The Truth About Disappointment in Psychotherapy (And Why You May Benefit From It.)

Counselling_session

“The most important things that each man must learn no one can teach him. Once he accepts this disappointment, he will be able to stop depending on the therapist, the guru who turns out to be just another struggling human being.”

-Sheldon Kopp.

Kopp was a very perceptive psychotherapist and writer; this memorable book, below, was written in the early 70’s.

 

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Kopp’s message is about each person becoming aware of the disappointments they experience in psychotherapy and by implication, in their life.

The pain of this will likely lead, if worked through with the help of the therapist, to a sense of freedom, greater confidence, strength and self-actualisation.

However, Kopp warns that therapy is hard and is not to be undertaken lightly. Before this enlightenment happens, people often go through a difficult process in therapy. 

This process usually begins with the realisation that the therapist is not living up to all they had initially hoped for.

Most people come into therapy expecting the therapist to sort things for them, possessing magical ways of changing lives.

Understanding that the therapist does not have any solutions might feel really upsetting. Sometimes, at this juncture, people become despondent, feel lost, or angry with the therapist.

If the therapist doesn’t have the answers, then WHO DOES??

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However, this phase in therapy can represent a crucial turning point. Negotiating such feelings with a sensitive therapist can mean that new learning will occur.

Expectations of the therapist being the longed-for parent or god-like figure (“Buddha”) need to be explored, perhaps in the light of the person’s unmet needs from the past.

When a young man, whom I shall call Peter, came into psychotherapy with me, depressed, self harming and suicidal, he had unconsciously hoped I would be a replacement for his absent mother.

Yet he was so angry that the therapy only lasted 50 minutes, that he spent most of the session watching (and hating) the clock, begging and manipulating me for longer.

The clock itself became a weapon that he perceived me as using against him, merely by having it in my therapy room.

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Focussing on the clock meant he could not use the time we did have. I worked at helping him with this, empathising with his enormous pain, whilst staying firmly within the time boundaries.

At the end of each session, I was, in the transference, his unavailable mother. He was disappointed with me for a long time and furious that there were others in the waiting room for me to see.

They felt like rivalrous siblings for him.

Slowly, as the months passed, he began to see my limitations, that I was a fallible human being and I could not be his fantasy mother.

I could not make the session last for as long as he wanted it (endlessly) and see him exclusively for therapy. This was a huge disappointment.

However, he also realised that I was able to help him develop a kind of ‘parent inside’, a feeling that he could care for himself, so that he no longer felt like an abandoned child. He began to also find some answers of his own.

Despite my shortcomings,  I was not abandoning him. Far from it. Peter began to appreciate what I could offer and forgot the clock. He stayed in therapy twice weekly for several years and grew into a strong, confident person, having accepted some losses and disappointments.

Managing Disappointment in Couple Therapy.

There are many couples who come for therapy disillusioned with each other. Therapy will usually be aimed at exploring expectations, tracing where these have come from and refocussing on reality.

For example, it may be that one or both of the partners had an unhappy childhood and abusive or inadequate parenting. Then, people might search for an ‘ideal’ parental replacement in a partner.

The unconscious hope is that unmet needs from childhood will be totally satisfied. This is, of course, a vain hope, in that we can never fully make up for what has been lost. We cannot be that needy child again.

However, it is possible to work towards meeting one’s unmet needs in a relationship in the present, as long as these are realistic.

Sometimes people are expected to be knights on white chargers, coming to the rescue  after a traumatic past. This is, of course, a recipe for disappointment.

Others are expected to fit the ‘perfect’, stereotyped image of what a wife or husband ‘should’ be, whatever that is in the individual’s psyche.

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Image: James Vaughan, Flickr.

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Such stereotypes are based on past experience, or on fantasy.

How do psychotherapists help people overcome disappointment in relationships ?

In a relationship where expectations are high, people will feel constantly dissatisfied, resenting the fact that the other cannot live up to their exacting standards.

This is about needing to control others, to fit them into a view of how they ought to be. It is often extended outside the relationship, to children, friends and colleagues.

If we expect perfection in others and wish for control , we will be projecting onto them our own thoughts about having to be ideal. We are imposing impossible behavioural criteria that we ourselves could never live up to.

We must question where these high expectations originated. Often, patterns of behaviour experienced as children become repeated in adulthood.

