Reflexions… On Loving Thyself

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I have been proactively studying and practising spirituality for 7 years. It has rarely conflicted with my Dramatherapy practice and studies, and I find that it actually complements my professional training.

One of the main teachers of my spiritual practice used to say this about the teachings of any religion or spiritual practice: “Love thy neighbour as thyself; and the rest is commentary.”

Meaning that, everything that everyone ever needs to know, and do, is in that little sentence. Simple? Yes. Easy? Not so much.

I have been observing for many years, that whilst most people understand the premise of that teaching and reality, they often leave out the last part of it. In fact, how many times do you just see “Love thy neighbour”? We are all trying to love and accept the “other”, but we often fail to love and accept the “self”. We forget the “thyself” part of the equation, and then we wonder why there is so much hate and misunderstanding in the world around us. We can only love and accept others in relation to how much we love and accept ourselves. If we don’t see enough love and acceptance towards others around us, is because there isn’t enough love and acceptance towards self.

I think most people know this, but not everyone feels this. Someone once told me that the most arduous path there is, is the one that connects the mind to the heart. And I’m not even adding the soul to that equation. Connecting the mind and the heart is a big enough task to start with.

Why am I writing about this today? Firstly, recent events and the ways in which we perceive the “other”, hate, and love. Secondly, a dear friend was questioning his spiritual/sexual identity recently, and I found myself using this teaching to make the point of acceptance clear. Thirdly, every point/topic/theme/concern/issue/etc. in the therapy room boils down to this: being able to love thyself. And yes, I can hear people scorning about this and its corniness/naivety, but I stand by this statement.

At one point or another, due to a myriad of circumstances, everyone’s development is affected by someone else’s words and/or actions, which then becomes internalised as a belief that “there’s something wrong with me” or “I’m not good enough”. Logically, it might be simple to state that there is nothing wrong with anyone and that everyone is good enough, because that information comes from elsewhere. It doesn’t come from the individual. No one internalises the belief that they are wrong, without an external influence giving them that information. But emotionally? Well, understanding this emotionally can take years, even decades!

Why? Because at the same time we might be receiving the message that we’re wrong, we’re also learning about right and wrong. Is anyone taught to love and accept what’s wrong? I feel and observe so many of us growing up under the conditioning that there is something wrong with us, having great difficulty accepting certain parts of who we are and of our history, hiding and hoping no one will notice. Even if no one else notices, do you know who will always notice? The other parts of you.

One of my favourite theories/techniques is that of Subpersonalities, by John Rowan. In it, there is the idea that we all possess distinct subpersonalities in our psyche, with different functions, motivations, origins, beliefs. No other aspect of my training has been more influential to me than this. The core principles of Integrative Dramatherapy – Self-Compassion, Relationships, and Integration – all stem from this. It is a technique I always return to, because it offers amazingly profound insights into someone’s behaviour, emotions, and traumas. Within someone’s subpersonalities, there is usually a very neglected, and a very over-compensating one. They are usually very dependent of and reactive to each other. They tend to disrupt the functions of other subpersonalities. Moreover, sometimes the very neglected and very over-compensating one, become one and the same. Their functions, motivations, and beliefs merge, and their origins disappear. The neglected becomes a bully and takes over the entire psyche, as it loses track of what it was there for in the first place.

Subpersonalities are very powerful (and surprisingly real) metaphors for our unconsciously-motivated behavioural and emotional patterns. The optimal goal is to have them all working together, interdependently, in an integrated manner. Integration, therefore, is not simply about having the “right” subpersonalities running the psyche, but to have all of them doing so, according to their own function and strength. Fear is a great example, for instance. Fear appears in our lives for a reason, often primitive and instinctive, but what happens to fear, and many other emotions, is that it overstays its mission, and its function becomes corrupted. It is there, but it is no longer serving the psyche, and becomes a block.

Thus, when a part of us begins to accept the conditioning that there is something wrong with us, according and in relation to others, a respective subpersonality emerges in the psyche to make sense of that new information. Depending on subsequent life experiences, that subpersonality will then live out its function and integrate, or it might overstay and change its function, which then permeates the entirety of the psyche. The individual is no longer able to recognise it, but it is still developing ways in which to express itself.

