, and acquisitiveness—these are all ways of protecting ourselves from the pain of abandonment, rejection, disappointment, and all of the other things that make us hurt.

Psychodynamic theory argues that everyone uses these tools all the time, and that “mental illness” is not illness per se, it’s simply that we’ve come to rely too heavily on only one or two of these tools. This means that emotionally, we spend a lot of life trying to eat soup with a fork, and wondering why we’re so hungry all the time.

As the old saying goes, if all you have is a hammer, everything starts to look like a nail…

Striving for Health

The upshot is that most of the time, even the weirdest and most frustrating “bad habits” are actually the person trying to help themselves, but not knowing how to do it in any other way. So they are not “exhibiting maladaptive behaviours,” they are striving for health.

The goal of psychodynamic therapy, therefore, is to help you strive in a way that fits better with both your own personality and the reality of world you live in. This means managing events and emotions in a way that makes your life better, not worse.

Starting from this perspective, then, psychodynamic therapy works towards finding the answers to the following questions:

  1. What are you suffering from?
  2. What emotional tools are you using to help yourself?
  3. Why do you use that particular set of tools?
  4. Where or from whom did you learn them?
  5. How well are they working?
  6. What tools would be more effective?

Talk Therapy

Talking these things through might seem like ‘just talking’ but there is a lot more going on than you might think. Speech is not the only way of exploring these questions, but talking allows us to express thoughts and emotions in a way that others can clearly understand, or figure out why we might not be able to express or even feel them in the first place. It also helps us:

  • feel safe in our surroundings
  • signal empathy and understanding and establish trust
  • confirm that we are percieving people and events correctly
  • make sense of confusing or painful memories
  • prepare for future experiences we’re not sure how to handle
  • normalize so-called ‘weird’ thoughts

A psychodynamic therapist uses the emotional power of speech not simply to help you understand yourself, but to soothe distress and resolve anxiety, to encourage mental and emotional flexibility, and to support and maintain the development of new emotional tools, new ways of thinking and feeling. Most importantly, it is in itself healing to have someone non-judgemental to talk to about things that frighten you or which you fear might push other people away.

Process Focused Therapy

To use another old expression, the proof of the pudding is in the eating. The same is true of psychodynamic therapy: the most important part of the process is the process itself.

A science-like approach using measurements, prediction, and goal setting can sometimes seem helpful and enlightening, but more often than not it interferes with the actual mental and emotional healing of therapy—ie. it reinforces already problematic defence mechanisms. Which is to say, most people are already experts at setting expectations that are too explicit, to high, and too rigid, pushing themselves to the breaking point to achieve them, and then punishing themselves harshly for “failing” to live up to these impossible demands.

This creates what is effectively a self-fulfilling prophecy of failure and low self-esteem. By setting all of these expectations aside and allowing the conversation to go as it goes, and focusing on the things you are actually feeling right now, the emotional work itself becomes much easier and more effective—because you are not continually interrupting yourself with judgements and criticisms.

As mentioned, most unhealthy and problematic defences are exactly this, our best attempt at living up to unachievable expectations while also trying to prevent ourselves from failing. The only way to resolve this emotional paradox is intentionally learning to tolerate ambiguity: talking about what you need to talk about, without worrying whether it’s the “right thing,” “important enough,” or contributing to your “forward progress.”

Long-Term Repetition

There are exceedingly few people who can learn to play piano in 12 weeks. The same is true of learning to tolerate and manage thoughts and emotions. Building confidence in our ability to tolerate bad feelings is not an easy skill to learn, and the above process needs many repetitions and many variations in order for it to become a automatic part of our everyday experience. This is why the psychodynamic approach is considered a long-term therapy. It takes time and it cannot be rushed.

You won’t be on the hook for the rest of your life, but there is way to predict how many sessions you will need. A large part of your therapist’s job is to try and make your work together efficient and effective, but, ultimately, it takes as long as it takes. As mentioned above, having rigid expectations interferes with your ability to do the emotional work you need to do. Beating yourself up and stressing yourself out for “taking too long” will only make the process take longer.

Working Through

Many people find that they need to talk about the same person or event over and over again, and worry that they’re being boring or obsessive. In fact, this is a natural and expected part of the process, particularly when they have experienced trauma and/or neglect. This stage of the process is called “working through” and many therapists and theorists consider it the heart of all effective therapy.

The most important thing to remember is that the impulse to repeat is a sign that whatever it is, it’s important for you. There’s something there that you need to figure out, and so that’s what you need to talk about, whether it’s once, or a thousand times.

 

Summary

Ultimately, psychodynamic therapy is about emotions and how they influence and motivate the things we do and say, most of the time without us even noticing. When we find that we are afraid where we don’t need to be, or aggressive when it’s not appropriate, or depressed when we have no reason to be, there is always an explanation and a way in which it makes sense. This requires us to start paying attention to what we are feeling, and to accept those feelings as they are, whatever they may be.

The method of psychodynamic therapy is to actively seek insights into and explanations for emotions, questions, and actions we either ignore or take for granted because “that’s just the way I am.” The one and only goal is to look at these unexamined feelings and ideas without judging or making excuses, so that you can decide for yourself if, what, and how to change.

Your therapist’s job is to be the mirror that helps you see yourself and cultivate this new perspective on your relationships, and who and how you want to be for others.

This takes time, repetition, and it can be hard work. After all, we get stuck in our protective patterns for good reasons, and it can be difficult to believe that a new way of doing things will actually work. But if you can trust the process, and yourself, it does, and it will.

Articles

What Does a Therapist Do?

So, the billion-dollar question: What does a therapist actually do?

Ask 10 therapists and you’ll get 11 different answers.

Different modalities have different opinions on this. Some think of the therapist as something like a doctor, taking a case-history and recommending treatments. Others see them as something like a teacher, instructing and correcting behaviour, giving and checking homework. Others see them as a coach, or as a scientist, or as an artist, or, or, or. There are lots of similar, but different interpretations of the therapist’s role…

The Psychodynamic Therapist’s Role

The psychodynamic therapist’s job is a to be a person with whom it is possible to be totally honest without being afraid of judgement or criticism. Naturally, pretty much every psychodynamic therapist has their own ideas about what this should look like. But, basically, the therapist’s role is to listen both rationally and emotionally, ask questions and challenge assumptions, and suggest interpretations which will help you become aware of yourself and what is going on between you and the people in your life.

