Breaking up with your therapist is also hard to do

Breaking up, as Neil Sedaka sings it, is hard to do. Equally so with your therapist, as I discovered on Wednesday. I felt pretty angry afterwards, which is a good sign that the therapist was not supporting where I was coming from. At one point I told him, “Stuff you!” What I should have said was: “Shut the f… up, this is my session and you’re doing all the talking.” Now I’m bit embarrassed about the ‘Stuff you’ part but he was giving this whole speech without any regard for how it was coming across. I managed to put my side of the story (quite well I thought) but his blunt interpretations have also given me food for thought. Maybe he’s actually partly right, I realised today. Still, he’s a bully and an ass.

Now I hope the slightly flippant tone of this post doesn’t make you think that I’m taking this whole break-up thing lightly. Far from it. But I also think that we need to be able to laugh about the stuff that’s the most painful to us. After all, choosing your partner is probably the biggest decision of your life so there deserves to be a lot of agonising over it, right?

Coming back to the therapy break-up, I was interested to read other people’s experiences. In the NYT, Richard Friedman says:

With rare exceptions, the ultimate aim of all good psychotherapists is, well, to make themselves obsolete. After all, whatever drove you to therapy in the first place — depression, anxiety, relationship problems, you name it — the common goal of treatment is to feel and function better independent of your therapist.
To put it bluntly, good therapy is supposed to come to an end.

But when? And how is the patient to know? Is the criterion for termination “cure” or is it just feeling well enough to be able to call it a day and live with the inevitable limitations and problems we all have?

The likeable Dr Rob over at shrinktalk adds the following:

… some clients are not connecting with their therapist or are not making progress that is to their satisfaction. No therapist can work perfectly with every client , and good therapists understand this. Again, honesty is the best policy here, and simply telling your therapist that you would like to work with someone else is completely acceptable. However, some clients struggle with this, and will often leave me voicemails with specious reasons so as not to deal with perceived confrontation:

I’m cured
My insurance won’t cover it
It’s too expensive
Your office is too far away
It’s too cold out
…
You are too young
You are too old
You are incompetent (commonly relayed as “you suck,” or “you’re an arrogant ass”)
I want to work with someone with blond hair
I need a Jewish therapist
Fuck off and die

Now I know he’s just joking about the “fuck off and die” part but it feels quite therapeutic just to read that and imagine someone saying it to their therapist via voicemail. Of course, as Rob also points out, very often clients leave therapy because the therapy is touching a nerve and it’s uncomfortable for them to go there.

For me, the answer was yes and no. Yes, we were touching a nerve and no, I wasn’t running away from it as much as getting frustrated that he wasn’t helping me to make progress in working with it. Just let me be, I wanted to say, let me do this therapy at my pace. And it also didn’t help that he was trying to pressure me into making a longer commitment to the therapy. Ambivalence is not a healthy state to be in, was the message I got, so you need to commit to the process. Now I agree that it’s not that helpful to be ambivalent but it’s also not helpful to ignore the ambivalence by rushing into a commitment. That way leads to resentment. What I think he should have done was to try and hold the ambivalence and try and be sensitive to the underlying anxiety rather than trying to bully me into doing things his way.

From a reader’s point of view I enjoyed some of the comments over at Yelp:

Take him/her out to dinner, get a couple of drinks going, and say, “It’s not you, it’s me.” Leave him/her with the check and SCRAM.

If it’s not working for you, be up front with him/her. Try to identify what it is that you are looking to work on and why that’s not happening. Maybe you’ve gone as far as you can go with this particular practicioner. You won’t know until you vocalize your concerns. … Sometimes it’s just time to move on.

As for the song, I like the Violent Femmes version.

A sackload of potatoes to Upington

Down by the (Orange) riverside

the long road to U-town

It seems like ages since I sat at this desk and fired off a quick post about this or that. The this of today is my Upington trip, which I alluded to above in the post about flirting and playing truant.

Perhaps the easiest way to do this would be the 5Ws and an H method we learned in Journalism school.
Who? Me and my colleague, H (an Afrikaans, conservative Christian type)
What? Drove to Upington to test the troops
Why? Because we were told to.
When? Last week
Where? That would be Upington in the hot Northern Cape
How? In a car.

Hmmm. I guess this method isn’t working as well as I hoped. Switch to Q&A.

What were the best and worst aspects of your trip?
Good question. There were a few good points. The first was having my misperceptions of Upington corrected. I’d always assumed that Upington was a hot, boring town in the middle of a hot, boring province and that it would be hell on earth to visit there. Wrong. Upington is an oasis of green in a hot, dry desert and the B&B we stayed in was, if not quite a home away from home, pleasant and hospitable and a mile better than its counterparts in Bloemfontein.

