When I consider sitting with my clients, I ask the question ‘What is the difference between how I sit with them and how I sit with a friend?’ I talk with them, I listen to them, I spend time with them, and I even care about them. Nevertheless, it is many years of training and practice that has taught me how to sit with the client therapeutically.
When I work with a client, I do exactly that. It is an intentional activity. There is a reason for them coming to see me and we are on a journey together. I do not sit there submissively listening or hoping that the fact that I am with them will somehow lead to a deep realization or epiphany. No, I try to understand the implications of their words and I may link statements with previous sessions. When one of my clients speaks about an early traumatic incident, my experience may lead me to working with their parasympathetic nervous system. When another client speaks about a fear of death and feeling like time is running out, I explore the existential anxieties they may have and what effect it is having on their life.
In my clinical work I allow myself to truly enter my client’s world. I see myself as being a part of their world, it is invaluable for me to use my own reactions. My belief is that to be of benefit to a client we must create an environment that nurtures the relationship, one that gives the client faith in the process as well as themselves.
Just as the client who sits with me is, I am inherently human and it is this ‘humanness’ that allows us to travel along the road together and to gain a deep understanding. This humanness shows (somewhat colourfully) the normal thoughts, misconceptions, fantasies, emotions, and mistakes a therapist like myself will make in a session, although at the heart of the matter is this relationship and a common purpose. Therefore, I also consider trust to be something that must be nurtured in therapy.
Throughout history, within cultures and societies there have been consistent beliefs that certain individuals possessed the power necessary to create change in an individual. Even in pre-historic rock art we can see depictions of healing ceremonies. There has always been those who are believed capable of entreating the higher powers to heal the sick and cast away the demons of the spirit. But what I do is not magic and sometimes I fear this belief is why people don’t come to see me. They think, “Sure, it is only talking.” “Therapists don’t really do anything.” “There is no real science.” (Actual comments I have heard). This is why I wish to take away some of the mystery, so I can show that there is a process, that we therapists do focus and work until we see a client change and become that person they wish to be. Although I must point out this is my way of working and there are numerous others.
Sometimes we all have moments when we feel like we are passive spectators to the life we are living. My role as a therapist is to help a person gain some control of the boat they are steering. The boat analogy has been used before but I see it in a different light. There are winds and waves that will move us along, change our direction, impeded our travels, but we must never forget that we are still steering. We cannot control the weather, just as we cannot control every aspect of life, but we can control how we respond. In the end, we decide how we will react and it is in this decision that we regain the control that we once had.
As a therapist, I may not be able to change a client’s world for them, but freedom may exist in helping them change their perception of that world and showing them the freedom and choice that they do possess. I do not see therapy as formal guidance, but its strength lies in its ability to open us up to new experiences and allow us to grow as well as to find our own understanding. Change and healing may then occur with how we can shape cognition, alter perception and change the way a person looks at the world and themselves.
The next question is “How do I do this?”
To start with I see my client as a whole. I wish to understand them by connecting with all the aspects that make them who they are: history, family life, hopes, dreams, fears, food, exercise, belief systems, work, parents, culture, gender, talents, relationships, etc. Gaining as much understanding about them as I can, with the aim of connecting every aspect of that person’s body, mind, spirit, and the emotions that they have and directing these powers to make the changes they need for the future. It should also be noted that it is important to allow for therapy to be introduced not just for the sole purpose of changing a particular behavior but also for allowing a client to work through any difficult issues in their life.
The next step I take is with “Agency thinking” (“I can do it”) and pathway thinking (“Here is how I can do it”). Here I take on the position of a motivating factor for the client. It is through therapy that the client is given the opportunity to work through their own issues with a person who will help inspire them to have a higher level of belief in themselves and in doing so also help them devise a plan to either remove themselves from their current situation or to perceive and act within it differently. Talking without effect is not going to work. What people tend to forget is that yes therapy is talking, but this is just a starting point, a way to bring the external world into a room and explore a new way of being. In the end work is done with experience, tests, empathic engagement, collaboration of goals, case planning etc, all grounded in science and practice. I help my client bring about change by bringing the client’s attention between external realities and internal possibilities in the room. In therapy a client is given the opportunity to raise self-esteem in an environment that affords a safe place to express emotion. The client possesses the hope that there is something that can be done for them. It is then by nurturing this hope and gathering their internal strengths and directing them towards the goal that allows them to find there is a power either within or without, and once accessed will accomplish the task.
How do we know what we are doing is right? Well we must test it and evaluate the outcomes, enter into the situation and see how it fits in the relationship. Therapy is able to excite the human capacity for self-healing, and it can reframe suffering situations or even boundary situations by altering the various dimensions of human life that are relevant to one’s health. Heightened emotions are expressed in the therapy room as both therapist and the client are in search for meaning and understanding. In fact all manner of dramas are enacted within the session. The therapy evokes past memories and places them within current context, some of which are of particular importance to the client in what shapes their perception of the world. Furthermore, each client develops their own therapy in conjunction with their therapist as they each discover what is important to them and how they view their interpersonal world.
