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psychogram #48

21/6/2016

 
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The good in goodbyes

19/6/2016

 
How are you with farewells? 

Do you avoid them? Leave the door ajar? Just walk away without explanation because if you actually said goodbye, the loss would be too real, and it might just hurt too much? Or the opposite: you actually care so little about the other person that you are quite happy just to flick the relationship switch to “off” and give them the silent treatment, a horrible practice known as “ghosting”?

Saying goodbye to someone that matters to you is saying goodbye to the person you were when you were with them—a better version of you perhaps; a funnier, smarter or more charming you. Perhaps a more innocent you. A younger you.
It’s saying goodbye to all the good times you might have together if you didn’t have to say goodbye—all the fun, shared plans and dreams you had dared to believe in, building a future on the shifting sands of your hopeful, fragile optimism. It’s all gone now, and forever, and it is unutterably sad.

We have to say goodbye for lots of reasons. Someone has died or they are dieing. Or they don’t want to see you anymore. Or you have woken up to the fact that, though you really love them, you can’t love them in the way they need you to, or vice versa. Sometimes you’ve just had enough: the pain outweighs the gain—or you realise you have been in denial all this time about the pain and/or the gain you imagined was just a fantasy.
PictureHit the road, Jack, and don't you come back no more
​Perhaps there has been abuse, betrayal, dependence, mixed messages, games, wasted time, passivity, boredom, endless conflict (often over minor things that represent major things—in Gabriel Garcia Marquez’ magnificent Love in the time of Cholera, the two protagonists’ differences were distilled and crystallised into an argument about soap). Your same old tired, unhealthy pattern, yet again. All kinds of hurt. You want different things. You have irreconcilable differences. It’s not you, it’s me. It’s not me, it’s you. You hate each other or, worse, feel completely indifferent. Sometimes it just comes down to choice between you or the other person. You have to choose you. Go on now go, walk out the door.

If you both try, you might be able to navigate through your turbulent waters, and find a way back to each other, and start over, perhaps with some new and different rules of engagement. But of course you might not be sure you want to--whether to stay or go is one of life’s toughest questions.

Perhaps this time, however, it really is the end. You might discover you can end this relationship without a moment’s hesitation, without a single backward glance, and you realise you only thought there was love. You were in love with the idea of love. But other times it is hard to say goodbye to love, and you are heartbroken. The amount of pain is proportional to the amount of love. If it hurts, it means you are human. You are alive.

​Goodbyes and badbyes
What’s your history with endings? Some good, some bad? One journal article itemises different kinds of ending (in the context of saying goodbye to your therapist, but universally applicable), all of which generally feature in every goodbye to greater or lesser extent. These include:

• Ending as loss. The other person occupied a huge part of your life and now they are gone. Whether or not someone died, it feels like a death. It triggers the memories and feelings of all the other losses, rejections and abandonments in your life, some of which—especially those in childhood—may have been quite traumatic. You try to end with love. You mourn. It will take time, but not just time.

• Ending as transition. You have outgrown the friendship, partnership, flirtation, romance, fantasy, engagement, marriage, friends+, FWB, NSA or whatever it was. Change is inevitable. The mighty river never stands still. This kind of ending is a rite of passage: You grow up, or have some therapy and wake up, and your nerdy school friends or your college sweetheart or your work buddies from your old job or this or that particular subgroup you used to hang out with no longer fit with who you have become. You might try, but you can’t turn back the clock. Be glad for what you had—and move on.

​• Ending as metamorphosis. Sometimes an ending marks a dramatic turning point in the life of at least one of the protagonists. Some kind of shift to a true self perhaps, or awakening, or enlightenment—a catalyst to saying farewell. Sometimes in turn, for the other person, the farewell itself is the catalyst for change. Such endings can be transformative, pivotal, life-changing. You say goodbye not just to a friend or partner, but to a worn-out version of you. Your familiar, comfortable cocoon falls away and you emerge, reborn as some kind of a butterfly. The wrenching flavor of such an ending/beginning is captured in Mary Oliver’s powerful poem, “The Journey.”
Set yourself free
One client has a letter written to him 20 years ago by the woman that he loved. She wrote it on her deathbed—a final farewell. 
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New beginnings are often disguised as painful endings
—Lao Tzu
 
