The "Proper" Way to Do Therapy
So, have I piqued your interest? There's of course no generally accepted "proper" way to do therapy. I've been around long enough to know there are many types of therapies for trauma healing. Most of them I don't know much at all about. But I was hoping that this post could pull together some of the "lessons learned" from my experiences.
It seems impossible to me that I was able to function, at one point, without psychotherapy. I do have hope that one day I will heal enough to not need it, for surely I cannot work this hard forever (as I wrote about in Trying to Give Myself a Boost). But for now, therapy is much needed. It provides a resource with which to navigate through the minefield that is healing.
The way I "do" therapy has changed over the years.
In the early years I said nothing. I remember being in my early 20s and being intensely fearful about sharing anything. But, aside from that, I didn't know what to say. I would watch the clock and remember looking at the time in two ways. I would either measure it by how much time had gone by or how much time was left. It was excruciating. That wasn't the proper way to do therapy.
Somehow I learned to talk. I don't remember when that was, but it happened. It was like a dam broke and everything came out at once. I was a mess. I still hated going to therapy. I was switching all over the place. I was unable to contain memories. I also ended up, for a period of a couple years, going many times a week. It wasn't uncommon for me to go four times a week back then and there were also the crisis phone calls and all the "drama" that people associate with the beginning stages of dealing with DID. You can read about that in Therapy as Life Support versus Healing. That wasn't the proper way to do therapy either.
I took a break from therapy from 1995-2001. I was self-harming but didn't really pay attention to it. I muddled through using the dissociative coping and got married and had kids. Well, technically my wife had them, but I was a crucial participant. I increasingly became distressed about the self-harm and felt it was getting out of control. But I had nobody to talk to. For some reason, I had not really mentioned it in my prior round of therapy. That was certainly not the proper way to do therapy.
In 2001 I entered therapy again. This time things were different. I had a "life" now and I was in my early 30s. I had responsibilities. I had children. I had a mortgage. There were still the crises, except they felt a bit different. I needed to address the self-harm. I learned to intellectualize in therapy. I thought I could figure this all out as a scientific problem. So, this is how we worked. We analyzed everything in excruciating detail. I did learn quite a bit from those years. It's important to know how to look at a problem, even a psychological one, intellectually. But I missed the boat. I thought being able to intellectually dissect a problem was the Holy Grail. I was wrong. I would often rush to therapy from my office and then rush back afterwards. I would often have no sense of what happened. It was all a whirlwind. I eventually learned that it was not safe to go back to work after therapy. So, I usually went home afterwards. Often I was a mess. I would have to medicate the emotional distress away. This was also not the proper way to do therapy.
For me, the proper way to do therapy is the hardest and most time consuming way to do therapy, but also bears the most fruit. There are a few basic principles I adhere to:
- Make time before therapy. I don't rush to therapy anymore. I usually leave a cushion of about 3 hours before therapy to sit in a safe place and allow my system to equilibrate. I assess where I'm at. I sometimes take notes on what I want to talk about. I listen to music. I write. I draw.
- Make time for therapy. My therapy used to be 45-minute or 50-minute therapy "hours". I've found this is not enough time when wading through the weighty issues of healing. In therapy, I can experience a number of state changes and emotions. These take time to address. My therapist and I have also learned to do more than just talk. We do art. Art has opened up new doors to younger aspects of me and to more destructive aspects of me. We can draw or paint the unsayable. Music has also been a healing force. My therapist and I are able to share pieces of music together which have particular meaning. For example, after we listened to Beethoven's Grosse Fugue several months ago, we had a deep discussion about why it was important to me. If you haven't heard the Grosse Fugue, you really owe yourself a listen. Relaxation and meditation have also been techniques we explore in therapy together. As a result of all these different approaches, the 90 minutes usually flies by. And that's not because I switched!
