self-analysis

April 9, 2017

What Does Your Therapist Dream About?

Therapists tell you little about themselves, especially their dreams. Why would they? The woolly, wild world of the unconscious might suggest the counselor is a rapist, murderer, or thief.

Looking at him through the lens of the dream makes the treatment about the practitioner, not about the patient. It cripples the client’s ability to project his own long-standing issues onto this person: react to the counselor as if he were a father or mother identical to the real dad or mom.

A crucial part of classical psychodynamic treatment relies on the client playing-out his long-standing relationship problems and historically driven expectations of trauma or rejection within the session. The patient is unaware, at first, of the “mistaken identity” going on, where his reactions are more about his own past than the practitioner. If the therapist reveals too much about himself, he risks becoming the man of his chaotic dreams to the patient, not a benign, but blank canvas upon which his client throws the paint of his own internal life.

Dream interpretation is an art, not a science. Its value is difficult to demonstrate, though some therapists swear by it. Too many possible interpretations, no way to validate them. Yet they can be helpful. Certainly they may enlighten. Regardless, dreams are hard for the patient to resist discussing. An open therapist needs to take in all the uncensored data provided, the better to serve him.

Though I claim no specialty in dream interpretation, what I offer here is a partial explanation to those who wonder about the kinds of dreams therapists have.

The simple answer is, I doubt they are much different from those of people of similar upbringing, temperament, and overall life experience. I might add two exceptions:

  • Certain kinds of dreams are recognized as symptoms within the diagnostic framework developed by the American Psychiatric Association. For example, one possible symptom of Post Traumatic Stress Disorder is: “Recurrent distressing dreams in which the content and/or affect (emotion) of the dream are related to the traumatic event(s).”
  • Conventional wisdom tells us that high achievers have recurring dreams dealing with things like being late or unready for tests. Since people with advanced degrees prepared well for examinations (and took so many of them), the unconscious disquiet of discovering you are not ready or present for a test, a crucial appointment, or a presentation requires no leap of insight. Many of us were either driven to succeed, afraid of failure, or both.

Ah, but this discussion is rather impersonal, so I will offer an actual dream of one person I know well and present you with two interpretations. Moreover, I invite you to take the interpreter’s role yourself: be the therapist.

Whose dream shall I speak of?

My own.

Get ready. Prepare yourself for the unexpected nature of the story. The partially unclothed aspect, too.

I was sitting in the smallest room of my old office suite. Yes, the washroom. Some vulnerability here, don’t you think?

The door to the W/C led to the waiting room, the lobby of the office suite. I shared the workplace with other therapists. Unexpectedly, one of those counselors opens the door to the washroom. A man. He walks through a side entrance I hadn’t noticed and was never there before. I pushed him out and spoke with him soon after.

The extra door was installed without my knowledge, he informed me. Even though all the other counselors rented the space from me, they somehow did this unilaterally, without discussion with me, and with no warning.

Several of them were in a meeting which I joined. I talked to them. I spoke of the danger to our patients, our duty to protect, and our professional liability. Since our clients all used this facility, I stated this unlockable entrance would constitute malpractice. The head of the group argued back, though I can’t recall the details of her rejoinder. The assembly of counselors was mostly docile and unpersuaded by my logic. In the end I went off, saw my next patient, and did my job.

What should be made of this, if anything? Well, I can recall failed attempts at rational persuasion dating back to my childhood. Mom ran the roost, like the female leader of the other therapists. My mother was a tough cookie and dad worshipped her. No amount of logic or effort were enough to effect changes in the family dynamic. Should I leave the interpretation at that or try another tack?

Let’s visit recent events as possible triggers of the sleepytime return to my professional practice. I read two disturbing books in the days before the dream. As Dr. Michael Breus notes, some believe dreams are “a means by which the mind works through difficult, complicated, unsettling thoughts, emotions, and experiences, to achieve psychological and emotional balance.”

