Tuesday, February 3, 2009

Learning From Things That Go Unsaid - 2

By Kevin Murphy, M.Sc.,
Psychoanalytic Psychotherapist
Dublin, Ireland.

I’m picking up where I left off last week on the concept of the client gaining self-knowledge through the unspoken actions between him or her and the therapist. Before I go into that, let me just say that the same things apply all the time in our relationships with people in our daily lives. It’s just that we tend not to notice them.
For the purposes of the therapeutic setting, however, the relationship with the therapist is a key factor in the whole thing. You have to believe that the therapist you have chosen is the right person for you. That’s usually done by checking out the person’s qualifications. If they haven’t spent time studying to be where they are then you are right to be wary.
But what of the person who has all the qualifications necessary and the client still doesn’t feel they are the right person for them? Is the therapist cold, uncaring, unresponsive? Sometimes that can happen and it isn't very nice. But most therapists are respectful and welcoming while trying to retain a professional sense of distance. They want to help the client overcome whatever it is that is holding him or her back but, equally, they don't want to be a surrogate ‘buddy’.
If there is nothing obviously amiss with the therapist but the client still feels they are in the wrong place, where then do we look for explanations? Is it the client’s own view, a privately held opinion, a vibe, a vague feeling? If so, then we are moving into the area of unspoken, and unconscious, repetitions of earlier relationships. The therapist, without doing or saying a single thing, has taken up the position of someone else from the client’s life, for the client.
When the therapy begins the client may think the therapist has all the answers, can put his finger on exactly what it is that is wrong. But after a few sessions, when the client realises that there is still an amount of work to be done and things haven’t changed as quickly as they would have liked, the positive feelings can turn negative and the therapist is now useless or uncaring or badly qualified or has an office that is too far away or the fee is too expensive.
Nothing has changed on the surface of things. And usually, none of this is ever spoken out. But the client is firmly convinced of these view and attitudes.
The therapist has taken up the position of important ‘other’ person from the client’s present or past life and one that is failing to help, is failing to get them out of their misery, or pain, or confusion. The therapist fails to love them, know them, understand them or even care about them. And yet, nothing could be further from the truth.
In reality, what the psychoanalytic psychotherapist contracts to do is to pay full attention to everything the client brings to the session ‘every single time’ the client turns up for their appointment. The therapist contracts to be there on time; not to exploit the relationship in any way; not to charge anything other than the agreed fee and to remember at all times that the client will have a certain amount of dependency on the therapist while getting stronger in themselves.
But therapy is a relationship and if relationships, either current or past, have been problematic for the client then this is going to surface in the therapy. If someone has been damaged by relationships, they will have difficulty trusting the therapist as ‘other’ to help. If relationships, particularly early ones, have been disappointing then the client will not allow themselves to even like the therapist. All of this is usually unspoken and yet it impacts directly on the therapy.
So if you accept that psychoanalytic psychotherapy is founded on a professional, talking relationship through which a cure is being sought, then how you ‘handle’ that relationship, just like any other relationship in your life, tells you a great deal about yourself.
In this light, what if you end your therapy half way through the treatment without any notice, by simply not turning up anymore and never explaining why? It’s a bit like ending a relationship by text, isn’t it? Ask yourself what it tells us about someone when they end a relationship by text? Or what if every week you arrive late, or don’t show up every second week without giving the standard 48 hours notice? Or after just two sessions begin asking how much longer will it take?
It’s a way of saying you don’t want to be there in the first place, isn’t it? That’s fair enough, but then why are you there at all? Because to be human is to live in that paradoxical place where we need other people and yet we don’t like having to need people. And that in turn leads us to why the business of conducting a relationship in a mutually respectful way with another human being is so fraught with difficulties.
The option of a talking therapy is always going to be a problem for those who see relationships as a threat because relationships are a two-way street on which they risk having something of themselves exposed. As such they will try at every turn to get away and hide. For these people there are always lesser demanding therapies that can be short term, non-speaking or pharmaceutical. But the best way of curing the human problem of psychical pain and unhappiness is through engaging in a professional relationship with another human being in the search for one’s own particular truth.

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