This is what makes the therapy different and more effective than other everyday encounters. Within therapy there is a consensus for a transition, both the client and the therapist are aware of this. Therapy can be used as a transition that moves a client from one position in their life to another. The Latin for “Threshold” is Limen which is where liminal is derived and in this way therapy brings those involved to a threshold, whether it be allowing the client to see a new way life, to act differently, rekindle repressed emotions, experience a new relationship or any other moment of change. They are brought to the threshold of awareness that once crossed allows a person to experience a new way of being. It is the completion of this transition that may be the key to health and growth.
What happens next is Separation. The separation comprises the removal from the ordinary situation of life which causes disturbance; whether a client is talking about work family life, relationship, past traumas, issues that cause stress, they are no longer in that environment which they speak of. Even if it is couples therapy, the couple is still extracted from their consistent environment into a new social structure. In all therapies the client goes through the threshold or liminal experience as they confront their past experiences within the therapy session. Finally reincorporation occurs where the client returns to their previous environment having experienced a new way of being. It is not claimed that this is a singular event that once completed releases the client of all their issues, however it is the stages which the client continuously passes through within the therapy setting until they have successfully navigated the past experience/trauma and created a new state of being.
Therapy is a process that transverses what a person believes they can accomplish and leads them down a path that was previously obscured. It is by no means simplistic, it requires a therapist to focus upon rigorous training and experience. It then entails the meeting of two minds and emotions to come to awareness. It is only when a therapist finally gathers the attention and focus of a client that they can then proceed to focus this attention on their life, their issues and their pain. When a person is capable of perceiving a new way of being then change will begin to occur. But first they must learn to perceive a better self and it is through using this potent internal power of perception that a client loosens the shackles that once held them.
“We shall not cease from exploration. And the end of our exploring will be to arrive where we started and know the place for the first time”
T.S. Eliot: ‘Little Gidding’
– A look at the pain of grief-
The above line may seem strange, even a little contradictory. “We can’t remember the future” you might say, but unfortunately we can, and sometimes these memories can cause us great pain.
When something monumental happens in our life and there are two paths to travel, we chose one and the result is we may never know what was down the other. For every choice that we make there is a negation of another choice that could have been ours. We are confronted with ourselves as a traveller on a road unable to return to a point and decide differently. How then may we live with the decisions that we make, when we also have the knowledge that we have destroyed an infinite number of other possibilities? ‘what could have been’ may haunt us forever. But what about the ultimate pain, when that choice is made for us?
When someone is taken from our lives through death we are confronted with the loss of the future we had together. When it is our mother, we remember her smile seeing her grandchild for the first time, with a sibling we may remember that 50th birthday celebration that will never happen. With a husband or wife we remember growing old together and with a child, we may remember the graduation ceremony that we will never see. Our lives stretch out ahead of us, we make plans and see what path we are on and where it may take us in 10, 20, and even 30 years. But because we have this amazing ability to think about the future so powerfully, we can also remember it when it is no longer possible. It is this memory of what could and should have been which can cause us the deepest pain.
This can be one of the most powerful factors of the grief process. A person may sit for hours clinging to the memory of what life would be like if that person was still in it. Even as life carries on and those beautiful yet painful memories subside, we still have those moments of crystal clear clarity where we can picture that person with us, what we would be doing right now if they were here, what they may say to us. Even a vivid memory of their touch can be so strong we can feel it on our skin.
What then may we do?
I believe we still have the ability and the propensity to create meaning out of the life we have, just as one life may no longer exist, there is still one that is full of hope. The path we are now on is unknown but full of potential. Therapy can truly help as it is a deep exploration of the future we may have within our reach. We may talk about the past but we do so while living in the present. The instillation of hope, the implacable grandeur of the life we still have, the search for meaning, all these factors come together to give us the power to build a new life, sturdy enough to sustain our new dreams and memories of the future.
The more fully a client may become aware of the control they have upon their actions as well as owning and accepting their experiences, the more they may be able to choose their responses unburdened by the weight of choice. It is about grasping life rather that evading and denying life. In stark contrast to this, to live in fear may destroy the possibility of living this life to our fullest ability. As one of the greatest therapists said, “He who has a why to live can bear almost any how”.