The Souls of Black Folk by W.E.B. Du Bois and The Revolt of the Masses by José Ortega y Gasset both carry profound messages about the dark side of humanity. The first deals with American slavery, the second with the growth of a naïve, destructive, anti-intellectual “mass man” who may destroy the pillars of Western civilization. Du Bois led me to watch Slavery by Another Name, a superb, but equally unsettling documentary on the color-line that existed in the South even after the emancipation of blacks. Their forced-labor and imprisonment by legal and extra-legal means was new to me.

I was powerfully affected, but not, I thought, to the point of emotional distress. Still, these books and the movie offered a larger vista on what happens when reason fails and men know only rights and not duties to something virtuous and greater than themselves.

One more feature of my dream was a lack of control. Being interrupted in the washroom by a stranger is profoundly threatening. One is literally caught “with his pants down,” though I felt more surprised and angry in the dream than in danger.

The books also might have amplified my personal concerns about the current state of Western democracy: another possible precipitant of the strange story. If this is so, then perhaps I should alter my life: dip a toe into the ocean of earthly woe, not bathe in it. Rather ironic, in light of what I did during my career, which on some days was a daily if not hourly immersion.

Other interpretations are possible, of course, but I hope you get the idea.

Your own analysis might tell you about both yourself and me. Do remember, that the therapist must remove himself from his issues when doing therapy, including his investigation of dreams. Freud was a notable exception who performed a self-analysis.

So, you now get to be the psychologist. Complicated, isn’t it? Give it your best shot.

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The first image is called Think Different by Neotex555. It includes within it a statue plus a portion of Kandinsky’s Fugue, the entirety of which makes up the painting that follows. Finally comes Sean Foster’s Cloud Frenzy. All are sourced from Wikimedia Commons. For more about the function of dreams, you might want to visit a very fine post by Dr. Michael Breus.

August 20, 2016

Treating Insecurity and Anxiety: Eight Roads to a Solution

512px-Anxiety_cloudImagine you are considering therapy for the first time. Or perhaps your treatment isn’t working. You stand at a crossroads, like the hub of a wheel where eight spokes beckon for attention. How should you choose among them?

Not all are good and you may even realize that as you decide. Here is a guide to thinking about what to do (and what not to do) with the weighty package of insecurities velcroed to your life. Click the link for a comprehensive list of the signs of insecurity.

ALCOHOL AND DRUGS. The issue of substance dependency should not be ignored. Recall the old Chinese proverb, “First the man takes the drink, then the drink takes the man.” Alcohol’s comforting relief and buoyancy is commonly replaced by longer term emotional darkness. Marijuana (cannabis) might mellow the smoker out but leaves underlying insecurity and anxiety untouched when sober. If you are attempting psychotherapy, best to tell the counselor the extent of your substance use straight away. The deepest wounds are slippery things. Grasping them is harder (if not impossible) when alcohol or drugs add to the excess lubrication.

WILLPOWER AND SELF-ANALYSIS. The old saying tells us, “When the going gets tough, the tough get going.” Yes, some few people manage their own psychotherapeutic project. Indeed, Freud analyzed himself. What is required? Although I know of no research on this, I suspect one needs a strong capacity for self-reflection, high intelligence, some degree of emotional openness, the courage to look in the mirror, tenacity, and knowledge gained through reading about treatment. Willpower is necessary because the self-analyst must inevitably get out of his head and leap the wall of fear to master behaviors blocked by insecurity: good eye contact, self-assertion, saying no, asking for things, making uncomfortable phone calls, inviting someone on a date, public speaking, etc.

THE SEARCH FOR A STRONGMAN. Some rely on a mate to perform avoided tasks. The significant other becomes a caretaker or body-guard, an individual who is sought to do the jobs the hesitant one believes he cannot: return a product to a store, accompany him to events otherwise avoided, and so forth. This is no solution to anxiety or insecurity, but a human crutch to sidestep the need to change. Another danger: too often the protector becomes an overlord, pushing you around or worse; the mister turned monster you hoped he would protect you against.