They will encourage you to be honest and to say whatever you need to say, no matter how “awful,” “rude,” or “unfair” it might seem. They will help you defend yourself from your inner critic and then to understand what that critic is trying to protect you from. They will ask questions and actually listen to the answers you give. Most importantly, they will have been through therapy themselves and will understand what it means to have someone to talk to who gets it, who actually listens, and who actually cares.

The non-reciprocal relationship

It might sound a bit of a strange thing to say, but the challenge here is being human. All therapists, regardless of modality, are human beings who feel all the things and have all of the desires, needs, phobias, and foibles that non-therapists do. Some modalities, particularly those which see themselves as “medical” and “scientific,” try to avoid this difficulty by simply rejecting and denying it.

In the psychodynamic view, however, this essential humanity is exactly what makes therapy work. It makes things tricky and complicated, but without it we have no hope of making the emotional and intellectual connections our clients need in order to heal and grow.

Keeping out of the way

Most people don’t need another parent, sibling, boss, or teacher. They need someone who is none of those things: neither a stranger, nor a friend—someone who is impartial, and on your side, and able to challenge you when you need it. And so the therapist needs to be able to consciously and intentionally not do and say the things a friend, sibling, or parent would typically do or say. They need to do the things that will actually be helpful and healing in the deepest way possible.

As you can imagine, hovering in this middle-ground is very challenging, and in order to keep the lantern alight for the client to return to when they’re being swallowed up by darkness, the therapist needs to set aside a lot of their own thoughts, impulses, needs, memories, fears, and coping strategies and focus only on what will keep the lamp burning. This doesn’t mean that they are playing the martyr, or being fake, artificial, cold, or restrictive—these days most therapists are openly warm, sharing, and caring in their practise.

But if I, as a therapist. am constantly inserting myself into the conversation, interrupting the flow of the client’s thoughts and emotions, then I am interfering with their process and signalling that their story is less important than what I think about it. I’d be doing the opposite of what I should be doing.

This means that if I want to serve my client in the best way I can, then I simply can’t do and say all of the things that would make the relationship “equal.” And so for the therapy to work, it’s not possible for the client to know as much detail about their therapist as the therapist knows about them.

To Conclude

This takes some getting used to, for sure. But that is also part of the therapeutic process: learning that old patterns aren’t universal—different kinds of relationship are possible. It is perfectly possible to have a deep, trusting camaraderie with someone whom you seem to know nothing at all about. But over time you will come to know them and the things that make them sad, or angry, the things that make them laugh. And they will, in time, share some of the experiences which have led them to react the way they do. It just won’t go the way you’re used to in “normal” life, and that’s exactly the point.

Articles, Beginning Therapy, Psychodynamic Psychotherapy

Psychodynamic Psychotherapy in Brief

Therapy is a method for:

  • improving self-esteem and self-understanding
  • changing unhealthy coping mechanisms
  • decreasing feelings of guilt and shame
  • resolving conflicts with others
  • developing/improving emotional regulation
  • confronting the existential negatives: pain, illness, ageing, freedom, responsibility, death, and loss
  • managing anxiety, compulsive thoughts, disordered eating and other issues
  • increasing empathy and emotional sensitivity
  • healing old wounds
  • mental/emotional hygiene and “preventative maintenance”
  • understanding confusing emotions and inexplicable reactions in both self and others

Therapy works by:

  • providing a “pressure valve”
  • increasing emotional tolerance
  • decreasing vigilance and defensiveness
  • increasing trust in self, others, and life itself
  • increasing tolerance for ambiguity and unpredictability
  • re-organizing and re-routing thought processes
  • regulating emotional processes through empathic interaction
  • integrating perception with reality
  • establishing control over “automatic” responses
  • increasing overall self-awareness
  • increasing understanding of what motivates other people
  • frank and honest discussion of difficult topics
Articles, Thinkings

Therapy is Weird

A Caveat Before We Begin: To be clear, my purpose with this article is definitively not to scare you or make you paranoid that therapy is harmful, or think that your therapist is dangerous and untrustworthy. Rather, I simply want to acknowledge the fact that you might already be feeling this way. You don’t need to talk to your therapist about it yet, but for yourself it’s important just to know that it’s OK for you to feel anxious before your therapy sessions, and that there is a good reason why you might feel uncomfortable enough to want to quit. Most importantly of all, these feelings don’t at all mean that you’re a “bad client” or that there is something wrong with you. As sincerely as it’s possible for text to put an idea across, I hope that this is the message you will recieve: You’re fine, it’s therapy that’s weird.

I’ll talk in more depth about the perfectly natural phenomenon of “transference” in another article, but for now it’s enough to say that how you feel about your therapist will undoubtedly have an effect on your comfort level and how deeply you can engage with your therapy. But, if you pay attention to your feelings towards your therapist and acknowledge them, those feelings will become less of an unconscious obstacle, and more of a conscious part of your therapeutic work. More importantly than doing “good work,” however, accepting that you have these feelings means that you will stop fighting against yourself, which conflict is, in my experience, the root of most of what is called “mental illness.”

I would argue that feeling weird about therapy just means that although you will (hopefully) eventually discover that your emotional “immune system” has been a little more enthusiastic than it needed to be, it is and was actually working just fine. And I hope this article will help you feel this way about yourself, too.

Therapy is Weird

So, to start with: therapy is a profoundly weird situation. There’s no other way to say it. In no other social arrangement are you expected to be utterly emotionally open with a total stranger whom you have to pay to listen to you. And in no other arrangement do you expect that stranger to absorb all of your emotions and then do the opposite of everything that seems to happen in a lot of our “normal” relationships (ie. they will listen actively, take you seriously, and not spend their time finding ways of making the whole conversation about themselves).

And before you can even start doing that weird thing, you are required to fill in forms and sign a contract, and thereafter each hour you spend talking to one another is framed by strict rules of responsibility and confidentiality. And, to boot, there is no other person in your life who will know so much about you and about whom you will know so very little.

There are many more weird aspects of therapy, but as far as I’m concerned, these are quite enough to start with. And if you find yourself thinking along these lines, rest assured that you’re not alone. There are many people who find this topsy-turvy arrangement confusing enough that they quit after only a session or two, and there are quite a lot more (like, a lot) who won’t even consider starting in the first place.

