An open letter…The margins of therapeutic practice

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To: All practitioners working at, and in, the margins of mainstream structures.

Last year, I presented a paper at The British Association of Dramatherapists’ Annual Conference, exploring the dynamics of visibility between margins and mainstream. I presented and reflected on my work as a therapist in a marginal profession with a marginalised client group, HIV+ gay men. I defended that more must be done to move Dramatherapy and the work that we do as a profession, from the margins, to the mainstream.

I am here now, to challenge and dismiss that assertion, and to accept, embrace, and own my place at, and in, the margins of therapeutic practice.

Some of the most common feedback I receive in my sessions goes like this:

“I was really anxious about this session, but I feel so much better now. I don’t know why.”

“What we did last week really shifted something in me, but I don’t know why or how.”

“At first I thought this was weird, but then it made sense. I don’t know how to explain it.”

Do you notice anything about those statements?

Yes, they all include “I don’t know” why, how, what, etc. And guess what? Most of the time, I don’t know either.

Now, let’s look at this scientifically.

In fact, let’s not. If I wanted to be a scientist I would have studied Psychology or Psychiatry. And not to say anything in particular about those disciplines, but I studied Dramatherapy. And that’s that.

I never had a scientific mind, or enjoyed that process very much. I was always a “feelings” and “energies” type of person. I could always sense things and knew them to be real. Could I prove it? Not really. Did I feel the need to prove it? Not at all. Why? I always felt that an authentic connection between people did not need a piece of paper to validate it.

I read clinical articles sometimes and think “What else is new? Tell me something I don’t already know!” Now, I completely understand and value the process of rigorous methodologies and studies in order to prove something, and create the necessary robustness that a health care profession needs in order to be registered and protected. But I never felt the need to go through those processes myself. I’m currently writing my first clinical article, and the headaches this is giving me are quite something. The idea of finding theories to prove the dynamics of human connection, is frankly stressful. I know, crucify me already!

However, somehow in between the beginning of my training as a Dramatherapist, and my current work almost two years post-graduation, I have found myself trying to be part of the clinical psychology establishment. Me! Of all people! Me, who has always pushed against established ways and systems.

Yes, for the past few years, I have found myself trying to seek the validation of senior clinical teams who demanded evidence-based research for my work and approach, and for years I have endured this fight with openness, poise, and willingness to learn. And yet, I have continued to be on the losing end of that fight, and I have finally understood why: I have been trying, mostly unconsciously, to make a marginal and relatively new therapeutic approach part of the established mainstream. And I have been trying to do this on my own, in my little corner of the Dramatherapy world.

Thus, after a renewed demand that I stop using the term Dramatherapy because there is no evidence-based research for drama as therapy, I finally decided to claim my own boundaries, and respectfully said no. No to this demand! As a registered and protected title, a Dramatherapist IS a therapist, and it is my professional and legal right to use it. Moreover, I will cease to attempt to be part of the mainstream, because, guess what? I doubt Dramatherapy will ever be part of the mainstream therapeutic establishment. And for the first time since I have started studying and practicing this approach, this is perfectly okay. I have experienced this recent situation as a classic case of “I’m not good enough.” Somehow, I have felt inferior to other psychological therapies, and this has been my drive to be part of, to be accepted, and validated by the more established professions in psychology and psychiatry.

And, if I may say so, I sense this is a general feeling amongst the profession. Not consciously, per se, but if I have been experiencing this, I can’t be the only one, right? I still remember a few years ago at the AGM of our professional association, there was a motion to seek out accreditation from the BACP (Counselling and Psychotherapy association), and a member of the community stood up and asked why we needed such a thing, if we were already a registered and accredited profession? I think this has stayed with me until now, because now I get it. Why, indeed? If we are strong, authentic, and boundaried enough in our conduct, why do we need others to tell us what great work we do? And if we don’t think we are good enough, then let’s all look at that, and have a conversation about it.

I can honestly say that it was a rude awakening this week to realise that, actually, I didn’t think I was good enough all these years of studying and practicing. That a part of me carried the belief that Dramatherapy was not good enough. That perhaps other professions had a point of challenging every single one of my moves and decisions. As I was going through my process of awakening this week, this anonymous quote came through on one of my social media feeds:

“Stop asking why they keep doing it and start asking why you keep allowing it.”