As we saw in Part 1 of this post, expecting the other to be perfect usually involves criticism and accusations. Learning to negotiate, to be non-judgmental and open-minded, compromising and adapting, are ways someone with over-high expectations can address their problems.

Couples and individuals are helped in therapy to work through past disappointments. They are encouraged to explore how they project onto others and ultimately to take back their projections. Then, hopefully, they will be able to accept the other, warts and all.

“You come to love not by finding the perfect person, but by seeing an imperfect person perfectly.”
– Sam Keen

Expectation has brought me disappointment. Disappointment has brought me wisdom. Acceptance, gratitude and appreciation have brought me joy and fulfilment.

Rasheed Ogunlaru

How to Safely Stay in Your Adult Self and Protect Your Inner Child.

 

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“We often tend to ignore how much of a child is still in all of us.”
Elisabeth Kübler-Ross.

“The most sophisticated people I know – inside they are all children. ”
Jim Henson

What does the term ‘inner child’ mean?

The child that we once were still remains inside us all. She or he is still there, in memories, reactions, experiences. Perhaps this child partly resides in our unconscious mind:

“So, like a forgotten fire, a childhood can always flare up again within
us.”

-Gaston Bachelard

Eckhart Tolle said that “The past has no power over the present moment.” However, the past will ‘flare up again’  if you, the adult, cannot prevent this from happening. If you lose your adult self, or do not have a strong enough set of coping mechanisms, the child that you were will be left alone.

Sometimes, people have been so badly traumatised in childhood that they need others to help them nurture their damaged selves. This is an absolutely understandable need for someone who has been hurt or abused in the past.

Lending Ego.

Then they may need therapeutic help. I like the concept of the therapist lending her ego’, that is, allowing the other person in therapy to ‘borrow’ their adult strength during this painful experience:

The notion of “lending ego” derives from the psychoanalytic tradition; and broadly conceived, it refers to a therapist’s functioning as an “auxiliary ego” for the patient. The patient is allowed to use or “borrow” the therapist’s presumably well-working mind and psychological capacities in order to enhance his or her own, relatively deficient, psychic functioning in particular domains. In effect, the patient is encouraged to think like the therapist, who presumably represents a good role model for mental health.

-Misch.

In a sense, we could extend this theory and say that as an adult, we sometimes might need  to ‘lend to our inner child’ our own, adult, protective ego or self.

Transactional analysis   is a kind of psychotherapy which views each of us as having 3 ego-states : parent, adult and child.

Counselling Directory explains these further:

  • Parent – Rooted in the past; a set of thoughts, feelings and behaviours learnt from our parents and other important people. This part of our personality can be supportive or critical.

  • Adult – Rooted in the present; relates to direct responses in the ‘here and now’ that are not influenced by our past. This tends to be the most rational part of our personality.

  • Child – Rooted in the past; a set of thoughts, feelings and behaviours learnt from our childhood. These can be free and natural or strongly adapted to parental influences.

When childhood, adapted behaviours and memories of trauma are rekindled, this can create difficulties in the present. The following case study illustrates this. (I have changed any identifiable personal details for confidentiality purposes.)

Childhood Fears in the Present 

The person in my therapy room was very afraid. Moira, an elegant, professional woman in her forties, happily married with three children, was curled up in her chair, weeping , trembling. The reason? She was contemplating meeting her abusive mother, whom she had not seen for some years.

Mother now lived in France, but she would see her at a wedding in London the following month. Moira wanted to attend and be strong enough to face her mother, but was terrified. Her fears were those of the child that she had been, revivified in the present.

An only child, she had been helpless and isolated with her powerfully undermining and narcissistic parent. She seemed now to have lost sight of her highly functioning, adult self.

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Over the next few weeks, we gently focussed on her awful memories and how powerfully they were affecting her adult life.

What frightened her most was the prospect of becoming a fearful, tearful wreck, in front of others. It took a while for her to realise this terror was, in fact, a memory. With help, she could regain her adult composure and, most importantly, hold onto this strong part of herself and not slip into her child persona.

She began to understand that she could use the strength gained over the past years. She had achieved this though her extensive education, her loyal friends,  years of psychotherapy, her supportive husband and being a mother.

It also became evident that the scenario she was envisaging had gone, that never again would she be a helpless child. Equally, her once strong mother was in reality older now, ill  and frail.

