Clinical Notes

There comes a point in psychotherapy where you might feel you have more freedom in your life, and things are working the way you want. After a lot of effort, you begin to understand how your life works. You might be starting to see changes: better relationships, deeper friendships, more satisfying work.

When you think about ending therapy at that point, it's worth considering something similar that happens in other areas of life. A band that has made it and sells millions of tickets for a tour. An actor who suddenly finds themselves on the A-list. They might let go of the manager, the producer, the director who nurtured them through a number of low-budget films. All of these decisions might be right, but perhaps not quite yet.

Consolidation and reconsolidation is where therapy really earns its money, just as good management, good production, and good direction do. The point at which you feel free to act is often the point where you most need help continuing with the reinvention: finding out how to sustain yourself in ways you certainly didn't in the past, doing these things for real rather than in rehearsal. Psychotherapy should always be real, but the extent to which it can become a rehearsal of the future rather than a repetition of the past is worth thinking about carefully.

The business of long-term therapy costs money. Sometimes it can be the most valuable thing you will ever do to continue with psychotherapy beyond the point where it feels as if you need it. Within that, there is plenty of room for a psychotherapist to exploit the people they work with, continuing well beyond the point where it is truly necessary. Who knows what is truly necessary? That is a question that needs to be asked and talked about carefully, when it feels as if something needs to change.

If you're frightened, edgy, wired, and I tell you there's a bear behind you, you'll spin round and look for it. Tell you the same thing when you're relaxed and laughing and you'll think I'm joking. The difference isn't the information; it's where you are when it arrives. In FEAR, RAGE PANIC-GRIEF, the nervous system isn't weighing possibilities. It's collapsing them. Anything is possible, as long as it's likely to be bad.

Here's a novel idea for anxiety. Most ideas in psychotherapy involve trying to resolve something. The resolution occurs by thinking about whatever seems irreconcilable. Forget about that. Just do something - anything. The feeling of your body in motion is a feeling of resolution. Then, see what you think of.

Hating yourself can become a habit when you are so alone, or feel so alone, that there is no one you can safely hate.

There's so much speculation about child development, some as if children constantly need bundling into a kind of adult-bound lift. Press the button to the top floor: MATURITY. 

This is very understandable. You could say that children are, at the same time, physically immature versions of adults and that they are not. Only believing the former misses the point of what brain activity, at any point, is doing. This will, hopefully, be the best brain activity, with the brain in its best form for that activity, for the task of becoming an adult person. Piaget says something like this, as does Jensen.  A child's thinking is organised differently from an adult's.

Parents: resist seeing what your child is doing now as a deficient version of what they need to do in the future. 

Encouraging that kind of activity rather than goading a child to behave as if they are older is the best thing, I think. The momentum of aging is a strange old thing.