And then it all made sense. It’s not just that people keep challenging my profession and training, it’s also that I ALLOWED IT to happen. I kept accepting their authority without question.

No more allowances on this front. I have put in place a healthy boundary: a boundary which whilst remaining open to new ideas and approaches, is also protecting and taking care of my own approach and my sense of growth within it.

By asserting this boundary, I am saying: this is what I do as a Dramatherapist. I use drama to explore the depth of individuals’ emotional experiences, and facilitate the sustainability of long-lasting change and fulfilment in their lives. No more, no less. No comparisons to other professions and approaches. No further explanations. This is it. I experience the value and worth of my training and talents on a daily basis, by the feedback I receive and transformation that I witness. And that is enough for me!

I choose to focus on causes. On people. On human connection. On compassion. On experience. On living, and thriving. And this is my commitment to all my clients, and myself.

 

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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.

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. 

Reflexions… On Doors

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Every now and then, I hear this in my therapy room:

“I’ve been in therapy for years, and I’ve never talked about this”, or “I’ve been in therapy for years, and I’ve never made this connection before”.

Anyone else experiencing this?

No matter what my response is in the moment, depending on what the disclosure is, I often think why this is. Why are people going to therapy for years and not addressing something? What are they doing there? And then I remember my own therapeutic process and get the answer: sometimes, people aren’t ready. Sometimes, something doesn’t become pertinent until a specific time in one’s life. Sometimes, layers upon layers of life events and emotional processing need to be peeled off before revealing the cause of something. I spent three years in continuous therapeutic process during my training, and didn’t start addressing a core wound until after a year post-graduation.

And then, I also remember this: I work as a Dramatherapist, which is an incredibly powerful profession within psychological therapies.

A bit of a disclaimer here: I’m quite rational and analytical in my cognitive processes. I can expand, elaborate, explain, extrapolate to my heart’s content. I often tell this to therapists and supervisors, because I am very good at hiding when talking. I have a moderately strong photographic memory which allows me to access articles, books, films, music, references in general, within seconds and incorporate that in my verbal expression. I disclose this, because I often just need someone to tell me to stop thinking, and start feeling. Because of this, I can also be quite the rational and analytical Dramatherapist.

I am still finding my balance between creative expression and exploration, and cognitive reflection. Therefore, I admit that my delivery of Dramatherapy is substantially filled with verbal expression, a talking therapy. But I also have to admit that whenever I have heard one of the statements above, it is always during a post-creative expression reflective experience. It is rarely when we are just talking, but always after we’ve done something drama-related. And here lies the power of Dramatherapy, and why I feel so passionate about it, regardless of how it is delivered and which techniques are used.

This past week, I explored this with two clients, after their admittance that they have both spent more than a decade in therapy and had not made such connections before.  I found myself explaining that individuals will often experience this in Dramatherapy because, as a therapy, we often go through the back door of the mind. We may knock at the front door of the mind, through some talking, but it is through the back door that our work may be most profoundly felt.

I don’t mean to imply that Dramatherapists are somehow surreptitiously tricking clients into disclosing information, but I have found in my practice that this is a regular, unintentional occurrence. In the sense that the mind’s front door is rational and analytical, and the mind’s back door is emotional and instinctive. The former is founded upon control, and the latter upon freedom. Creativity is the corridor that connects both doors. And most of the time, even I’m surprised at what my clients and I find by going through the back door.

And this is where our work is invaluable: the creative processes we use are not meant to trigger for the sake of it, and sometimes they don’t. But when they do, our psychological training will enable us to hold, contain, and support the emotional ups and downs of our clients. I believe Dramatherapy is a tremendously powerful approach, and to be able to do it is a gift and talent. The combination of depth and enjoyment that Dramatherapy provides to psychological development and wellbeing are astounding. How do I know this? Because I often get this feedback: “I have never told this to any other therapists”, “I didn’t know I wanted to talk about that”, “I didn’t know that was there”, “I can’t believe how quickly we’ve progressed”.

I will support myself here a little bit and say that part of why this happens may be due to my own approach, but it is also important to acknowledge that part of it is the client’s readiness at this point in their lives, and, of course, because of Dramatherapy itself.