“Fear of breakdown is the fear of a breakdown that has already been experienced”
D.W. Winnicott

She was generally comfortable and secure in her adult identity in daily life. She wanted to be able to face her mother, exchange greetings, no more. She could have chosen to ignore her, blank her, but she did not feel this was right for her.

Having focussed on staying in her adult self and on protecting the frightened child aspect, she did manage to enjoy the wedding and cope with the meeting with her mother with dignity and strength. She also saw how ‘weak’ her mother appeared.

“She seems to have shrunk and her voice is less strident,” she told me. I think her mother had shrunk, perhaps physically, but certainly in the way Moira saw her. And Moira had grown psychologically.

“We don’t see the world as it is, we see it as we are”

Anaïs Nin

The confidence this gave her was enormous; she could overcome her childhood fears and recognise that the child she was would never be alone again. Time had passed, changes had occurred and Moira could now protect the damaged child that she was. 

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“To abandon the child ‘within’ means that the adult ‘without’ will be an adult in name only. And frankly, I can only name a handful of things that are that tragic.”
Craig D. Lounsbrough

“She held herself until the sobs of the child inside subsided entirely. I love you, she told herself. It will all be okay.”

H. Raven Rose

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Once the adult feels secure in herself, then she can let her child aspects play and be liberated, enhancing her adult life :

“We nurture our creativity when we release our inner child. Let it run and roam free. It will take you on a brighter journey.”
Serina Hartwell

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Do you have anything to add? Have you had experiences of inner child work in therapy? Do share in the comments section below if you can. Thanks. Linda.

This is why your home is so important to you – Finding a Home Inside Oneself. Part 2.

Finding Our  Inner Home.

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Home is so Sad.

Home is so sad. It stays as it was left,
Shaped to the comfort of the last to go
As if to win them back. Instead, bereft
Of anyone to please, it withers so,
Having no heart to put aside the theft

And turn again to what it started as,
A joyous shot at how things ought to be,
Long fallen wide. You can see how it was: 
Look at the pictures and the cutlery.
The music in the piano stool. That vase.

Time passes. We change. Home changes. Yet, the longing for home is a familiar theme across literature, poetry, drama, music and art.

Sometimes, this might feel like an unmet need, one that is impossible to satisfy externally. People erect magnificent edifices as their homes, each bigger than the one next door.

Yet there is often still a desire to seek further. What is the meaning of this desire?

Collinson explains:

“This is because home, the real home we are seeking is something within ourselves and our own being.  Symbolically, it is the center of the mandala.  Home is connection with the centre of our own being; it is to be accepting of and at home with the deepest part of the self.  But to find that, we must undertake an inner journey.”

Collinson.

For this journey into the self, we might use meditation, religion, psychotherapy. This journey is surely one where we must discover for ourself; we are at the centre of the mandala.

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It is true that a home inside the self is what many people might be seeking when they come for psychotherapy. In this case, home means so much more than a place, a building, bricks and mortar. This home is related, not to physical space, but to psychic space.

This home is about feelings, unrequited and unmet; it is about memories, some traumatic, some wonderful, yet gone forever. It is also about unresolved loss and grief, perhaps guilt at letting go of loved ones.

It can also be related to fear of change and a need to live in the past. There might be a fear of letting go of objects and people that may once have felt secure.

People with such issues often want to shed their ‘baggage’, as it is often described, but they feel unable to put it down, to feel relieved of their burdens, to relax into their internal space and their present lives.

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Perhaps it relates to a fear of growing older and of the responsibilities of adulthood. Just as some people hold onto material objects and hoard them, so we can do this in a psychical way, holding onto the past. We may hold onto both good and bad experiences, which prevent us moving forward in the present.

“There’s nothing more difficult than saying goodbye to a house where you’ve suffered.”
Vasily Grossman, Life and Fate

The ‘rubbish’  that blocks the room in the image below may be compared to the psychological jumble of ‘messy’ feelings from the past that people bring into therapy. This past luggage blocks the person from moving on and really living, just as the junk is doing in the picture.

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Household of Compulsive Hoarders Donald Trung. Wikimedia Commons.

The journey is one into acceptance of the reality of the self, past and present. For the home that has been longed for is a kind of displacement, a dislocation of feelings onto a fantasy, an idealisation. The longing for home is a longing for a place that has gone, that belongs in the past.