- Make time after therapy. I have found that it's important to process what we process in therapy. This is the part that bothers me greatly. I usually feel that after the time preparing for therapy and after therapy itself, I'm entitled to a break. But, if I just go home afterwards, a lot can be lost. So, I bring my laptop with me, sit in the lobby, and write until things start to make sense. I'm usually co-conscious, so while initially the barriers start to be erected, I can offset this by taking time to write. Eventually, I'm able to make some meaning and I learn more about parts of me. This is true even if I don't have a complete picture. I can usually put enough of the pieces together, but I have to do it soon after therapy or this information gets lost in the noise.
I've also learned that I cannot figure everything out all the time. I know that really none of this is about figuring things out. It's about the mantra my therapist gave me: Relax, Breathe, Feel, Listen, Choose, Allow. It's interesting that none of the words have to do with figuring things out, intellectualizing, or any of that.
This is the balance to be struck. The balance between thinking and feeling.
It's hard but it's the proper way to do therapy.
27 Comments
Welcome
"Healing from Trauma and Dissociation"
I'm Paul, a father, husband, scientist, educator, photographer and musician. I'm also a survivor of childhood sexual abuse.
Mind Parts consists of my own insights on the aftermath of childhood sexual abuse, namely trauma stress and the full spectrum of dissociative coping mechanisms, including dissociative identities. Through a blog, I explore the healing process in a variety of ways—using creative contributions of original art, photography, poetry, and music as well as, hopefully, though-provoking essays. Mind Parts is also home to two support services. The quarterly Ezine Trauma Recovery Highlights is a look at some of the best online resources. Also, the monthly Expressive Arts Carnival makes available activities which are published as a group "Carnival."
Comments are welcomed, but if you prefer, you may contact me offline. My belief is that sites like this one can contribute by offering unique perspectives and knowledge, thereby enhancing opportunities not only for survivors but for readers and society as a whole. Namaste!
Wow.
What a fascinating post, and a wonderful explanation of your process.
I haven't been at this as long as you have. Partly, I think that is because I am a married woman. I met my husband when I was only 17 and as a man, he had the typical male sense that it was his job to fix me. It's what men do, they solve problems....
For this reason, to protect his ego, I waited a very long time to go into therapy. I wanted to make it true, that my Lancelot was going to save me and make me whole.
No one person can save any other person.
When I first told my husband that I felt I had to go into therapy, he cried. He felt like he had failed. We have had a lot of talks about how this is not true, how it wasn't his job, but still, on occasion, I will tell him something that I realized in therapy and he will say "well, I told you that a long time ago."
Because I was in my late 40s when I entered therapy, I did approach it differently than people who are younger. I didn't feel like I had time to put in half a life of therapy. I was, and am, positively driven. I have gone through many of the stages you describe here, but I have gone through them in weeks and months instead of years. I just cannot let myself sit there and not talk, or watch the time go by, or I start beating myself up. I did the intellectualizing, as well.
It took me about eight months to get to the point where I really started to make progress, and in the 18 months since then, I have made "years of progress", according to my therapist. It is hard work! It is sometimes way more work than seems humanly possible.
I was fascinated to hear of your journey and to see how it mirrors mine. You have put it here very clearly, and it really has made it more clear to me exactly what I've been doing.
I also make time before, during, and after my appt.s I think the after time is the most important part.
Sorry, this is long and disjointed. I have so many thoughts on what you wrote, I can hardly stop myself
Shen, Thank you for your thoughts. I am glad to hear that others can do things on a timescale that's different from mine. This is really remarkable and a tribute to you.
Hi Paul -
Of course you piqued our interest. Great summary of your process - I'm still in the earlier stage of looking at the clock and trying to intellectualize everything. Processing afterwards is a big key, I think. If I wait too long, I forget lots.
In addition to your other skills, you are a good writer. Thanks for sharing.
OLJ
Hi Journey, Great name! Intellectualizing certainly has its place. As I wrote, it helps to set you up for greater self-discoveries. I wish you well on your journey!
