Category: Myths about psychotherapy

Who Are You? – I really wanna know

Me, My Self, and I

Who are you? That’s easy! I am me. I am myself. Ok. And who is yourself? Myself is what I think and how I feel.

What do you think? That depends. Sometimes I think this and sometimes I think that. And sometimes I reflect and change what I think. So, what you think isn’t fixed. It is changing all the time.

And how do you feel? Well, sometimes I’m happy, sometimes I’m sad and most of the time I just am. Ok, so at different times you think and feel differently? Yes. And at different times you think and feel more like yourself than at others. Yes, ok. Now and again, I do something I didn’t expect. This can be really good or, unfortunately, it can be really bad. But usually it is ok. What about when you feel tired? Yes, I don’t feel like my usual self. And sometimes you may feel unwell or be suffering from an illness. Yes, then I don’t feel like my usual self. But what is ‘my usual self’? And aren’t you changing all the time? In some good ways I would very much hope that I am.

From this you could say that there isn’t one fixed thing that is myself or indeed any one thing that is The Self. In other words, there isn’t one set of thoughts and feelings that defines who I am. Yes, there are the thoughts and feelings that I have and those that I don’t have. Some are desirable, some are distressing. Some are fleeting and some can last pretty much a lifetime.

These are the sort of responses we come up with when we consider who we are. Theorists go further talking of a Self that explains who we are and how we come to think and to feel as we do. This Self varies from theory to theory. There can, for example, be A True Self and A False Self (Winnicott, 1960), or an Authentic Self (Joseph, 2016) and a Shadow Self (Jung, 1951).

Further terms are introduced to describe how our Self exists in the world around us. Acting Out (Freud,1920), for example, may be used as a way to achieve something we desire while clearly not fitting with our actual thoughts and feelings. And Masking (Goffman, 1956) may enable the person to fit in with who they are with and the circumstances they are in without showing how they actually are in that situation.

Let’s follow this lead and say, at least for now, that the True Self is the desirable state: the way we want to be, doing the things we want to do, being with the people we want to be with. Would anything that deviates from this state be evidence of falsity and, perhaps, the presence of a False Self? At least from the theory this would seem so. And this covers a pretty big range of behaviours that on this reading would need to line up if we are to truly be ourselves.

From this you can begin to see why both in theory and in practice the emphasis has been on the false, the inauthentic, the mask and on whatever it is that lurks in the shadows.

Now surely the purpose of therapeutic enquiry is to bring about healing through understanding what has gone wrong.  So, it’s hardly a surprise to find that therapy often begins with questions as to how and why things have gone wrong for the person. And the usual, the commonplace and the satisfactory are marginalised or, worse, left unconsidered.

This would suggest that the literature and the subsequent practice focusses on the exceptional and perhaps takes the usual as a given. And I’m not sure that such theorists and practitioners would be entirely happy with such an assessment of their work.

For example, The False Self is often presented as a defence to keep out the undesirable or what is harmful. This results in you having to put up with the current situation in order to fit in or to comply. In other words, to meet our needs in difficult circumstances and to take care of ourselves where others are absent or are not fulfilling their relational role. It’s not great but it’s the least bad option.

Often such adaptation works. It keeps you functioning. The people around you may even think you’ve got it all together. This however can lead to you feeling as if you are wearing a mask that dampens spontaneity, reduces your enthusiasm and can result in feelings of emptiness and thoughts of pointlessness. All while giving an appearance of you being your True Self. And over time, maintaining such a false position can lead to feelings of emptiness, low self-worth, disconnection, burnout, and the sense that life is passing you by without you being able to live it fully.

So, if you don’t know already, what are the signs that you may be living your life from a position that may be described as false? Well, maybe you don’t say what you truly think or feel. Sometimes, you aren’t even sure what that is. Perhaps you constantly try to get everything right in your life, in relationships, and in your work and never stop. To do this you tune in to what others expect from you and adjust your behaviours accordingly. While everything looks fine on the outside, you feel flat or numb, or even, invisible.

Yet still you cannot get rid of the feeling that something is missing. If only you knew what it was then you could get it and then life would be all right. And you are constantly people-pleasing and feeling anxious about getting things right for them and hence, you believe, you.

However, such feelings don’t reflect what actually exists, and what in fact happens, does it? Maybe we do what we choose to do most of the time and maybe that’s as true and authentic as we are going to get. Maybe our Real Self is what it is and maybe it just gets on with living. And maybe our Real Self sometimes gets it wrong. We have all made poor choices. We have all felt differently about certain people and about particular places over time.