Places change, the people in them change, yet often the idea of home remains unchanged, the same in our memory. Years later, one’s childhood home will look different in reality. Some things will look smaller, other things bigger. Buildings may have altered, been destroyed, or extended, repainted, redesigned, just as we have redesigned ourselves, since.

Loss of Home.

Losing one’s home can precipitate depression and fear. Such distressing experiences as eviction, fire, flood, demolition, divorce can all result in loss of one’s home and all are traumatic and highly unsettling. Hopes and dreams are shattered, as is “the rhythm and comfort of everyday activities.” (Thompson).

We are a part of our environment and it is important to us. Moving house is one of the greatest stressors, along with death and divorce. Some people refuse to leave their home when it is threatened, even risking their lives.

People need a place to go to, to return to, where they can feel warm and safe. With no place to call their own, many people feel disorientated, lost, unwanted. How many people want to return home to die? It is as if they can then rest easier, knowing they have departed the world from a cherished and familiar place, perhaps surrounded by loved ones.

Home is……

Home is not only represented by bricks and mortar. There are many ways of describing home.

People, and objects, may be defined as home. Here are some quotations which illustrate this fact:

“Is it possible for home to be a person and not a place?”
Stephanie Perkins

“Books, for me, are a home. Books don’t make a home–they are one, in the sense that just as you do with a door, you open a book, and you go inside. Inside there is a different kind of time and a different kind of space.”

― Jeanette Winterson

“Introverts live in two worlds: We visit the world of people, but solitude and the inner world will always be our home.”

Jenn Granneman

“Home was not the place where you were born but the place you created yourself, where you did not need to explain, where you finally became what you were.”
Dermot Bolger

“Thank you, Mr. Rochester, for your great kindness. I am strangely glad to get back again to you: and wherever you are is my home—my only home.”
Charlotte Brontë.

I don’t care if we have our house, or a cliff ledge, or a cardboard box. Home is wherever we all are, together,”
James Patterson

“I don’t mean what other people mean when they speak of a home, because I don’t regard a home as a…well, as a place, a building…a house…of wood, bricks, stone. I think of a home as being a thing that two people have between them in which each can…well, nest.”
Tennessee Williams

 

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Photo by Rustic Vegan on Unsplash

“Your true home is in the here and the now.”
Thich Nhat Hanh

 

Is Forgiveness Always the Best Option?

“Always forgive your enemies—nothing annoys them so much.”

Oscar Wilde

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Do we always have to forgive?……

Can we ignore the shoulds, oughts and have-to’s, the pressure from some religions and from the often well-meaning, peacemakers ?

Even time-worn sayings urge us to ‘forgive and forget:’

“To err is human; to forgive, divine.” (Alexander Pope)

“Without forgiveness, there’s no future.” (Desmond Tutu)

“The weak can never forgive.” (Gandhi)

“Only the brave know how to forgive. … A coward never forgave; it is not in his nature.” (Laurence Sterne)

Without forgiveness, the famous quotes imply, we are weak, cowardly, hopeless.

It is hard to find quotations about not forgiving. There are exceptions:

I will remember and recover, not forgive and forget. (Dalai Lama)

“If you can’t forgive and forget, pick one.” (Robert Brault)

“Everyone says forgiveness is a lovely idea, until they have something to forgive.” (C.S. Lewis)

Whilst forgiveness may bring considerable benefits at the right time and in the appropriate situation, it is important that people do not feel pushed into this, to please others.

Perhaps there is no single answer to the difficult question of ‘Should we forgive?’ In reality, there are many ways of thinking about this. Each situation is different.

It is impossible to ‘advise’ on whether someone’ought’ to forgive another who has wronged them. We cannot know what is right for anyone else.

We do not have to forgive. Forgiveness is an individual choice and needs to be done for the benefit of the self. It may not always be helpful.

The Role of Psychotherapy.

It is hard to generalize about forgiveness; there are different levels of offence and ways of receiving others’ behaviour. Some things may feel unforgivable. For those who may have been severely abused, victimised, betrayed, or whose loved ones have been injured or murdered, perhaps, most understandably, forgiveness may be unthinkable. It may also be contraindicated for some people.

Forgiveness might not always  be healing or releasing. It could be disempowering. Not forgiving may actually give a hurt person something to hold onto, some personal power, in a situation where they have felt powerless.

It would be detrimental if one were made to feel bad about not forgiving. It would also be a denial of the depth of pain that has been suffered. One cannot merely ‘forget’ this.

