Can therapy on its own deal with addiction?

I sometimes work with clients who have addictions, such as alcohol or pornography. A question I’ve had to ask myself is whether one-to-one therapy alone is sufficient in dealing with addiction.

While I think psychotherapy is extremely useful in helping clients learn about the underlying causes of their addiction, I believe that usually the individual needs extra help in coping with the day-to-day challenges of addiction.

An obvious source of such support is a 12-step group such as Alcoholics Anonymous, Narcotics Anonymous or Sex Addicts Anonymous. These are called 12-step groups because their model has 12 steps that that individual is encouraged to complete as part of the recovery process.

I know that some therapists discourage their clients from 12-step groups, perhaps because they disapprove of the spiritual aspect or see it as a ‘one size fits all’ approach.

The advantage of these groups is that there are many of them dotted around the country, especially AA, and they are free or only ask for a small financial contribution.

Of course, not everyone takes to the 12-step model and some people struggle with the spiritual aspect. There are other support groups for addiction that do not adopt the 12-step approach, but these may sometimes be harder to access.

Either way, the advantage of being in a group is that the individual learns that they are not alone, that others are facing the same challenges. The individual can also find inspiration from hearing others’ stories and experiences. 

Social circle

One of the main challenges in many addictions is the addict’s social circle – he or she often finds themselves socialising with others who have the same addiction. A benefit of a 12-step group is that it offers a new community of like-minded people and therefore reduces loneliness and isolation, which in itself can be a trigger for addiction.

I don’t see any competition between individual therapy and 12-step groups –  I think they can complement each other. The aims are the same – to help the client stop a damaging addiction. 

I like the emphasis in 12-step groups on taking responsibility for one’s actions and accepting that one is powerless in the face of the addiction. Accepting the power of the addiction over one’s life is a key part of making positive changes.

Where I think therapy can help in particular is the individual relationoship the client makes with the therapist and the changes that can emerge over time through that relationship. Meeting with the therapist every week can help the client, in particlar, work through some of the early childhood experiences that may have contributed to the addiction.

One of the things some people struggle with in 12-step groups is reference to a higher power. I understand that for some this is difficult but I think it can be understood not in a conventional religious way but rather as a recognition that there is a greater meaning to our lives, one that is beyond our ego.

Another teaching of 12-step groups, that one is powerless in the face of the addiction, represents the paradox that in addmitting this powerlessness a person can actually be taking an essential, first step towards freeing oneself.

Overall, therefore, I believe that 12-step groups offer a lot for people with addiction and that their model can complement individual counselling or psychotherapy.

Image Creative Commons license courtesy of pixabay.com, https://tinyurl.com/376zvcfk

More information at http://www.patrickmccurrycounselling.co.uk

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When sleepiness enters the therapy session

Like Sleeping Beauty awakened by the kiss of a prince, the therapeutic process can be seen as a process of awakening or making conscious what has been unconscious.

Which makes the topic of sleepiness in therapy sessions interesting. I sometimes find myself feeling unexpectedly tired in a therapy session. I may even suppress a yawn.

When this happens I usually feel a little embarrassed and may try and hide my sleepiness from the client. After all, who wants to see a therapist who seems like they’re about to nod off?

But I’ve discovered, over many years, that sleepiness is often an indicator that something else is going on in the session at an unconscious level.

First of all, I’ll ask myself if there’s any external reason for me feeling like this, such as having had a bad night’s sleep. Usually this is not the case.

Having eliminated other possibilities I can then turn my attention to what is happening with this particular client and what is going on in the session.

I’ve sometimes tried to hide my sleepiness from the client but have found that the nature of therapy is that each person is continually picking up subtle and non-verbal information from the other. Hiding a yawn or dropping eyelids is almost impossible.

What I’ve discovered is that when sleepiness arrives it signifies that something is being repressed or “squashed” in the session. It is usually a powerful emotion such as anger. 

I think the reason for the sleepiness is that if we are unconsciously repressing a strong emotion such as anger it has an effect on the energy in the room. I sometimes think of this as being like holding a beach ball under the water – the effort required in holding the ball under the water is a drain on the rest of the body.

In the same way if a powerful emotion like anger is being “held under the water” it has an effect on the energy in the room and that can translate into me feeling sleepy.