The second plus was meeting some fine (pleasant, kind, polite, interesting) colleagues from the Northern Cape. The woman in charge was a little older than me and she drove her team around in a minibus taxi which was just like a mom’s taxi and she was just like a mom. A fun, spunky-type mom. The psychologist who tested with us had recently climbed Mt Kilimanjaro and was an adventurous sort. And no, I didn’t flirt with either of those two women but I did let the spunky, mom-type have my extra ice-cream (which I got through being politely assertive).

The worst part, apart from the 9-hour car journeys there and back, was having to make small talk in Afrikaans with H, my conservative Christian Afrikaans colleague. On the plus side, I have made a new friend who I can go diving / taking pictures/ hiking with. But on the minus side, I had to listen to stories about his ex-girlfriends for five days. I know that many of you will wonder why I chose my current profession if I don’t like listening to people talk about their exes for long periods of time. And we are talking loooong periods of time. But allow me to point a small difference. In the therapy room I can call time after 50 minutes. “I’m sorry but we’re out of time.” On a long car journey with no CDs along for the ride (what was I thinking?) I was forced to listen, nod, listen some more, make appreciative noises (in Afrikaans) and then form an opinion and have a discussion.

“Yes, she does appear to have borderline tendencies but, you know, borderlines can also be very loving when they feel they’re understood.”

“No, I’m not very religious and I don’t go to church more than perhaps, once a year.”

“Hmm, that’s an interesting [conservative, religious] expression. I hadn’t heard that one before. How does it go? He is no fool who gives up what he can’t keep to gain what he can’t lose? Yes, I see. Giving up your earhtly life for eternal life. Right.”

(Sorry, I am being a passive-aggressive nasty person here but it’s quite therapeutic so feel free to skip off to the next post if this grates you.)

I knew I was in for trouble when 10 minutes into the journey he apologised for bringing a sackload of potatoes along for the ride. That’s an Afrikaans expression in case you didn’t know, which refers to bringing a whole sackload of problems into a discussion. You start off with a little potato and, before you know it, you have a whole table full of them and you’re being asked to give your considered opinion on each one.

One little extract from my journal might be helpful:

“I like H but I also find him quite boring and I get tired speaking Afrikaans all the time (or most of the time). He tires me out – the chronic fatigue, the negativity re L and the other girlfriend (the one with the beach phobia), the limited interests, the conservative outlook about absolutely everything except diving, the lack of empathy with others, the child-like need for approval and encouragement …”

Reading this again, I realise a few things.
i) I’m judgmental.
ii) I’m able to be empathic but I resent being put in a situation where I have little choice but to be empathic for long stretches of time
iii) I get uncomfortable with people who are conservative without any idea of how their conservatism impacts the people around them.

I’m also aware of something else. My own anxieties about my job and everything else that I have on the go this year makes me less tolerant of people such as H. I start to worry that I’m going to have to be friends with him for life. Would that be such a bad thing? Maybe I need to lighten up a little, or to shoulder those potatoes with a small shrug and a little smile. Hmm, potatoes did you say? Let’s roast a few over the fire and see how they taste.

Playing truant

One of the things I like about Adam Phillips’s writing is that it’s designed to return us to our own thoughts. So it was with not a small degree of interest that, on returning from my internet-less Upington trip, I picked up my latest London Review of Books (LRB) and read his piece, “In Praise of Difficult Children” (12 Feb 2009).

Here’s a taste:

… the adolescent is the person who needs to experiment with self-betrayal, to find out what it might be to betray oneself. Not what it means to break the rules; but what it means to break the rules that are of special, of essential value to oneself. …. So called delinquent behaviour is the unconscious attempt to find the rules that really matter to the delinquent individual. And this is a frightening quest. Betraying other people matters only if in doing so one has betrayed oneself.

Now I won’t claim to have been a very rebellioous child or a wild teenager but my brother did call me a “bolshy biscuit” and also “Bolshy the Bolshevik” as a result of my temper. I learned the hard way that losing my temper with my mother is generally not a good idea, and I turned that anger inwards and became a slightly depressed young man instead. But that’s not what this blog is about. It’s about breaking the rules, and following them, and how it’s good to do both. Isn’t that liberating, to be told that we need to have a truant mind in order to work out what’s really important?

I suppose I could apply that to my Upington trip in the following way. I’ll just come out and say it, to spare P and myself any further agony. I didn’t flirt with anyone in case that’s what you’re thinking but I did find myself wondering what it would be like to do so, for example with the young woman that runs the kitchen at the picturesque B&B we stayed at. She was quiet with a shy smile and a tentative flaunting of her prettiness. (Note to self: are you sure you want to write this? This has trouble written all over it.)