If you're brave enough to say goodbye, life will reward you with a new hello
―Paulo Coelho

You just slip out the back, Jack
Make a new plan, Stan
You don't need to be coy, Roy
Just get yourself free
Hop on the bus, Gus
You don't need to discuss much
Just drop off the key, Lee
And get yourself free
―Paul Simon
 
Ev'ry time we say goodbye
I die a little
Ev'ry time we say goodbye
I wonder why a little
—Cole Porter
(sung 
here by Lady Gaga)
 
It’s over it’s over it’s over
―Roy Orbison
 
This is the end
Beautiful friend
―​The Doors
​
It remains unopened. He can’t bear to say goodbye.

​Another client kept all the letters from a former partner that he still hankered for. One day, he decided to burn them all, and he was astonished how intense the flames were—the old love letters produced a great deal of heat and light. It was a symbolic experience: he realised how much energy his continued infatuation took from him. After the bonfire, he was able to reclaim that energy, rouse himself from his post-break-up doldrums, and move on in his life with vigour and confidence and a renewed sense of love.
Three endings
• “Casablanca”: In wartime Morocco, Rick (Humphrey Bogart) rekindles an earlier love, forged in Paris, with Ilsa (Ingrid Bergman). But she is now married—to an underground resistance leader, a fugitive, on the run from the Germans. Rick engineers an escape for him, but at the 11th hour, he makes Ilsa get on the plane, too, telling her she would regret it if she didn’t: “Maybe not today, maybe not tomorrow, but soon and for the rest of your life.” Rick stays behind in Casablanca. A noble sacrifice? Or having regained the love, perhaps he didn’t really want the actual woman, too.
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Casablanca: Have a nice life
PictureThe Wlid Things: Max masters his demons
• “Where the Wild Things Are”: In Maurice Sendak’s classic 1963 children’s picture book, young Max is sent to bed without supper for bad behaviour. His bedroom magically transforms into a jungle, and Max gets on a boat and sails to a fantastic land where wild beasts roam free. He is able to tame them with a magic trick and is hailed as the king of all wild things. Then he wants to go home:

But the wild things cried, ‘Oh please don’t go--
we’ll eat you up—we love you so!’
And Max said, ‘No!’
The wild things roared their terrible roars and gnashed their terrible teeth
and rolled their terrible eyes and showed their terrible claws
but Max stepped into his private boat and waved good-bye
​

A young boy gets to know his emotions, his rage, his scary shadow side, but refuses any more to live at the mercy of these things—he says goodbye to that old, exhausting version of himself and grows up. (How’s your relationship with your inner “wild things,” by the way?) Back in his bedroom, Max discovers supper is waiting for him—still hot.





PictureA Doll's House: To hell with all that
• “A Doll’s House”: Ibsen’s play—written in 1879 but still highly relevant and much-performed—tells the story of Nora, trapped in a stifling bourgeois marriage, characteristic of so many traditional pre-feminist heterosexual couples of yesteryear. One piece of research from the 1970s showed generally elevated levels of psychological distress in single men—and married women. In many old-fashioned partnerships the man holds the power and control, while the woman is subservient, obedient, repressed. The union—controlling parent “ego state” meets submissive child “ego state”—has a dysfunctional kind of equilibrium that can last for years, decades even. Until—with or without therapy—the latter finds their voice, their power, and wakes up. (Or, in fiction, comes to a sticky end, punished for the temerity of wanting to shake off their shackles, eg. Anna Karenina, Madame Bovary and other desperate housewives.) In the last scene of Ibsen’s play, Nora rejects her enslavement to the marriage, motherhood and the tightly constraining, stereotypical role that she has been assigned. She slams the door on the Doll’s House and walks free.

What do these endings have in common?
• A decisive, dramatic finality
• An action taken with a great deal of courage
• A sense of wisdom prevailing over convenience
• Style, and some good lines. Yes, we’ll always have Paris.

But fiction is easy. Real life is messier and far more complicated.
 