This can also happen in the individual’s own life – disowned anger can lead to a kind of energy-sapping depression.

When I acknowledge my sleepiness and begin a conversation with the client about what might be going on, often the sleepiness disappears. Naming what is going on has an effect on the energy in the session.

We can then explore whether the client may have other, less conscious or less “acceptable” feelings about the topic they are discussing. We don’t need to somehow resolve the issue but instead we enquire into what may be happening. 

Having that discussion can open up new perspectives about the client’s experience and relationship with his or her emotions.

Image Creative Commons license, courtesy of Tomas https://www.flickr.com/photos/tma/2438467223

For more information visit http://www.patrickmccurrycounselling.co.uk

‘The green-eyed monster’ – dealing with jealousy

‘Jealousy is the green-eyed monster that doth mock the meat it feeds upon.’

From William Shakespeare’s Othello

While writing this blog on jealousy I looked up ‘jealousy quotes’ on the internet and almost all were negative – the main message is that jealousy is something aweful, something to be judged and condemned, something to feel shame over.

That coincides with my experience with clients, where typically a client will feel some embarrasment at disclosing jealousy about a partner.

I’m using jealousy to descrive the unpleasant feeling that someone, or something, will take away someone we love. So, a child may feel jealous if their sibling is getting more attention from mum. Or you may feel jealous that your partner seems over friendly to their work colleague. 

‘Jealousy’ by Edvard Munch

You may even feel jealous about the attention your partner gives to their social media account or mobile phone.

Of course, jealousy in its extreme form can be an awful experience for both the jealous person and their partner. It can lead to controlling behaviour and destroy relationships. 

Jealousy as a teacher

But rather than always being a negative emotion I think there’s another side to jealousy. From a soul perspective, where everything has a place, jealousy can be there to teach us something about ourselves or our relationship. It can be pointing to something in our lives that needs attention.

First of all, jealousy may be signalling that our relationship needs attention. Perhaps we have been taking our partner for granted and so he or she, unconsciously, begins to show a lot of interest in someone or something else. 

Our jealousy shows that we care. It represents our passion. If we can use the feeling as a starting point for a discussion about the state of the relationship then something good can emerge. 

It can also be asking us to look at whether there are sufficient boundaries in our relationship. By communicating my jealousy I’m also beginning a conversation about  what kind of boundaries I would like. By being willing to have an uncomfortable conversation about jealousy and boundaries I am also communicating that I value the other person and our relationship.

Jealousy can also point to something within ourselves that needs attention. 

For example, it can show us qualities within ourselves that we may have suppressed. If I am afraid my partner is attracted to someone who seems more confident, or more entertaining than me, that can be a sign that I am suppressing the part of myself that is confident or entertaining.

In other words, the jealousy can be an invitation to look at myself and the parts of myself that I may have disowned. Many of us have disowned our passionate or wilder parts, in order to fit in, but that suppression comes at a cost.

Projection

In all kinds of relational issues we can find ourselves projecting things onto the other other person. With jealousy, the obvious possible projection is that it is not our partner who is unhappy with the relationship but us. 

We may be dissatisfied with our partner but reluctant to admit that to ourselves, or not wanting to have an uncomfortable discussion. So what happens is that unacknowledged dissatisfaction is projected onto them, so that suddenly they are the person who we fear will leave us.

The jealousy can actually create huge problems in the relationship, so that they do want to leave us, thus confirming our original fear.

Another form of projection in jealousy is when something from our past is being re-created. This is often a triangle from the past, such as having a sibling who seemed to receive more attention from mum or dad than we did.

Those old feelings can re-emerge in adult relationships so that, what may seem a minor issue, becomes almost unbearable because it ignites the intensely painful feelings from childhood. Unless we are aware of what is going on we can find ourselves dominated by the jealousy without ever realising quite why.

Image courtesy of Wikimedia Commons, https://tinyurl.com/6awu25fw

For more information visit http://www.patrickmccurrycounselling.co.uk

Why being ‘caring’ isn’t always a good thing

“Rescuing [in therapy] is often not much more than a way of rescuing oneself from an unbearable experience.”

