Therapy!

I think it might be important to write something about therapy, to make my bias clear.

Therapy has a very strange and unscientific foundation. Traditionally our role is shaman or showman (the only real difference between the two are the cultural beliefs underpinning the performance). It was Carl Rogers - following Jung - who introduced the notion that therapy isn't complicated, that healing occurs when one person is truly hearing and accepting another, and providing a safe space for that other, to speak openly and honesty. 

Certainly Jungian theory seems complicated, but underneath it all Jung honoured his patient's process. He found significance and meaning in their words, he didn't pathologize. Also, despite Jung's love of the deep, and of 'depth psychology' and though symbols can be read ontologically (by asking what category of thing is this) Jungian psychology is also epistemological. The self functions as if it is split into types of thinking (ontology / archetypes) but a therapy that empowers a person to encounter memories and experiences thorough each mode - as thinking /intellectual, feeling. sensing. intuition causes a person to notice how knowledge is made, creating by doing - self awareness. Such older roots are still a part of therapy for all sorts of reasons, both good and bad. They are not so good when they have been turned into a 'cargo cult', paint by numbers, or when they are sold as a check list of questions.

My own home territory of solution focused therapy has been stripped down and sold as GEMS (goal, exceptions, miracle question, solution....) and if that is all one thinks SFBT is, then I agree - this isn't therapy. So, no - I don't ask about goals or talk about solutions. Nor, by the way, is Narrative Therapy about using fairy tales...

It seems true that the weirder the underpinning notions sound, and more obfuscation the therapist (or grifter!) creates, the more books are sold and the more powerful is the break from the flow of habitual thinking. 

This can be therapeutic - including some of the grifts -  but it can also be coercive if it is done in the wrong way.

Coercion - being compelled to enact a theory one believes to be wrong will be uncomfortable, up to painful for the client. It happens, and it is traditional, and it remains a part of some types of therapy because? Bewilderment added once a week to a life that is already painful, may also prove to be a distraction, I think we are back to something I recognise from  BDSM here. 

Submission to flip coercion 180 degrees. 

Bewilderment - dog's can't look up moments' - can lead to a client importing (introjecting) the therapists' theories. There is something about shock, surprise, confusion that allows new theories to be absorbed. And a new, compelling theory can start a process of evaluating a situation from a different perspective. Or a person can import the thing wholesale and cling to the unscientific, unsubstantiated and generally dotty notion, as a life raft.

Clichés sell even better!

This is why I try not to use theory with clients, because I don't wish to do the above. I do my best to leave doctrine and mythos to religious institutions. Basically my style is simply collaborative interaction. Done right, collaborative therapy - for the therapist - feels like releasing a wild animal from a trap...and if a person feels worse when they leave the therapy session, I've not asked the right questions or picked up and honoured enough of the fragments of useful and functional, from their dialogue with me.

OK, I'm going to quote from Mann, David. Erotic Transference and Countertransference: Clinical practice in psychotherapy to illustrate how theory can organise information to obfuscate a situation. The book is a collection of essays by different therapists, about their experiences of erotic transfer in the therapy room with their clients. 

The definition and description of the problem of Eros in therapy begins with Freud defining  the client's erotic feelings as resistance. This quote gives a flavour of the Freudian view.

Marco Chiesa (1994) conceptualises the erotic transference as a delusional manifestation originating from an intrapsychic pathological organisation which is established to protect the subject from the pains of the depressive position and the fragmentation of the paranoid position.

Peaches says it better perhaps? So what does this look like in therapy? Mrs B's husband and psychiatrist had both insisted that Mrs B attend therapy:

She (Mrs B) did not know why she was coming and spent most of the first week in silence. She found the unstructured nature of therapy extremely painful and difficult.

Her husband and the psychiatrist had insisted that she attend. How does it feel to be sent to therapy because your husband thinks that you need it? The word that comes into my mind is betrayal. Is he saying, I can't help you and I want you to be different?

So, what does Mrs B do?

Mrs B took to turning up to therapy in provocative clothing and her therapist concluded that:

Detailed analysis will reveal that several aspects and functions operate at different degrees in the same patient: for instance, defensive, destructive and regressive elements were present in Ms B, who sought to ward off terrifying persecutory maternal and early Oedipal object representations, while seeking to destroy her therapy by seducing me.

At which point I conclude that common sense and reason are non-existent here. Now we can agree that this really is all about Mrs B's confrontation with the terrifying parental dynamic, or we can imagine instead asking Ms B what she thinks the psychiatrist and husband are hoping for, and what she would like for herself in relation to this, and then create a dialogue, asking - as it seems relevant to the therapist in this case - how she feels when dressed 'provocatively'. And onwards to look at all the ways Ms B can be as powerful (?) as she is possibly portraying herself to be?

Meanwhile, the therapist needs to dig a bit deeper into how the - in his words provocative - clothing makes him feel. It's all well and good that he can call it an attempt to seduce him, but what if it isn't?! 

I suspect he'd say that Mrs B wasn't able to know her own mind - unless she agreed with him. As, he is the one who really knows what's going on!

Resistance is a useless concept for a collaborative therapist. If a client doesn't want to speak or want to engage, this too is communication. What it tells me is, I've asked the wrong question, or we are not talking about what the client wants to talk about.

Resistance is not something concrete, only a concept used as an explanatory metaphor. Resistance is only one among many ways (including cooperating) to describe what it is that the observer is observing.’ (de Shazer, 1982, p 12)

What I take from all this is how the power dynamic really screwed up any chance for Kit and I to use erotic transfer as David Mann suggests:

Erotic fantasies will almost certainly be activated in both patient and therapist. Therapeutically it may be highly desirable that they should be. As the erotic is at the core of unconscious fantasy life it follows that any depth work, if deep psychological change is to occur, must surely come to terms with the erotic unconscious. If the erotic transference and countertransference are not developed and worked through it becomes difficult to envisage how this side of the patient’s unconscious will be reconstructed.

The above is true for any sexually powerful relationship. And the changes go both ways, between both people. In love we are opened and opening each other. As I hope I've explained in this post, the explanatory metaphors evolved by Freud create the opposite; distancing and alienation. 

And so it is that this quote below from Kit crystallises my intention for this blog. To explore and to criticise, rather than dismiss....I am of course, now honour bound to be contrary and tangential to the end!

Kit: The other thing I was very aware of recalling, was that you were closing the way to a very particular type of exploration. Because you brought up the idea that your feelings might be transference in order to then dismiss the idea" [+]