However, if you can get used to it—and it does take some getting used to, though it usually doesn’t take as long as you might think—you’ll find that the various strangenesses of therapy are not only helpful, but actually necessary for the whole thing to work. A lot of the time, people find that they actually need and want their therapist to be a stranger, because that way they they know they can trust them! Which sounds logically backwards, but there it is…

Thus, given that the whole situation is so upside-down and inside-out, I would be much more concerned if you didn’t feel at least a little bit uncomfortable during your early sessions.

SNAFU: Situation Normal, All Fucked Up

What can contribute to this confusion and discomfort about the whole therapy thing is when your therapist doesn’t acknowledge or even seem to notice the weirdness. They act as if the whole thing is perfectly sensible and normal—because for them it is totally normal. They spend all day in this weird space of talking to strangers about all of the intimate and taboo things that nobody talks about in public, and so sometimes they forget that what they’re doing can feel very risky indeed.

But ask them about their own first few months as a trainee therapist and they might tell you just how bizarre and uncomfortable the whole thing seemed. And more importantly, they might tell you about their own talker’s block and how incredibly nervous they were about being emotionally intimate with perfect strangers—and how terrified they were of talking about taboo subjects, offending someone, or simply saying something “stupid.”

So to be super clear: In my view, it is a good thing that you initially feel uncomfortable, because you are indeed in a profoundly weird situation. Feeling uncomfortable just means that your emotional “spidey senses” are doing exactly what they should be doing— they’re picking up on the many strangenesses of psychotherapy.

Finally, the thesis statement

Hence this article. There are a number of common feelings, reactions, and fears which trying to “open up” in this weird situation can bring up for people. On top of this basic strangeness, there are a number of common themes which can contribute to your discomfort with your therapist. As I said in the caveat, I present them here with the express purpose of normalizing them, because they are nothing to be ashamed of and nothing you need to hide from anyone, especially yourself.

Even the “neurotic” or “paranoid” feelings described below don’t necessarily mean that you’re “disturbed,” “defective,” or “mentally ill.” Human consciousness has both “rational” and “irrational” aspects, yet we are generally encouraged to (unfairly) punish ourselves for “being irrational” and have learned to shame-blame ourselves by calling them “crazy,” “weird,” or “insane.”

Not only is there no need to punish yourself for being nominally “neurotic,” but this “insanity” is a part of you, a vital and important part that can be understood, integrated, and leveraged as an emotional skill, rather than rejected as a source of shame and embarrassment. In other words, many of the thoughts and feelings we think make us “crazy” or “weird” are in fact incredibly common, and I would argue are indeed thoughts and feelings that everyone has from time to time. They just seem crazy or weird because nobody talks about them—because they’re afraid that everybody else will think they’re crazy and weird!

Waiting Till You’re Ready to talk about difficult things is not “resistant” or “withholding”

However, I want to be careful here. Just because it can be helpful to talk about “weird” or “unacceptable” thoughts and feelings, forcing yourself or feeling forced to do so before you are ready can be deeply upsetting and even harmful (depending on your personal history, of course). In therapy, you are not obliged to be any more open than you feel safe being. So, again, I am offering this discussion as something to think about, not necessarily as something you should or must talk about with your therapist right away.

And while we’re on the topic: Although it often doesn’t feel this way, and in spite of the fact that nobody talks about it; the only thing you are actually obliged to do in therapy is pay for your sessions. Literally everything else is voluntary. Unless your psychotherapist is also a doctor or a psychiatrist, they have no authority over you at all—and even then their authority is very, very limited. Unless they have a court order, no one can make you take pills, or do homework, or even turn up for your sessions.

Everything is therefore your choice, and in relational psychotherapy that’s the point. The conversation itself is the “therapy,” so, you choose to talk about what you need to talk about, if you want to talk about it, because you need to talk about it. And you talk about it how you want to talk about it, so that you get what you need out of the conversation. There’s more to it than just talking, but that’s the foundation: what you decide is important enough to talk about.

In other words, you are absolutely entitled to decide for yourself what, when, how much, and to whom you talk about your inner life. As a therapist, it is my legal and moral obligation to never force any technique, intervention, interpretation, or belief on you—including insisting that you be “open” and “honest.”

And so I am honoured, privileged, and gratified that you might be willing to share anything with me, but it would be grossly unfair, unethical, and immoral of me (or any therapist) to make you feel guilty or ashamed for choosing not to share.

What is getting in the way?

So, if you do find that you are unable to get into the swing of your therapy and “open up” with your therapist—and if you decide that it is indeed a problem for you—here are some “weird” and “crazy” thoughts, feelings, and perceptions that might be contributing to your difficulty.

Choice Paralysis and High Expectations

High expectations

First, in this age of science, therapists like to present therapy as being the pursuit of reasonable, rational, and realistic thinking. And yet, this pursuit of sensibility is itself surrounded by a pervasive mythology, in many cases bordering on woo-woo. One of these mythological beliefs is held by clients and therapists alike: every word spoken in therapy must be deep and profound and important.

If nothing else, that’s a pretty high bar to live up to, especially considering how mundane and repetitive most of day-to-day life can seem. And the fact that therapy is generally pretty expensive only makes this worse: it can feel like every “unimportant” word is wasting both time and money.

Choice Paralysis

On top of this, we all have so many thoughts, so many feelings, so many problems, and so much stress that it can seem impossible to know what is “really” important and what isn’t. Like trying to choose the “best” mustard from the 400 varieties on the shelf at the supermarket, when trying to decide the “best” thing to talk about in therapy you can easily get overwhelmed and paralysed by the “simple” act of choosing.

If you mix this endless choice together with the aforementioned need to be a mythically “perfect” client—adding in, perhaps, the 50 minute time limit, and a soupcon of anxiety that your therapist secretly thinks you’re stupid and boring—and you have a perfect recipe for “resistance.” In the reality of therapy, however, people often find that nattering about “unimportant” things is not only relaxing and helps them feel safe, but this “meaningless chatter” frequently uncovers something incredibly important to the problem that is bringing them into therapy in the first place.

Magical Incantation

Next we have perhaps the most “irrational,” but to my mind the most important feeling of the group: the fear that by speaking about an “unspeakable” event it will magically make Something Bad happen.