Subpersonalities tend to overstay their mission when they are neglected. We think we are taking care of something by ignoring it, but we are only forcing it to find new ways to express itself. This often appears in “random” events, behaviours, or emotional outbursts. We say “I was not myself when I did/said that!”. And we’re probably right. The subpersonality was ignored in its authentic expression, and so it found a new way to catch our attention, by changing itself completely and being someone/something else.

In short, this subpersonality was not shown any love or acceptance. It was deemed wrong, and forcibly ignored, and put to the side, or the back of the psyche. So, over time, the neglect turns into something else: resentment, anger, shame, disgust, hate, sadness, destruction. All of this, because it wants to be listened to, seen, cared for, validated… loved. The psyche, in the form of behaviours, emotions, and physical sensations, is constantly reminding us to focus on the “thyself” part of the equation. Love your neighbour as THYSELF! This is the paradox: the most important part of the teaching, comes last. It is a test in itself. Can we get past the obvious and notice what the core message is?

We believe we must always love others first, but the opposite is true. Without self-compassion, it is hard to create and maintain healthy and authentic relationships. Without helping our subpersonalities relate to and love each other, we cannot expect to treat others in ways which are balanced, authentic, and loving.

A client told me the other day, that they were not willing to change until the rest of the world changed too. Perhaps exacerbated, I challenged that position by asserting that the world was not sitting across the room from me, and that I was not being the world’s therapist, but an individual’s. And this is the trap: because we place the emphasis on others, we believe that others are responsible for loving, accepting, and validating us, and yet, we are often incapable of doing that for ourselves, and even go so far as rejecting that responsibility for the self.

LOVE THYSELF! The rest is commentary.

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Ask the Dramatherapist… “A session with my psyche”

Exactly two months ago, I began to experience a nagging sense of questioning what I was doing with my life, and even wrote about it in the March Reflexions feature. I rarely experience this, particularly in the professional context.

I was always fairly certain about what I wanted to do, but the how has been through some dramatic changes. And today, the how was questioned to such an extent, that it also made me question the what.

“Do you want to be a Dramatherapist? Do you even want to continue helping others?” Talk about a slap in the face! I haven’t questioned my what in about two decades.

As someone who has been actively working on self-awareness and reflection for the most part of the last 10 years, it is very clear to me that these questions will be around for a while. Particularly that second one. When the what is questioned, one must pay very close attention. I guess this is what growing older entails. Can I go back to my playground, please? Anyway…

This post will begin to address the first question above, in a way which I have never done before in this blog. I was so taken aback, that I decided to try and do some Dramatherapy on myself. For all the non-Dramatherapist readers… have you ever wondered what it might be like? Well, here it is.

One of my favourite tools in Dramatherapy is my deck of Archetype Cards, by Caroline Myss (2003; http://www.hayhouse.co.uk/archetype-cards-a-80-card-deck-with-guidebook).

From the accompanying guide book:

Archetypes have been around since at least the time of Plato (…), but it was the 20th century visionary Swiss psychologist Carl Jung who put archetypes on the map of modern consciousness.

In essence, most archetypes are psychological patterns derived from historical roles in life, such as Mother, Child…; they can also be universal events or situations, such as Death. Along with our individual personal unconscious, which is unique to each of us, Jung believed that “there exists a second psychic system of a collective, universal, and impersonal nature that is identical in all individuals.” This “collective unconscious” (…) is inherited, rather than developed, and is composed largely of archetypes and mythological figures.

Although archetypes are both ancient and universal, they become personalised when they’re a part of your own psyche.

Now, from theory to practice. I use these cards in various ways, but this is one of the most common ones. I asked myself “Who am I as a Dramatherapist?”, and went through the deck, picking out the ones which instinctually resonated with me. The instinctual resonance is key here, because it prevents the rational mind from making too many decisions. Below, is the result of this first exercise: 11 cards.

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Fig 1. 11 Archetypes: Shape-Shifter; Companion; Alchemist; Guide; Prostitute; Child:Wounded; Seeker; Healer; Pioneer; Artist; Addict

Immediately, I felt drawn to some of them and not others, so I removed the ones that didn’t hold enough resonance, which left me with 7 cards, as below.

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Fig 2. 7 Archetypes: Addict; Prostitute; Child:Wounded; Artist; Pioneer; Seeker; Healer

As I looked at this second selection and got in touch with feelings and sensations, by taking a few deep breaths and grounding myself, I began to gain some clarity on feelings of who/what was in control – expressed by the Shadow attributes of the Addict (allowing addictive patterns to have authority over inner spirit), the Prostitute (placing material considerations and security above self-empowerment), and the Healer (failing to care for oneself).