One of my clients was telling me yesterday that they were really enjoying the dance between their conscious and unconscious mind, and I just felt like saying “ABSOLUTELY!!!”. That is exactly how I feel about Dramatherapy – I love the dance, and drama, between conscious and unconscious processes. I love engaging and spending time with the back door keepers. Their language is different, yet the same, for they communicate through symbols, metaphors, feelings, and sensations. They are unpredictable, but often, they just want someone to spend time with them, and then they will happily, and safely, take you inside the house to show you what is calling for attention.

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.

 

 

 

Ask the Dramatherapist… “Old Wounds”

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Welcome to the first “Ask the Dramatherapist…” post!

**Disclaimer: I will write from personal and professional experiences, because ultimately, that is all I can offer. Each therapist will have a slightly different stance on a subject, a theory, or a technique. This is not a reflection of the different professions themselves, it is merely a reflection of the humanity of each therapist, what they resonate with, and what each one of them brings to their respective profession and training.

This month’s question:

Is there an instance in which seeking therapy would open old wounds and leave someone worse off than if they hadn’t ‘turned the stone’ in the first place? 

This is a very important question. It is also a question many people have prior, during, and after therapeutic processes, as it is a question which conjures up a certain level of fear, insecurity, and doubt. And I would also add vulnerability to that list.

Therapy, in general, will bring up vulnerability. It is impossible to escape that. I find that there are two main types of people who attend therapy: those who proactively want to know more about themselves and use it as a personal development tool, and those who, for one reason or another, feel forced to seek help – both voluntary and involuntary. In all cases, there will be a conflict between the parts of the Self which want to heal, and the parts which want to remain the same. The resolution of this conflict – the Integration of the Self – will involve cessation of control, opening up to honesty, leaps of hope and compassion, and visits to past, present, and future.

This Integration doesn’t happen overnight. It takes time. It takes energy. It takes trust. It takes relationships based on compassion and boundaries. It takes process. The process of therapy is a very interesting one, because it involves a relationship between two human beings, whose only difference is that one of them has studied and been trained to facilitate healing processes. They both have wounds – old and new – and they are both constantly learning from them.

And this is where a therapist’s training, and, I may add, their own experiences of therapy and healing, come into play. Which theories have they learned and practiced? How much therapy have they had in their own lives? How much processing of their wounds have they done? For instance, some professions require that a therapist attend therapy whilst training, and others do not. Some theories defend that one should always go to the old wound and re-experience it, others focus more on present and future, others offer a combination. Some theories incorporate the body in the equation, others do not.

The first thing that strikes me about the proposed question is the expression “old wounds”. Does a wound ever stop being a wound? Wouldn’t healing entail that a wound is no longer there? What is a wound? Are we talking about trauma here?

None of us can escape wounding. But wounding may have widely disparate effects on people. And wounding comes in many different manifestations. It may be extreme or subtle. It may happen in an instance or progressively over time. It may be intentional or unintentional. It may lead to death or life. It breaks people down or it breaks people through.

Whatever it does, though, wounding does cause breaking. It breaks us open to feelings, experiences, learning, pain, love. But do we stay open or do we shut down? Either option will involve vulnerability, but this will be experienced very differently depending on the option. Open vulnerability involves willingness and understanding to experience both pain and love – the foundations of human and spiritual growth and development. In open vulnerability there is an acceptance of the circuitry of life: something is born, something lives, something dies, something else is reborn. It assumes and thrives on connection and fluidity. Closed vulnerability involves refusal of this circuitry. It is living, but there is an undercurrent of fear, insecurity, and doubt. It assumes and thrives on separation and judgement.

Is there wounding that does not affect a person’s life? Yes.

Is there wounding that affects a person’s life? Yes.