Such ‘bygones’ are not ‘bygones’ when they still hurt and when there are reminders through dreams, flashbacks and terrible memories. Forgiveness needs to be an inner decision, made voluntarily and at a time when the trauma survivor is ready.

What is crucial is that thoughts and feelings accompanying a lack of forgiveness are prevented from ruling- and ruining- one’s life. 

Feeling grudges, remaining angry and ruminating bitterly over many years, is traumatic and self-destructive. Psychotherapy can enable people understand, work through and let go of such issues, so that they do not take over as much. 

Whilst the memories will never disappear, (can some things ever be forgotten?they may become less potent and people can feel freer as a result. They are helped to  manage the memories better.

Once worked through, vengefulness towards another matters less. They become less significant, their power has gone. They may not be as prominent in one’s thoughts.

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Can you forgive someone who has not expressed regret or apologised?

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If the offending individual has not apologised, some people will never forgive. Yet it is still possible for others to find forgiveness within them, even when the offence has been serious. They do this for themselves, for their own healing:

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Sometimes, people feel they cannot move on without forgiving. This is fine, but, especially if the wounds have been deep, there needs to be an awareness that maybe they might not be able to trust that person again.

The forgiven one does not have be in the other’s life, or to be fully reconciled. Sometimes the relationship survives, but is different. Perhaps it will be reduced in terms of time spent or the quality will change.

Things will have altered; depending on the degree of pain caused, the experience of feeling wronged might mean that the bond has been altered forever. Forgiveness is different from reconciliation.

Feeling Able to Forgive and be Reconciled.

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Image: Pinterest

Forgiveness can be a difficult process. It is important from the beginning that the hurt suffered is acknowledged by the survivor of that hurt. It is also part of the forgiveness process to grieve the betrayal, disappointment, loss, emotional or physical damage.

Emotions like anger, retaliatory feelings, rage and murderousness might arise, as well as sorrow and anguish.

Such feelings need expression,  preferably to the perpetrator. This is frequently not possible, but it can still be cathartic if such pent-up feelings are revealed in therapy or to another empathic person.

The process of forgiveness takes time, as does rebuilding trust. It does not mean that one pardons, disregards or condones what has been done, or absolves the perpetrator of all responsibility.

Perhaps there might, however, develop some objective understanding of what prompted the other to behave as they did. In time, it may be that such awareness produces new attitudes of increasing goodwill towards the offending person. Rumi has said “From understanding comes love.”

It is important also to have some insight into one’s own personal reactions to the hurt or betrayal that has occurred.

Forgiveness can have considerable therapeutic benefits. Research has indicated that

“…developing a more forgiving coping style may help minimize stress-related disorders.”

On a hopeful, yet still realistic note, I end this post with this thoughtful quotation:

“Forgiving does not erase the bitter past. A healed memory is not a deleted memory. Instead, forgiving what we cannot forget creates a new way to remember. We change the memory of our past into a hope for our future.” ― Louis B. Smedes

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Would anyone reading this be willing to share their experience of forgiving/not forgiving in the comments box below? It would be helpful to hear people’s view and experiences if possible.

Empathy: What is it and How Can We Show It? Find Out How Therapists Do This.

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https://www.flickr.com/photos/prabakarant/

 

“Can I see anothers woe,
And not be in sorrow too.
Can I see anothers grief,
And not seek for kind relief.

On Anothers Sorrow
William Blake, Songs of Innocence and of Experience

 

What is Empathy?

Empathy is the ability to put oneself into the world of another, in both a thinking and feeling way, as far as that is possible. It is really trying to understand how that other person sees and experiences the world.

There is a difference between empathy and sympathy or compassion. Sympathy is feeling affected by and sorry for someone’s situation. Compassion is feeling caring concern towards them and their plight and wanting to offer help. Empathy is a more total experience of someone else’s perspective, an intense attunement, putting oneself in another person’s shoes.

Empathy has been thought of as a natural aspect of most people’s personality, a fundamental, innate part of us that enables us to relate to and socialise with others. However, some recent research has indicated that it is mostly a learnt quality, influenced by upbringing and environmental factors.

This, and other research projects now mean that scientists can actually witness the areas of the brain involved with empathy:

With the technological advances of the 21st century, studies began using functional magnetic resonance imaging (fMRI) to research empathy, frequently using empathy for pain as their experimental paradigm. Two seminal studies (Decety and Jackson,
2004; Singer et al., 2004) simultaneously posited that a specic set of regions of the pain matrix(specically the anterior cingulate cortex [ACC] and anterior insula [AI]) are activated both by experiencing pain and by watching others experience pain.