What does this mean? I interpreted it in the context of what I’ve been feeling – an overemphasis on business, rather than passion, and a focus on others’ wellbeing, before my own.

There were also feelings of neglect of the following Light attributes – Artist (expressing a dimension of life that is beyond the five senses), the Wounded Child (awakening compassion and desire to serve other Wounded Children), and the Healer (passion to serve others by repairing the body, mind, spirit connection).

I felt this neglect was mainly about passion, and the fact that I have been feeling disconnected from the purpose of why I do this work.

Three main observations from this exercise:

  • The aspects of the Healer were present in both groups – I realised I was feeling controlled by its Shadow attributes and neglecting its Light attributes.
  • I realised I was quite angry at the concept of Pioneer.
  • The Seeker felt completely invisible and ignored.

I was curious about the anger directed at the Pioneer, and realised that this archetype had driven all the other ones to their extremes, and that its Shadow attribute of a compulsive need to keep moving on has been the driving force in my psyche for many months.

I then proceeded to engage in an instinctual dialogue between myself, as therapist, and the Pioneer archetype. This type of dialogue is done by following a flow, allowing the unconscious to speak by writing the first things that come to mind, rather than to rationalise it or try to make sense of it.

This dialogue revealed that the Pioneer was running away from something by pursuing something else in the future, rather than facing its fear in the present. It also allowed me to understand that part of my motivation of being a therapist was not appropriately aligned to the present and future, but still stuck in a distant past, which led the dialogue to an end, for the Pioneer couldn’t get past this obstacle.

I then went back to the cards I had previously picked and asked myself, which one of them could the Pioneer reach out to first, for help? I often pose this question to clients, because ultimately all the archetypes can be helpful, but it is also important to establish which one of them could be helpful in the here and now, when facing an obstacle in the present. Having many sources of help can often be overwhelming, so sometimes it’s important to identify and focus on one of them, and take small steps. The answer this time pointed to the Artist.

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Fig 3. 2 Archetypes:  Artist; Pioneer

I employed the same dialogue technique, but this time between the two archetypes. The content of their conversation was not that surprising: lack of passion, burnout. The realisation that my motivation for wanting to be there for others because I didn’t have anyone there for me, has led me to the exact same place: to feeling like there is no one else there for me. I continue to support others, whilst feeling unsupported.

At the end of this “session” I am left with the questions: how and where do I find others for support? And how do I re-ignite my passion?

This blog has aimed to show a glimpse of what a creative psychodynamic process can be like in Dramatherapy, as well as that the therapeutic process is often about trying to answer a question, only to find more questions.

I feel that the questions will never stop, but I also feel that life, and living, happens in the process of answering questions as they appear in our lives. 

Ask the Dramatherapist… “Addiction”

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I recently had the privilege and pleasure of being a visiting guest lecturer at the Dramatherapy programme in Anglia Ruskin University, Cambridge. I presented and delivered two different sessions, related to my clinical specialisms: addiction, and sexuality in the LGBTQI+ community.

During the Q&A section of the lecture on addiction, one of the first-year students asked me whether I believed addiction is something people can truly overcome, or not. This is a great, and yet complex, question.

Prior to my work in addiction, I had no experience in this field. I had a very strong personal motivation and curiosity, and general knowledge of reading different research sources on drugs, and treatment approaches. I also had personal experience of addiction, as a family member and friend, and of substance misuse in my personal life.

I don’t share this very often, but I spent a big part of my early 20s drinking irresponsibly and dangerously, and dealing with the consequences of such behaviour. I felt very confused at times, because at one point, I recognised that I had stopped being able to do certain things without alcohol. Things like dealing with overwhelming emotions. Or going for a meal. Or a party. Having sex. Sometimes, even, going to sleep. At the time, I didn’t have anyone that I could confide in with these doubts, and so I kept avoiding the question of whether I had a problem.

And then, on the night of 22nd July 2011 someone spiked my drink in a club and I lost consciousness for most of that night. I woke up feeling completely ashamed and confused at a dear friend’s house, and made my way to my small flat in Camden. As I lay in bed that morning, wondering what had happened to me and feeling completely lost, I received a text which said: “Have you heard what happened to Amy Winehouse?” This was a big life-changing moment, for as I lay in my bed wondering whether I needed to stop drinking, I received news that Amy Winehouse – who lived literally around the corner from me – had died from alcohol poisoning.