Now we didn’t exchange more than a handful of words: hello, good morning, how are you, are there any more eggs etc. but there was something about her that was intriguing. I put it down to loneliness on my part and being away from my girlfriend and tried not to think more about it.

But reading Phillips’s short article on playing truant, I’m remembering an earlier piece he wrote on flirting. That it can be helpful, important even (at least in imagination), to ‘flirt’ with other people to realise what is important about your relationship. This can also be applied at other levels as well – flirting with ideas, or with another job, in order to explore what’s frustrating you about your current situation.

Now the counter arguments to flirting are legion, and I’m well aware with quite a few of them. I know, for example, that it’s hurtful and rude to look for too long at another woman in my girlfriend’s presence. Experience tells me that a quick look, followed by a reassuring comment (if one is required) that the women in question is pretty “but not as pretty as you are” is the way to avoid trouble. I think the issue is not whether one notices an attractive person of the opposite sex (or even the same sex for that matter) but whether or not one makes your partner feel secure in the relationship. Of course it’s also not entirely up to you whether or not your partner feels secure – but the watchword here is probably sensitivity.

I’d be interested to hear any thoughts on this one.

Away

I’m leaving in a few minutes for a week-long work trip to Upington in case you’re wondering why there’s no posting or commenting happening here at the Couchtrip. I was planning to do a post on relationships in line with Valentine’s Day but I guess that will have to wait. But what I can leave you with is this – an interesting journal article on Donald Winnicott and Masud Khan.

In the December 2008 issue of the journal Psychoanalytic Review, James Hamilton explores the “tragic misalliance” of these two very famous psychoanalysts. I’d heard of Khan in the way that you hear about examples of psychologists to avoid copying. Very talented but rather disturbed, Khan was kicked out of the British Psychoanalytic Society for misconduct which included sexual indiscretions with supervisees. Winnicott, in contrast, was hugely influential in understanding the mother-child relationship and promoting ‘good-enough mothering’, as well as establishing the mother-child relationship as the template for good psychodymanic therapeutic practice.

What makes the connection between the two interesting is that they had an “intricate personal and professional affiliation, which included Khan being in analysis with Winnicott for 15 years”. Two quotes to whet your appetite:

Winnicott had enormous therapeutic ambition, and an overriding need to be a rescuer …. This trait predisposed him to take on unusually difficult patients as well as marry his first wife, an artist, despite advice from friends not to do so because they considered her “mad: that is, she claimed she could communicate with T.E. Lawrence, with whom she was infatuated, through her parrot. (Rodman, 2003, p.291)

In summary, Winnicott’s intractable guilt over not being able to alleviate his mother’s chronic depression and for outliving friends killed in World War I was instrumental in his becoming an analyst and a rescuer who was prone to overestimating his therapeutic effectiveness while refraining from exploring the vicissitudes of aggression in his analytic work. This internal obstacle … in Khan’s case, promoted harmful acting out that was harmful to his patients and supervisees while ensuring his professional downfall.” (Hamilton, 2008, p.1032)

Have a good week.

Why she left

I’m a slow reader so it’s taken me 40 pages to get really hooked by Orhan Pamuk’s The Black Book. First there were all the different Turkish names and characters to get used to. Who’s Galip again? Is he married to Rüya? I have enough difficulty with P’s friends and spouses and children so a whole cast of Turkish characters was always going to be a challenge.

But now that I’ve arrived at the central plot I can relax into the story. Basically, Galip’s wife has left him. Gone. Disappeared with nothing more than a 19-word farewell letter. As the blurb says:

Could she have left him for her ex-husband, Celál, a popular newspaper columnist? But Celál, too, seems to have vanished. As Galip investigates, he finds himself assuming the enviable Celál’s identity, wearing his clothes, answering his phone calls, even writing his columns …

I also have to agree with the blurb-writer that Pamuk’s novel is “a cascade of beguiling stories about Istanbul”. The style is clever too and I like the way he intersperses the story with Celál’s entertaining (and intricately told) columns. I’ve just read the one about Alaaddin’s shop and I loved the way it enabled him to provide wry commentary on such a wide spectrum of Istanbul’s population.

For me there are also echoes of Tim Winton’s The Riders (in which Scully tries in vain to work out why his wife never arrives at their new home in Ireland). It’s a powerful question: who do women (and people generally) leave? As someone who’s been both a leaver and a leave, it’s a poignant mystery which involves suitable soul-searching. I’m guessing that Galip’s story will become a detective story to find the mysterious Rüya but I’m enjoying the psychological side of it. I’ll keep you posted. One quote:

He took comfort in the promise Rüya made next: it too was four words: I’ll be in touch. He sat up all night, waiting in vain.
All night, the radiators and water pipes groaned, gurgled and sighed. There were flurries of snow. The boza seller wandered past at one point, hawking his millet drinks, but he never came back. For hours on end, Galip and Rüya’s green signature stared at each other …

Snows of measured seriousness (aka Board Exam Blues)

Today I wrote my board exam and it was, on the most optimistic of assessments, only so-so. When I walked out of the University building in Parow, I was confident that I’d got the sub-minimum of 70% required to pass. But of course when I got home, I got out one of the Acts and checked the relevant provisions. Ouch. That’s one question on which I clearly didn’t get the sub-minimum. I’ll have to wait three whole weeks before I learn whether I’ll be doing this all again in June.