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Image:Flickr. The City Project.

Science has revealed that there are neurological indications that can be detected when a person is feeling empathy:

Whether it’s watching a friend get a paper cut or staring at a photo of a child refugee, observing someone else’s suffering can evoke a deep sense of distress and sadness — almost as if it’s happening to us. In the past, this might have been explained simply as empathy, the ability to experience the feelings of others, but over the last 20 years, neuroscientists have been able to pinpoint some of the specific regions of the brain responsible for this sense of interconnectedness.

 

Why does Empathy matter? What are its effects in Psychotherapy?

Being understood is in itself a highly therapeutic experience; feeling that another has really ‘heard’ you and comprehended both the thoughts and feelings that you have expressed can only improve one’s state of mind.

Many well-known psychotherapists have underlined the crucial importance of empathy as a core skill:

 

“…deep understanding is, I believe, the most precious gift one can give to another.”

(Carl Rogers.)

Empathy is the capacity to think and feel oneself into the inner life of another person.

“The empathic understanding of the experience of other human beings is as basic an endowment of man as his vision, hearing, touch, taste and smell”

Heinz Kohut

 

People often feel better after one or two sessions of therapy; this is most likely because of the fact that they have felt really heard. This is frequently an enormous relief, a new and freeing experience for many people, who might never have felt such care and attentiveness from another.

Obviously, empathy alone is not enough to bring about real lasting change; there are many other therapeutic aspects of the process.

However, empathy is important in helping create a vital sense of acceptance as an individual, validation, and safety, all through the process of psychotherapy. Without it, there can be no progress, no healing, no real connection:

“For it is an immutable truth, that ‘WHAT COMES FROM THE HEART THAT ALONE GOES TO THE HEART.’  (Coleridge)

How to show Empathy.

Therapist’s self-reflection is crucial, achieved through introspection, their own therapy and through regular individual and group casework supervision. In this way, a therapist can work though any personal blocks and obstacles that might be in the way of showing empathy to all kinds of others.

For example, if a therapist had struggles with a dominating father, then it might be difficult to show empathy to what is perceived as a dominating man in the therapy room.

Empathy can be shown in a variety of ways, both verbal and non verbal. For instance, showing a non-judgemental attitude is crucial. This is achieved through:

1.Body languagean accepting, open stance (arms and legs relaxed, unfolded), eye-contact, (but not staring) nodding supportively, mirroring the client’s body language and expression (subtly), having an accepting and warm facial expression.

2.Demonstrating understanding : gentle and accepting tone of voice, lack of judgement, never interrupting the client and allowing the client space and time to talk. The counsellor will often reflect and paraphrase the client’s thoughts and feelings to show this understanding.

3.Listening skills:There are several ways in which the therapist or counsellor can demonstrate that they are really listening. These are both verbal and non verbal. Listening and attending skills are crucial for the client to feel heard and validated.

Empathy.

Oh, the comfort, the inexpressible
Comfort of feeling safe with a person,
Having neither to weight thoughts,
Nor measure words–but pouring them
All right out–just as they are
Chaff and grain together,
Certain that a faithful hand will
Take and sift them,
Keep what is worth keeping,
And with the breath of kindness
Blow the rest away.

George Eliot.

 

Have you experienced real empathy in psychotherapy or counselling? Can you say how it helped? Leave a comment below.

 

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Image: Flickr. University of Hawaii.

Depression:Can Psychotherapy Help? (2)

 

Minstrel Man
by Langston Hughes

Because my mouth
Is wide with laughter
And my throat
Is deep with song,
You did not think
I suffer after
I’ve held my pain
So long.

Because my mouth
Is wide with laughter
You do not hear
My inner cry:
Because my feet
Are gay with dancing,
You do not know
I die.

 

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Image: Nik Shuliahin. Unsplash.

Can psychotherapy help those who experience the hellish afflictions of depressive illness? The answer to this question is that it is possible to treat some people through psychotherapy. Obviously, there is no universal panacea, no magic cure and this treatment is not for everyone.

However, there are several kinds of psychotherapy which have been shown through research to help depression. A GP or therapist will make an assessment to help the person decide which modality might suit them. Many have found different forms of psychotherapy helpful. 