Hi Paul I came to your blog through the lovely Vicki. I have been feeling quite lonely on my therapy journey so it has been interesting to read some similarities with your experience. I hate dissociating during therapy I can't see the point in it, it just makes me feel awful. I can't see how it's healing, it feels like a weakness. So I'm quite confused by it all. I've had to stop therapy since I lost my job (bloody recession) and I thought I would collapse without therapy but now I think I could do with a break. I haven't had a good support system. Starting my blog and meeting some lovely people already has been very good for me and is helping me cope with all this. All the best
Hi Speck of Dust, I feel terrible calling anyone that. I hope your screen name was not meant to be pejorative. You raise an interesting point about dissociating. Dissociating in therapy may feel pointless, but it can also be what parts of you need in order to be listened to. It is almost always jarring. It doesn't always need to feel like a weakness, though I can understand why you would think that. I think that a lot, but not always. I'm sorry you've had to stopped therapy and have it be not by choice.
Hi Paul,
Thanks for sharing this. It helps me understand your healing path. It helps to know what other survivors have experiened and gone through as well as what they find healing.
I think that I started out having trouble sharing, but was seeing a guy who was very used to teaching during the therapy hour. I went to therapy because of my overriding health issues and even though I presented with a history of child sexual abuse, we dealt with learning skills. That was helpful.
When I wanted to start working on the abuse issues I felt the need to find a woman therapist who was knowledgable on trauma psychology. I don't think that she was. It was always easy to talk about my abuse issues. I soon started reading and learning. I soon found myself very comfortable in expressing the emotional, abuse impact, and knowledge areas during therapy. Learning a lot and quickly convinced me that I needed to find a different therapist, after less than six months.
From then on I have been a highly motivated client. I would say that I prefer to be the one in control and prefer someone who is both empathetic and knoweldgeable.
Thanks for sharing so much.
Kate
Kate, It's admirable how you are able to take control of your own healing and know what you need. It's obvious you work very hard and that this work is helping you find peace and healing.
Paul,
This is a very lovely post to read. I found myself chuckling Make time, Make time, Make time... Wonderful!
I just know how this is so important. When I first began having memories my kids were all babies. Out of necessity I had to Make Time or literally I could not survive the whole process. Over the years as processing lightened I have become less diligent about Making Time. Now my youngest is 14, and only two still live at home. I am once again beginning to have more memories. This post is just what I needed to remind me of very effective processing tools that I used in the past.
There is nothing like time is there, it is a miracle. I truly believe we have all the time we need to heal and become whole if we will allow ourselves to take TIME.
Thank You so much.
Fondest regards,
Vicki
Thanks Vicki. I'm glad the post was helpful to you. I'm sorry you are having more memories now, but know that you made it this far.
I wonder if you are given the mantra "Relax, Breathe, Feel, Listen, Choose, Allow" because your therapist trusts you to do the work. She knows you're motivated to work hard on the issues you are facing; but that in that motivation we all sometimes forget to allow ourselves the time for the concepts within the mantra.
Take care,
Michelle
Michelle, Yeah, I think so. I do have trouble with these concepts, though. Accept is a four letter word you know!
The name 'speck of dust' is from a lovely poem. It's about freedom, being able to go everywhere. :)
Ah, this makes me feel much better! What a wonderful image.
Hey, Paul -
I learned the hard way not to go back to work right after therapy. . . it's hard to answer the phone in a professional manner with snot dripping down your face, LOL.
Excellent post . . very well written!
- Marie (Coming Out of the Trees)
http://mmaaggnnaa.wordpress.com/
Marie: I'm glad you learned this lesson. For me it was what you mention, but also about keeping myself safe. Good for you!
Hmmm... some of this was like reading about myself - especially the intellectualising. The difficulty is that actually has been one of my coping mechanisms from a VERY young age. I don't have DID but have pretty distinct parts that are different ages and hold different feelings, memories, abilities, coping mechanisms. And one part is SO the intellectualiser. He will argue his way out of anything and distract from emotions at every point. I'm trying to learn to let the other parts have a say, express feeling before he jumps in so fast. But it's hard when intellectualising has got me to where I am, and is a positive aspect in some ways.
