Case From Psychotherapy Practice: Should The Therapist Be Attentive To His Life During Psychotherapy?

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

At the moment, she is raising three children alone and is trying to build relationships with a new man, which also turn out to be not very simple and similar to all the previous ones. As a matter of fact, it was the actual complications of these relations that were the last straw that prompted V. to seek psychotherapy

For some rather long time V. described to me in detail the difficulties existing in her relationship. The content of the story contained quite a few tragic episodes that could, under other circumstances, cause a lot of sympathy, pity and, perhaps, even pain. However, almost throughout V.'s story, I was rather in thoughts and fantasies about my own life, and I was thinking about insignificant events.

Periodically feeling vaguely guilty, I tried with an effort of will to return myself to contact with V., however, I managed to do this only for a couple of minutes, after which I again "selfishly" plunged into the experiences of the little things of my life. Apparently, the severity of the tendency to ignore V. was beyond my strength. Stopping in this process and returning to contact with V., I caught myself on a clear indifference to her story. The experience was difficult for me and even at times excruciating. It seemed to me cruel and non-ecological to inform V. about it. I ran in my head about possible interventions that might be useful in such a situation. After some time, having returned to contact with V., I caught myself realizing an emotional mixture of indifference that had already existed for some time and new rather pronounced pity and irritation that had appeared. In addition, I clearly felt that I was not very appropriate in the entire actual situation of therapy, which was determined until now by her story. I nevertheless decided to trust the phenomena that had arisen in contact and placed them in contact with V. In response, she burst into tears, felt unnecessary, abandoned, and began to experience feelings for me, surprisingly reminiscent of her experiences of relationships in previous marriages. A situation that seems to resemble a dead end, from which there was currently no way out.

The tension persisted for some time, after which V. said: “Why is it so easy to ignore me ?!”. I replied that it is hard for me to be in a situation that substantively presupposes the need for me, for my care, and according to inner feelings - both mine and V. herself - I find myself completely unnecessary. Such a statement surprised V. very much in the sense of the mismatch of her expectations from me as a person capable of bringing her relief, and the absence of any needs and wants for me. I asked V. not to confine himself to the realization of such a discovery, but to try to place all the components of this impasse in contact with me. In other words, I invited her to say both phrases to me: "I really need you!" and "Go away, I can handle it myself!" It's time to surprise me - we have encountered significant resistance to this experiment. After some time, V. nevertheless uttered these phrases, and at the very first words her voice trembled, and her throat spasmed in convulsions. Suddenly I felt a sharp excruciating pain in response, which was what V. said. She looked at me with wet, inflamed eyes and admitted that it was equally unbearable for her to recognize the need for someone and rejection from others. I said that I sympathized with her and that I believed that she apparently had good reason for this. V. began to say that no one had ever really cared about her. Unbearable pain filled our contact, although it seems that at that moment he was able to endure a significant intensity of the experience. I asked V. to tell me personally about his pain. This story was significantly different from the one I heard in the first minutes of the session - it was thoroughly saturated not just with words, but with the experience of these words.

At the same time, I quite clearly experienced V. with every cell of my heart. In the course of the conversation, V. said that she was speaking now as if for the first time in her life she had received the right to her experiences, her needs, her feelings and her fantasies. I suggested that V. stay in contact, not trying to escape from it (the temptation to escape from contact with me was very pronounced in V.) and to be very attentive at this moment to what she now, right at this moment of the session, needs. V. said that she had already received a lot from this last episode of the session and that she no longer needed anything. I drew her attention to whether this message to me is not a return to the same situation in which it is unbearable to desire something. V. with tears in her eyes confirmed that she wanted to escape from here. In response to my proposal to listen to herself now, V. said that she felt a burning shame from the realization that she needed contact with another person.

I thanked V. for the courage with which she remained in contact with me through such significant stress. At the same time, he added that she has the right to her desires. V. said that she was very grateful to me for the fact that for the first time in my life I received permission for my desires, and for the feeling that they are important to someone else in this world.

Toxic shame transformed into an emotional cocktail of embarrassment, gratitude, and dimly realized desires. At this point, the session ended. At subsequent meetings, V. gradually more or less successfully advanced in awareness of her desires, revealing the need for care, recognition, freedom to take rash actions, etc. The focus of therapy was the process of forming V.'s ability to clearly articulate his desires in contact with other people.