For example:

  1. The Bad Thing itself will be magically called forth and caused to happen, or to happen again.
  2. Some other, unrelated, Bad Thing will happen.
  3. Some Good Thing will be prevented from happening.
  4. The world, or society, or ourselves will explode, disintegrate, or fall apart.

We have all had experiences that we do not ever want to repeat, and we also all have ugly thoughts, wishes, and phantasies that one half of us wishes for and the other half is terrified would ever happen. We also all have emotions so powerful that we worry our heads or hearts might explode. And our memories and imagination can feel so real that we worry that these impossible things are in fact just about to happen. Just say the magic words…

Speak of the Devil and He Shall Appear

To put it another way, the words we speak have a kind of magic to them, and we often feel that just giving voice to a thought can make it come true. So much so that in spite of our “rational knowledge” that talking to therapist cannot make them happen or happen again, it still feels better not to take the chance.

To my mind, calling this feeling “irrational” in the pejorative, insulting sense is unfair. After all, In the real world, even the most “rational” people (lawyers, scientists, doctors, etc.) use the magical power of words, wishes, and curses to affect outcomes all the time—it’s a part of how we think and interact with the world. They use incantations to positive ends when knocking-on-wood, predicting experimental outcomes, hoping and praying, promising, pledging fealty, signing non-disclosure agreements, and making marital vows. On the other hand, they all also use magic words negatively and prohibitively when complaining, devising rules and laws, handing down advice, warnings, and thou-shalt-nots, and invoking divine intervention (“Heaven forbid!”).

In therapy, however, the fear of incantation has a special meaning because it usually connects to feelings, experiences, and expected events that have or will hurt us personally in some way. Just like the athlete who refuses to talk about an upcoming game for fear of “jinxing” it, people in psychotherapy are often afraid of jinxing the precarious emotional balance they have established for themselves and hurling themselves back into the abyss of suffering they have worked so hard to escape.

Therefore, the anti-incantation impulse—the impulse not to speak about a frightening thought or memory—is not a “crazy,” “irrational” thing we do because we are “neurotic.” Rather, it expresses a perfectly natural desire to protect ourselves from a physical danger and/or emotional pain we hope never to experience again.

Judgement and Objectification

Being treated as an object is a profoundly unpleasant experience. “Object” here can mean being used as a physical object, as in physical violence, rape, or sexual harassment. But it can also mean being treated as a psychological, scientific, or medical object, a thing to be studied, assessed, judged, and categorized.

For some people, being objectified and judged is not only emotionally destabilising, but is also the actual cause of their so-called “mental illness.” Many people find that the core of their PTSD, for example, is the fear of again finding themselves helplessly overpowered by an uncaring aggressor. And there are therapists and theorists, for example, who argue that conditions like “schizophrenia” and “schizoid personality disorder” are actually caused by a lifetime of being objectified (eg. having parents who treated her/him/them like a doll to be dressed up and manipulated).

Sadly, for a lot of people almost all of their previous experience with psychological care and intellectual training has been conducted within an objectifying context—that of observation, inspection, grading, correction, and diagnosis.

Doctors and psychiatrists, and to a lesser extent psychologists, are explicitly trained not to get “emotionally involved” with their patients and to maintain an attitude of “objectivity” at all times. This serves a purpose and there are one or two justifiable reasons for it, but unfortunately, what most people are actually looking for when they go to the doctor/psychiatrist for psychological help is emotional support. They are seeking the feeling of being taken care of by someone who understands and communicates emotionally, with particular emphasis on the word care.

Instead they are frequently met with objectifying measurements and dismissive treatments (eg. CBT homework and a bottle of pills), which only makes them feel misunderstood and rejected, and often makes their “illness” worse.

School teachers, too, although many are warm and supportive, are routinely required to objectify their students. Through standardized implements like homework, pop-quizzes, and end of year exams, one of a teacher’s major responsibilities is to ensure that their students “measure up” to expected standards.

For many future adults, this is a source of profound and lasting emotional distress, which only accelerates as they move into post-secondary education, and then explodes when they transition into the working world full of its depersonalising uniforms and business attire, repetitive tasks, performance reviews, sales quotas, productivity metrics, commissions-based compensation, and unreasonable expectations of continual growth.

When we begin therapy, we find ourselves sitting across from someone who in many ways closely resembles a teacher, doctor, and psychiatrist—the very people by whom we are most commonly objectified. And so, just being in the same room with the psychiatrist-like therapist, the fear of judgement and feeling of objectification can arise quite naturally for those who are sensitive to it.

Unfortunately, many psychotherapists actually see their role as being doctor-like, teacher-like, or boss-like, and so make things harder for their clients, and this may be what you’re picking up on. For example, in spite of the fact that most psychotherapists are not medical doctors or psychiatrists—and are therefore legally prohibited from officially diagnosing psychological “disorders”—they nevertheless begin their work with a new client by “assessing” them in terms of popular (but hugely problematic) diagnostic categories like Major Depression, Generalised Anxiety Disorder, Borderline Personality Disorder, and so on.

As a result, such a therapist begins each new therapy relationship by treating their client as an object—ignoring the person and focusing on the symptom—and thereby missing, rejecting, or dismissing the client’s need for emotional connection. This makes the therapist feel safe and in control, but leaves the client feeling disconnected and alone.

Obviously, this is emotionally hurtful, and it’s usually when and where psychotherapy fails. Objectification is a common complaint about Cognitive Behavioural Therapy, for example—which relies heavily on testing, homework, and paperwork, and listens to the client’s subjective story and emotions mostly as a means to symptom identification (ie. categorization and judgement). And the objectification is not only done by the therapist of/to the client—you are also actively encouraged to objectify yourself.

A lot of clients will tolerate this as long as their insurance is paying for it, but they often come away feeling disappointed and misunderstood. Obviously, this is the opposite of what we’re going for, and you’re right to be sensitive to being treated as an object in this way.

Shame and Punishment

Children are often ridiculed for crying, or sent to their rooms for being angry, or slapped and hit for being too exuberant or too rebellious. In teenage and adult life, many parents and partners still use physical violence to control emotions and behaviour, and even more teachers, bosses, social media “influencers,” and even random strangers will use non-violent, emotional means to coerce or punish us into doing, saying, and thinking what they want us to do, say, and think.