We must be aware of when our grief becomes too much to handle. Some signs to be aware of are firstly the physiological symptoms. These can manifest in such symptoms as diminished appetite, sleep disturbance, energy loss and exhaustion, somatic (no observable biological reason) or physical complaints. Negative feelings are expressed as the wish to have done more, perceptions of mistakes, or regrets about unresolved issues. All these thoughts and feelings can stop us living the life that we know our loved one would have undoubtedly wished us to have. When that person we love with all our heart is taken from our lives we begin to understand the importance of cherishing the present. We then must walk into the future as we live our life not just for ourselves but for the person who did not have the chance to live it with us.
As a therapist I care deeply for anyone who is in pain and I want with all my heart to help the person face their fears, accept their position, strive for new health and find a sense of peace within their lives. Facing up to the reality of death and helping my clients take the present moment with both hands and live it to the fullest is one of the greatest gifts we can share. The client I sit with may be able to move forward out of the suffering they may have being experiencing and into a new sense of peace, where we take responsibility for the life that has been left for us, even if it is without someone who we deeply wish was sharing it with us. In the end we are living two lives, the one we have and the one that was lost. We carry them with us forever, in the memories we have and will have, until we too are carried on by the heart of someone who loves us.
As Shakespeare once said
“So long as men can breathe, or eyes can see,
So long lives this, and this gives life to thee.”
Author Alan Oates
As 2018 arrived I was struck by a theme going through social media. No matter where I went, Facebook, Whatsapp, SnapChat, YouTube, Twitter etc, there it was. This theme was something I was familiar with but I never paid much attention to. What am I talking about? Well, to put it plainly, to have a so called “resolution” was in some way just fooling yourself. As the hours and days went by scrolling my life away I saw posts across Facebook suggesting New Year/ New Me as “bullshit”, people posting memes that the New Year would bring the same “ass hole person I was the year previous ”, or “Brace yourself, here comes the New year/ New me brigade”. But for some reason this brigade never arrived. I didn’t see these posts about the “New Me” that people were so sure were coming. I decided to stop and think about this.
Now don’t get me wrong, I love a good meme as much as the next person. When I see one that is on the money I laugh and continue to scroll, who doesn’t do this? I’m writing now because we can laugh at this and move on or we can stop and talk about it. Whoever is reading this I want you to think about your social media accounts, picture in your mind those funny memes, or those nice messages that where taken straight from a greeting card telling everyone to have a wonderful new year. I love these messages and it does show the capacity we have for happiness and fun. But, how many messages can you remember that where not just “Have a great New Year…” or “May the New Year bring you everything you want…” Take a moment, how many messages actually said what people truly hoped for?
As I write this I struggle to remember some messages that I would have loved to see. What about these:
“Hey Folks, here is to learning another language in 2018, … Going to get healthy and take up dancing, let the fun begin… 2018 is finally going to be the year I start volunteering at a homeless shelter’… Guess what folks? I am going to be a mentor for a child who really needs help in 2018. This is something I’ve wanted to do for so long”.
The list of our hopes and dreams for 2018 are endless, yet we are too afraid to even tell people! The result of this?
Well, to be honest the result is, in the end we don’t get the support we need to accomplish what we hoped for. How sad it is that we are paralysed by this fear of being ridiculed for our dreams. What I’ve seen and felt is that there is a terrible shame attached to admitting, and perhaps ultimately failing, in our New Year resolution that we simply can’t move. We don’t want to be thought of as attention seeking or even the ultimate shame, just looking for LIKES.
Yes we tell our partners and close friends what we want in person but we don’t tell the world because we don’t want to fall into the category of the “bull shit brigade” as one meme states.
Now how about seeing this post from someone who you love and care about…
“2018 is going to be the year I finally talk to someone about everything I have been struggling with for the last few years. No more nights spent crying. Here is to a brighter year for me”
Not easy to read is it?
I understand the discomfort; if we can’t tell people our dreams, how can we tell them about our nightmares?
But it’s the same problem, we focus so much on what it means to have a post that people like and get the smiley or happy face we hope for, that the result is we don’t ask for the help we need. The Real World we live in is getting better. When we open our door and walk out, mental health is being spoken about in open forums. We can tell people in work we have anxiety depression or stress. We don’t judge the people struggling with mental health for getting help, at least not as badly as we used to. However, we forget that there is another world we inhabit where there is still a stigma. The World of Social Media. The ever-growing need for approval based on this social media likes, retweets, posts, comments, followers, links etc. means we become paralysed with fear. It is shown that people do not find it as easy to respond to lines like the one above. Why not? Painfully enough the answer is simple; It doesn’t make us smile. So we move on, how painful, how sad and how true.
As I finish writing this post, all I can think of is how much we need to support each other. We need to change how we look at the world through social media. Hopefully over the next few years I will see posts of people’s dreams, but I also hope I see their fears and nightmares. When I see these fears, I will do something, I will be there for the people that I care about and who need me. From now on I refuse to continue scrolling my life or anyone else’s away.
Author Alan Oates