In the meantime, this is what happens when I’m supposed to be studying but end up watching Sky News instead.

Snows of measured seriousness

If you went down to South Wales yesterday, the hills were alive with tones of measured seriousness. For two days Sky News reporter Katie Stallard has been reporting on snow-covered roads in the South. Yesterday she was at Abelare in South Wales where her coverage had a sense of quiet melodrama.
Now I’m quite prepared to accept that with all the studying and avoiding of studying I’ve been doing that I’ve lost some perspective on the issue but I’ve never seen a snow-covered road in South Wales or elsewhere for look so, well, moving.

On Monday she helped to rescue a man who had been stuck in his old Mercedez Benz on the hard shoulder of an icy road with no mobile phone and five coats which he wore at the same time to keep warm.
“Jamie MacDonald has been sitting in his car since 8 o’ clock this morning,” said Katie earnestly, fixing her eyes intently at a point behind the camera. She added that he had fallen asleep at one point but had finally been towed to safety.

Watching this quiet melodrama, I couldn’t help wondering about the love that the British have for a crisis. Preferably a crisis in which the whole of Britain is at risk of being swamped by danger (in this case snow or the cold) and everyone has to rally round and do their bit.

Was it being trivial to think that we weren’t a million miles away from this:

we shall fight on the beaches,
we shall fight on the landing grounds,
we shall fight in the fields and in the streets,
we shall fight in the hills;
we shall never surrender …

Probably. But the cadence of we-will-survive-against-the-odds is possibly similar.

And then I changed channels. Oprah was interviewing the cast of The Secret Life of Bees and I was hooked. The talent, the drama, the sheer stamina of that national institution that is Oprah. British actress Sophie Okemodo looks brilliant in this too by the way.

And then it was back to Sky in case I’d missed some more of the drama in Abelare before flicking back to South African TV. The Joburg police were on strike and there was political intimidation in KwaZulu-Natal. It was all a bit humdrum and anti-climactic and I couldn’t help thinking that Katie would have done better. Which then got me thinking about what would happen if our daily lives were small soundbites on satellite news.

Katie: I’m here in South Africa where blogger Pete has been holed up in his bedroom for THREE days trying to cram for his Board exam. How do you feel?
Pete: Aaargh, I think I’m losing my mind.
Katie: He says that tomorrow he’s writing his porfessional board exam and that if it goes badly, he could well lose his mind.
Pete: Aaargh, I’m losing my mind.
Katie: This is Katie Stallard for Sky News, South Africa.

What do I know?

Thanks to Litlove for this tag, which gives me a chance to write a quick post before I get down to studying for the day. Ten things I know should be easy right? But I’m feeling the pressure to show how clever I am, or well-balanced, or just ‘real and deep’

1. Love is Transference. This can be very helpful but it’s also a limited perspective. Love means different things to different people. Perhaps we could say that “falling in love” is transference but that the growing-and-changing-and-appreciating-and-struggling every day form of love is much more than that.

2. Next to Love, the next most important emotion is probably Fear. Notice the ‘probably’ there. That’s my fearful side providing a qualifier in case some very wise person comes along and says “what rubbish – it’s Anger or Hope” or whatever else I happen to have overlooked!

3. Anxiety forces us to grow. A helpful distinction is between different kinds of anxiety — natural, toxic and ‘sacred’. The fear of fear itself, which we’re seeing so much of with this credit crunch, is toxic anxiety. The ‘sacred’ kind confronts the big questions of existence.

4. Paradoxically, facing up to our vulnerability can make us stronger.

5. Anger is healthy, but not if you give yourself over to it.

6. Violence feeds the Ego.

7. People are motivated primarily by self-interest, which is why it’s important to enlarge our idea of the Self.

8. We are constantly changing (often in subtle ways).

9. Trauma works in cycles. I read an excellent quote by Martha Beck a while ago in which she was talking about grief as walking along with a huge boulder on your back. As you make your progress, this burden gets lighter and lighter – from a heavy rock to a light pebble – until you hardly notice it at all.

10. There’s always a Middle Way, especially when it comes to dealing with conflict. Being assertive for me means standing up for yourself while still acknowledging and respecting the other person.

Consider yourself tagged if you’ve read more than two of these posts and haven’t posted one yet yourself.