The challenge here is a subtle one. Many people come to learn that they should feel guilt and shame, not for expressing thoughts and feelings, but rather for having thoughts and feelings in the first place. They have been taught, incorrectly, that there is no difference between thoughts and actions, and so will feel profound and debilitating shame and guilt for having “bad” thoughts and feelings—even if they never express them and never act on them.

Thinking about eating an entire tub of ice-cream is not the same as actually eating an entire tub of ice-cream. And yet, we often feel as ashamed about wanting to punch someone as we would if we did actually punch them. In other words, we feel that the fact that we are capable of the “bad” thought means that we are by definition a “bad” person. Believing we are a bad person leads us to expect punishment for our “badness.”

To state my point clearly: thoughts and actions both exist, but they are not the same thing. Thoughts only become actions if you choose to act on them, and by choosing not to act on thoughts that might hurt others, you prove that you have nothing to be ashamed of—in fact, you have something to be proud of.

But from the thought-shame perspective, it is quite natural to resist the pressure to talk to a therapist about our various “badnesses.” Because we don’t want to be told that we are bad, and we don’t want to be punished for it with embarrassment and shame.

Thought-Reading and Being Transparent

For those with a history of invasive, controlling , and manipulative parenting and teaching, the above feeling of thought-crime can combine with a “paranoid” feeling that their private thoughts are visible to everyone around them. Shame then multiplies with shame because although they “know” they will be found out at any moment, nobody actually seems to notice. They thus feel as if they’re “getting away with it,” and live their lives waiting “the sky to fall,” or for “the hammer to drop.”

Enter the therapist, who not only closely resembles those objectifying, judgemental, and punishing authority figures from which punishment typically comes, but who also has the mythical, woo-woo reputation for being able to read minds and know what you are “really” thinking. Even in the least extreme version of this, it seems fair to expect that someone would be wary of even sitting in the same room as someone like that, much less engaging with them on an emotionally intimate level.

The Correct Thing to Feel

Emotions are a natural physiological response to the things that happen to us. They are meaningful signals which help us understand what is going on and allow us to remember how to deal with a situation we have experienced in the past. Emotions innately develop and become more nuanced as we mature, and with experience all kinds of feelings become associated with particular people, places, sounds, smells, colours, textures, thoughts, tones of voice, gestures, facial expressions, actions, events, and expectations.

People from the same culture may share a large number of these associations, and there may be a certain number of these which are common to all human beings, but the entire, specific constellation of your individual emotional network is utterly unique to you. In other words, there is no right or wrong way to feel about a particular situation, there is only the fact of the feeling itself as you experience it.

And yet, many people are convinced that there are rules which govern the “correct” way to feel about particular situations. Pop psychology abounds with incorrect and unfair interpretations of scientific research—much of which research is itself deeply flawed and problematic. Instagram is awash with injunctions to be “brave,” or “strong,” or “resilient.” TikTok accounts are full of rich and beautiful people telling us how to think and feel if we want to be as radiant and successful as they are. And there isn’t a religion in existence that doesn’t have some set of commandments forbidding us from lusting, or coveting, or being “greedy.”

From my perspective as a therapist, it’s easy to see how someone might expect me to act as an enforcer of these rules. I have spent the last decade studying psychology and training to be a therapist, so I should know the official rules, right? And people very frequently ask if it’s bad that they feel angry with their wife/husband/partner (Answer: No!), or if it’s OK to hate their parents (Answer: Yes!). Feelings are not actions, and can’t hurt anyone (even yourself), and so there is no such thing as a “good” or “bad,” or “correct” or “incorrect” feeling. How you decide to act is one thing, but what you feel is what you feel, period.

Cultural Gatekeeper

The image of the therapist as a moral gatekeeper is especially off-putting for people who “deviate” from the “norm” in some way. People of non-european descent often find the emphasis on individualism and the protestant/catholic flavoured morality of psychotherapy unnatural, uncomfortable, and often just plain wrong. Those of a non-hetero-normative sexual orientation or gender identity often struggle with therapy’s distressingly recent history of being used to force gay people into being straight and trans people into being cisgendered. Even people who simply come from more “emotionally expressive” cultures can find the emphasis on self-regulation and introspection restrictive and oppressive.

And this kind of social and moral instruction was, in fact and unfortunately, a part of the original formulation for Freud’s psychoanalysis—the basis for every kind of psychotherapy now practised. A significant part of his responsibility, as he saw it, was to help people get their “defects” and “neuroses” under control so that they could behave like good, orderly citizens—and in his view, the list of these “defects” was very long.

Although there are few therapists nowadays who are as openly paternalistic as Freud was, there are nevertheless a number of prominent therapeutic approaches and individual therapists who have this kind of controlling, correcting, and instructing vibe. Again, this may be what your spidey senses are picking up on.

Rejection, Exile, and Death

Rejection hurts, a lot, and being afraid of it is not crazy or irrational. Nor, in my opinion, is it a sign of a “mental disorder.” Like all of our most “irrational” thoughts and fears, there is a solid emotional logic behind the fear of rejection and it is perfectly sensible that people feel that fear and aversion as intensely as they do.

Amongst many other things, being rejected by one person implies the threat of being rejected by everybody. The feeling of belonging in the world, and especially of being cared for and about by the people you yourself care about—-this is a part of the bedrock of self-esteem and emotional stability. Even on the most pragmatic level, there are very few people who are able to physically survive in exile. And so total social rejection not only guarantees suffering, but also threatens death.

So, the fear of the pain of rejection is not some irrational “oversensitivity” which marks you out as crazy or mentally ill. Quite the opposite, fear of rejection simply reflects how vulnerable we all are when we can’t find somewhere to belong.

But, again because psychotherapists appear to be “experts” who know and speak “the Truth”— and because the Myth of Therapy includes the therapist’s mystical ability to read your mind and “know what you’re really thinking”—for some people their therapist can represent the threat of ultimate rejection.

To put it a bit more clearly: It is very common for people to feel that their personality and emotions are too big, or too confusing, or too overwhelming, or too unacceptable—too much—for anyone else to tolerate. And if even a psychotherapist can’t handle you, and has to reject you, well… it means you are now a Reject, officially and irrevocably.

I can’t think of anyone who would approach that happily and without at least some trepidation.