My experience of more than 100 individual and almost 400 group therapy sessions has led me to look at wounds in the following way:

  1. What is the initial presentation of the client? What do they want and need from therapy? Why did they come to therapy? This varies greatly, but usually there is a perceived, potential or actualised problem. Some kind of barrier or blockage that is preventing them from being and feeling happy or content with their lives: relationships, work, family, self, etc.
  1. What is the current pattern of behaviour causing this blockage? How is it affecting their lives in the present? What is the relationship between behaviour and emotion? What is the dynamic between thought and action? How does the body feature in that equation? What is the STORY that they are telling themselves? Who are the characters?
  1. Where does the story start? When was the first time they felt whatever they are feeling right now? This is the first visit to the past. The aim is to first figure out the origin of a pattern of thought, feeling, behaviour. Once we get there, it is important to assess: is the wound open or closed? Do we need to explore it further, or are we able to acknowledge, honour, and leave it be? This takes us back to the questions above: is the person still affected by it, or has the person actually moved on?
  1. Is the story still relevant? For example, fears usually appear for a reason. They are a defence mechanism. But what usually happens is that we continue to use and experience that fear beyond its expiry date. The initial situation for which we needed fear no longer exists, but we keep the fear – the thought, feeling, behaviour pattern. It’s the same with our life stories. Do we need to keep telling the same story? Are we doing that out of necessity or habit?
  1. Create and rebuild bridges between Past, Present, Future. How does what happened then, affect someone now, and how can they move forward? This is the process I follow in my therapy work, but it’s not necessarily linear. It is often cyclical. It is a constant negotiation and assessment of how much Past one should visit in order to benefit the Present and Future.

I don’t believe in exploring a wound for the sake of it, and I’ve witnessed instances where exploration was not beneficial. And I admit, I may have crossed a line a few times in the early days of my training. And I also admit, I’m not exempt from crossing them again. New situations arise all the time, we are constantly learning, and no one is perfect. But in those instances, the main concern is working with the person to re-establish the boundaries around the wound, and between us.

However, I do believe in the power of re-visiting something and changing one’s perspective of a situation, person, or the Self. What I have learned with that, though, is that someone needs to be ready to go to the Past, on their own terms, in their own time, when they decide to do so. The therapist is there to show the different options, not to choose one.

Wounds can be tricky though. We may live for many years and decades without many effects of a wound, but then something seemingly unrelated is able to re-trigger some unresolved trauma: a diagnosis, a car accident, giving birth, someone’s death. Everything in us is connected. Nothing exists in isolation. Old wounds are often opened up again in therapy because sometimes resolving work-related anxiety or stress is connected to how someone’s parents spoke to them as children; sometimes a life event, such as a diagnosis, will actually release a blocked memory and a significant childhood trauma is suddenly re-opened and everything that was trapped in the body, mind, and soul of that person is released and begins to demand attention and healing.

Thus, seeking therapy may often open old wounds. Not because it’s planned, or necessary, but simply because our life events are connected, and if something is triggered here, it might re-trigger something over there. Both client and therapist are unaware of these dynamics until they actually manifest themselves. It simply comes down to this: we don’t know, until we do.

What happens in those instances is that a negotiation should take place between client and therapist: what does the client want to do? Do they want to go back to the wound, or do they want to manage it as best and efficiently as possible in the present moment, and in the future? The client always decides in Dramatherapy. I show them the options, and they choose. I often have clients in my Addiction work who want to manage their drinking or drug taking, and don’t want to consider sobriety. My role is to show them the options, and they choose. Not me. The same with wounds and trauma.

Is it okay for someone to change their mind about their choice? Of course! Always!

The bottom line is this: therapy may or may not open up old wounds. If it does, then the therapy space is probably one of the safest spaces to take care of that. The problem lies in the fact that, sometimes, in the exploration and integration process, the old Self wins. The Self that wants to remain the same, that prefers the comfort of known pain and suffering instead of unknown potential and transformation, will take over, close the wound, live in closed vulnerability, and stop treatment. This is not optimal for the client, but if it is their choice to end treatment, then it is their choice. The being left worse off is not necessarily about the content of therapy sessions, but about the duration of therapeutic treatment. Sometimes treatment is cut short for a variety of reasons, and therein lies the potential danger of feeling worse off, because if a wound is re-opened and then left untreated, it will cause further damage.

Thank you to my friend who submitted the question, and I hope this helps to understand the therapeutic process a bit better.

 

Reflexions…On Being Human

Humanity in the therapy space

I have been wondering for months on what the topic of my first ever blog should be about. And after one of the most intense weeks of therapeutic interactions I have experienced so far, I knew what I needed to write about: on being Human.

I mean, what’s better than that as a starting point?

