Psychotherapy Blogbriefs is about my experiences, learnings, discoveries, thoughts and suggestions as a therapist in Santa Fe over the past 18 years, and as a human during the course of my life.
These are difficult, dramatically changing times. It may seem as though personal unhappiness - frustrations, dis-satisfactions, confusions - is increased without understanding why. Part of what is happening is much beyond the merely personal. The entire world is in upheaval, from economic crisis, to environmental crisis, to human rights crises, to wars upon wars and abuses upon abuses. These realities effects your personal equilibrium whether you are aware of it or not, and increase your experiences of dis-stress.
Why is it so difficult to befriend oneself? To treat oneself with deep respect and love? To truly care for oneself? To honor one's heart's longings and callings? What do we imagine the risks of doing these things to be? What do we fear losing if we did? How far might you be willing to go in the service of your truth? How do conflicting desires prevent you from serving your true purpose?
Who are you, anyway? What are you doing here? What master are you serving? How are you contributing to the welfare of the world? Or are you? If you're not, you'll no doubt be diminished within yourself, and will feel this in any number of self diminishing ways. The reality of happiness and sanity requires an orientation that is not merely selfish. The reality of happiness and sanity requires something other than the worldly wisdom of dog eat dog, and every man/woman for him/herself.
This is, of course, risky business. It does, of course, go against the grain. It does not conform to the "norm". It requires a certain courage, a certain willingness to swim up stream, if you will. Oh, this is nothing new, yet translating this understanding into "mental health" reality is and always has been a challenge, seemingly reserved for the relatively few. Yet in these times, there seems to be the necessity of expanding from the few into something more. Maybe it always seems that way.
Know Thyself. After all, this is what depth psychotherapy has to offer. Related to the classical quest for the good life, for wisdom, for happiness. It is in knowing oneself that one enters the possibility of true happiness, of liberation from the pettiness of selfish ambitions, and of escape from the tyranny of egoistic demands.
To know thyself is to know God, to know Truth, and, as one master told us, the Truth will set you free.
Psychotherapy has the potential to blend an understanding of basic life skills, with the exploration of deep identity. Making relationships work well; learning to work effectively with one's own mental processes; developing insight about and understanding of one's behaviors, language, thinking, and feeling; having and making choices beyond what one thought was possible or available; addressing "symptoms" and manifestations of distress and unhappiness; accessing real meaning and value in one's life; re-connecting with the lost deep ecology of one's right place in, and one's right relationship to the (natural) world; being able to love.
Basic life skills: how to relate properly to oneself; how to relax and renew; how to align one's behaviors with true (ie., substantive, satisfying, grounding, beneficial) meaning and value; how to be effective in controlling oneself, rather than trying to control others; how to most effectively and beneficially change thoughts and feelings; how to develop humility, courage, and trust; how to release attachment to what one thinks one needs; how to experiment and explore intelligently and beneficially; how to cultivate the true precursors of happiness; how to surrender.
"Thank you for your heartwarming email.
I did not expect such understanding and was touched.
Please take care and continue to be blessed!"
I just wanted to share a recent communication from an intermittent client. Why? Aside from the fact that it says something good about me, it also illustrates the kind of recognition, reflection, appreciation, and client support that good therapy ought to include. As a client, you have the right to expect these things from your therapist, and they will provide the foundation for a fruitful therapeutic relationship and therapeutic experience for you.
What's the likelihood that therapy will have any beneficial effects for a client who is not motivated to undertake the journey involved?
Motivation here would include things like: being aware that you are somehow in distress, or that you are not functioning as well as you'd like to be, or that you behave in ways that are counter productive/destructive/injurious; recognizing that you need some help to "sort things out", that you have not been able to "fix" things on your own, even though you may have tried repeatedly; and then, with all of this awareness and understanding, actually seeking help.
This would be different, for example, from a man who, when asked what brings him to therapy, answers that he is doing it because he told his wife that he would. (Did his wife threaten to leave him if he didn't? Does he expect that he will be able to appease her - and maybe get her off of his back - if he appears for a couple of sessions?)
This would also be different from someone appearing for therapy because they have been court ordered to do so, while their only motivation is to avoid going to jail.
Of course, it is possible for someone in the above examples, while they may not be motivated initially in the sense that I have described, to develop some level of motivation on their own behalf if they only appear with some regularity, but this would be, in my experience, an exception, rather than a rule.
So how ought such a client (I use this term somewhat loosely here, since such a person is, by definition, not a "real" client at all) and such a situation, be approached? Of course there is no single correct answer to that question, and different therapists will indeed answer it differently. Let me then answer it only for myself.
As a bit of background information, there was a time, much earlier in my professional career, when I was willing to try to motivate unmotivated clients "for their own good", so to speak. I believed that I could indeed somehow convince these clients that the process of therapy, and in particular, the process of therapy with me, was just what they needed. It could and would truly help them, and they ought to become converted to this view.
What I discovered over some time with this approach was that not only was I wrong in my expectations, but that the process of attempting to motivate someone else to do what I believed was going to be helpful to them succeeded only in exhausting me, and did not do much good, if it did any good, for this "client". I have since settled into what I consider to be a much more realistic and intelligent approach. This consists of being fully available to any client whom I believe I can actually help, as long as they are sufficiently motivated to be helped. To put it another way, as I was taught long ago, and as I have come to appreciate as sage wisdom, the therapist should never work harder than the client in therapy.