I took it this a sign, and decided there and then to stop drinking completely. And I did – for two whole years. And what happened in those two years was that something shifted, and I was able to understand my escapism for what it was, including the understanding that it wasn’t about alcohol at all. And so, I have been able to go back to drinking, without abusing it, or without escaping into it. How? I’m not sure. If I knew, I would package it and help make millions of people feel better.

Why am I sharing this with you? Because, ultimately, this is what drives me. The experience of this shift, from feeling helpless to feeling in control. The experience of managing my self-destructive part. Because I don’t exactly know how this happened to me, I remain completely open to everything when it comes to addiction treatment and approaches. I am open to the medical/disease model, the 12 steps model, the harm reduction model, the relapse prevention model, to name just a few. I am open to everything because I have also learned that different clients will need and connect to different things, or a mix of things. Some clients actually find it helpful to think that they have a disease, and others don’t. I go with what is helpful for each client. Who am I to say anything, anyway?

I am driven to finding the answers that will enable people to stop the suffering in their lives. I never assume that I know something. Sometimes, I think that I do, and a client proves me wrong. And I never feel defeated about it. Not even when a client dies. It makes me more determined. One thing I always mention when referring to addiction, and which people tend to forget or dismiss, is that addiction truly is a matter of life or death. When a client tells me that if they pick up a bottle again, they will die, I believe them unconditionally, because it is the truth. To me, this work is not textbook. It is real life, about real lives. When a client goes to sessions for weeks and then they stop going, there is always a feeling of dread. And this feeling is very real.

Another thing that I notice in my addiction work is the weight of the consequences. I would argue that shame, guilt, and regret, kill more people than the drugs themselves. Of all the things that I believe that I know and learned through the years is this: we need to be more mindful of the language that we use in treatment. The idea of lapsing or relapsing may carry with it such overwhelming weight for clients, that when they lapse or relapse, they end up feeling worthless, like failures, and a waste of space.

I don’t claim to possess answers to anything at the moment. I feel that I spend most of my time listening and following what is needed. The weight of a lapse or relapse is absolutely unnecessary. It carries with it the illusion that someone needs to start again from the beginning. I would always argue that we never fully go back to the beginning, because making a mistake does not imply that we have lost our skills or knowledge. We will always be slightly more ahead than we think. This goes for me, and my clients.

I work from the position that yes; addiction can be overcome. Always. This is my hope and my guiding light through the darkness of active addiction and its aftermath. How is this achieved? I am still figuring that out, but I know that it starts with the following:

  • Looking into, listening to, and treating each person, as a person.
  • Caring deeply, and unconditionally, because they are living beings and for no other reason, and many people don’t even know what this feels like.
  • Being open to dark and light, death and life, and everything else in between.
  • Practising, and encouraging, meaningful and authentic connections.

I am a firm believer that the opposite of addiction is authentic human connection.

Reflexions…On Butterflies

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It may be a strange analogy within the context of therapy, but do you ever experience being in a clinical session with an individual client, or a group, and the dynamics of that session give you some kind of butterflies? That feeling of excitement because you want to know more, of hope that the unknown will turn out okay, of belonging because you feel you are in the right place, of achievement because you have found something special, and of awe because you have witnessed someone’s spark?

I recently saw my first clients with pronounced clinical depression, and the bleakness of those presentations stopped me in my tracks. Every day, I work with chaos, anger, sadness, ups and downs, glimmers of hope and joy, life and death, shame, guilt, anxiety, to name just a few. But bleakness to the point where there is no alternative, no hope, no light, no movement… well, I was not ready for that.

And this got me thinking about a lecture in my first year of Dramatherapy training, where a lecturer said – and I’m paraphrasing here: “Just because you’re becoming therapists, it doesn’t mean that you can, or should, work with everyone and every kind of condition. You actually have a choice on that.”

I remember how deeply that resonated with me, because I recognised that a part of me did think that I would be somehow responsible to respond to all the problems of the world. I remember mumbling that to myself for days… “I have a choice. I have a choice. I have choice.”

Sometimes there is nothing scarier than having choice. It means that a decision must be made. That something must be left. That something must be taken. And that we are responsible for the consequences of whatever that decision is.