Patti Owens*

You’d think, as a therapist, I’d be a big fan of caring for other people. And I am. Caring about the welfare of others is an essential quality in a therapist, not to mention for nurses, doctors, social workers and others.

Caring for others is an undervalued quality in our culture, which places greater value on material success, independence and individualism.

But there is also potentially a shadow to being caring, which is when we use caring for others as a way to feel good about ourselves or control others. I’m using ‘shadow’ in the Jungian sense, which means the part of ourselves that we hide, repress or deny because it contradicts how we would like to see ourselves.

This shadow side of caring is sometimes understood as embodying the rescuer archetype. A good way of understanding this is the drama triangle, a psychological model that describes relationships in which we may find ourselves occupying the rescuer, victim or persecutor role.

If we are in the rescuer role it’s very difficult to be present with someone else in pain without needing to try and fix the problem. 

This is because the rescuer has often not come to terms with his or her own pain. They may have suppressed their own wounding and instead regard themselves as mature and competent and in a good position to help or advise others. 

But the caring of the rescuer is not just coming from a place of care, but rather from a superior position. It is also controlling in that it needs the vulnerable person to behave in a certain way and to feel grateful for the rescuer’s caring.

People are sometimes attracted to become therapists, nurses and social workers because they are themselves wounded but the way they cope with this wounding is by projecting it onto other people and ‘helping’ them.

The therapist with a rescuer complex can find it difficult to simply be present for a client who is in pain. They can seek to resolve the problem by giving advice or they may collude with the client by agreeing that everyone else is to blame. They may also find it hard to hold boundaries in the therapy because to do so may feel ‘unkind’.

In its extreme form being too caring can lead to codependent relationships, in which the ‘caring’ partner enables the alcoholism, addiction or dysfunctional behaviour of the other person. I explored this in a previous post. In this situation the caring partner may complain about the other’s behaviour but is still, at a deeper level, invested in the behaviour continuing.

Image creative commons licence, courtesy of http://www.procpr.com, https://tinyurl.com/522mvhhj

For more information visit www.patrickmccurrycounselling.co.uk

Don’t try so hard to be your ‘best self’

“[Our] refused and unacceptable characteristics do not go away; they only collect in the dark corners of our personality.”

Robert A. Johnson

Striving for our ‘best self’ can set up a difficult dynamic

A brief internet search on ‘best self’ throws up articles such as these: ’10 powerful ways to be your best self!’, ‘The complete guide to becoming your best self’, ‘How to be your best self and get what you want in life!’

And there’s a lot more like these. 

But is this focus on trying to be your best self always helpful? I’m not sure.

Instead of trying to be our ‘best self’, why can’t we just allow ourselves to be…well, ourselves?

Of course, most of us want to ‘improve’ in some way, whether that means being kinder, less irritable, harder working or more patient.

But I’m wary that too rigid a focus on being our ‘best self’ can become another stick to beat ourselves with. For those of us with fierce inner critics, which probably means most of us, the ‘best self’ ideal can be another goal to struggle with, another thing to fail at.

There’s more than a hint of perfectionism in the ‘be your best self’ message. The implication is that the parts of ourselves that we don’t like (or that other people feel uncomfortable with) must be denied or suppressed.

But it leaves out our human frailties, the mistakes we make, the times when we are far from our ‘best selves’ – when we’re irritable with our children or partner, flop out on the sofa watching reality TV, or drink one glass of wine too many.

There’s a place for effort and striving in our lives, but if that takes centre stage it can also lead us to shame ourselves when we fail to live up to an ideal. 

For those of us who may have been criticised as children for not achieving, that’s a painful place to find ourselves.

In my view, a more interesting approach is to become curious about ourselves and our behaviour, especially when we find ourselves engaged in behaviour that negatively affects our relationships, work or self esteem. 

Rather than judging ourselves, can we instead reflect on (or get help in therapy) the behaviours that seem unhelpful. Sometimes when we take amore enquiring attitude we can understand why we behaved in that way. We may discover an unmet need that the behaviour was responding to, albeit in an unhealthy way.

With more awareness of ourselves and what underlies our behaviour we can find ways to honour the different parts of ourselves, including the parts that we find difficult. 

