Generally speaking, I would want to meet with you twice before beginning a therapy process. During these two initial sessions, I would want to learn about the story of what has brought you into therapy. I am interested to learn from you how you have made meaning of the difficulties which you’re going through. I want to learn about what you are experiencing, how you understand your experiences, and what solutions you might have tried, whether successful or unsuccessful. I would then want to learn about your early life. I need to have a full sense of your family relationships, your early development as a child, your personality throughout your history, and any patterns of difficulty which have been with you through the course of your life. Once I learn this backstory from you, I will make a recommendation to you, as to whether we proceed with psychodynamic therapy, or with a more focused and short-term process. What we focus on in our therapy process together would of course be absolutely unique from person to person. I believe that there are a small number of key therapeutic aims though, which I would most likely introduce through the process.
Reflection – It’s all about thinking. Thinking carefully. Thinking deeply. Thinking consciously. So often, in my experience, therapies begin with people feeling confused about damn near everything. Why do I feel this feeling? Why do I do this thing? Why do they respond in that way to me? To begin with, for many of us at least, we seek therapy when we realize that being unable to make sense of our feelings actually makes the feelings feel worse. Developing a reflective capacity is key to emotional and mental health. Therapy aims to foster reflective capacity by helping us understand more about the things in life that shut down thinking. We need to learn about our triggers, our emotional pressure points, and our reflex reactions to these. It’s almost always the case that our primary struggles in life result from reflex reactions to emotional triggers. Therapy aims to help us address these reflex reactions, to slow ourselves down just enough to be able to think about what is happening, form opinions and perspectives on it, and act on the basis of choice rather than compulsion.
Intimacy and separateness – Before being human we are relational. I believe that relationships are primary to human health. The capacity to be comfortably close to the people we love, and comfortably alone when those people are not there, is a central indicator of health. People so often describe difficulties with knowing how to tolerate and balance closeness and distance in a relationship. Closeness relies on having and expressing needs, faithfully trying to meet the needs of the other, and tolerating the extent to which needs sometimes cannot be met. A perilous affair. Separateness relies on a capacity to be comfortably at home with oneself, trusting in the consistency of the person we love across time, and feeling safe enough to be alone with our thoughts; all of them. Separateness is linked with the experience of solitude, in which we can find peace and comfort in our own company, knowing that our separateness is still linked with those we love.
Thinking about other people’s minds – The capacity to relate to others in the world relies on our own willingness to think about what might be happening in the mind of the other. We need to be able to reflect on what a person might be thinking, feeling, wanting, fearing, in order to relate to them as a person in their own right. It is important that we try to imagine what a person might be thinking when they act in a certain way. The ability to appreciate our separateness from the other person is an important part of this. Given that we are separate from another person, it must be true that a) their thoughts are their own, and arise from within their own minds, b) they can make up their minds and change their minds at their own will, c) we can only have an idea about what they might be thinking and feeling, we can never know as a fact what is in their minds, and d) as separate beings in their own rights, it is up to them to share with us the reality of what’s in their minds, and not for us to tell them. It requires a lot of tolerance and maturity to give other people space to have their own minds, without imposing our own thoughts, feelings, needs and wishes on to them. Separateness, which I am defining here as the capacity to tolerate the complete otherness of the other, is a crucial aspect of maturity, and I see it as a central aim of therapeutic work. The ability to think about other people’s minds in a mature way relies on separateness and is a feature of our development which enables our relationships and our adaptation to the world around us.
Channelling the self - It is so often the case that people enter therapy at times of transition in their lives. These periods of transition are immensely creative and potentially fulfilling times, although often quite scary because they involve us reforming and evolving in ways that are not always supported and welcomed by those around us. As exciting and scary as transitional periods can be, they are also times of feeling trapped and stuck in our lives. The reason for this is what we call resistance. The resistance to transitional periods is linked with defensiveness. Essentially our minds react to the anxiety that we feel when we anticipate change by shutting us down in one way of another. At times like this, people find themselves procrastinating, intentionally avoiding life-enhancing opportunities in work and in their relationships, relying increasingly on potentially addictive self-soothing behavioural patterns, and resisting healthy life choices. The consequence of this is that people start to feel increasingly hopeless about their futures, become highly self-critical and judging of themselves, and feel socially anxious due to their expectation that others will view them as they view themselves.
Enter psychotherapy… In terms of being confronted by transitional barriers, the work of psychotherapy is to think our way out of stuckness by tapping into the intrinsic resourcefulness in each of us. I am so often deeply humbled and impressed by people’s abilities to adjust to the pain and suffering in their lives. Each of us has a natural and unique set of talents that we harness in our process of navigating life and the world. Commonly, people will enter therapy as times of having lost clear knowledge of their capacity to channel themselves in their service of living well. The capacity to channel the self, which I see as a unique set of gifts possessed by each individual person, reveals itself in various ways. A central source of self-channelling ability comes from our creative skills. It is very often the case that people’s choice to harness their creative potential, whether it be poetic, visual, melodic, percussive, lyrical, rhythmic or theatrical, leads to solutions in life. These are the solutions of self-channelling which I’m suggesting are a primary focus of therapeutic work. It is about desire, need, wish to engage with what feels most meaningful, so that we can find the energy to tackle those aspects of reality which may feel less fulfilling, but are equally important, like ironing and IT returns.
Compassion inside and out – In my view, the capacity to be compassionate with ourselves is one of the single most important markers of mental and emotional health. The absence of internal compassion is one of the primary reasons why we suffer in life and is so often a reason for people’s entry into therapy. I say this because at the beginning of therapy people often describe experiences which they do not recognize as indicators of a lack of compassion. People entering therapy comment on the fact that they’ve resisted coming for a very long because entering therapy means that they either are or appear to be, weak. This is just one of many judgements which accompany people on their entry into therapy. Internal judgements such as these show that people, instead of being supportive and respectful of themselves when they’re going through tough times, are instead harshly self-critical and at times self-punishing, often as an attempt to root out the distressing emotions.
Other common signs of lack of internal compassion include self-neglect, workaholism, self-isolation, lack of exercise, and disengagement from creative pursuits. I find that the recovery of self-compassion is one of the most difficult aspects of therapy, and change in this area often takes a very long time. People often struggle to see how important and enabling self-compassion is. It is about developing a different kind of relationship with our minds and our bodies, in which we change the narratives by which we live. Let me give you an example. The narrative “I’m just fat and lazy”, is an extremely self-critical and even self-hating way of stating a problem. A more compassionate way of stating this could be, “I’m really struggling to make healthy life choices for myself, and the consequences of this are making me feel unhappy and resentful of myself.” Yup, it’s a bit of a mouthful, but where self-compassion is concerned, the story is usually not a short one.
An attitude of curiosity – I do this work because I find people fascinating, and I find the process of engaging with people’s stories deeply fulfilling. Curiosity about the mind, heart and soul is central to the work of therapy and is a sign of health in a human being. Most often people enter therapy under particular circumstances, involving a) a certain kind of pain, either foreign or familiar, b) a problem requiring a solution, c) a yearning for a different quality of experience in themselves and in their relationships. Curiosity about the self isn’t often on the list, although I believe it to be one of the most important aims of therapy. Asking questions about how we came to be the way we are is similar to the act of learning from history, and this equips us with a greater sense of command over the difficulties which may arise in our futures.
