Should Therapy Be Forever Introspective?

                                                                                                                          And then the day came,
when the risk
to remain tight
in a bud
was more painful
than the risk
it took
to Blossom.

This poem, long attributed to Anaïs Nin, but more recently to Elizabeth Appell, unwittingly touches on a therapeutic problem:

What if the person “tight in a bud” is captured by the safety of a therapeutic process: too long within the bud, not beyond its green wrapper reaching toward the light?

Does therapy sometimes risk cocooning the patient too long, uncovering and uncovering and uncovering depths of feelings and insights at the expense of progress in the world outside of the therapist’s office? Put differently, if “the unexamined life is not worth living,” as Socrates tells us, is the overexamined life unlived?

I am accustomed to self-reflection both inside my head and in my practice, but I think we do have to acknowledge each side of the question. We need self-awareness, but the place where it resides is sticky, full of creatures who grab us and hold us fast. At least, they try to.

Life is something of a leap, a challenge: a reach for love, learning, helping others, and fulfilling the “becoming” still unrevealed in us. The world offers us differing models, from arrogant, thoughtless, unreflecting leaders who are, nonetheless, men of action; to those of us whose exploration is more inward, but may be confined by that inwardness.

We are offered fictional and mythological models, too. These are all people of action. When they go underground to visit dead souls, as they do in Dante’s Inferno and Homer’s The Odyssey, they are struck by how out-of-place they feel. They must, inevitably, return to the world of the living.

One version of hell on earth is an endless preoccupation with grave feelings and haunted days; consumed with envy of those who live with abandon. How ironic that some of the externally risk-averse accept a familiar hell in a box. As Nietzsche wrote in Also Sprach Zarathustra, “Verily I do not want to be like the ropemakers: they drag out their threads and always walk backwards.”

I helped many untangle themselves from the grip of dead or distant childhood abusers. I learned, too, by examining my own history from an over-the-shoulder perspective. We must be careful, however, to avoid an endless backward look; especially if one already has an inward bent. Walking backwards will then be the only direction available.

Action, usually taking the form of work, is an antidote for brooding. Passive distraction such as video watching is not the answer. The mind is like a device attached to rubber band: unless engaged (or retrained by a serious meditation practice) we are subject to the pull of the elastic, snapping back to troublesome preoccupations and general discontent.

Insight comes not only from focusing on the past, but experience in the present. You will never resolve everything in your history. You can resolve enough to free yourself – enough to act. Sometimes therapy does require years. Know, however, what your goal is. Consider a move toward it at the earliest appropriate time even if the bulk of your therapeutic process is still dealing with yesterday’s wounds. Work with your therapist to fashion a path down and in as needed – yes – but also identify and step into the road up and out.

A good therapist can be your guide in both places. A more limited one may lead a fine tour of Rembrandt, the seventeenth-century Dutch painter, but ignore the glories of contemporary art.

Each one is a worthy escort, properly placed and timed.

Don’t stay in either gallery longer than you have to.

The top photo is Grand Central Station – (1957) by Brassai. Next comes Alberto Baumann’s Introspection (2003) and then Rembrandt’s Man in a Golden Helmet (1669). All are sourced from Wikiarts.org.

18 thoughts on “Should Therapy Be Forever Introspective?

  1. I’m laughing out loud. In my email, the headline read, “Should therapy be forever?”

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  2. This is exquisite.

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  3. Love this….so true! I quit therapy with my therapist’s blessing) this week after 6 years on and off….and I am excited to start living and moving forward. Your post comes at a great time! Thanks for your words of encouragement, always.

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  4. It is very difficult to know when enough work is done. I agree that exploring past trauma can be endless. I’ve been at it for 5yrs weekly and still find that I am gaining a lot of improvement. At some stage I would like to go fortnightly but not sure when. Difficult getting the timing right.

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    • Indeed, timing is hard to gauge. Most therapists, however, permit people to return if they leave too soon or if other life events cause them to return for consultation. Your continued improvement certainly reinforces the argument for staying.

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  5. “Insight comes not only from focusing on the past, but experience in the present. You will never resolve everything in your history. You can resolve enough to free yourself – enough to act.”
    ~ A gem of wisdom, Dr. Stein. I have found in my own tortuous journey that only in engaging with the present can I grow and move forward into the future. I cannot change the past. But forgiveness – of myself and others – has relieved me of many of its burdens.

    Liked by 1 person

    • Forgiveness, properly applied, takes not only the injurer, but the injured off the cross. Your journey is a testimony to respecting the importance of forward movement. Thanks, Rosaliene.