Our time is up
How do you say goodbye to your therapist? Do you just stop coming without warning, despite the fact your therapist may have a termination clause in their terms and conditions (I ask for a notice period of at least two sessions). Such a clause may sound self-serving for the therapist but it’s really for clients, who are denied the benefits of a proper ending if they don’t show up. It’s an opportunity to review and consolidate all the work you've done, to say what you’ve been trying to say all these weeks, to offer up feedback, to have a sense of direction going forward. To say goodbye.

“Many clients come to therapy with issues about unsatisfactory endings or losses,” write Emmy van Duerzen and Martin Adams. “It is important that the client does not experience the end of therapy as something else that ended unsatisfactorily.”

A recent article in The Guardian—“Breaking up with a therapist”—quoted a 28-year-old woman from Seattle, who has ended three of her relationships with her therapists by “ghosting” them: “The whole point of having a therapist is not being emotionally invested in them, [and] they aren’t emotionally invested in you if they’re doing their job right,” she said.

I disagree with this point of view. Therapy without emotional investment is like decaf coffee—nice enough but missing the key ingredient. Without some sense of understanding, acceptance and connection, without feeling anything, the potential for lasting change is limited.

Clients often wonder how important they are to their therapist. “You must have a lot more interesting clients than me”—I’ve heard that a few times. Or the other day a client stopped midsentence and said: “Don’t you ever get bored of listening to this shit?” There’s an assumption that for the therapist, saying goodbye must be easy, maybe even a relief in some cases. It’s never written about, but for the therapist, too, goodbyes can be hard.
 
Dearly departed
One thing about goodbyes between people who love each other is that they are never really final. Maybe the goodbye doesn’t hold, and you get back together. Or you keep bumping into each other, or you haunt each other on social media. Even if you stop seeing someone you love, they have become part of you, and you part of they—powerful “internal objects” that continue to grow and influence you. The love, the energy, the relationship—these things keep evolving even in the absence of any further refuelling by each other’s actual presence. Human connections can thrive despite a lack of geographical proximity. Or even a lack of the loved one being alive. Jung was 21 when his father, a pastor, died. His father appeared in dreams throughout his adult life. He became a much greater guide and teacher to Jung in death than he ever was in life. Death shall have no dominion.

Last word
Goodbye!

psychogram #46

6/6/2016

 
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psychogram #43

16/5/2016

 
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psychogram #42

9/5/2016

 
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psychogram #36

29/3/2016

 
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psychogram #34

14/3/2016

 
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The state of the union: Stay or Go?

10/3/2016

 
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On June 23, citizens of the United Kingdom are being asked to vote whether or not we should remain faithful to the European Union.

Should we try to patch things up and make it work? Or, perhaps citing “irreconcilable differences,” opt for a separation and divorce?

Stay or go? Such a stark, black-and-white choice in a scenario characterised by multiple shades of grey. Does it feel too good to leave—but also too bad to stay?

There are push and pull factors on both sides of the ledger:

Stay: pull factors
• We like Europe and the Europeans, and they like us. The way you wear your hat, the way we sip our tea. We learn from each other. Our doors are always open to each other. We’ve known each other such a long time. We’ve been through such a lot. We work well together. We’ve more or less kept the peace for decades and our joint finances are successful. Let’s stay together.

Stay: push factors
• We don’t want to be alone. We’re deluding ourselves—we’ll be lost without you. The breakup will just be dreadful. All your friends will turn on us, along with some of ours. Our children will be taken away, and they will never forgive us. We’ll end up broke and disheveled, knocking on your door with a begging bowl. The day will come when we will ask ourselves: If you’re so clever, then why are you on your own tonight?
​Should I stay or should I go now?
Should I stay or should I go now?
If I go there will be trouble
And if I stay it will be double

--The Clash
 ​
Go: pull factors
• We’ll be free without you. You’ve been holding us back all these years. Unshackled, a great deal of joy and energy will be released and we will surely do great things. We can become the person we have always wanted to be. And we can see other people! Already we’ve flirted with China, Brazil. It’s all very exciting! Unchain my heart.