Themes

As you can see, there are certain themes that emerge when looking at the internal experience of starting psychotherapy. Authority, mind-reading, judgement and objectification, predicting the future, being fundamentally a “bad” or “wrong” or “incorrect” person. Being unacceptable, unwanted, unlovable, too much, too weird, too “irrational.”

It’s no surprise that these themes are important to new clients and interfere with their ability to participate. These are big, important, painful feelings that we are naturally disposed to avoiding. But not just because they hurt. They hurt because they are important, that’s what emotional pain means: something bad is happening, and I don’t like it. Naturally, what that Something Bad is, depends on your personal history, but everyone has Bad Things they never want to experience again.

Your therapist is about to become an important person in your life who will have direct access (if you choose to give it) to your innermost self. They will influence your thoughts, emotions, and experience, and you don’t yet know what they’re going to do with that influence. So yeah, you want to be careful not to let the wrong person in.

The Person of the Therapist

A therapist is a human being first and a mental health professional second. This means that behind all of the kindness and good intentions, they nevertheless embody the same potential for confusion and pain that we have experienced in relationship to other human beings. In our first therapy sessions, we have not yet learned—emotionally, physiologically, and unconsciously—that our therapist has truly learned (hopefully!) how to minimize their negative impact on people.

As I said at the outset, there is nothing wrong with feeling any of the above feelings, they’re what you’re supposed to feel when you are vulnerable. Hopefully, however, they will pass, and in time and you will eventually become comfortable. In my experience as both a client and therapist, working through the discomfort and learning to trust your therapist is an immensely important part of psychotherapy. But it is not always easy, nor should we expect it to be.

Client-Therapist Mismatch

While it is true that learning trust is central to therapy, it’s also important to say that your “resistant” feelings might not be abating because you’re working with the wrong person, or doing the wrong kind of therapy. We all have people in our lives—and often in our families—with whom we simply don’t get along. The missing spark, the wrong wavelength, the irritating miscommunications and misunderstandings, the feeling that they just don’t get you and you don’t get them—all of these things happen in therapy too.

If these feelings persist, and you just can’t seem to get rid of them, then maybe perceiving something outside of yourself—something between you and your therapist that just doesn’t work. This is something I would in fact encourage you to talk to your therapist about, as uncomfortable as it might be—but you are absolutely within your rights to honour your intuition and find someone who is a better fit.

Therapy is not for Everyone

There are all kinds of psychotherapy, and so it’s a common belief that there must be a modality that will fit everyone—with the implication that there’s something wrong with you if you can’t find “the right” therapy for you. I want to challenge this view and say that therapy simply does not work for some people. And, you might be one of those people.

Admittedly, the impulse to say that therapy “just doesn’t work for me” can come from an emotional anxiety which could well benefit from the sort of working relationship that therapy offers, but this argument itself has the potential to be used in a coercive way. Ultimately, the point remains the same whether you adore psychotherapy or loathe it—participation is 100% your decision. And I mean it quite sincerely when I say that maybe what you need is to learn to play the drums, or get a new job, or find a rabbi, a Zen master, or a new friend.

Emotions are Complicated

The magic of being human is that our emotions, memories, and imaginations are so incredibly powerful. The creative faculties that dream up comic book characters, or jetpacks, or poptarts, or quantum physics are the same ones that create all of our “irrational” thoughts and feelings. But sometimes those thoughts and feelings become so powerful that they start to interfere with your ability to live and have relationships with other people. As far as I’m concerned, that is the only metric that matters.

So, to conclude, I want to reiterate (yet again) that nothing in therapy is obligatory, nor are any of the above thoughts and feelings obligatory. You might experience all of them, or you might experience none of them, and those who do are not any “crazier” than those who don’t.

Which is to say: in my experience, the “resistance” that many feel to therapy is in fact perfectly sensible—particularly if you have a history of abuse, manipulation, or objectification. Our “irrational” feelings are simply an attempt to creatively predict and prepare for whichever negative outcome seems most probable or that we most want to prevent. The fact that your therapist believes themselves to be a safe and trustworthy person, does not mean that you have to agree with them. Being circumspect is perfectly healthy and “rational.”

And when you’ve found the right therapist and feel ready to talk about the things they make you feel, you’ll discover that the feelings that make you distrust your therapist are literally the exact feelings that the weird rules and boundaries of therapy are deliberately designed to let you talk about and work through in a safe, healthy way. In other words, there may be no one in your outside life who will know so much about you and let you know so little, but there is also probably no one else who will be happy when you tell them how deeply you loathe, fear, and distrust them!

Articles, Beginning Therapy, Psychodynamic Psychotherapy

Ego-Strength

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Everyone struggles with low ego-strength at some point in their lives. Things don’t always go our way, and negative experiences great and small can come as a major blow to our self-confidence and our self-esteem. On top of this, the stress and strain of our fast-paced, high-pressure lives make it difficult to manage even the “simplest” of life’s demands, often leaving us feeling drained and weak and incapable. In general, though, we expect that with a bit of rest and relaxation, we’ll soon be up and ready to go.

However, for a lot of people, this doesn’t happen. They get knocked down and they stay down, and they begin to wonder if they were ever really standing in the first place. Even without any specifically negative event, a great many people seem to drift through life on a tide of stress, anxiety and depression, low self-esteem and absent self-confidence. They put others’ needs before their own, to their own detriment; they speak of being invisible and unlovable, being somehow intrinsically flawed, basically bad; they feel inferior and worthless, empty, lonely, and afraid; they make resolutions and try to set boundaries, but continually find that their efforts at self-assertion fall through; they struggle endlessly with addictions and addiction-like behaviours, especially with food, sex and/or pornography, alcohol, cigarettes, and bingeing on movies and/or TV.

If you’re reading this, chances are that at least one of the above applies to you in some way. Whatever your personal struggle might be, there is no shame in finding life difficult, especially when it comes to relationships with other people. When we look from the right angle, however, it becomes surprisingly simple to understand the feelings that trouble us. Once we understand the what and why of the way we feel about ourselves and other people, we then start to believe that we can resolve the emotional conflicts which cause us so much suffering. It is never easy and rarely quick, but it is possible and worth the effort it costs and the turmoil the process often causes.