That honouring may take the form of expressing those parts in our relationships or it could be finding a way of honouring that is more symbolic and less about literal expression, such as working with our creativity. The important point is that we have an accepting attitude to the different parts our ourselves rather than a judging attitude.

Image Creative Commons, www.snappygoat.com

For more details about my psychotherapy practice visit www.patrickmccurrycounselling.co.uk

The myth of the idyllic childhood

Very often when I ask a new client about their childhood they reply that it was happy or even ‘idyllic’.

When I hear this I’m sometimes tempted to say, ‘People with happy childhoods don’t usually end up in therapy’, as  an old supervisor of mine used to say.

Usually though, I prefer to allow their story to unfold over the coming sessions.

Typically, those people responding that they had a happy childhood will refer to material things, such as ‘we always had nice holidays’. But they far less frequently talk about the emotional aspects of their families and whether their own emotional needs were met.

Sometimes, I pick up a rather defensive message from these clients, that everything was fine in their family growing up and they don’t really want to take about it further, These are often the clients who want a quick fix solution or a ‘strategy’ to deal with whatever painful experience it is that has brought them to therapy.

Emotional challenges

But if they stay long enough, as I get to know the client better, it often emerges that they struggled with some quite deep emotional challenges when they were children.

Perhaps they had parents who were unhappy with each other, an emotionally distant father or a mother who was critical. Or perhaps a sibling who outshone them or who bullied them. They may have been the family ‘star’, who was pressured to succeed, or the ‘responsible’ child who was not allowed to have their own needs.

So, why the desire to present an image of happy families?

I think in most cases it’s not an intentional misrepresentation but a story we tell ourselves. We love our parents and don’t like to feel disloyal, so it’s understandable we would try to preserve their images, in our own minds and also with others.

It is also often the case that we forget, or play down, the bad times when we look back. It’s not uncommon for people who have had very difficult childhoods to have memory blocks for much of that time.

Cultural messages

There is also a cultural message many of us receive that it is wrong, unfair or childish to blame our parents and so we can take on a persona of the ‘well adjusted’ adult who takes responsibility for their life. 

While I agree that personal responsibility is important, it is also important to be able to acknowledge what happened in our childhood that may have affected us and how we relate to the world.

My belief is that none of us had a ‘happy’ childhood. By that I don’t mean that we necessarily had an unhappy upbringing or that our parents were cruel to us, just that, as well as providing lots of good things, it was impossible for our parents not to let us down in certain ways. 

Our parents were flawed human beings, as we all are, and how they responded to our emotional needs as children will have been influenced by their own childhoods.

When we can acknowledge what emotional wounds we may have received growing up and find a new way of relating to those wounds, something inside us can begin to shift. It may involve feeling grief and/or anger. It is a process that takes time.

Ultimately, it is embarking on this process that allows us to give a place to those early wounds and to come into a different relationship with ourselves and, over time, our family of origin.

For more details about my psychotherapy practice visit www.patrickmccurrycounselling.co.uk

Image from Pixabay, Creative Commons licence, https://tinyurl.com/1q6kvlbl

The power in therapy of ‘talking to yourself’

One of the revelations that many who enter therapy experience is that the process becomes not just talking to the therapist but also, in a deeper, way talking to themself.

This was highlighted recently by artist and cultural commentator Grayson Perry, in the BBC Radio Four programme Start the Week. (see link at bottom of this post).                                                                                                                                  

Grayson Perry

Perry, who went into therapy in his late thirties because of anger issues that were threatening his close relationships, says that up until then he was suspicious of therapy: “I used to take the mickey out of it and I found it a little bit irritating but then gradually I met a lot of my wife’s therapist friends and thought ‘these people are really nice to talk to’.”

Once he began the process, he says, he found the sessions cathartic: In a way you’re doing therapy on yourself. I used to say I’m going to therapy now to talk to myself.”

This made me think about how part of the power of therapy is not getting the observations or thoughts of the therapist, but actually hearing yourself speak out loud the thoughts that have been rattling around your head in an often unformed way.

Clients often say to me: “Having this space once a week, where I can speak all this out loud, makes things seem clearer in my mind and I get to see more of what’s really going on.”