Go: push factors
• For the xenophobes, anti-immigrant hysterics, little Englanders, Daily Mail readers, empire nostalgists and Social Darwinists, the decision is easy. They’ve never liked you, and never wanted anything to do with the arranged marriage. And they think they’re better than you—“we” are surely good, whereas “you” are surely bad, lazy, criminal, dirty, weak, perverted, bankrupt, corrupt, attracted to peculiar foods.
We don’t think those things, but we’re tired of being treated with contempt. We never get a say, our opinion doesn’t matter. We always have to compromise and do it your way. You are maxing out our joint credit card. You are too bossy, aggressive or passive-aggressive. You make the rules, we have to follow them. You’re just not very generous, and you're never going to change. And we’re just too different. We can still be friends, but if we stay married things will only get worse. Love will tear us apart.
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​Your relationship referendum
The EU referendum is powerful metaphor for your more personal, intimate relationships, partnerships, marriages. Are you unhappy? Should you stay or should you go?

Again, there will be a tapestry of circumstances. Some push factors foreclose any other considerations, for example domestic abuse. Others can be big but not necessarily insurmountable, such as an affair or betrayal. And there are always pull factors keeping you together: your shared history, the convenience of the status quo, and, above all, children.

And how will it be on your own anyway? The stereotype is that women feel the immediate emotional impact of a break-up more than men, but long-term fare much better on their own than men do. A piece of research from 1972 suggests that marriage is bad for the mental health of women, which given the power dynamics of some very traditional marriages isn’t surprising, although later figures show no gender difference.

You imagine a glamorous bacherlorhood perhaps, free of obligation and duty, exploring all those things you wanted to do but never had the time. Maybe the reality is you are home alone in an indifferent world. There are no invitations to dinner or weekends away. Just you and the deafening sound of the phone not ringing. Who wants to be lonely? But maybe some loneliness would be good for you?
 
Preliminary investigations
• Jannah Walshe recommends a clear-headed assessment of the relationship—not so much the other person—first alone and then together, with questions like these: Is this relationship serving us both or just the other person? Do I spend more time questioning whether the relationship is right or wrong than enjoying it? Is there more to learn for me in this relationship, or can I best learn and grow outside of this relationship? Would leaving this relationship be an act of self-care?
• Similarly, Bruce Derman Ph.D. offers 7 questions to ask if you’re thinking of divorce, starting with: Were you ever really married? Was there a time when you has an us, with reciprocal, mutual intimacy? Or have you always been a bit like flatmates who sometimes have sex?
• Take Relate’s relationship MOT quiz.
 
It’s good to talk
The best advice if you’re not happy is to return once again to a simple, four-letter-word: talk. It’s not easy, especially if one of the problems in the relationship to begin with was not talking.
• Relationship and marriage expert Dr. John Gottman claims couples wait an average of six years of being unhappy before speaking out. You will never get those six years back again.
• Belgium has the highest divorce rate in the world, 71 percent, and the second-highest suicide rate in Western Europe. These facts are often attributed to “binnenvetter”—a characteristic Flemish personality who bottles things up inside.
• It is so much easier to talk with a mediator, referee, coach, guide—a couples counsellor. Find one online or through organizations like Relate or the Tavistock Centre. In “Hold me tight,” Dr. Sue Johnson advocates “emotionally-focussed therapy”: “seven conversations for a lifetime of love” that explore and promote each partner’s emotional responsiveness to each other. “Emotion comes from a Latin word emovere, to move,” she writes. If a couple is going to reconnect, they have to “let their emotions move them into new ways of responding to each other.”
 
Tough decisions can be made with compassion
• In his book ”I love you but I’m not in love with you,” Andrew G. Marshall says “the ILYB conversation,” with 100 percent honesty, can lighten the path to a relationship renaissance—or to the exit sign. If the latter, the ILYB talk will help you to make sense of the breakup. Having a clear, truthful narrative about why the partnership ended is crucial to the mourning process—to be left, cheated on or suddenly “ghosted,” without explanation, can cause months and years of misery.
• Whether you stay or go, it’s never black and white, and you have some control over what the shades of grey look like. In “Rewriting the Rules,” Meg John Barker writes that you don’t have to follow the old stereotypical rom-com/sitcom rules of a break-up which dictate it’s completely over, there’s a good guy and a bad guy, and the former will never speak to the latter again. Relationships don’t end, says Barker, they change. Breaking up with someone with love and respect can spare a lot of pain all around.
 
