Who the hell do you think you are?

What is it that psychotherapy is meant to be doing?  This is a question that I am, by necessity, obsessed with.  Michael Foucault thought that paying someone to tell you how to live your life was a completely absurd idea.  I agree, this should not be the aim of psychotherapy.

When I was in training, there was a fellow intern that I found insanely irritating.  One afternoon, as she came out of her session with a client, she made a celebratory fist pump as if she had just scored a goal or something.  I asked her why she looked so happy with herself, “I just got my first client to cry” she said, celebrating.  Her attitude was indicative of an underlying misconception about therapy:  That you get it “right” when it is a difficult, painful, and exposing process.  It is often all of these things (hence the mandatory box of tissues on my table) but these things are not the goal.  Discomfort is often a part of the process that we need to endure, but not try and relish in.  Listening to Adam Phillips, a contemporary psychoanalyst, there is nothing wrong with the therapeutic conversation being a pleasurable experience for both client and therapist.  However, therapy to a great extent necessitates a confrontation with the “self”.  Such confrontations are unfortunately not always comfortable.  We are, therefore, likely to avoid them.

A client skips her therapy session to have botox.   There is an inherent symbolism to this:  Choosing to “save face” rather than “face our self”.  We can be particularly ugly to ourselves at times.  Therapy has no place rubbing our noses in this.  But there are unfortunately places in us botox can never reach.  “I can help you, if you just give me the chance” is how I ended our last therapy session.  That is about as much as I can do.  People cannot be forced or chastised into therapy.  They will never find any beauty in their own agony in this way.  Phillips heeds that “people can only develop in their own time and their own way.”

Therapy is not just about confronting ourselves.  We do come to therapy to discover who we are and how we became this person.  But we do so in order to go beyond who we think we are.  In this way, therapy is a place of self-invention.  It is, therefore, the work of therapy to help people find the freedom to live their lives.  Usually, the greatest obstacle to this freedom is the conception we have of ourselves.  “This is just who I am” is the greatest injustice anyone can do to themselves.

Therapy, therefore, asks us to answer an inevitable question: How do we get in our own way?  We stay in the bad relationship that keeps us unhappy.  We continue to drink despite our self-loathing for it.  We keep our anxiety alive by not making the changes we know we should make.  Simply pointing these things out is of little use to a client.  Rather the therapist offers the opportunity to describe yourself back to yourself in ways that will provide a view of what you do to yourself.  Psychotherapists are (and should be) awfully bad life coaches.  Telling people how to live their lives tends to be of short-lived benefit.  And, what is most challenging, is that people generally want you to do this (so that they can take their resent for their parents out on you later).

We were walking through the cane in the late afternoon.  “The earth is starting to travel back towards the sun” she says aloud.  I think to myself; the air does feel a little warmer, but the sun is still setting at its oblique angle to the horizon.  Fiona points out the full moon rising on the opposite end of the planet.  “Does the moon change its orbit too?”  she asks herself.  She is not asking me a question, she is talking aloud as a form of cultivating awareness. Phillips says “In order to articulate something, we have to have someone to listen.”  My role in that moment, was not necessarily to give her an answer.  But, nevertheless, it struck me that I didn’t actually know the answer in any case.  “I don’t really know what she is talking about?” I thought.  But, I didn’t say anything in case I sounded stupid.

So much of our lives is spent like this – with little awareness of what is actually going on.  There are aspects of our lives that are so familiar to us that we don’t bother to even consider them, let alone understand them.  We are busy hurtling through space and time without any need to give it much thought.  Most of the variables of our lives are just there, as they always have been.  This is also the case with the experience of our own selves.  We are so familiar to our selves that we become unfamiliar to who or what we actually are.   Therapy can be a means of thinking aloud about this in order to bring awareness to it.

In order to try and aid this process, I invite clients to write.  The other day a new client sent me pages of very loosely constructed sentences.  I usually welcome this but in her case I suggested that she write more comprehensively about herself.  When she told me that she had been deeply offended by this, I tried to explain that “If therapy is about making sense of yourself to yourself, then the more comprehensive we can be, the more useful this will be to you”.  She had had this fantasy that she could bring me the pieces of herself and I would hand her “self” back to her complete again.  I have an idea, in her case, why she needed this from me at the time but this builds on another dangerous misconception about therapy – that we arrive broken in order to leave fixed.  After all, “All the King’s horses and all the King’s men, couldn’t put Humpty together again.”  There are some things in life that can simply not be put back together.  What if therapy is about knowing, understanding and appreciating the broken bits of ourselves, rather than piecing them together again?  A sense of “wholeness” then, so to speak, may not come from being “fixed” but in making sense of why and how we came about feeling “broken” in the first place.

