Disappointment With Psychotherapy. How To Survive It?

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Where does psychotherapy usually begin? As a rule, with the choice of a psychologist (psychoanalyst). The client found the site of a psychotherapist, read articles, or received a recommendation and phone number from a psychologist from his friends. Life practice shows that from the moment the desire to get an appointment with a psychologist appears until the very appeal, it often takes more than one month, and sometimes more than one year. Although the opposite situation often happens. I saw the site, got a phone number, called, signed up and came right away

What is the process of selecting a specialist connected with, and how does it happen?

It all starts with feeling your need for help in understanding yourself, your motives, internal conflicts and desires. In a word, with the desire to understand your inner world. But often this kind of motive turns out to be deeply hidden behind other more vital requirements: the desire to change a problematic situation that seems unbearable, to get advice, support or psychological advice regarding your problem.

When a psychologist (psychoanalyst) is selected, the client has unconscious ideas and fantasies about a future meeting and about further work with a psychologist. As a rule, high hopes and expectations are pinned on the specialist. Although at a conscious level there is an understanding that a psychologist is not a magician and cannot change a situation, give "wonderful" advice or offer a ready-made solution. A psychologist can only help to better understand oneself, to meet internal obstacles and limitations that lead to external problems and to find resources to overcome them.

Often, ideas about the psychologist and about the upcoming psychotherapy, in one way or another, turn out to be idealized. After the first sessions, there may be a feeling of emotional uplift and lightness associated with the fact that there is an opportunity to speak out, evacuate a problem situation from your inner world and share it with another person. This gives a sense of hope that the problem has already receded. But alas, these feelings turn out to be just an illusion.

The complex feelings behind the problem situation have not evaporated anywhere and, moreover, they begin to return and more clearly manifest themselves in the situation of psychotherapeutic communication. In psychoanalytic psychotherapy, this phenomenon is called "transference." For example, when a woman, having problems in her relationship with her husband, feeling resentful, ignored, dissatisfied, angry and dependent, also begins to feel herself in a therapeutic relationship. She begins to react painfully with a feeling of resentment or anger to the analyst's silence, to look for shortcomings in him, to reveal her exactingness and claims. As a rule, such a confrontation with one's feelings in an actual transference situation turns out to be extremely painful and difficult to bear. And it is at this moment that hopes and illusions collapse. The stage of frustration in psychotherapy sets in.

Disappointment is an extremely difficult feeling. In moments of disappointment, everything seems meaningless and useless, there is a feeling of a new impasse and a feeling of hopelessness. As a rule, it is at this moment that the resistance of psychotherapy reaches its peak, and, unable to withstand such internal tension, the client slides into acting out (turning his feelings not into words and understanding, but into concrete actions), for example, leaving psychotherapy, suddenly cutting it off.

Often such impulsive enactments from the point of view of conscious logic seem quite understandable. I came for help, for relief, and instead of this I get another difficult, tense and “problematic” situation unfolding in a therapeutic relationship. And here it seems a very logical way out to leave, although it is the resolution of the “problem” situation in a transferable relationship that provides a positive experience that contributes to the solution of the current situation.

The meaning here is that behind the formal logic there is an inner desire to minimize mental pain, to devalue the therapist, make him “needy” and quit (by playing, for example, by reversing roles what the husband did with the client or her mother did with her in early childhood age). Acting out, as well as devaluation, gives only instant relief, and sometimes a sense of triumph, but then all those complex feelings of resentment, helplessness, dependence, anger, anxiety return.

Leaving (and sometimes running away), the client wants to put his problem in the therapist and leave him in the "fools" to experience difficult feelings, for some time free from them. (When the other person near me feels bad, I feel better because I may not feel my pain). This temporarily saves you from unbearable feelings of frustration, vulnerability, helplessness and a sense of impasse.

In addition to shattering illusions and idealized ideas about analytics and psychotherapy, setting is another factor that leads to disappointment in psychoanalysis. Setting is a set of rules by which analysis or psychoanalytic psychotherapy is carried out. This is the so-called frame that separates and protects the internal psychoanalytic reality from the external.

The setting usually includes the stability of the place and time of the psychoanalytic sessions, the regularity and duration of psychotherapy, the size of the psychoanalyst's fee, the payment of missed sessions and the inability to shift the time of the session or reschedule it. Also, when concluding a psychotherapeutic contract, a prohibition on friendly, business or other personal relations between the psychologist and the client is stipulated, as well as the fact that the completion of psychotherapy should take place with the mutual consent of the client and the psychotherapist. If there is no such decision, it is imperative that the completion of psychotherapy is discussed and analyzed over several sessions.