Professionals may say ok but why should we waste our time talking to people about how their life is ok for them? We want to know what’s wrong so we can use our professional skills to help them fix it. This may seem very reasonable. Thing is, how do I come to find out what a good or satisfactory life would be for me if I am spending all my time fixated on what’s wrong with it. An exaggeration perhaps but where is the balance between analysing and supporting what is both good and true while examining what is bad or false or inauthentic or hidden?

Maybe the balance is there. Maybe it’s just not expressed explicitly, at least not as much as it could be. Well, I’m not sure I’ve ever come across a consultation where the client simply says how normal things are or one where the therapist asks them to say more about their normality. It’s far more usual for professionals to focus on the problems their clients or patients may be having and to work on understanding the issues they are having and the problems that are arising from these issues.

And maybe the idea of a True Self and a False Self just gets in the way of what is actually there; you, me, us, alive in the world together. Maybe the task we all have is to create ourselves as we wish to be, not as we happen to be and not as others tell us be. If so then we would be able to appreciate what is good about ourselves and seek the company of people who can nurture us and situations that will allow us to grow. And maybe that’s what every single one of us should know and should do.

References

Michel Foucault – The History of Sexuality 3: The Care of the Self (1984)

Sigmund Freud – Beyond the Pleasure Principle (1920)

Erving Goffman – The Presentation of Self in Everyday Life (1956)

Stephen Joseph – Authentic: How to be yourself and why it matters (2016)

Carl Jung – Aion: Researches into the phenomenology of the self (1951)

The Who – Who Are You? (1978)

Donald Winnicott – Ego Distortion in Terms of True and False Self (1960)

“Once you start psychotherapy you never stop”

Myths about psychotherapy: Number 4

The Importance of Contracting.

One of the first questions clients ask about their psychotherapy is ‘how long will it take?’ Well, people suffering anxiety or depression often begin to find some relief within the first two to four months of psychotherapy. And people with deeper issues such as trauma, relationship issues, or sexual problems often require longer.

So, given that psychotherapy works to the completion of a psychotherapeutic contract, the question then becomes when this completion should be. Well, your psychotherapist should always have a contract. This contract sets out your goal for psychotherapy and sets a date for completion or review. When this contract is met, you will either wish to come out of psychotherapy or to set a new contract. When you first enter psychotherapy, you may not be clear what your contract is. In this case you and your psychotherapist will work on this and agree your contract together.

Now, psychotherapy depends on frank, probing and revealing discussions that raise deep and sometimes troubling feelings. To allow these discussions to take place, your psychotherapist will provide a safe space for you to hold these discussions and for you to have your feelings. In this safe space you may come to express yourself more clearly than ever before. You may come to get in touch with and to understand your true feelings. In time you may, in this safe space, work out how to use your understanding together with your true feelings to bring about healing.

Taking all of these considerations into account means that as you proceed with your psychotherapy you should be evaluating where you have reached and whether you are close to meeting, or have met, your agreed contract. And, of course, your psychotherapist will help you to do this. You should always feel able to ask them how things are going and to talk about how far along the road you are.

Once the concerns that prompted you to start psychotherapy are under control and once the concerns that were bothering you are no longer weighing you down then it may be time to think about ending your psychotherapy. If you are feeling confident about your life and now have tools that work for you, then it is probably a good time for you to end your psychotherapy.

And please, if you have had a successful outcome, make sure the end of your psychotherapy is a positive experience. Just as everyone’s psychotherapy is different, so every ending is different. Together with your psychotherapist, acknowledge your release from what was troubling you. Psychotherapy can help us to be free, to belong and to get along. If this has happened to you then why not share this with your psychotherapist?

“Psychotherapy is too risky”

Myths about psychotherapy: Number 3

Why doesn’t everyone have psychotherapy? Is it because some people are suspicious of, or even hostile to, psychotherapy? I think the answers to these questions are based on misunderstandings.

I sometimes hear people say that psychotherapists “mess with your mind”. Well ok, it is true that psychotherapists seek to bring about changes to harmful thoughts, hurtful feelings and damaging behaviours. But in every case the person doing the changing is the client not the psychotherapist.