Stay or go? Or something else? Perhaps if you listen, you might just hear the generous, loving voice of your own wisdom. It knows it's not all your fault. It knows it's not all your partner's fault, either. It has compassion for you both.  It knows what to do. Trust it.

​To partners past, present and future—to Europe—let’s give thanks, and be grateful. We had some really special times together, didn’t we? We’ll always be there for each other, on some level. Things die, love lives on.

Perfect love

15/2/2016

 
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It's Valentine's Day, in case you hadn't noticed. What kinds of love are in your life? ​Are you satisfied? Many clients come for counseling with one complaint or another about love.

Last year I worked with a client called Jim (not his real name—“Jim” gave me permission to write about him but I have changed his name and the details of his story to protect his anonymity). Jim worried that he was incapable of lasting love. “I just can’t trust it or commit to one person,” he said. “I am a commitment-phobe.”

A few months earlier he had ended a four-year relationship. It was fine, he said, but he knew in his heart she was not “the one.” Instead of feeling free, however, he was miserable. “It’s as if I fired the gun,” he said, “but it backfired and blew up in my face.”

The ex—who he described as “the nicest woman in the world”—was moving on with her life; Jim meanwhile couldn’t stop crying. He had to keep taking bathroom breaks at work so he could sob.
In one session, Jim was really struggling. He had just met his ex at the flat they’d shared to sort out the remaining stuff and hand over the keys to the landlord. At the exact moment they said goodbye, Jim realized how much he loved her—the exact opposite scenario to getting cold feet when walking down the aisle. But it was too late.

Jim was inconsolably sad. Here was a smart, successful and worldly man who felt an utter failure. He was worthless, he said.

We explored Jim’s story. When he was very young, Jim’s parents split up—his dad had met someone else. More than three decades later, this event was still casting a long shadow. Young Jim had gone to live with his mum—a terrible Oedipal “victory”—and quickly learned to adapt to the new configuration. Children are so very good at adapting.

​Survival strategies

In therapy, Jim reflected on what might have been going on for his young self at the time. Young Jim, he felt, came to three conclusions, perhaps largely unconsciously:

• The divorce was all his fault; if he could be really a perfect little boy perhaps he could be forgiven—and even bring his parents back together;
• He had to spare his distraught, bereft mum from any further pain by being good—the perfect son, student, happy, successful;
• Being left was really painful—much better to dump someone than be dumped by them.

These “rules for living” allowed Jim to navigate his childhood. He did a near-perfect job of being near-perfect. He was the consummate little diplomat in all dealings with his parents. He worked exceptionally hard and truly excelled at school. But inside he was consumed by feelings of guilt and worthlessness.

As an adult, Jim had extremely high standards, both for himself and others. He was by his own admission “an asshole boss.” Romantically, too, everything had to be perfect. Instead of being himself, Jim felt under enormous pressure to be a kind of idealized storybook partner—charming, thoughtful and magical. Jim’s “false self” brought great rewards, but he felt it all to be a grand illusion. Sooner usually rather than later, Jim or his girlfriend would fail to be utterly unimpeachable and the relationship would completely unravel.

The therapy began with an exploration and identification of these patterns, followed by an acceptance of them. The “false self” was a very necessary part of Jim. It allowed him to survive as a child and thrive as an adult. But there was so much more to him. In therapy, Jim felt his way to connect more with the parts of himself that are “a bit rubbish” and this freed him up to connect more with others; to stop being a chameleon and start listening to his own emotions and desires.

When a new relationship started, Jim tried a new approach: honesty. He allowed himself to express his feelings and be vulnerable. He gave up some control, including in the bedroom. With an enormous sense of relief, Jim discovered he could be himself.

Jim was not a commitment-phobe. What he was not prepared to commit to any longer was the demand that he be perfect.

Perfect Jim? He got dumped by the much more likeable Imperfect Jim.

Perfection is not love. It is the imperfections that make a person lovable.