PSYCHOTROPIC MEDICATION. Medications, like other drugs, carry possible side-effects. Antidepressants can impair sexual performance, anti-anxiety tablets often have addictive properties. While a good psychiatrist will carefully watch for these, pharmaceuticals do not create a sense of security and confidence beyond the time you use them. Moreover, to the extent that the psychotropics help you feel better, your motivation to tackle underlying reasons for your symptoms may be reduced. That said, sometimes susceptibility to anxiety and depression is inherited and biologically-based, making the booster of drugs a necessary and permanent mode of treatment.

Girl_suffering_from_anxiety

AVOIDANCE AND THE INTERNET. Anticipation of discomfort, humiliation, or failure translates to turning down invitations — limiting chances for growth, accomplishment, and joy. The troubled soul is assaulted by hatchet-bearing ideas that have become permanent, non-rent-paying residents in the head. The data set of the insecure is based on an unfortunate history. The job of recovery translates to writing over your old history by gradually taking on social challenges and accumulating successes reinforcing your effort.

Beware the false god of the internet! The more time you worship at its alter and “let your fingers do the walking” on the keyboard, the less you have for direct human contact (involving actual walking out of the apartment). For all its marvels, this deux ex machina can become a screen behind which to hide the human face, trading yours for a virtual one. Yes, social media can be a stepping stone to a life beyond the keypad. For many, however, it’s another form of concealment and self-distraction. You can identify too fervent online social network disciples by the pain they will suffer for their god: a malady called text neck, the product of bending over their smartphone.

PSYCHODYNAMIC PSYCHOTHERAPY. Psychodynamic treatment, the traditional talking cure, can be a foundational part of counseling. It helps one clear the life-history undergrowth undermining a healthy self-image, planting  seeds of sturdiness to deflect the inevitable defeats we all encounter. Such counseling also lifts the weight of self-blame by recognizing the fingerprints of others on one’s problematic background story. It cannot stop there, of course. Grief and grieving demand attention.

Beyond relieving submerged pain, one must eventually take psychoanalytic insight for a test-drive: try new behaviors just as one would a new car before purchase. However much a “depth psychology” approach is needed, empirically based (research supported) interventions provide the practical impetus for emotional availability, symptom reduction, and behavioral change.

COGNITIVE-BEHAVIORAL THERAPY (CBT). Many of the well-researched and effective treatments just referred to fall into the category of CBT. Obsessive-Compulsive Disorder (OCD), for example, is among those problems amenable to this set of tools. Indeed, attempting a solution for OCD psychodynamically is, in contrast, a therapeutic cul-de-sac. CBT can often, however, be combined with more traditional talking therapy to join the best of both worlds.

ACT (ACCEPTANCE AND COMMITMENT THERAPY). ACT is described in the following way on its website: “Developed within a coherent theoretical and philosophical framework, Acceptance and Commitment Therapy (ACT) is a unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility. Psychological flexibility means contacting the present moment fully as a conscious human being, and based on what the situation affords, changing or persisting in behavior in the service of chosen values.”

Plowing through this technical language, ACT deals with the losses most patients have sustained, traveling from a grieving process toward acceptance of those life circumstances that can’t be changed, reduced avoidance, learning to live in the moment via meditation, deciding what is most important to you, and choosing behavior consistent with your stated values.

WE ALL TAKE TURNS at life’s crossroads. Sometimes the best advice is to make no movement, patiently waiting for the traffic to clear. Do remember, however, not choosing is also a choice. The clock is always ticking, even if, in the digital age, we must strain to hear it.

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The top image by John Hain is called Anxiety Cloud sourced from Wikipedia Commons. The photo beneath it is Girl Suffering from Anxiety by Bablekahn at Kurdish Wikipedia.