Of course, such rules at first glance may seem rigid and incomprehensible, but, nevertheless, in addition to protecting the interests of the psychoanalyst, they have their own therapeutic meaning for the client. We will return a little later to the question of the psychotherapeutic meaning of the setting in psychotherapy, but now let's look at the situation through the eyes of a new client.

As a rule, the client comes with the hope of help, support, approval, reassurance, unconditional acceptance and the psychologist's readiness to always meet him. That is, at a symbolic level, the client wants to get a good, kind host mother. But the psychoanalytic space symbolically represents both the presence of the mother's image (acceptance of the client's feelings, sympathy and empathy) and the presence of the image of the father.

Unfortunately, in our post-Soviet culture, the role of the father in the upbringing of our generation was secondary, often the father was a detached and devalued figure in the family. Although the task of the father in the upbringing process is to introduce prohibitions and restrictions into the child's psyche. You can see for yourself how bad things are in our country with the observance of laws and regulations. So the emergence of the rules of psychotherapy, which do not allow merging with the psychotherapist in the stormy ecstasy of experiences, turn out to be a very structuring and disappointing factor.

Often the client has an unconscious desire to collude with a psychoanalyst to get around the rules: "Can I not pay for missed sessions if I get sick?" "Can I come when it's convenient for me?" But alas, no matter how inhumane it may seem, the analyst insists on adhering to these rules, which often causes great disappointment, protest, resentment, misunderstanding and hatred. At this point, it is imperative that the analyst can empathize with the client's feelings and help him cope with those feelings.

In fact, psychotherapy as a study of the unconscious is possible only within the framework of a psychoanalytic setting. After all, we do not do surgical operations on the street or in the kitchen, but go to the hospital and arrive there as long as necessary for recovery.

One of the most important tasks of analytical psychotherapy is to help the client in accepting reality, and it is the frame of the psychoanalytic setting that is a clear manifestation of this objective reality, which subjectively can be perceived in different ways. When the client manages to internally accept the psychoanalytic setting (and not just formally agree with the rules imposed by the analyst for some reason), he begins to feel more stable, to feel the security of the space that is formed in the therapeutic couple for working with the unconscious.

To summarize all of the above, it is important to note that in order for psychoanalytic therapy to really begin, the client must experience two kinds of disappointment: disappointment in analytics and disappointment associated with the framework and limitations that reality dictates to us. Only in these conditions, while maintaining involvement in the therapeutic process and interest in your inner world, you can embark on a long and exciting journey called "analytical psychotherapy."

Of course, if you look at disappointment from a philistine point of view, then this is the end of all hopes and a complete impasse. But if we look at disappointment from a different point of view, then we can notice that disappointment occurs precisely when illusions are destroyed, and reality appears to us as it is. Destruction of illusions, acceptance of reality is always a slow and painful process. On the one hand, it brings pain and disappointment, and on the other hand, it gives us the opportunity to change something within ourselves in order to adapt to this reality.

In psychoanalytic psychotherapy there is a saying: "Real psychotherapy begins only after the client's disappointment in the therapist."

The charm is gone, the fruitless hopes are gone … In their place comes the understanding that the therapist is not a magician and is not able to solve a single problem for the client, and in order for at least something in life to begin to change, you will have to work on yourself, face your feelings, make difficult internal decisions and begin to understand yourself better.

On this path, the psychoanalyst is a guide and reliable support. When the disappointment in psychoanalysis is overcome and lived through, and the analysis continues, a new and interesting way of knowing our inner world, our unconscious and ourselves opens before us.

In fact, real psychotherapy always works to the point of losing faith in its healing powers. One of the most important tasks of psychoanalytic psychotherapy is to return the ability to live, understand and differentiate one's own feelings, lost as a result of traumatic events that close the ability to feel, instill fear and stop personality development, make it "dead". Psychoanalysis helps to "revive" "frozen" feelings and return to the path of self-development, which is impossible without going through the stage of disappointment. Only after experiencing disappointment does it become possible to acquire new life meanings, to revive faith in life and in one's own strengths, as well as to restore the ability to love, which is one of the main criteria of psychological health.