Ability vs. Attribute

Unfortunately, the way we talk about psychological experience tends to confuse and disorientate us. Ego-strength is not something you “have” in the sense of ownership (e.g. “I have a TV”), it isn’t really a thing at all. Rather, “having” ego strength means being able to assert yourself and feeling comfortable in your own skin. High ego-strength means you can establish and maintain healthy boundaries with others, and tolerate those inevitable occasions on which your boundaries are crossed. You are able to receive criticism (constructive or otherwise) without feeling guilty, ugly, dumb, or worthless. And when you look back upon your misdeeds and stupidities, you feel embarrassed, perhaps, but you don’t feel ashamed.

So ego-strength is not an attribute like height or hair-colour that you do or don’t have — it is an ability and a skill which can be built up through deliberate effort and practice. It is an emotional muscle which allows us to bear the burdens of life without being weighed down or crushed by them. You are able to say yes to the unexpected, and to say no to the unwanted, and mean it. You can bend with the wind and shelter yourself from the rain. When the power goes out you light a candle and visit a neighbour instead of sitting alone in the dark.

Later-Life Learning

Ego-strength, like learning to walk and talk, is easiest to develop as we ourselves are developing. Given the right circumstances of healthy attachment and emotional support, ego-strength grows naturally and “builds itself into” the child’s basic experience of the world and view of themselves. The rare and lucky person who grows up in this optimal environment will be able to believe in and trust their emotions and perceptions, to have faith in their own abilities and intentions, to trust others, and create deep, intimate emotional bonds.

Sadly, very few of us grow up under these ideal circumstances. Many kids get barely enough care and support to develop into adults who are reasonably able to manage the demands of life — and a great many don’t get even that much. To be frank, many, if not most of us find ourselves barely holding on by a thread.

However, there is no reason to think that just because we didn’t get it in childhood, ego-strength is somehow impossible to develop later on. Some people compare it to learning a new language, or exercising and getting psychically fit, or learning how to paint or play an instrument — but the essential thing is that ego-strength can be developed later in life and it is never too late. There is no question that it is more difficult to do as an adult, and more painful, but there is also no question that it can be done, or that you can do it too.

Psychotherapy & Ego-Strength Building

This, fundamentally, is what psychotherapy is: Building up your emotional muscles, your ego-strength, so that eventually you no longer have to worry about not being “strong” enough to handle the stress, confusion, and anxiety of adult life.

The “work” in therapy is first to understand how you have come to be how you are. Often, people find themselves talking about how they grew up, what their early life was like, how well their parents/caregivers got along, and their relationships with all of the people who helped raised them. This doesn’t mean “going back there” or “re-living” your most painful experiences, rather, it means acknowledging and accepting the full truth of who you are. This, of course, brings up strong feelings, but this is what your therapist is for, to help you learn the skill of managing and regulating the feelings that arise out of past experiences and present emotional conflict.

And as these muscles grow, as their ego-strength increases, most people find that they become less and less dependent on their coping mechanisms, their “bad habits.” They feel less guilty for taking time for themselves and less ashamed of making mistakes. They can walk down the street without fearing the judgement of others and can assert their needs and wants without feeling selfish or greedy or rude. Lifelong depressions lift, anxieties fade into the background, and day-to-day living gradually becomes more fluid, and put simply, easier.

Patience Will Out

Learning a new ability takes time, there’s no way around it. Real understanding and meaningful change come from assimilation and integration, re-shaping yourself to make room for new ideas, thoughts, and feelings. You can’t build up your ego-strength in a month, any more than you can learn to speak French, or Russian, or Farsi in a month. It takes time for your mind to displace old patterns and trace lasting connections between new and existing meanings and beliefs. Some people learn faster, and some slower, to be sure, but regardless — it takes as long as it takes.

And, ironically, if you start from the idea that building up your ego-strength will take longer than you’d like it to, you’ll have a much easier time and the process itself will go much faster than you expect.

Articles, Beginning Therapy, Psychodynamic Psychotherapy

What is Psychodynamic Psychotherapy?

introduction: therapies and modalities

All forms of psychotherapy start from the belief that meaningful human contact is intrinsically healing. There are many approaches to establishing and maintaining this “therapeutic” contact, and you have likely heard of a number of them: older therapies like Freudian, Jungian, or Adlerian, for example, or newer ones like narrative therapy, bibliotherapy, or motivational interviewing.

Each “modality” is generally represented by its creators and practitioners as being utterly separate from all of the rest, with its own unique techniques and methods for psychological and emotional healing. Some of this is, frankly, ego-driven on the part of the modality’s “inventor,” and some it is marketing designed to catch the eye of potential new clients, and some of this representation is for the purpose of secure grants and funding for research. That said, however, there are in fact real differences between psychotherapeutic approaches.

These differences begin as emotional and philosophical intuitions and ideas about what motivates human beings and how to alleviate suffering. While these initial intuitions and ideas usually begin with only one or two therapists or theorists, over time they are gradually elaborated into larger constructs, concepts, and methods by the many therapists and clients who contribute thoughts and observations and experiences to the larger body of understanding.

As modalities grow, they are slowly codified into specific theories of how the mind works, often accompanied by a “toolbox” of specific “interventions” and techniques that are accepted as useful ways of helping people understand themselves and resolve their emotional distress: Talk therapy, guided meditation, dream journals, expressive dancing, hitting mattresses with tennis racquets, free association, body work, and even just sitting together in silence.

There are hundreds of these interventions, and within each modality there is continual discussion back and forth about which techniques work best for whom and how best to apply them. However, for someone approaching therapy for (perhaps) the first time, the most important thing to remember is that each theory and corresponding “modality” is basically just a set of rules and expectations about how the therapist is supposed to behave—and the kinds of things the client is supposed to talk about, pay attention to, and do.

And the goal of all of this is to relieve psychological suffering through effective, meaningful human contact.

With that in mind, let’s now turn to the question in hand: What is “psychodynamic” psychotherapy?

Psychodynamic Psychotherapy

Psychodynamic psychotherapy (which is what I practise) focuses on internal experience and making sense of the things that happen to us; what we feel and why we feel it. In other words, it tries to understand the movement and relationships (the dynamics) of and between the thoughts we think and the feelings we feel (our personal psychology).

In our day-to-day lives, most of the time anyway, we do the things we do without realising what we’re doing or why. When these things cause us problems, it then leads to the common feeling of being out of control and of being unable to change—of being in thrall to “bad habits” we hate, depression we cannot shake, being “triggered” by trivial events, and overcome by anxieties that won’t go away no matter how “rational” we try to be.