There is a combination of factors in relation to the origins and causes of clinical  depression; it has both chemical and psychological origins. Therefore treatment often needs to address both of these, in terms of medical or psychiatric help and therapy. It is up to the individual to decide, along with professional advice, which treatment or treatment combination may be right for them.

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Medication for depression certainly has its place and has been proved to be effective. Indeed, it can be life-saving. Obviously different drugs suit different people, and some work generally better than others.

However, there is still plenty of room for further research:

New treatments are badly needed, the experts say. Most of the drugs in the study are known as SSRIs, which are thought to work by increasing levels of a chemical messenger called serotonin in the brain, but nobody knows for certain. “We don’t have any very precise treatments for depression at this point in time,” said Geddes.

Guardian

 

Dr Tim Cantopher, in his helpful book Depression:The Curse of the Strong, underlines the fact that depression does not happen to weak people. He refers to the increase of stress in our society, which he feels is the commonest cause of clinical depression:

This illness nearly always happens to one type of person. He or she is strong, reliable, diligent, with a strong conscience and a sense of responsibility, but is also sensitive, easily hurt by criticism and has a self-esteem which, while it may look robust on the outside, is in fact quite vulnerable and easily dented. This is the person to whom you would turn in times of need, and they would never let you down.

 

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Keeping quiet about one’s depression can make it worse; sometimes people share with friends or family and that may be helpful. At other times, being able to talk with a professional therapist may be the best way though one’s problems.

The therapist will help look for meaning, for what might lie, psychologically speaking, at the heart of the depression and emotional suffering. Insights may be gained into past experiences that may have been damaging, into negative ways of thinking and destructive behaviour patterns, all repeated in the present.

Long repressed thoughts, feelings and significant dreams can come into consciousness in the accepting and non-judgemental atmosphere of the therapy room.

Sometimes, a depressed person feels so isolated, so alone, in a very dark place. As a therapist, it seems often like a privilege to have someone try to communicate this pain of loneliness, of feeling locked inside, trapped in a dark hole, vessel. or tunnel.

Rather than attempt to ‘pull out’ the person, I wonder if there is any way I can be in there with her, even for a second? Of course I cannot know exactly what it feels like for her, but I have been in my own ‘dark spaces’ , so I know them inside myself.

Having someone even express the wish to be in that terrible place with her, may make the depressed person feel less afraid, less alone. Of course, this has to be handled sensitively and, crucially, with an awareness of timing.

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Issues like unresolved anger, grief, disillusionment, may be explored and worked through in a way that can provide understanding into the roots of the problems. Then perhaps new ways of managing such feelings may be discovered.

Gradually, such understanding may lead to re-evaluation and change, so that old patterns can be broken and new ways of being discovered.

People become trapped in their past, which is very depressing. Coming to terms with long-held feelings and disappointments can be a releasing experience, for these can inhibit personal growth and development. Adjusting to newly-found truths about oneself and one’s past may be difficult, but it often leads to increased energy for life and the wish to move on more hopefully and constructively.

Do you have thoughts about this post? Has psychotherapy helped you with depression? Feel free to share whatever you can in the comments. 

The Real Truth About Mindfulness

‘Many benefits and fruits of Zen practice are real, but they are not to be gained, nor pursued. Just sit, regularly, for a sustained period, and see what is here right now.’

Rosenbaum and Magid

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Mindfulness and Psychotherapy

Many psychotherapists find that mindfulness is of value in terms of their practice. There is a considerable evidence base that it can be an effective therapeutic tool. (Also see Baer, R. A.  and  The Lancet,)

Psychotherapists using mindfulness techniques help patients to understand, for example, that ‘thoughts are not facts’ (Christine Dunkley & Del Loewenthal) Self- awareness is vital, and such therapy can help people understand how they might be contributing to their own distress. For example, we might learn to accept the impermanence of life, instead of denying it:

“It is not impermanence that makes us suffer. What makes us suffer is wanting things to be permanent when they are not. We need to learn to appreciate the value of impermanence. If we are in good health and are aware of impermanence, we will take good care of ourselves. When we know that the person we love is impermanent, we will cherish our beloved all the more. Impermanence teaches us to respect and value every moment and all the precious things around us and inside of us. When we practice mindfulness of impermanence, we become fresher and more loving.” Thich Nhat Hanh

There are three main ways in which mindfulness is used in therapy: (Barker)

  •   Teaching mindfulness to clients
  •   Practising mindfulness themselves in order to cultivate therapeutic qualities
  •   Attempting to create a mindful encounter in therapy itself

The techniques of mindfulness are used in several different therapies. For example, Mindfulness-Based Cognitive Therapy blends mindfulness with Cognitive-Behavioural therapy.