Ultimately, you bring who you are into therapy in order to discover who, in fact, that is.  As you make your discovery, you are likely to try and discard some aspects while cultivating others.  I think that successful therapy requires the ability to hold an essential contradiction in this regard: to take your “self” seriously enough to explore it but not so seriously that you become stuck in who you are.  When we either take ourselves too seriously or not seriously enough, we enter a kind of madness.  As Zizek puts it: the beggar who thinks he is a king is mad, but the king who believes he is in fact king is equally mad.  Therapy is about contemplating the forces that have shaped us and our behaviour.  The people, places and experiences that have given rise to the idea of “who I am”.

How did I come to be in the world in this way?  How would I rather be?  What gets in my way?

In order to be useful in the world, we have to hold onto who we are to some extent.  At the same time, we need to avoid becoming stuck in that identity.  Although psychotherapy appreciates that we are the product of our pasts, I don’t believe that it should support the idea that our lives, still to be lived, should be completely dictated by the life we have already lived.  Psychotherapy should come with a dose of permissiveness, in this regard, that looks towards a futures self.  Under the influence of Phillips, I would like to suggest that therapy should be weighted towards considering our unlived lives as much as it considers the lives we have already lived.

Imagine if life was a stage and, at any given moment, each of our particular lives was a performance on that stage.  There is both a freedom and an entrapment to this.  The freedom lies in how a “performance” is never fixed and there is always the possibility of invention.  The entrapment lies in the role we find ourselves playing in relationship to both the audience (for example, broader society) and those we share the stage with (for example, our family members).  It is as if our lives have handed us a script that we, before we even make it to adulthood, know far too well.  We run the risk of just playing out this script over and over again, even when “new actors” arrive on our stage.  It is in our families of origin that we have rehearsed this play until it is no longer “play” at all.  We cease to experiment, to some extent, with who or what we could be.  Therapy can be a way for us to “play” again with the idea of our selves.  The problem is, as Phillips puts it, that we’ve judged ourselves before we have found out who we really are.  Psychotherapy is permissive in that it, hopefully, suspends this judgment.  But it is in our struggles, as therapists, to suspend judgment that therapy risks impotency.  All too often we are too impartial in our attempts to intervene in the forces (internal or external) that cause trouble in people’s lives.  How many times should we sit back and watch Humpty Dumpty fall?  I told a client the other day that I can’t sit back and watch him continue to fuck up his life like this.  It squanders his money and my time.  In that moment, I felt that this was the most ethical thing to do.  Doing so, however, runs the risk of placing pressure on the client to be someone on behalf of the therapy.  There is no freedom in that.

Herein lies the delicateness of the therapeutic relationship:  If I am going to try and describe you back to yourself; especially the parts you either can’t see or don’t want to see; this requires a certain frankness on my behalf.  I think I owe it to you to try and help with embarking on the difficult process of integrating the things you have been denying without making too quick a presumption about what those things are.  Because these are usually the things that get in the way of a future version of yourself that you would most likely prefer to be.  It is a gradual, intensive, sometimes uncomfortable but never sardonic process.  It is, however, difficult not to come across like it is the work of therapy to tell you who or how to be.  Or to shame the parts of you that you are already trying to hide from view (consciously or unconsciously).  After all, who decides and how do we decide what is an acceptable way to live our lives?

To answer this question is to ask, “Who do you want to be?”  I believe that any relationship that is good for us (not just therapy) should be excited about the answer to this question.  Most of the time, people have an idea of the lives they want to be living but aspects of the lives they have already lived (and therefore aspects of who they believe they are) get in their way.  Therapy is, therefore, a process of getting you out of our own way.  And, to achieve this, we must first know who you think you actually are and how you came to think that.

Ultimately, a therapy room should have enough seats for the full stage performance of who you are: your sometimes broken self; your often more fixed self; the past versions of yourself; imagined future selves; and all the people that have had a significant role on the stage with you.  But, the actual process is much simpler than we might think.  You just have to have the courage to show up every week and face your own life.