I also remember thinking “How selfish!”. How selfish that I, a therapist, could refuse to help someone, when I’ve been given all these tools to do just that. And yet, there was also a relief: I didn’t have to help everyone.

And through the years, I have been not only actively and consciously making this choice, but I have also been noticing something else. That, perhaps, whatever butterflies a therapist experiences towards a specific client group or clinical context, may be in alignment with some kind of inner talent, skill…an aptitude. Allow me to expand on this.

In my first year of training, I also remember having a chat with one of the lecturers about which client groups I wanted to work with, both practically in terms of my clinical placements, but also generally, in terms of profession and career. It was always very clear to me that I wanted to work within addiction, and with gay men. These were clearly aligned and influenced by my own lived experience and by wanting to know more about myself, by helping others through similar experiences.

It sounds selfish, I know. But I believe that this is something mostly unconscious at first, rather than conscious – this idea that we might want to know more about ourselves, by working with others who share similar life experiences. This became more conscious to me, the more clients I met and worked with. And also, sometimes it’s not even about the condition or context, but about the effects, the aftermath of an experience. For instance, a great friend of mine has never spent time in prison, and yet, she has great affinity and aptitude to work and empathise within that field. Even in my work within addiction, I notice it every day, that I have much greater empathy and affinity towards clients who have overcome active addiction and are now in active recovery. I tend to find the aftermath of active addiction much more fascinating.

Why has this come about now? I have been noticing through the years, and particularly in the past few weeks, that there are certain clinical presentations to which I’m really drawn to and am greatly curious about, and others to which I’m not. And when this occurs in a session, when I’m not drawn towards something or feel no curiosity at all, I notice it immediately, because I always feel like I have to “work at it”.

I felt this particularly during the sessions where I was presented with complete bleakness. I was taken aback, not simply because I couldn’t get through, but also because there was a part of me which, frankly, didn’t necessarily want to get through. This got me thinking about the why of this occurrence, and also why I literally feel so alive in certain clinical contexts, and so indifferent in others. As I’m writing this, my inner therapist just said: “There’s probably a reason in your lived experience for why this is, and if you give it enough time and space, you’ll know exactly why.”

He’s right. My inner therapist tends to be right. And as I think about it further, without getting into much detail, I can connect why I tend to distance myself from both intense bleakness and active chaos – such as psychosis, or drugs withdrawal. I’ve learned and witnessed how well I can create deeply profound connections with individuals who, whilst still experiencing chaos and distress, are also willing and stable enough to want to create some kind of change in their lives.

I feel this may be related with my 7 years of active spiritual practice. If there’s a willingness and an awareness that change is required, no matter how faint this is, and no matter how many difficulties that individual has experienced in the past, or is experiencing in the present, then my curiosity, my drive, my empathy, are fully there. But if I can’t feel that from the client, then those traits don’t seem to make an appearance.

I have been very aware of my choices recently, both in relation to what I feel curious about, and to how much chaos I am willing to engage with on a daily basis. I have been noticing that my aptitudes, and my butterflies, may lie in clinical contexts and presentations where someone has already decided to change, no matter how determined or faint that decision is. And then I look at and talk to some of my colleagues and realise that their butterflies lie elsewhere.

This is the beauty of healthcare professions, and where we can find relief from the potential pressure of wanting to help everyone: there is always someone who is interested, driven to help, experiencing butterflies, in every single clinical presentation that exists. I don’t have to worry about helping everyone, because there are other professionals who are helping people at every single stage of their recovery. I don’t need to feel guilty about not feeling more curious at the earlier stages of someone’s treatment, because someone else is, and I feel that the combination of my knowledge, skills, and talents, is better served when there is a certain level of, or potential for, stability and balance.

Reflexions…On Questioning

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It’s been a prolonged silence since my last post. I have been sitting with this resistance, trying to make sense of what exactly was going on inside me, and realised that, ultimately, I have been questioning myself, my role, and my profession.

I found myself in clinical supervision the other week, questioning whether I would like to be a therapist for a long time, or not. A great gift I’ve received in my life is an ability to learn lessons quickly. This ability goes hand in hand with my other key ability of being able to empathise deeply and sensitively with almost everyone. By feeling deeply, I have often arrived at insights and personal resolutions, quicker than other people in my life going through similar trials and tribulations. But this may often also feel like a curse. The deep and intense feelings, followed by insight and resolution, followed by a continuous “what’s next?”. Sometimes, this is extremely tiring. And I feel that this is where I have been recently.