The psychodynamic view is that the thoughts and actions which cause us so much trouble are actually ways of escaping from uncomfortable emotions, or forgetting about the things that make us feel them. Denial and repression; escapism through food, drugs, sex, and entertainment; obsessive work, or cleanliness, or exercise; rigid and dogmatic rationality that ridicules “silly and stupid” feelings—effectively, these are all simplistic ways of hiding from strong emotions, bad thoughts, and difficult memories.

You are not broken

Contrary to a more mechanistic view of mind and emotion, the psychodynamic approach does not assume that these so-called “maladaptive behaviours” (this term is inaccurate and misleading on a number of levels) are the result of faulty cognition, or a “chemical imbalance, or a broken brain. Quite the opposite: they are active, intentional adaptations we make in order to manage difficult circumstances and unresolved traumas.

To put it another way: We choose to act in these ways because it makes us feel better, it makes us feel safe, like we have some kind of control over the world. Even if we don’t know why, even if it’s only for the briefest moment, and even if it brings serious side-effects with it—it works, and until now that’s all that has mattered.

However, while our respective coping/survival/protection strategies were effective in the past and have gotten us this far, they probably aren’t as effective as they used to be, and today probably cause more problems than they solve.

Understanding our Personal History

This is largely because we each chose our preferred coping mechanisms at a time when we were too young to really understand what we were doing or what the consequences would be. As children, with a limited range of options, we found a strategy that worked and so we used it.

In order to develop a mature and balanced approach to difficult events and emotions, we need to understand what makes the childlike ones so powerfully attractive. A large part of this is understanding what we were feeling at the time that made us need to reach for a coping mechanism in the first place—because often, the more intensely we rely on an unhealthy/unhelpful strategy in adulthood, the more intense the childhood aversion/fear/trauma was. And the tighter we cling to it, and the harder it is to shake and re-shape.

Very often this is reflected in the form of the coping strategy we use. The most problematic ones are always the most childlike:

  • stealing (I want it!)
  • denial and lying (I don’t want it to be true!)
  • cheating (I want to win!)
  • directly seeking comfort in foods we know are bad for us (Feed me!)
  • escapism, drugs, alcohol (Make me feel safe and strong!)
  • neediness and disruptive attention-seeking (Love me!)
  • distrust and avoidance (I hate this, and I hate you!)
  • throwing a temper tantrum (Give me what I want!).

This is one of the reasons why psychodynamic therapists seem so obsessed with their clients’ childhoods, particularly their family relationships. Because human beings learn primarily by example (monkey-see, monkey-do), and the coping strategies we choose are often the same as (or the exact opposite of!) the ones our parents used. And if we didn’t learn them from our parents, we almost certainly learned them because of our parents.

More generally, however, it is our earliest experiences of support or criticism, love or neglect, success and failure which lay the foundation for our entire future self. These experiences can have been with anyone we ever encountered in our youth, and everything that has come after is built upon and interpreted in terms of them.

Talk therapy

The psychodyamic model is built on the finding of thousands of therapists and clients that “working through” our personal histories—taking the time to remember, talk about, and reflect upon our childhood experiences—is psychologically healing. It does so (in part) by creating a coherent sense of your own story and the people and events who have made you who you are. It also helps you put the past into the past, and to recognise when it is interfering with the present. This lets you build and maintain a sense of solid structure within yourself: who, what, where, why, when, and how.

Most importantly, however, it helps you tolerate the “stupid” or “irrational” feelings you have been trying to escape from. Talking openly about emotions lets you see that the opposite is true, everything we do is emotional, and we have feelings about everything. Verbalising them therefore helps you understand that having strong emotions does not make you a monster, or selfish, or childish, or irrational, or immature, or any of the ideas we use to punish ourselves for being “bad.”

Simply put, there is something magically liberating about allowing yourself to remember events you have banished to the back of your mind, and hearing yourself say out loud the things you have so long been terrified of letting out. Doing this over and over again without being punished, or judged, or criticised, or ridiculed, or rejected—being instead praised and encouraged—is a major part of the healing process.

Re-Learning, Re-Adapting

However, your present life is just as important as your childhood. Because it is in the present that you have to actually make the changes you want to make. You will inevitably encounter situations which stir you up and you will then have decide not to react in your old-established ways.

By talking about your present life and how it relates to your past, you create intelligible chains of cause and effect which allow you to see things differently, to understand what is happening and why, and then to behave in a way that is consistent with who you want to be.

This is by nature a process of trial-and-error, and exploring your day-to-day successes and failures in your therapy sessions helps to reinforce the new patterns and integrate them into your self-image.

In other words, you are re-learning how to be in relationship with the people around you, and re-adapting to the circumstances of your life as they really are. Psychodynamic therapy sees this re-adaptation process as having three basic, interrelated elements.

  1. Our coping strategies and defence mechanisms are activated and strongly influenced by thoughts and emotions that happen outside of our immediate awareness. Because we can’t see them, we can’t understand them, and therefore can’t yet change them.
  2. The patterns which give rise to these hidden thoughts and emotions don’t spring up from nowhere; they have grown over time and have been continually refined and reinforced through experience. To change them we need new experiences, and those experiences must also be reinforced over time.
  3. By talking about the past we are looking at old events with new eyes, and we can learn to see what was previously invisible. By talking about the present, we get a clear view of what is really happening. And by talking about the future we direct our development towards what we actually want.

In other words, becoming aware of our unconscious motivations allows us to break old habits, to then have new experiences and cope in a new way, and to gradually, but intentionally reinforce new patterns so that they continue on into the future.

Moopidoo

Each session is a chance to step out of the normal form and flow of space and time and see and experience things in a new way. The focus is on you and only you, because that is also the point. The psychodynamic therapist keeps their needs and automatic reactions out of the conversation so that you can see, feel, and understand those parts of your memory and perception which are normally hidden from view. They do it gladly because they know the value of it, and that it can work no other way.

And as you discover more things about yourself than you ever though you could know, and see yourself becoming the person you always knew you should have been, you’ll (hopefully!) understand and be glad of this somewhat strange arrangement. Because above all, psychodynamic therapy has as its goal to see you, know you, and respect you for exactly who you actually are. It is a feeling that everyone craves, and which everyone ought to experience at least once in their life.