Happy Valentine’s Day!
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An interpretation of Freud

22/1/2016

 
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​Long considered a sexist dinosaur with a cocaine habit and some bizarre ideas—does anyone believe that little boys literally fear castration, want to kill their fathers and have sex with their mothers?—Sigmund Freud is enjoying something of a renaissance.

As Oliver Burkeman recently outlined, the therapy Freud invented, psychoanalysis, is at last gaining some much-needed empirical support, while at the same time the default treatment on offer in the U.K., quick fix, symptom-focussed cognitive-behavioural therapy (CBT), is increasingly looking like some sort of snake oil.

CBT appeals to our common sense. But common sense isn't as common as we'd like to believe.

Freud’s revelation was that we are not necessarily always logical, rational beings making optimal choices as we navigate through life’s vagaries, that we are in fact to a large extent strangers to ourselves.

A few years ago, a relative had a terrible holiday in Italy. On returning home, in retaliation, she boycotted her favourite local Italian restaurant and has not been back since. This marvelously illogical yet so very human protest is typical of how inventive and fluid our psychology can be.

Unlike my relative’s very deliberate restaurant boycott, however, Freud argued that much of what we do operates “under the hood,” out of awareness. Our conscious, stated desires can be different from or even completely opposed to our unconscious ones. We might say we want to give up smoking, or find a partner, or start (or finish) a big project, or do something bold and courageous, but somehow we find ways to ensure it doesn’t happen. We make mistakes, and we vow never to be so foolish again, but then we find ourselves doing the exact same thing. Over and over. Freud called this “repetition compulsion.” Britney Spears called it “
Oops, I did it again.”

According to Freud, our unconscious motivations generally can be traced back to our formative years. We learned how to be in the world as children, and decades later this blueprint remains. Sometimes it’s as if we were insisting on still using a crutch long after our broken leg has healed. The blueprint includes an imperative to repress disturbing ideas, thoughts, emotions, events, memories and conflicts from long ago. But they are not so easily silenced—they retain some kind of energetic charge which can find all manner of expressions, sublimations, projections and other creative outlets.

One of Freud’s patients, five-year-old “Little Hans,” had an intense fear of horses—Freud said they represented his father. “Rat Man” had an obsessive, intrusive fear of torture involving rats and bottoms which Freud linked to early experiences of discipline and sexuality. “Dora” had a suicidal breakdown after being propositioned by a family friend because, claimed Freud, she was repressing a lesbian attraction for the man’s wife. Freud’s most notorious cases are summarized here.

Freud argued that neurotic symptoms, when unmasked, usually make some kind of sense. They have an intent, a meaning; they exist to resolve something or defend us from pain, guilt or shame. Merely removing the symptom without addressing the cause—the CBT approach—might just lead to another symptom.

And anyway, a symptom is not so easily removed. Since it serves a purpose, writes Freud, a patient will “make the most of it, and when it comes to taking it away from them they will defend it like a lioness her young.”
​

Freud defined his invention of psychoanalysis as “the science of unconscious mental processes.” The power of the unconscious is his greatest legacy.

Darwin told us about ourselves as members of the animal kingdom. Marx told us about ourselves as members of society. Freud told us about ourselves as individuals.
​The battle within
A cornerstone of Freudian psychology is his 1923 structural model of the human psyche. The idea—which wasn't original: Plato proposed the same thing two millennia earlier—is that we have three parts to our interior system of government, which Freud called the id, ego and super-ego. The selfish, erogenous, childlike id seeks gratification. The autocratic finger-wagging super-ego by contrast is a sanctimonious, guilt-inducing presence, forever hectoring you about what you should be doing. Mediating in between is the harried, democratic ego, trying to keep everyone happy. It’s like having Caligula, the Pope and Bill Clinton sitting around the negotiating table. On different days, some voices are louder than others. Freud likened the internal conflict between the three constituents to a legendary 5th century battle between Attila and the Romans and the Visigoths.