I am a therapist who believes that whilst a therapeutic training and education can indeed be used to help anyone in any kind of circumstance, the therapeutic relationship can also be much deeper and purposeful when I work with clients going through the lessons that I’ve been through. I often say that my areas of expertise are not an accident.

And maybe it’s a phase that every therapist goes through – but no one really talks about – or maybe I’m particularly tired this month, but I would be dishonest if I didn’t admit that this question popped up in my mind this month, startling my sense of identity and purpose: “Is this really all I want to do and be?” The answer was a very strong NO, which is still echoing in my heart.

I feel that I have come to this standpoint after a continuous and quiet questioning of the therapeutic process itself. What is its purpose? How do I understand healing, personally?

I used to think that therapy was supposed to help people overcome internal obstacles, and by default, external ones as well. And that healing would come from that process of transformation. But I guess what I have been really questioning is this idea of overcoming. I’m not necessarily basing this on any specific theory or methodology, simply on my own experiences and understanding.

Because what I continue to witness in my therapy rooms and sessions is a revolving door of the same presentations, conflicts, histories, narratives, in different people, with slightly different nuances, but the same. Even with the same person, when I think something has been processed, there’s another layer. And I wrote about this in a past blog entry. This idea that, yes, we can always keep digging, there are always more layers, more nuances to explore, more depth, more intensity, more pain, more trauma, more, more, more. But at what point do we stop looking backwards, into the past?

These questions are for me, really. I don’t intend to imply that every therapist might be questioning this, and maybe for some professionals these matters are very black and white. I just feel that I spend a lot of time in the grey areas, wondering what the balance is between past and future. And wondering whether we actually overcome anything? Does an experience such as a trauma ever disappear? How does overcoming and healing apply to trauma? Does it ever go away? What is my job in relation to these questions?

For instance, the complexities of gay men’s mental health. And when I say complexities, I mean that, based not just on clients’ experiences, but also my own. All these studies and articles of how gay men are more susceptible to more ill mental health, substance misuse, addiction, compulsive behaviour, suicidal ideation, bullying, abuse, etc. Sometimes, I’m reading academic or clinical articles, and I’m thinking “No kidding!”. I could write an article about my life and use that as a template.

Many other client groups have this experience – I’m calling it the intersectionality of pain. Pain does not discriminate, and it often doesn’t just stay on the one lane. It’s a complex web of experiences, which by moving something here, will trigger something there, and then by going there, will trigger something else further away or down, and on, and on. This is just my own process. And if I go through this, I am certain many others experience the same. All of us could spend the rest of our lives in therapy. But is that the point? Is it possible to move forward, simply by moving forward?

And I bring this particular example up, because its constant presence in clinical presentations makes me question whether the therapy may also focus on other aspects of a person’s life. I have created this session for groups which I lovingly call “The Gift Session”. It’s a session where I help individuals become aware of their inner qualities, their inner light. Just because. No other reason, no agenda. Just that. And someone usually asks “How is this relevant? I thought we were here to deal with our pain?” So, in every “Gift Session”, I usually need to explore why people tend to reject the gift of becoming aware of their inner light, and why/how that awareness could actually be the key to the end of their suffering.

Could therapeutic work focusing on qualities and inner light literally and figuratively illuminate the way through the suffering and chaos? How much healing and peace can we find through continuous exploration and analysis of pain and trauma?

Ask the Dramatherapist…”The Client’s Role”

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I was recently invited to participate in a research study about Dramatherapy as a psychological therapy and profession. I met up with the researcher last week, where she asked me a series of questions about the different aspects of my practice. After asking me what I perceived the role of the therapist to be, she asked me “What is the role of the client?”

I will admit to you, as I admitted to her: I don’t think anyone has ever asked me that question before, and I don’t know if I have spent much time considering it either. This startled me, and I have been thinking about it ever since. What is the role of the client? WHAT IS THE ROLE OF THE CLIENT?

Have other therapists considered this before? Am I alone in this?

I mean, I have considered many aspects of the client’s experience and process, but I don’t remember anyone ever phrasing it in such a way. What is their role?

This is my response, and reflection, as of February 2017, a week after the question was first posed to me. I believe that my views on this will probably change as time passes, and experience settles, but this is my here and now, and good enough, response.

