T
Therapists in therapy; Training; Transference; Trauma; Truth
Therapists in therapy
Any therapists worth seeing have had (or are still having) loads of therapy. Why? Well obviously because we’re famously all a bit fucked up. (Some clichés are true.)
Another reason is that all reputable trainings require therapists to be in weekly therapy throughout their three to five-or-more training years. That’s a lot of therapy.
But there’s a more profound reason. Therapists need somewhere to process our difficulties too. We need help working out what we’re feeling, how we’re behaving, what we need and how to get it. And having therapy is a great and constant reminder of how fallible we all are and how valuable the experience can be. If we can overcome our challenges, or keep trying to, maybe we can help others do the same with theirs.
A therapist who thinks they’re all sorted is a really bad therapist.
Training
Psychotherapists generally go through up to five years of training. Training involves three core ingredients: theoretical knowledge (from Freud to the present day); therapeutic skills (variously in groups or “goldfish bowls” – giving therapy to another colleague while other students watch and review) and personal development. The latter, perhaps the most important ingredient of the three, happens during the training but also outside it: for instance, most trainings require students to be in therapy throughout (see above).
Different trainings focus on different modalities (approaches) but all trainings will focus on those three ingredients in their own way.
So when you meet your therapist you should be able to assume that, at minimum, they have a well-developed sense of themselves, their skills and the theory which underpins everything they do.
Transference
Transference is one of the key ingredients which most therapists, particularly those who work at the more psychodynamic end of the scale, have in mind throughout their work. It means who we become for the client.
Almost inevitably, as the therapeutic relationship develops the client will start to project onto the therapist aspects of their own relational patterns. The client experiences the therapist as uninterested, or punishing, or lustful, or shaming, or judgmental. With help, they can come to see that those feelings are based on their previous experiences with others. Gaining access to this crucial dimension of relationship is often a key component to undoing its power.
Trauma
Trauma is an individual response to a traumatic event, generally one which the person experienced as a threat to their life or bodily integrity. Trauma is the mainstay of what most therapists do for a living.
Some events – a serious injury, say, or a sexual assault – are very likely to induce some form of trauma response. But many trauma responses have roots which are more opaque, or even completely unknown. As with most material that is explored in therapy, though, it is the client’s response to the event more than the event which is crucial to release for the person to find their way back to equilibrium.
Of many enormous challenges which trauma can induce is the absence of a narrative timeline. When we experience a trauma, often the part of our brain that stores memories is knocked offline, over-run by our ‘felt responses’ to it. When the trauma is over, our body retains the feelings but our mind confusingly does not retain the memory. That’s why some people experience flashbacks: their mind is trying to slot what little it has retained into a sequence. That’s why, when working with trauma, very often the key technique is to tune in to the feelings it evokes (even in the abstract) rather than the memories it induces (in fragment).
As Babette Rothschild – an expert on the subject – writes in her accessible and detailed book Trauma Essentials – the keys to managing trauma lie in four stages: developing an environment of safety and support with the client; cultivating a strong therapeutic bond; pacing the work at a manageable level including “applying the brakes before the accelerator”; and identifying and utilising the client’s internal and external resources.
Simple as those may sound when summarised, for some clients even the first of those stages can take months or years. How to treat trauma in therapy, like trauma itself, is a completely personal experience, not a generalisable event.
Truth
Carl Bernstein, the legendary American journalist, is fond of saying that the job of the journalist is to find “the best obtainable version of the truth”.
Therapy is not journalism.
Frequently clients will worry that in their telling of a story or their reporting of an experience they may be missing a detail or inaccurately expressing what someone said or did. That maybe their memory is partial. Of course it is. That’s the point.
It is almost never important (or even particularly valuable) to hear in therapy a 100% “accurate” reporting of a memory. Such a thing isn’t possible; I’m not going to interview the other people who were there. The only purpose of a story is to access what the client took from it: what their truth is.
The only truth that matters is the client’s. Anything else: call for Woodward and Bernstein.
Next Week: U
‘Unconditional Positive Regard’; Understanding; Uses of Therapy