      Liked by 1 person

  6. Speaking of being introspective, would you mind answering another question about daydreaming?
    Sometimes, when people daydream and they think they are alone, they often end up engaging in strange and seemingly spasmodic hand motions. Often, at some point, one of their hands ends up brushing against the face and, in any case, they realize that they’re getting carried away and stop, often only to be doing the same thing five minutes later.
    Sometimes, when other people are around, they proceed to embark on a grand fantasy of a daydream and usually manage to stop themselves before going into the bizarre hand motions because they realize that other people are watching.
    Once in awhile, when they think, mistakenly, that no one else is around, someone walks in on them and catches them in the middle of a full-blown daydream, with arms and hands moving like pistons in an engine, to their great embarrassment.
    Are these people merely subconsciously acting out their daydreams, or are they doing something else?

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  7. Excellent article, Dr, Stein! When I started therapy while in the midst of great upset, I found my therapist on the web and called him after reading his bio because he sounded kind. I was unaware of the different models of therapy….I just needed someone to help me with something from my past that had been triggered by an event. Thankfully, my therapist practices CBT and does not dwell in my past but focuses on the present. He acknowledged the horrible event, put everything into perspective, said all the right words to ease my angst, and taught me tools to deal with what had happened. The issue that brought me into therapy has been put to rest. I see my therapist biweekly and he helps me strategize with ways to deal with all the little things in life that increases my anxiety and drives me nuts. I have no plans to end my therapy anytime soon because he calms down and launches me back into the world for another two weeks. Since I suffer greatly from two illness that are not helped by anxiety, I choose to stay with him, if he will have me. A lifetime of anxiety does affect your health….take my word for it!

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  8. Awesome article, Dr. Stein! In treatment, I often get accused of “intellectualizing”–a form of therapy interfering behavior, but there are times I want to “switch the subject” to a more here-and-now dialogue, where I’m focused on my present goals, enjoying the moment while also taking life’s challenges as they come. I don’t mind diving into how my past interferes with the present sometimes, especially when I’m dealing with past trauma issues, but there are times where I think a cigar is simply a cigar, and that the present has nothing to do with my past traumas, but rather my own passions toward a better future. I’ve spent countless years in treatment, though not all with the same therapist. I’m still waiting for that aha moment when I can finally say that I’m a recovered trauma victim, but that moment hasn’t come. I believe in salutogenesis, or meaning-making, as well as in positive psychology, grit, and resilience. I believe in defining resilience as the presence of strengths in the midst of still dealing with psychopathology related to trauma. I can live within the tension of the two, but sometimes I think that therapy is neverending, that the hope for a “cure” (or at worst a better management of my symptoms) seems nearly impossible. I’ve taken time off from therapy to attend and then graduate from school, work on research projects, and earn the accolades that came with acing all of my courses and winning awards, but the trauma symptoms remain. I don’t know how much introspection is necessary, but I do know that there’s much to my story I want to tell but haven’t yet. There’s a burning desire to tell my story and place my trust completely in the therapist, but I think that’s what’s been holding me back – a lack of trust. After I graduated from college, I took time off to get back into treatment, and it’s been a swinging pendulum between the now and the past. I’m still afraid to tell the secret, though sometimes I want to go slowly and dive into details for some odd reason. Some therapists can handle that, others can’t. It’s important for me to go into detail, but maybe it’s not important for treatment goals, so I trust the therapist. Still, there’s something that I feel is missing. It’s like some special well of tears that pool deep within me but can’t come out. It’s a special fountain of words and emotions I want to express to someone, but I have no idea why and am too afraid of feedback. It’s almost as if I want to reverse my age and speak as a child. Maybe I want approval. Maybe I crave something I’ve lost and cannot get back. Maybe I just need to grieve. I’ve never processed through the grieving stage with any therapist, and I don’t know why I’m still stuck at what I believe is “phase I” of treatment. I want to move on, but I don’t know what the therapist is or I am waiting for. Moving forward with school while taking a break from therapy is something my therapist says is avoiding the very thing I need until the next crisis. Perhaps she’s right, but I’m disabled because I tried therapy and work before, and that didn’t work. I don’t know how I’d be able to get off of disability while also being in treatment. If it’s not the insomnia and fatigue throughout the day, it’s my anxiety and panic. I’ll be doing equine therapy soon with the vets (it’s only a weekend ordeal, but I’m excited about that), and then back to this new brainspotting treatment I’ll try out again. I’ve had so many different types of treatments over the years, and I benefited from all of them in one way or another. However, I’m still not sure when I will be good enough to go back to work, and I really do want to get to that point. Introspection seemed narly at first, but now it’s more of a road block for me. I don’t know if I have done enough or if I need to do more. And my brain hurts, LOL.

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  9. A very rich story, but not for me to say what happens or should happen now. The good thing is you are getting some things out of treatment and accomplishing much out in the world. Would that all of us could say as much.

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  10. I am awfully sorry to keep bothering you this way, Dr. Stein, but one other possibility occurred to me in regards to my previous question.
    Do you think that the behavior that I have described in my previous question just might be a form of fidgeting? If the person exhibiting the behavior spends a lot of time alone, could that possibly make any difference?

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    • No problem, Joseph. I’d have to know much more about the person or persons who do this and then try to find research on the question, so it’s really out of my league.

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