The topic became apparent in different ways throughout the week, but it was fully felt this past Friday. In a group therapy session exploring clients’ inner aspects of Light and Shadow, I was asked to play God twice, a Victim, a Beggar, and a Bully. Beyond the fact that this can be really demanding – to take on and play aspects of a client’s inner and unconscious psyche, in order to reflect this back to them – what I was really left with at the end of that session, was a sense of humanity.

When I mentioned this to the group, there was a collective nod and sound of resonance. They knew what I meant. I had played characters under their direction, which allowed them to not only see aspects of themselves, outside of themselves, but also to have an awakening or awareness of the changes they would like to make.

I expressed that the most prevalent feeling and common thread between those characters, had been a sense of confusion. I explained that I felt confused by their directions, that I didn’t feel like I had enough knowledge about these characters to know their motivation. That they didn’t give me enough knowledge about them. And, in fact, they didn’t have enough knowledge themselves. It’s easier to be aware of one’s actions, but one’s motivations? Not so easy, or simple!

I suspect what these motivations might be, but I also feel that it’s important for them to figure them out. To peel off the many superficial layers of motivation, and find the core driving force behind their emotions and behaviours. This is no easy task, and it’s rarely a smooth experience. But it’s what makes us all human, and it’s what helps us relate to one another in the therapy room. It’s the human relationship between us which facilitates the catharsis, and healing.

I learned a very important lesson when I first started working with adults in substance misuse services: that the most profound and effective way to work through their addiction, was actually to remove the label of addiction. To not treat them as addicts (whatever that actually means!). And to treat them as humans, fellow human beings, in fact – beings of shadow and light, destruction and healing, doubt and hope, fear and love. And in the process of accepting that they were just like me, I had to own, show, and reflect my humanity back to them. My very own perfectly imperfect humanity. That is how my clients started sharing aspects of their lives with me, that they had never shared with anyone, not even their 1:1 support workers or counsellors.

Slowly, I learned that I couldn’t just be Ryan, the Dramatherapist. I had to be Ryan, the person. I had to learn to accept my limitations, my challenges, my own darkness, and to let that transpire in the sessions, in appropriate and healthy boundaried ways.

I understand the need to see and perceive certain professionals as perfect, or well put together, or having it all figured out. But the truth is, no one has it all figured out. We only stop learning, evolving, and changing when we die.

People may also think that they want someone to tell them what to do and how to live their lives when they meet with a therapist, but ultimately, transformation and long-lasting change can only occur when each individual figures it out for themselves. I always tell my clients: “I can show you the way out of your own prison, take you to the gate, be with you at every step of that search and journey, but eventually, you need to cross that gate on your own.”

To me, connection, transformation, and evolution can only truly occur through authentic human relationships. If I’m just being a therapist, and you’re just being client, there’s only so far we can take that dynamic and relationship. If I look at you as a condition, a diagnosis, a clinical presentation, and you see me as someone who imparts knowledge, advice, and tells you what’s best, we will only be able to work on the superficial. There is no depth or resonance in that interaction.

So, this is what I use to keep my therapeutic high horse in check, and to allow my humanity to flow and be present:

  • Every feeling is valid. I believe that we cannot prevent or stop feelings. We can only do that to actions and, to some extent, thoughts. If you feel something, then you feel something. That’s it. No rocket science. I encourage you to feel it, whatever it is. We can then figure out the next step together.
  • There is no good or bad, right or wrong. This is about being mindful of judgment. Please note that I didn’t say removal of judgment. I don’t think we can truly do that in our human interactions. But we can be mindful of it. And we can accept people, places and things as they are. Not good or bad. Not right or wrong. Just as they are. Just as you are. Just as I am.
  • Transformation and balance are possible. People make, create, and maintain long-lasting transformation and balance in their lives, all over the world. Is it easy? Not at all. Is it possible? Absolutely!
  • We are all human. Behind every human interaction there is a variation of one or all of these needs: to be seen, heard, validated and loved.

This isn’t always easy to maintain, and it often involves a very delicate balancing act between professional and personal values. When I feel off balance, I do the following:

  • I take a few deep breaths. I focus on the rhythm of my breath, the simplest, yet most important function of the human body. Without breath, there is no life.
  • I ask: “What do they need?” This usually shifts the focus away from my own anxieties and insecurities, towards the needs of those that I am supporting.

This two-step process has never failed me. It connects me to my own humanity first, so I can then connect to others. Once those connections take place, the therapy begins.