The battle is as old as the hills and most people—and families, cultures, countries—generally have a default setting, either on the side of the super-ego, favouring restraint, prudence, safety and being “good,” or on the side of the id, living their lives with more freedom, spontaneity, creativity, passion and throwing caution to the wind. Many clients belong in the former category, paralysed by a brutally harsh inner self-critic. The more you try to please the super-ego by doing the “right” thing, the more demanding and punitive it can become. The super-ego usually has its origin with parents, but also can come from teachers, bosses, governments and religions. Freud writes that it “rages against the ego with merciless violence.” That violence can be the cause of much psychological and somatic distress.

Therapy is about shining a light on these and other haunted caverns of the unconscious, understanding them, accepting them—making the unconscious conscious or, as Freud put it, “where id was, there ego shall be.” To be enlightened is perhaps to have no fears, illusions or deceptions about one’s propensity for darkness.
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Case vignettes*
• After a lifetime of short-term relationships with troubled men, Karen is lonely and desperately wants to settle down. She has a social life, she does various evening classes, she has joined a dating site. “But there are no good men out there,” she complains. Her checklist of criteria that must be fulfilled is so long that she has effectively ensured it will never happen. She is thus spared the pain of rejection. In therapy we learn that Karen’s father left the family when she was 10 and was barely spoken of again.

• Dave lives under a blanket of depression. He collects evidence everywhere for his worthlessness. Every chance remark, askance glance or unsuccessful outcome is added to the rap sheet and presented as evidence that there’s no point. He is thus relieved of having to take responsibility for his life and the possibility of real failure is averted. Dave initially dismisses the fact the he was born into an acrimonious divorce—which he feels was his fault—as irrelevant “ancient history.”

• Jessica is a workaholic with no time for relationships. She has risen to the top of two professions and is considering starting a third. She has a history of unexplained physical complaints and finally sought out therapy when one morning, on her way to work, she inexplicably burst into tears. She came to realize how as a teenager, after her father had died, she had become “the man of the house,” helping her depressed, bereaved mother, looking after her younger siblings, getting a part-time job to make ends meet. She held the family together; now she lives alone.

​

*These are fictionalized, representative stories; names and details have been changed

PictureFreud's facial expressions run the gamut from utter foreboding to grim disdain.
Therapy today
Freud’s influence was far-reaching and profound. But he was a flawed character. You get the feeling he started to believe in his own myth. Patients often had to fit into his theories rather than the other way round. Any dissent might be met by indignant harrumphing or an ended friendship. He was capable of exploiting his position as a white male authority figure for personal ends. His work was sometimes more to do with furthering the legend of Sigmund Freud than with healing.

Some of his ideas and speculative musings have great metaphorical and symbolic value, yet he invited ridicule by insisting on speaking in absolutes and the rigid certainties of hard science. He was somewhat obsessional, detached, and ironically perhaps not so much of a people person, once writing, “I have found little that is ‘good’ about human beings on the whole. In my experience, most of them are trash.” The best they could hope for was “common unhappiness.” In photographs, his facial expressions run the gamut from utter foreboding to grim disdain.

Freud claimed psychoanalysis worked. He would identify unconscious motivations and unhelpful patterns, explain them to the grateful patient and, thus fortified, the patient would make better choices going forward. Except that very often they didn’t.

Today’s therapists who work at any depth will, like Freud, want to uncover your blueprint, your patterns, your unconscious processes. They might explore your childhood, interpret significant memories, analyse your dreams, which for Freud were the “royal road” to the unconscious. But they know that, while self-knowledge is helpful, it only takes a client so far. Lasting change and healing comes from the heart as well as the head, through acceptance, support and love. Research shows it is the therapeutic relationship itself which heals.

Good therapists are not inflated with their own importance, nor blinded by their own certainties. They treat clients ethically, not just because there are codes of ethics to abide by, but because ethical therapy is inherently good therapy. Above all, they are fully engaged with the client, noticing what is happening between them, and always working in partnership with them, in their best interests, rather than lording over them as they lie on the couch, prostrate and exposed (whether as a client or a therapist, I prefer to sit chair to chair and eye to eye). A good therapist cares.

It’s not enough to know and be known. To thrive in this life it helps, too, to love and be loved.

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    John Barton is a counsellor, psychotherapist, blogger and writer with a private practice in Marylebone, Central London. To contact, click here.


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