Another concern is that psychotherapists follow ‘crackpot’ theories that at best do nothing and at worst cause harm to the very people they are supposed to be helping. In their training psychotherapists learn to evaluate a range of approaches. In doing this they find out what is useful in these approaches, and to recognise and avoid potential pitfalls. At the end of their training psychotherapists tend to adopt one or two of the approaches studied following certain figures and practicing particular psychotherapeutic techniques.

Related to this is the fear that psychotherapy is a waste of time. This is sometimes expressed in the form “All that time and all that money to just talk about my problems” or “I’ve given away all my secrets for nothing”. At the surface level this may seem to be true. You will spend a lot of time talking about very personal things. Yet psychotherapy is not simply talking. Psychotherapists are trained with people like you in mind. They are trained to know what they can and what they cannot do. Their knowledge expands and deepens with experience.

And they are aware of the risks. Your psychotherapist will begin with an assessment session to judge whether they are the right person to offer you psychotherapy. You will then spend some time discussing the issues you are bringing to your psychotherapy. From this, you will together agree a plan for your sessions.

You will always be in charge and should always feel in charge of your psychotherapy. To make sure this happens your psychotherapist will check-in with you at the start of each session. They will also check-out with you at the end of the session to see how you are feeling and to ask if you want to say anything further.

Where your psychotherapist thinks there could be beneficial changes to your sessions they will suggest these changes in advance. They will ask whether you agree to the proposed changes and if you don’t agree to adopt these changes then they will not be adopted. Your psychotherapist will remain open to your views throughout your time together. They will hear you and keep your psychotherapy safe.

“My friends can give me all the help I need”

Myths about psychotherapy: Number 2

Nurturing social support from loved ones and friends is an important part of maintaining our mental health. Our needs, however, sometimes go beyond these relationships. When they do, we can benefit from professional assistance.

Psychotherapy may seem similar to friendship. There are however some important differences. Like your friends, your psychotherapist will listen to your feelings about your current concerns. Unlike your friends, psychotherapists are trained to talk with you in ways that will help you to acknowledge your true feelings and to find positive ways forward. In doing this your psychotherapist will be empathetic and non-judgmental. They will not tell you what to do or offer to do it for you.

In friendship your friends’ needs and interests are as important as yours whereas your psychotherapy is all about you. Everything your psychotherapist does is directed towards helping you.

Friendship does not need a plan or purpose beyond enjoyment. So, with your friends, you can relax, have fun, play sport or visit different places. In contrast, psychotherapy is planned and purposeful, moving towards one or more mutually agreed ends. And with your psychotherapist, you can only do psychotherapy. Your psychotherapist may be friendly, but they are not your friend.

Some of your private thoughts or feelings might appear hurtful or shocking if they were said to a friend. A psychotherapist is a trained professional who understands that we all have unpleasant thoughts and feelings. They know that talking about them in a safe space is important and helpful. They will not judge you.

Sometimes you may not know what you truly think about someone or something. Your friends may assume they know your thoughts already and rush to find quick fixes. Your psychotherapist will sit with you, listen and help you to clarify your thoughts so you can come up with the right solution for you.

“Psychotherapy is only for crazy people”

Myths about psychotherapy: Number 1

As much as I’d prefer not to use words such as ‘crazy’ or ‘mad’ they keep on coming up time and again in phrases such as “Psychotherapy is only for crazy people” and ‘You have to be mad to see a psychotherapist”. In fact, I’d say that such words speak to the most common misconception there is about psychotherapy. So, allow me to tell you how I see this.

Just as everyone has physical health, so everyone has mental health. Just as you can work on your physical health so you can work on your mental health. When you face challenges with your physical health you seek appropriate professional support. Similarly, when you face challenges with your mental health you should seek appropriate professional support.

No one is perfect. Your capacity to function varies from area to area. You may be very practical and not so sympathetic. You may be very sympathetic and not so practical. This means there are many reasons for you to come into psychotherapy. Perhaps you want to form a lasting relationship or start a family. Perhaps you are wondering about a career change or retirement. Maybe you are coming to the end of your life or maybe a love one has recently passed away. Psychotherapy is not just about anxiety or depression or for people who are in crisis.

Psychotherapy offers you the opportunity to understand yourself better. In coming to this understanding, you will come to appreciate certain things about yourself both positive and negative. With this understanding comes the ability for you to address longstanding and unnoticed unhelpful beliefs and damaging behaviours. This in turn will offer you the opportunity to move towards a happier and more fulfilling life. In psychotherapy, everyone can grow.