If you are considering therapy, also consider your level of motivation for being helped, for making positive, healthy and rewarding changes, and for being willing to work at this, rather than expecting your therapist to miraculously fix you through their own efforts. I'm not sure that I see any point in beginning something that you are not able or willing to invest yourself in. mdavid-lpcc.com
It's been quite a while since I've posted anything, so I thought I'd visit and see where an aimless ramble might lead; or as one client calls it, "babbling". In reality, this "babbling" always leads to something meaningful, and unforeseen. Maybe that will be the case now.
The theme of how change might be effectively facilitated is an interesting one, and there seem to be at least two very divergent views on this. One being what I'll call the more common view, that change is best facilitated by some kind of active "assault", or effort in the direction of the desired outcome. If you want to feel less anxious, for example, you set about to reason with yourself, and even argue yourself out of the irrational ideas that you harbor that actually create and cause your anxiety. When once you've seen the light of this reason, and have managed to actively and even aggressively replace your misguided thoughts with more realistic ones - one's that accurately reflect a set of circumstances and conditions which would not lend themselves to distressing levels of anxiety - you will, naturally and automatically, so to say, feel less anxious. This strategy does indeed work, for some people, in some situations. I like it, and I use it, when appropriate.
Then there is the much less known or understood method which says that it is possible to take a more "passive", or, more accurately, a more contemplative or reflective approach to the situation, in which one learns, through practice, and through the development of the capacity for a heightened tolerance of distress, to be more accepting of oneself in all of one's moods and qualities, allowing the inevitable process of organic change to take place without too much interference.
There are some keys to the successful implementation of this approach, and they include the aforementioned capacity to tolerate distress, to "sit with" -as in sitting meditation, for example - one's experience, while learning how to let go of judgments about it and about oneself, and to relate with oneself and with one's experience more tolerantly, more forgivingly, more compassionately.
This method or approach makes certain working assumptions, of course, among them being the one that says that desirable change will occur in a context, in an internal environment, of kindness and gentleness with oneself, perhaps more easily, but certainly more gracefully than under aggressive terms. You could say then that this approach gives a higher value to this context/environment than the former one does. I like this too, in that the metaphor is closer to something like organic gardening than to field maneuvers. Let's pay attention to the soil in which we are planning to grow something wholesome and delicious. Let's cultivate it, prepare it with the proper healthy supplements, tend it and it's produce. Like raising healthy children. This will significantly increase the likelihood of a desirable outcome.
This method, it seems to me, is much more in accord with the urgently needed concepts of sustainability and conservation.
These days I seem to be more keenly aware of the necessity to be able to appreciate the reality of paradox, not only in life, but, of course, in therapy. Just yesterday, for example, I found myself talking to a couple about the fruitfulness of being able to recognize and somehow truly get the gist of this experience in their relationship. I'm not talking about an abstract conceptual understanding only, but an experiential understanding of what it feels like - liberating, if truly "grocked" - to embody the reality of paradox. A simple, yet, I think, powerful example: the necessity to be able to accept oneself (and one's partner for that matter) in a deep and loving way, with all of one's foibles and imperfections, while fully embodying the willingness, and even the necessity to make (healthy) changes. (Dr. Marsha Linehan has articulated this paradoxical imperative perhaps most formally in her Dialectical Behavior Therapy).
To me, this "truth" has a philosophical, ontological ring to it. It speaks somehow to the way things are in the universe, including how they are in relationships and intra-psychically. So, coming to appreciate this view of the way things are has important psychological, relational, and therapeutic implications, and might be used very effectively in these contexts. This relates to the notion that the truth actually does set one free, psychologically, emotionally, spiritually, if it is fully integrated and experienced.
How different it feels, how freeing, to deeply understand that apparently contradictory elements in one's life, elements which normally create a psychological tension and distress, do not need to be "reconciled" or eliminated, but that they are in fact true simultaneously, and may both be allowed to be. A mundane, yet sometimes critical example of this in relationships: it is possible to love and relate harmoniously with a partner who has attributes and behaviors that one does not like, without feeling that one must insist that these attributes or behaviors disappear, and feeling perpetually frustrated when they do not. (There are, of course, limits. If the attributes or behaviors that one does not like happen to be something like abusive actions, or destructive addictions for example, then it may indeed be appropriate to insist that these change or "disappear").
There is a felt terror that underlies many common efforts to avoid contact with the deeper dimensions of the self. This can be called the existential terror surrounding death - or, more descriptively, I think, the sense that one will disappear, and cease to exist - or the terror which attends early experiences of neglect or abandonment by primary caregivers (which is, after all, the reflection of the very real possibility, known by the body in its wisdom, of its own demise). However one wishes to name it, this terror is a primal experience which requires a certain direct attention, and even some significant degree of conscious surrender or acceptance, on the way to re-establishing the total commitment to and reconnection to oneself that will be the basis for psychological integrity.
It is terrifying to approach this core, and the prospect is often associated with a belief that one will be swallowed up by the immensity of the experience. This fear is an exaggeration. One does not disappear, but one is transformed, which may be tantamount to the same thing in one sense at least. Who one has experienced oneself to be may indeed change very significantly.
In other words, with the proper understanding and the proper commitment, and, I will add, with the proper guidance and support, it is possible to approach this terror safely, and to not only survive this approach, but to learn to experience a depth of psychological freedom and wholeness that perhaps no other process will offer.
And yes, this does enter into the realm of the "spiritual", but let's not be too quick to define that realm in simple terms.