But while therapy may be, in some ways, a conversation the client is having with themselves, I strongly believe that this also depends on the presence of the therapist. It is the fact that there is another human being, who is interested in your experience and who is listening, that helps create the conditions for the client to really open up.

And when we have the space to open up we are often able to see patterns of behaviour in our lives and may ask ourselves, ‘Why did I make that choice?’

Through the relationship with the therapist the client is able to gradually deepen his relationship with himself. He learns that his feelings are important, that there are often deeper emotions he may not be in touch with and that much of his behaviour is underpinned by unconscious patterns.

Start the Week, BBC Radio 4

 

Developing a healthy ‘internal leader’

My way of working with clients involves seeing them (and myself) as made up of different parts. While we may think that we are unified, coherent personalities, when we pay attention to what is going on inside us we often discover a collection of many different parts, or sub-personalities.

These may include a part of us that criticises or judges us (the inner critic), a vulnerable yes often playful part (the inner child), a part that tries to win approval from others (the pleaser), a part that can feel defeated or powerless (the victim) and many others.  These sub-personalities are connected to the idea of archetypes (universal patterns of behaviour and being) developed by psychologist Carl Jung.

But what kind of internal leader do we have who is in charge of these different parts?

According to therapist Stacey Millichamp, in her book Transpersonal Dynamics, our personalities can be compared to political regimes. We may have an internal ‘dictator’ who orders the rest of the psyche to behave in a certain way.  These kind of clients tend to be very controlled, even uptight. 

Milliband says: “Honesty is suppressed and freedom from the regime must be found through covert, secretive means…[there is a] fear of punishment, disallowing spontaneity and creativity.”

Such clients can be hard to work with because they often keep secrets, fearing that if they are honest in therapy it will be used against them in some way.

A different client may have a fragmented psychological regime in which there is a lack of internal leadership that can create a frightening and chaotic internal world for the person.

Part of the therapist’s role is helping such clients develop a strong internal leader who speaks to them in a firm but compassionate way. Such a leader can allow the difference parts of ourselves to be expressed in an appropriate way.

The internal leader is a bit like having an ally who we can rely on, who is on our side but who will also tell us the truth about ourselves. 

So, how do we develop such an internal leader or ally?

According to Milliachamp, there are several ways:

• think about a historical or present day leader who inspires you and describe in detail what you admire about that person

• develop self-talk that is evidence based and encourages getting reality checks about situation’s in your life.  This is because often we have fantasy scenarios in our heads that are based on negative ways of seeing the world and our place in it.

• spend time with people who embody the leadership qualities you are seeking. This may be in person but could also include attending workshops or reading books. 

The client may also look to their therapist to model positive psychological leadership and I have had clients who have said things like, ‘When I found myself in that situation I heard your voice in my head and that helped me decide what to do.”

When staying positive can become a negative

We live in a ‘think positive’ world, in which people are encouraged to hide or deny their vulnerability.

But this can come at a cost, as shown in research published this week by the charity Macmillan Cancer Support*. The research showed that this ‘think positive’ attitude among people with cancer, espcially those with a terminal diagnosis, was preventing honest conversations about end-of-life care.

More than a quarter of people surveyed said they found it hard to talk honestly about their feelings around cancer and a similar number said they felt guilty if they could not remain positive or portray themselves as a ‘fighter’. Health and social care professionals were generally reluctant to bring up the subject of end-of-life care with patients, the survey found.

The result of this was that many people with cancer were not having vital conversations until far too late and were dying in hospital against their wishes.

I believe this research has wider significance and shows the down side of an excessive focus on ‘thinking positive’ or being a ‘fighter’.  There is an important place for these qualities in life, but when taken too far it can become denial and a way of avoiding vulnerability.

When we adopt a think positive attitude too rigidly, we can easily slip into viewing ‘negative’ emotions such as vulnerability, fear, sadness and anger as somehow wrong or things to be battled against.

Miriam Greenspan talks about this in her book, Healing through the dark emotions. By ‘dark’ emotions she she doesn’t mean they are bad but rather that as a culture we have kept these emotions in the dark.

“In the throes of grief, fear, or despair, we generally believe that giving feelings like these too much space in our psyches is a sign of emotional weakness or breakdown,” says Greenspan.