I've had different kinds of therapy experiences - as a teenager they did CBT with me - just reinforced my parents' instructions that feelings weren't acceptable, you must rationalise and explain them away. I've gone years without any therapy. Then 3 years ago started back in therapy with a systemic psychotherapist. Then in a psychodynamic therapeutic community, then back to one-to-one (the same person again).
I too learnt to make time before and after. Before I used to go straight to it and it was like being "fine" and holding it all together, walking through the door and then trying to open this huge box, get stuff out, put the lid back on and leave again in an hour. No Chance! So we have longer sessions now - sometimes very long. Although my psychodynamic head says oh no what about the 50min hour and boundaries?! But actually this works really well for me. When I knew what the time boundary was I would start to clam up and not want to talk a good half an hour before the end, to prepare myself for leaving. So in an hour - this wasn't much use!
I also do psychodrama once a month which is a great way of exploring and working out certain issues.
Anyway sorry for going on! Just really could relate to your post. Thanks!
Beautifulstones: Yes, there are many positive aspects to being able to intellectualize! I never heard of systemic psychotherapy, but just read up on it. Sounds like you've tried quite a bit and also learned some important lessons. It feels like I have a lot of drama in therapy, but I think this isn't what you mean! I again read up on that and it sounds very interesting.
Haven't we all suffered enough though? I want time to live. EMDR therapy can speed up the healing process. You don't even have to tell the therapist what comes up!
Yes, time to live! "Speck of dust" is from the Stephen Levine poem?
Paul -
Another comment to say what a great post that has elicited good comments. Perhaps the healing process is also helped by knowing you have provided help and insight to others.
Thanks!
Well, I'm not sure how much I help others. I mostly find it's helpful to me that what I write resonates with others. Makes me feel less alone with all of this.
Hello Paul -
I totally agree with your process, and I'm so glad you wrote this post. I just figured out the things you wrote here a couple weeks ago. It was a really slow process for me to learn these things about myself, and I wish I had read your post 5 years ago! But it is all a growing process...
It dawned on me all of a sudden that I cannot intellectualize feelings! I like the way you put it better though.
It is very reassuring to know that someone else also needs to take time to 'do therapy right'. I also have to take time before, during and after as well, at least to get the most out of what I am doing/working on.
I find the more time I take to process each session, the more I get out of it.
Thank you for the great post!
Hi Paul,
Thanks so much for this post. It is incredibly helpful to me and very brave of you to share.
Petr.
Thanks Petrogenic. I appreciate you saying what I wrote was brave. I have a problem viewing anything I do as being brave, but somehow easily label what others do as being brave. But thanks!
After nine months of therapy, a crisis at work finally sent me to my therapist's room in genuine tears that celebrated the moment of sadness I was experiencing, in her presence. I allowed this sadness and she used the opportunity to say 'now you are ready to understand not intellectualising everything - use this time and this place to allow your emotions and feelings.' At the time I agreed, but now as my next appointment approaches I am finding it harder to grasp what it really means to 'not intellectualise'. How do I find that place again, so that the real healing of the past untapped things can happen? I get it, but I don't. It is like I am trying to intellectualise the concept of not dong so...sigh. Thanks for your post. It helped.
DizzyButterfly, Thank you for the comment! If you already got to a place, no matter how fleeting, where you felt your emotions, then it's a place you can get to again. I call these places touchstones. Cherish it. It means you can do the work of healing. You have proven it. And taken the first step. We just have to do a couple things. One: Believe in ourselves. Not all the time, but sometimes. Second: Give yourself permission to feel. Again, not always, but sometimes. Fear is normal. For many of us, feelings have been hidden away so neatly for so long. It's hard work. I am glad you took the first steps.