Therapy… Who needs it?

By Tony Yates:

Shiatsu, aromatherapy, cranial massage, CBT… Alternative therapies for mind, body and spirit have been mushrooming up ever since the 80s and now flourish alongside traditional counselling. Some want to reach your mind through your body; others would introduce you to the universal mysteries; one or two want to re-acquaint you with the wisdom of your tribal ancestors. The choice is bewildering. Where on earth is a mind in need of help to turn?

The sceptic as always has an answer: turn to a good friend and take a bottle. When it comes to life we are all amateurs. Why pay good money to a so-called expert? You can’t go on blaming your parents forever. Besides no one promised us a rose garden. Now I’ve a sneaking admiration for that stoical view, and I speak as a self-confessed therapist. In today’s market-driven society, every whim and whimper it seems is catered for by some consultant or other – for a fee of course. Whatever happened to that proverbial stiff upper lip? On the other hand – and here I put my counsellor’s cap on – many of those sceptics lead lonely and isolated lives; life has taught them to be wary of depending on anyone. If only they knew counselling could help. However, if you’re not a sceptic and the New Age is beginning to look rather old hat, where do you start? Ad what are you letting yourself in for?

Psychodynamic counselling has its roots in psychoanalysis, t is less intense and less frequent. Psychodynamic therapists seldom see their clients more than twice a week, and usually only once. Both schools, however, believe that we all pass through certain psycho-sexual stages of development in childhood, and how we and our parents negotiate those stages pretty well determines the kind of adults we become. The past, therefore, lies just under the skin of the present; rather like those X-ray photographs of Old Master paintings that reveal the artist’s first attempts lurking beneath the finished surface. With this as its canvas, psychodynamic counselling takes as its subject the dynamic and ever-changing relationship over time between counsellor and client. As you can imagine, that leaves a lot of scope for misunderstanding. For the protection of their clients and themselves, psychodynamic counsellors are therefore bound by a written code of ethics – with serious sanctions if they fail to observe them.

The ‘therapeutic alliance’, as it is called, is like no other relationship. It can and should be deeply intimate, but is held in check within strictly-observed boundaries. Sessions begin and end on time, whether the client is in floods of tears or not, and they take place in the same room at the same hour every week. Inflexible as it may seem, it comes to feel like a safe and dependable container.

Trust is a problem all clients have in common. If the counsellor’s room is a sanctuary, it can also feel uncomfortably like a torture chamber at times. Trusting this intimate stranger with memories and feelings you thought you’d never share with anyone is like giving all your hostages to one fortune. We are all afraid of putting ourselves in another’s power, even someone we have gone to for help. There will be times when you’re convinced that your counsellor is laughing at you, or thinks you are pathetic, or disapproves of you in some way. It is important that you communicate these suspicions. At such times your therapist will feel that he or she has been cast in a role, that a mask has been placed over his or her face; a mask, as it turns out, of someone from your background. Of course you know she’s not your mother, doesn’t look anything like her, but for a while back there, well, in a way she was – and you reacted accordingly. As you and your counsellor become aware of these unconscious misjudgements (the professional word for it is transference) you begin to realise that you have pinned that mask unknowingly on other people in your life – with disastrous results.

Through ‘transference’ – the way we related in the past, usually to parents – subtly distorts the way we relate to others in the present. The distortions are not always negative. Idealisation is also a distortion and inevitably leads to disillusionment. We experience people in part as they are, and in part as we expect them to be, and we expect what early experience has shaped us to expect. Whenever a couple have a flaming row, the ghosts of their original families are often as not the hidden protagonists. They are so much a part of us, so much under our skin, that we are unaware of their existence or their origins. It seems we can never entirely shake them off?

This is what psychodynamic counselling is really about. If you like, it’s a kind of exorcism, a laying to rest of old obsolete ghosts. The defences we erected in childhood will also be there, but don’t expect to dump them overnight. In childhood they helped to keep us from mental breakdown; now they too are obsolete and actually obstructive. Adults have breakdowns when their life-long defences suddenly fail to defend. Counselling, however, is not like peeling an orange: one skin and you’re into the juicy bits. It’s more like peeling an onion; the aim is not to reach the innermost skin (an impossibility anyway), but to peel off the old superfluous skins, or defences, that prevent you from being open and intimate.

Whatever your feelings, you begin to see that this relationship with your counsellor is both the problem and the solution. Unlike others that went wrong and ended badly, this one offers the chance of getting it right, of coming back to it again and again until it feels more secure, more open, even playful. It’s a chance not to rewrite the book, but to rewrite the ending. Of course life can still bring misfortune and misery. As Freud himself said, the purpose of psychoanalysis is to enable people to experience ordinary human unhappiness – as opposed to neurotic unhappiness. Freud was a realist.

Who needs it? It is not for everyone. If you suffer from an addiction, or phobia, or a compulsion, you would be better off seeing a Cognitive Behavioural Psychologist (CBT) first, or joining a support group that specialises in that problem. But if you feel that you yourself are the problem, and it affects the way you relate to others, you will need a therapy that addresses both causes and symptoms in greater depth. Recommendation is probably the best way of finding a good counsellor. Failing that, you could turn to your G.P, or The Counselling & Psychotherapy Resources Directory, published by BACP, or of course the Internet. When you do start don’t be afraid to ask your therapist if you can review the situation after four or five sessions. You should know by then whether you feel compatible or not.

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