She describes this attitude as ‘emotion phobia’ and says that while we can push these feelings away for much of the time, sooner or later we experience a major loss, shock or trauma and our habit of pushing away dififcult feelings no longer works.

In my work as a psychotherapist I often have clients who have got the message, usually from childhood, that their feelings (and particularly their ‘difficult’ feelings like sadness, vulnerability, fear or anger) are not okay.

These are the clients who want me to make such feelings ‘go away’. Instead I encourage them to try and name the feelings they are struggling with, to locate where in their bodies these feelings live, to see if they can allow these feelings to be present and to trust that there is a purpose in these feelings.

My experience is that there is always a reason for particular feelings in our life. If we can shift our perspective away from judging the feeling (and ourselves for having it) to being willing to experience it we can begin a different kind of ‘conversation’ with the feeling.

We can then begin to explore what this feeling is trying to draw our attention to in our life, or pehaps to  something in our distant past that needs to be given a place.

* https://www.macmillan.org.uk/aboutus/news/latest_news/fighting-talk-can-leave-cancer-patients-unable-to-talk-about-death-and-dying.aspx

What does our psyche want now?

I recently attended a talk by the American depth psychologist and author James Hollis, whose books I had long admired.

James Hollis

“I often ask my new clients if they they think they have a soul and what it may be asking of them,” he said. That made me think. Hollis did not mean soul in the Christian sense, but rather the part of us that is separate from our ego, that is part of our unconscious and that has a connection to something larger than ourselves.

In the traditional religious meaning, soul is opposite to body, but in depth psychology soul refers to the Greek word psyche. Rather than being this ethereal, floaty thing that many of us imagine, in this sense soul is closely connected to our human experience, particularly our deep emotions, our longings, our joys, our mystery. This was an idea developed particularly by the archetypal psychologist James Hillman.

By ego, I mean the part of ourselves that we are aware of and which we think of as ‘us’, but which is only the tip of the iceberg and does not encompass our unconscious. It is our ego that tries to control our lives, and our environment, and which is constantly on the lookout for threats.

We need our ego to run the business of life, but if its needs dominate then our psyche/soul may need to make itself felt through neurosis and painful symptoms.

Writing in his book What Matters Most, Hollis says soul is a metaphor to describe our essence: “It is the energy that blows through us, that enters us at birth, animates our journey, and then departs, whither we know not, at our passing.”

Soul, by its nature, is actually impossible to fully define. While it lives in the unconscious it is constantly making itself felt in our conscious lives, through our emotions, dreams and imagination.

The reason Hollis asks his clients if they think they have a soul is because he is wanting to get away from the assumptions many people bring to therapy; that they have a ‘problem’ and that it is somehow the therapist’s job to get rid of this problem.

Depth work is not about solving the problem but about recovering the life we’ve somehow lost along the way, he says. Clients often come with a symptom, such as an addiction, a depression, an anger issue or a relationship problem, and they want the therapy to eradicate this symptom.

But depth therapy does not “cure” people or eradicate symptoms. “We don’t solve these problems, we outgrow them,” says Hollis. But to outgrow them may mean exploring what the meaning of the symptom is, what is our psyche trying to get us to pay attention to in our lives?

Mostly we are governed by our egos and we think we know what we want or what we need. But the psyche/soul may have a different idea of where we need to go. It is our ego that desperately wants to get rid of the symptom.

Some approaches, such as cognitive behavioural therapy (CBT), try to get rid of the problem the client brings. CBT can help, and I use some CBT  approaches in my integrative therapy. But my experience is that often CBT can seemingly get rid of the symptom, only for it to re-appear in another form. If the underlying issues are not dealt with this is always a risk.

But how do we know what our psyche is asking of us? One way of exploring this is through therapy with a practitioner who has experience in working with the unconscious. Other ways in include noticing our dreams and what they may be telling us.

As palliative care doctor, and therapist, Michael Kearney says in his book Mortally Wounded: “My own personal and work experience has [shown me]…that soul is connected to depth, to death, to the imagination, and that it brings with it a sense of meaning.”

 

Further reading

By James Hollis:

Swamplands of the Soul, Inner City Books, 1996

What Matters Most, Gotham Books, 2010

By Michael Kearney:

Mortally Wounded, Morino Books, 1996