M
Madness, Masturbation, Meaning-Making, Money
Madness
Madness is a horrible word with a history of being used lightly or inaccurately and as a means of diminishing others. Sometimes it’s a synonym for angry or eccentric.
For the purposes of a blog about the therapeutic process ‘madness’ is probably more usefully thought of as a catch-all for “clinical” or “pathological” – people with the kind of presentations which lend themselves better to doctors and psychiatrists than to therapists and counsellors. But even that doesn’t really cover it.
Sometimes, however great or caring the therapist, a client needs more than talk and process to navigate their difficulties; they need pharmaceutical help. With medication that person is able to get to a base level of ‘functionality’ which they cannot access consistently without it, and with that medication they are better able to make use of therapy. Fine.
But, in any case, just because someone is ‘mad’ – in whatever way we mean that – does not mean they cannot be reached by the therapeutic process. R D Laing, the famous psychiatrist whose booked The Divided Self is one of the most influential psychological books of that period, called madness “a sane response to an insane situation”. His approach was to try and not be distracted by the noise and messiness which psychosis and other extreme presentations can provoke and to hear the message beneath.
Sometimes, with all sorts of very challenging presentations, the question I ask myself (and maybe the client) is: ‘If this reaction was a choice, which it isn’t, why would you do it?”
Looked at this way, very often it’s not that mad after all.
Masturbation
Yes I thought this one would get your attention. This is not an entry about masturbating during a therapy session which, by and large, would be what therapists might term, in our customarily calm tone, An Incredibly Problematic Idea (see E for Ethics).
Rather, masturbating is one of the few experiences in life which is completely between us and ourselves. It’s for nobody’s benefit but ours; it works because of what we do, feel, think and need. Plus, for some people, it feels like a subject too personal to talk about. Sound familiar?
Most of what we discuss in therapy will feel, at some point, too personal to talk about, or be about what we feel, think or need. The difficulty of discussing it, at least at first, is the point. Masturbation is the whole essence of the challenge of therapy encapsulated in one act.
As with sex, food and many other subjects, our relationship to the subject of masturbating very often contains an essence of us and so contains the least filtered version of how we operate in the world. Not that many clients raise the subject, for understandable reasons, but many more would benefit by doing so.
If your therapist feels the subject is too much for them, then you know what to call them.
Meaning-Making
Therapy isn’t journalism. It’s not a place to try and establish the facts as accurately as possible or as fairly to all sides. It’s a place to see what your experiences and feelings and relationships have meant for you. And only for you. What did this experience mean for you beyond the facts of it?
Malcolm’s wife has left him. What does this mean for him? Did it mean she was too good for him and of course it was going to end this way? Did it mean he can never trust anyone? Did it mean she was a vile person who was trying to ruin his life? Did it mean everything valuable has a shelf-life? Did it mean he’s a bad judge of character? What has he taken from the experience of being left by his wife?
Mischa always cries every time she passes through Ipswich. What does that mean for her? Does it mean Ipswich has memories for her which elicit tears? Does it mean she’s too much of a mess to be worth exploring this with? Is she happy or sad or relieved, or perhaps they are frustrated tears? Does it mean she’s further away from London than she feels safe being? What does passing through Ipswich mean for her?
Every experience we have – however big or small – will have a meaning which is unique to us. Therapy is where we get a chance to understand what those meanings might be and to see how those meanings have woven together to create our experiences of the world.
And, perhaps, a place to change some of those meanings to something more helpful.
Money
I pay for my mortgage, holidays, haircuts and chocolate bars with the proceeds of people’s misery, anxiety and shame. For most therapists (I hope) the fact of that is, at various points, an uncomfortable truth of what we do. Ok, we could say the same thing about doctors re people’s illnesses, undertakers re people’s deaths, or tutors re people’s ignorance. But somehow talking to people in a room about their problems doesn’t seem quite as ‘expert’ as that; surely anyone can just talk?
There’s lots one could say here about the costs of therapy training (generally five years or more with total costs in fees, textbooks, therapy and lost income of anywhere between £40k-£100k). Or about how therapists will generally have done hundreds of hours of therapy while training (and sometimes beyond it) for free, or even paid to conduct therapy. Or the essential fact that you are not paying for the therapist’s time, you’re paying for the years of expertise which got them to that place.
All of that is true but none of it is very important to you when you’re needing help for your problems and a therapist is expensive, particularly if you’re going to be working for an open-ended period as most people do. But maybe this helps:
The money is what makes it work.
It’s the money you’re paying that makes you turn up: if it was a fiver you’d be more likely to skip sessions when you’ve had a bad day at work or you don’t feel like it.
It’s the money that makes you share what you share in the session: it’ll feel like a waste if you turn up and don’t actually say what you need to say.
It’s the money that reminds you that this person who you adore, or hate, or feel suspicious of, or reminds you of your abusive parent, is a professional person with whom you can explore your feelings (including about them): if they can’t handle it, that’s their problem, that’s what you’re paying for.
It’s the money that keeps you safe: this is not a social occasion and the money metaphorically placed on the table between you reminds you (both) that however much like other relationships it may sometimes feel – whether in a good, bad or confusing way – it isn’t; it’s a professional relationship, however intimate or complicated.
And it’s the money that reminds you that you want to have a better life: it’s your investment in yourself. You could have spent it on chocolates, box sets or games consoles but instead you spent it on making yourself happier.
The money is what makes therapy work.
Next Week: N
Narcissism, Neuro-Diversity, Neuroses, Non-Verbal Commuication