If therapy is about helping the different parts of who we are know each other and communicate better: how can that be done when we are already grown and have are set ways of thinking and not thinking? You know how neuro-scientists are now talking a lot about the brain's plasticity? well, psychotherapists have discovered that a while ago: not using MRI's and CT scans, but by listening, feeling and thinking in the consulting room.
We first learn to become ourselves through playing and through relationships. If our relationships are not good enough for some reason, if we missed out on opportunities to play for some reasons, the selves that we become are compromised. Psychotherapy, as a basically humanistic practice, supports the belief that this can change. Some therapists believe that providing a better relationship: being an empathetic parent- substitute is enough to "heal" an adult who has suffered trauma, insufficient love or had confusing role models. Though I think empathy and positive role modeling are essential for a successful therapy, it takes more than that for an adult to benefit from a therapeutic process.
A person's needs in therapy vary. Here is one way I think about the different needs and the ways in which they can be addressed in therapy: - Difficult life transitions: illness, break-up, birth of a child, death of a loved one, immigration, career changes: those are times when our "me" can be overwhelmed. Adults, like children in times like these, need some extra support. In our world of specializations, a therapy relationship can be one of those special places where you can get support in difficult times. Much like a yoga class, a massage, meditation or an improvisation class, a therapy session can help our minds make new links inside and out in the world that will help reorganize ourselves to adapt to the new situation. Being able to think through things in the presence of another supportive (and hopefully smart!) mind, can be very useful.
- Creativity problems: people come in to therapy when they feel they are not fulfilling their potential. This is a problem of translating between "me" and "not me" experiences and can be helped using expressive arts therapy, sand tray therapy and meaningful conversation in a supportive, safe environment.
- Depression: can be thought of as a lack of communication between one's different parts of "me" and "not me" experiences. When a person does not know his own feelings he can feel very alone, even in the presence of other people who love him. Therapy can help in those situations by bringing up memories, feelings and thoughts and creating a safe space to "play" with them i.e understand them in a different way, so they make sense to our "me", so you can find a way to think, feel and know those experiences as your own. This can be a longer, more intimate process that is often surprising and rewarding.
- OCD, PTSD, night terrors, Anxiety: When you are suffering from OCD, flashbacks, Anxiety or Panic attacks, we might say that some of your "not me" experiences are not only isolated (are not able to become translated into "me" experiences) but also dissociated- they are not experiences that can be thought about in symbolic ways such as words or art. Instead only body sensations can capture the essence of those experiences. Flashbacks and anxiety attacks are intrusive, involuntary and many times very scary. OCD is sometimes a way a person's mind finds to try and control those intrusions, much like superstition tries to control the unknown powers of the universe by known and repetitive rituals such as knocking on wood or spitting five times. Therapy can help with this sometimes-debilitating conditions by creating a safe sincere, caring relationship in a safe environment and only then starting to untangle the complicated network of internal relationships between different aspects of the patient's internal life. Art therapy, photography, somatic techniques and sometimes EMDR are extremely helpful in creating new, caring internal connections than can translate dissociated experiences into a language than can be useful and adaptive in a person's day to day life.
- Dissociation, Bi-Polar disorder: Many clinicians believe that dissociative identity and bi-polar disorder are deeply rooted in a history of early childhood trauma. Persons who have used dissociation as a way to cope with a very harsh environment starting at a young age would probably continue using these strategies throughout their lives. The goal of therapy would then be for the person to know their different, dissociated parts, to find a way for them to treat each other with respect, compassion and empathy and to use the ability to see the world from different points of view in an adaptive and sometimes incredible way.
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