As it is often common in the life of a therapist, whenever a big question comes up, it tends to show up within therapy sessions, in very unexpected ways.

A few days ago, as I was concluding a group session and making a summary of the work and insights the group had undertaken and experienced, I found myself talking about my role, and their role.

Within that discussion, I was stating that I tend to see the therapeutic process, not so much as a discovery of something, but as a re-discovery. Meaning that, I truly believe each person knows themselves better than anyone else, but their intuition and reason are often clouded by judgement, fear, doubt, expectations, pressures. Everyone has and experiences glimpses into their core every now and then, which we tend to dismiss as “odd”, “peculiar”, “unreasonable”.

My perception of what I do as a Dramatherapist is often of a guide through these clouds. I’m not influenced by someone’s judgement, fear, doubt, expectations, or pressures, which makes me able to navigate through these clouds with curiosity, empathy, and clarity. My role is often about helping to remove the clouds, not so that clients can discover themselves, but so that they can re-discover themselves. Everyone has and experiences glimpses into their core every now and then. We all know what we feel and think, whether or not we have the vocabulary to express it to others. These are different matters: the knowing and the expressing.

And so, as I continued with this metaphor of clouds and removing them, I found myself saying to my Monday group that their role was to make decisions, to choose. Let’s pause here and imagine that I am guiding you through your clouds. As a Dramatherapist, I will do that through prompts: “I notice that… your body language has changed; your tone of voice is different; you said this but did that; where would you like to go next?; what would you like to do next?; to say?; breathe, don’t forget your breathing; pause, take a moment or two; what does it look like, feel like?; it’s okay; I’m here.”

These prompts represent opportunities for the client to choose: to say something, to do something, to ask something, to express, to hide, to move forward, to move backwards, to remain, to settle, to change.

As I guide someone through their own clouds, I will make observations about what I see, notice, and feel, in the therapy space and all of this is meant to create clarity about the different choices a client has in those moments, but also in their lives outside the therapy room. I can do that for them, but then I can’t make any choices for them.

However, to make a choice, one must have the awareness that one has a choice. It also then involves personal responsibility and autonomy. The therapeutic process, and the therapist, must aid in this: the empowerment and awareness of personal responsibility and autonomy. This may sound like too much, but that’s why therapy isn’t always easy, and it shouldn’t be. It should make things simpler, but not necessarily easier.

And a choice doesn’t have to be of the life-changing capacity either. A choice can be as simple as choosing a pencil over a crayon. And the more often one makes simple choices, the easier it becomes to make more complex ones. But the choice must always be made by the client, and this is how I see the client’s role: to make a choice.

It feels like this: I guide a client through something, I make my observations and present the choices at hand, momentarily remove myself from the dynamic so the client can make a choice, and once the choice is made, I return to the dynamic to continue the journey through the clouds. That split second and moment of temporary withdrawal on my part is designed to allow the client to feel that they have made a choice on their own. Small moments like these, of choosing a pencil over a crayon, or the colour of a piece of paper, is what signals to the conscious and unconscious mind, as well as someone’s heart and spirit, that they are in control and empowered.

 

 

 

Reflexions…On the Duration of Therapy

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I have recently experienced a shift in paradigm, in relation to how I experience therapy. I experienced this in the context of my own personal therapy, and I am currently questioning many aspects of my training and practice – which is both frightening and exciting!

For the sake of context, I studied and trained to become a Dramatherapist for 3 years. One of the requirements of that training was that I needed to be in personal therapy throughout that period of time. This included group and individual therapy. Both of those experiences were long-term: I spent 30 weeks in group therapy, and the remaining 120 or so weeks were spent in individual therapy.  Say what you will, but that is a lot of time to be spent in continuous self-reflection and processing of emotional and behavioural dynamics.

Combined with that experience, is my own experience of my tutors and lecturers, and even of available research, whose presentation of clinical case studies seemed to always feature long-term cases. I am not saying that the content only featured those cases, but the ones who stuck with me were often of long-term therapeutic relationships.

And I must admit, that up until this recent challenge to the paradigm I was following, I wasn’t even aware I was following such a paradigm. This paradigm entailed that effective, long-lasting, and authentic healing therapeutic relationships, could only occur in the context of long-term therapy. No one ever told or taught me this, but somehow, through the experiences of my training and studying, I had unconsciously adopted this as dogma. Even though most of my clinical experiences as a therapist have been facilitating short-term interventions! But I recognise now, that I always had this longing to “find” a client with whom I could work with for years. I still do. And I will probably be able to have that experience at some point in the future.

