Instant relationship fix

My archives remember a rather messed-up guy who, in his teens, made the desperation mistake of adopting an immature joker archetype, then continued to endorse and feed it well into his late thirties. He still tried to be popular, tried to be the funny man, wanted to be extra-special, even using the word “glory” to describe his ideal. As you know, some childhoods are stamped in as trauma and the child never leaves. You have a man-boy, a woman-girl who can’t see beyond their early feelings and needs because the past is where they live, their ocean, while the present is the waves and whitecaps.

His relationship of three years was sick, like indigestion. He would actually cringe when she walked in the door. I don’t know what she saw in him. But he wanted it to work and I drew the line:

“You can end the hurt and destructiveness immediately, absolutely immediately, by putting your needs aside. If you really care about her, you can just be hurt, not angry. ‘That hurt me,’ not ‘but you do worse.’ Here is where this comes from: One of my first clients was a young mother who was unique. She said at her first session, ‘I mistreat my daughter. I’m the most important person in the room. I’m not going to be able to be a good mother until I heal from my own past, my own baggage.’ And she was right. Why shouldn’t that apply to marriage, to committed adult relationships: ‘I can’t be a good spouse until I deal with my own past’? Why do adults think they’re fine? Or troubled in their own life but worthy in their marriage? But like that mother, who can’t afford to wait until her demons are exorcised to stop abusing her child, must quickly do right, you can stop being poisonous immediately, while working with me into your foundational injuries. Your father left you and your mother, then returned five years later with a new young wife and children, and your mother put up with it. Breakdown after breakdown, she put up with it. And you lived in that swamp and that tear gas.”

In his partner, a man wants corrective justice for his past, but he doesn’t know it. He wants pure respect and love and accommodation just as the child he still is needed them. I’m very sorry. You get that from your dead mother and father, in here. Your partner gets your care.

Brief, solution-focused heart surgery

I’ve been seeing therapy clients four to six days a week for twenty years, so I felt appropriate when a frightened Counselor Intern asked me: What do you talk about after the first session? How do you keep therapy going week after week?

When I heard the questions, my first and shameful reaction was to wonder what my nemeses in spirit, Cognitive Therapists, do after they’ve pointed out the illogic or irrationality or catastrophizing or “musterbation” of the client’s thinking. That should only take a session or two, shouldn’t it? Though I’ve gone to Cognitive-themed workshops over the years, I’ve never gotten any sense of the paradigm’s ability to create depth or continuity. Nor have I ever been able to fathom the chutzpah of a modestly intelligent counselor’s belief that he or she can correct “thinking errors” in other adults, can open their mind to a long-elusive, just-missed, or too-stupid-to-figure-out life-changing truth.

The fact is that despite my disdain for that severed-headed approach, I am envious of any therapist who would laugh in the face of the question: “How do we run the show?”

Except that –

I’m sorry, the majority of you: The answer is not that the client determines the hours. For one, many clients would just talk on and on from their surface tension (angsty) and defenses (euthymic), or they would die in the water, an emotional clot rising to the surface, with nothing to say. Two: They do not know how to solve their problem. The internal gravity of their wound will be resisted over and over again. They will float above it forever.* And three: It is extremely likely they do not know what their problem is. Their problem is not a fact, but a feeling. And the feeling is not in the here-and-now. It is their child that has not moved on, has not grown.

So for you who laugh at the questions, there’s a better-than-fair chance that you are doing things wrong and are not helping anyone beneath the palliative and mutual self-delusion plane.

I have a belief, pretty much unarticulated until this writing, that the emotionally investigative process (that is: “therapy”) should be limited and self-limiting by the client. I suspect that this belief lowers an unconscious curtain on my therapies at a certain point. Once the client has reached a motherlode of her childhood wounds – grasped them stripped of the adult rationalizations and “knowledge,” cried them, grown a backbone astride them – it is time to leave her to her own life. Her foundation will be somewhat cleared out, deepened. Her house will have open windows, a stronger front door. A term of therapy may be three or four months, but probably not longer. She shouldn’t continue to live in the regressive subterrain. But neither would she flap on in her adult persona.

This would be to acknowledge, or tip our hat to, the fact that we can’t not be a nebulous and partially grown person living in our own individual world. (There is only so much and so little we can do.)

One of my most grateful clients, an artist, attended weekly for almost a year. There was horrendous child abuse in his roots. We worked directly on that – insight, catharsis, abreaction, some “primal scream” – for a short while. The rest of that year was urged, I believe, by a peculiar place in him that wanted his truth to be recognized with care and some perceptive feedback. That may have meant that he was strong enough to let his child come into the room many times, though our conversation was often what you might call “refined”: philosophy, creativity, the psychological soul. He was unique in my experience. Most clients cannot knowingly live in their past and in their present equally. They shift to the unknowing.

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* That is, until Freud’s “interminable” has been reached.

Imagine it's your 20-minute psychiatric appointment

I have become a cold, cruel therapist. Any client sitting before me would never know this. My victims are those who no-show or late-cancel their appointment once too often. Their future-scheduled sessions may get erased. They are notified of this, not asked about it. Shooting myself in the foot has never felt so righteous.

This stand’s inspiration was a principle expressed to me by a clinical supervisor at the beginning of my career. At that time I felt embarrassed being bequeathed it, as any new therapist should. She said: “Your clients’ appointments with you should be as important to them as their appointments with their medical doctor or their psychiatrist.” A new therapist should blush hearing this. I did. Over the next fifteen years her lesson would occasionally pop into my head, triggering a little laugh and the old blush, even though I knew I had actually helped some people find a better life, and maybe saved it. I’m not laughing any longer. I have come to be certain that helping the spirit is at least as important as helping the body. If soma and psyche were in a lifeboat with only enough provisions for one, neither could be justified sacrificing itself for the other. And there are many times when a wounded body will survive, but a wounded soul will die.

To go further, I believe that a Master’s-level therapist can be as powerful and salutary a presence as the best medical doctor. The nature of a good therapist is simply the consistent application of some of the best qualities of a decent person – empathy, nonjudgmental care and perceptiveness – with some intelligence thrown in. These can therefore be some of the most formidable people you will meet.

And the potentially life-saving person you need right now.

So, to my present and past clients: Would you cancel or ditch your doctor’s or psychiatrist’s appointment as easily as you would your psychotherapy appointment? You know you wouldn’t. Pills are easy, fixing the life your parents left you is difficult and unpleasant. Sitting or lying on a couch and moving the chemistry of defeat, of childhood, is painfully paradoxical: Healing is hard, the most desired is the least desirable. It can feel like strength to avoid therapy and handle your life on your own, and like weakness to be a receiver of help. You are fighting the most human urges to become your most human.