Reflexions…On the Duration of Therapy

2017-01-2-13-03-20

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?

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