But this is not a debate between long- and short-term therapy. This is simply an awakening, a new perspective, and the curiosity to see where this may lead.

It is very poignant that the first question someone submitted to my “Ask the Dramatherapist…” feature was about uncovering old wounds and the potential negative effects of such actions in a therapeutic setting. I wrote in that post that, often, old wounds are uncovered unexpectedly. That dealing with something here, will trigger or awaken something else over there. And that we won’t know that will happen, until it happens.

This is what happened to me recently. I received some life-changing news in May 2016 and decided to go back to therapy to process the information and its manifested and potential effects on my life moving forward. In the process of doing this, a very painful and traumatic memory re-emerged from the depths of my unconscious and demanded to be processed for the first time in two decades. I had not planned this at all. In fact, I had “worked” so hard at keeping it hidden that not even the intense psychological process of studying Dramatherapy for 3 years had come close to unblock or shift certain life experiences. They were carefully and deeply locked, hidden, and mostly forgotten. The psychological split and disassociation around this experience were very effective.

But then, May 2016 happened. And many “problems” became irrelevant. I was able to finish many chapters, close many stories, and retire old roles that had overstayed their position in the spotlight. Many layers were peeled, which left the core exposed. I felt incredible relief at this purge of old personal narratives, but felt equally apprehensive about the core. I had never addressed it, let alone give it a voice, or time and space. Now, I can easily run away from something if its presence is faint or mild, but if it’s staring me right in the face, I tend to just go for it.

And so, in open and honest discussions with my therapist, I decided to engage in intense trauma work, using a technique and approach called EMDR (Eye Movement Desensitisation and Reprocessing), often used with PTSD to reduce the long-lasting effects of distressing memories, by engaging the brain’s natural adaptive information processing mechanisms, thereby relieving present symptoms. In EMDR, in careful agreement with the therapist, the client chooses a, or the most, painful memory they have about a specific event, and reconnects to the feelings it created, the messages it produced, and the effects it had. Whilst recalling all of this, the client receives one of several bilateral sensory inputs, such as side to side eye movements. I will let you conduct further research on this, if you are interested.

The main point, however, is that through EMDR, I was able to experience the memory differently, in the sense that the feelings it created, the messages it produced, and the effects it had, changed. Not dramatically, not completely, but they changed. And this shift has had a profound effect. And for Dramatherapists reading this, as well as other professionals working with psychodynamic approaches, you will hopefully understand when I say that I cannot explain what the shift was. Only that there was a shift, and that I feel different, lighter, and more relieved. Somewhere in my unconscious, the perspective of this event changed. And this happened within 8 weeks of treatment.

The week after a particularly intense session, I sat down with my therapist and she asked me where I would like to go next. And even though she didn’t verbalise the different options, as a therapist myself, I felt what they were: to stop or to continue. And this is where my paradigm shift happened.

I knew I could continue. I could choose more memories – and trust me, there are a ton of them now! – and continue to follow that process. But like I said earlier, there was something different in me. Reprocessing that particular memory had shifted how I perceived other memories, how I perceived myself and my role in my own life.

We had purposefully agreed to meet two weeks after the intense session, so that I would have time to process it, by simply living my life. And as I started living my life more openly, freely, and emotionally, I realised that I was okay. At least, for now. And that, right now, I didn’t need to continue reprocessing memories, even though I could. And this stopped me in my tracks: I could continue, but I didn’t need to. I didn’t need to continue with this therapeutic relationship, because, right now, my catharsis was enough. And I didn’t need to continue to prod, analyse, investigate, explore. In fact, I didn’t want to. I had spent two decades trapped by something I couldn’t even recognise, and now that something was no longer there. All I wanted, correction, all I want, right now, is to simply live my life. To start new chapters, new stories, and allow new roles to take centre stage.

This is not a defence of anything in particular, simply a sharing about a shift in perspective. That therapy doesn’t always need to be long-term. That profound catharsis and change can actually occur within a short period of time, and that both experiences can be equally valid.

This is a commitment to follow my curiosity in what feels like a brave new world to me: could my Dramatherapy practice enable this as well? What can I do to be more effective in my efforts to facilitate long-lasting change in the context of short-term therapy interventions?