Mindfulness Based Stress-Reduction Therapy, developed byDr Jon Kabat-Zinn, aims to help alleviate some of the anxieties of daily life.

It is often used in the treatment of chronic diseases, with some beneficial outcomes. It is frequently offered as a group therapy, focussing on such aspects as staying in the present moment and the importance of the individual taking regular time out for meditation.

Critique of Mindfulness 

‘The commodification of mindfulness and meditation is increasingly prevalent and problematic’ Rosenbaum and Magid

 

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Whilst there is no doubt that mindfulness can be helpful and therapeutic, it has limitations. It is not for everyone, and needs to be used professionally.

Whilst there is considerable value in using mindfulness to reduce stress and increase self-awareness, it must be emphasised that it is not a panacea for all ills.

‘There is a contemporary shift in its use and meaning, which actually distorts mindfulness, taking it far from the original Buddhist emphasis on ethics and consideration of others. The danger is that it will be diluted into a corporate, self-serving and over-secularised commodity.’ Rosenbaum and Magid

An increasing backlash against this popular trend is occurring, in that it is becoming fashionable and commercial. It is often promoted as a kind of designer cure-all, another ‘one size fits all’ solution to life’s ills. Another criticism is that it encourages a narcissistic focus on the self.

Thus, there are mindfulness colouring books, mindfulness apps and books like Mindfulness for Dummies, The Mindfulness Diet, Mindfulness for Dogs, Mindfulness is Better than Chocolate, Mindfulness on The Go, Mindful Birthing and so on.

‘…this new corporatised McMindfulness – which in the long term will do as much as a McDonald’s Happy Meal to sate a person’s gnawing hunger for a richer life.’

 Daily Telegraph

 

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Incredibly, a Chicago burger bar sells ‘a more mindful burger.’ Joiner.

I wonder how they might advertise this product? Your ideas are welcome in the comments box below. Please contribute whatever comes to mind!

Here’s my take on it:

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One American headline asks:

‘Does L.A.’s Absurd, Narcissistic, and Pricey Mindfulness Trend Have Its Benefits? 

In Los Angeles, mindfulness has become a hot commodity (Los Angeles Magazine)

The writer’s conclusion is that it does: ‘Bring on the chakra exorcism and $24 hemp smoothies,’  she adds, entranced by her experiences. One of these ‘experiences’ is lead by a woman ‘spending the full 15 minutes with a hand over her heart, head tilted dreamily to the side, whispering, “May I forgive myself” over and over again.’

There is criticism of mindfulness as a process that prevents thinking, that it can be used as an avoidance of considering difficult situations, merely by an unquestioning acceptance of them.

Although the NHS supports mindfulness, an Oxford academic claims it stops people thinking deeply:

‘I think mindfulness and meditation are bad for people, I absolutely think that. People should be thinking.’ ( Theodore Zeldin)

This misuse of the concept surely constitutes another form of mindlessness; there is  criticism that corporate organisations use mindfulness in order to stop employees thinking about problematic work issues. (Hackspirit.com)

In similar vein, some schools and universities have used mindfulness to reduce student stress. However, there has been criticism that, as in the corporate setting, such use masks institutional flaws by focussing the problem on the students’ mental health.(Harriet Swain)

Another criticism resides in the ‘infantilising’ nature of this approach, in that it implies that students are going to be troubled emotionally if they do not engage in mindfulness.

Of course, some children are troubled emotionally; at this present time, the evidence of this in terms of child suicides is painfully apparent.

Offering mindfulness exercises is not going to help such children:

Pooky Knightsmith, vice-chair of the Children and Young People’s Mental Health Coalition, said such exercises could be actively harmful for those who are particularly vulnerable or have a history of trauma.

“If a child is suffering abuse at home, being given space and time for thoughts to drift through your head isn’t necessarily good,” she said. “Schools need to be aware of the potential risks, even with the most seemingly nice of interventions.”

(Independent,2017)

Have you had experience of mindfulness? What do you think of it? DWill you let me know in the comment box below?