P (Part 1)
Pace, Paradoxes, Paraphrasing, Pauses
Pace
Therapy is not a science, but an art. And, as in music, theatre or any act of storytelling, one of the key arts is pace. Too slow and it can feel under-energised, unmotivating, stuck. Too fast and it can be superficial, distanced, disconnected. As with all arts, there is no right or wrong: there’s what works.
Petra speaks at huge speed: story upon story, detail upon detail. It’s as if her life tumbles from her mouth in every session. This is a bad sign. But Peter speaks at just the same rate: avalanches of detail, masses of subject. But for Peter it’s a good sign.
What’s the difference? Well…
Petra is performative. Talking and talking and talking is what she does at work and it’s her comfort place. In therapy she talks so much that key details, clarifications or feelings have no room to breathe. She’ll say nothing to her therapist that she couldn’t quite easily say to her best friend, and even if she does he or she may miss it because of all the other details smothering it. Petra’s pace needs to change. If she can dare to slow down, pause, think before she speaks, connect with feelings rather than stories, maybe she can access something different. Petra needs to pause.
Peter, on the other hand, is usually a man of few words. He contemplates everything he says; picks his phrases with the delicacy of a poet; never says anything he’s not certain will be accepted, and comes from a background in which control was everything. For months in therapy his silences were louder than his words. But now he’s talking. Words come out of his mouth fluently and fluidly. Sometimes he loses his clarity but his passion and his feelings come in their place. His therapist can feel the release that finally opening up is doing for him. For Peter, at least for now, a fast pace is a huge help.
Petra and Peter’s respective therapists (and yours) need to help find a pace that is the most helpful. That won’t always be your normal pace.
Paradoxes
Phil loves his mother but he never wants to see her again. Pamela wants to have sex but is absolutely terrified of it. Ped is excited about their career change but hasn’t slept for three weeks worrying about it. Pablo finds therapy vital but also dreads it.
In these paradoxical situations people sometimes feel that they need to pick one of the two forks in the road they find themselves facing. Unfortunately, both forks lead over a cliff. They are stuck in what Melanie Klein (see ‘K’) called the “paranoid schitzoid” position. What they actually need to do is acknowledge that both forks have their merits and problems: that the new job is scary but also desirable; that sex would be wonderful but may also be frightening; that it is possible to love someone that you can no longer tolerate being with; that therapy is worthwhile but also emotionally taxing.
Therapy is a great place not to ‘decide’, but to tolerate. To allow both sides of the coin to get their say.
As American baseball player Yogi Berra infamously said: “When you come to a fork in the road, take it.”
Paraphrasing
Paraphrasing is one of the basic therapeutic skills in which the therapist repeats back in their own words what the client has said to them, perhaps in summary form. So, for instance:
Polly I think the reason I’m always late for these sessions is that I’m not really sure I want to come. It’s hard sometimes, and I get upset, which is embarrassing, and part of me thinks why the hell am I putting myself through all this?
Therapist So you’re ambivalent about coming to therapy each week.
Therapists deploy this tool for two main reasons: to allow the client to hear their own thoughts from the outside and perhaps hear them afresh. But, also, to check if we’ve understood it right. We may have picked up the wrong emphasis, or the client might have not been as clear as they need to be.
So the conversation might lead to this:
Polly I think the reason I’m always late for these sessions is that I’m not really sure I want to come. It’s hard sometimes, and I get upset which is embarrassing, and part of me thinks why the hell am I putting myself through all this?
Therapist So you’re ambivalent about coming to therapy each week.
Polly I’m not ambivalent, no. I know that I want to do it, I accept that it’s hard. To be honest I think it’s not the therapy per se, it’s you. I feel really uncomfortable you knowing all this stuff about me.
Therapist Ah ok. There’s something about how you experience me which feels very uncomfortable, perhaps more than the material itself.
There’s now more clarity, and maybe the conversation can go down a more useful line.
Pauses
Any list of therapeutic clichés includes the client finishing their thought and the therapist sitting quietly, staring at them, saying nothing. Why the fuck do we do that?
I promise you we’re not trying to annoy you.
Sometimes we don’t respond immediately because we feel you may have more to say and we’re giving you the space to elaborate further, perhaps noticing something in what you just said which needs more space. Sometimes we want to make sure the session is run by what you need to explore and not by what we may think is important; if we talk too soon we may take the conversation into an area which is not what you need that day. Sometimes we just don’t have anything to say and we want you to be the person who indicates where the conversation should go next. Sometimes we just want to keep the pace gentle, to avoid it feeling too much like a Q&A.
Whatever our motivations, it’s helpful to notice what the inevitable therapeutic silences bring up for you.
Awkwardness maybe (“I don’t know what to say now.”)
Embarrassment. (“I’ve run out of things to say now. He must think I’m an idiot.”)
Anger. (“What the fuck am I doing spending all this money if I have nothing to say?”)
Relief. (“Thank God. It goes at my pace, I don’t need to race to get a word in like I do at home.”)
There will be dozens of other examples.
All are useful. All are worth mentioning.
Next Week: P (Part 2)
Projection, PTSD, Punishment