Tuesday, September 30, 2014

Case #113 - Leadership into intimacy

Jeremy was a genuinely nice guy, sensitive, considerate, thoughtful. He brought up the issue of his speediness, as compared to his wife, who was slower. On the one hand he tried to be considerate of her, telling her that it was ok if she didn't finish some things around the house. On the other hand he was frustrated at how long it took for her to do things - he wanted to take over sometimes. He was also frustrated because there didn't seem to end up being much space for doing things together, as a result of her slowness.
I asked him what he wanted more of in relationship. He said - appreciation for the kind of work he does….and then he mentioned that they had a date night that was supposed to be regular, but rarely happened.
Knowing Jeremy and his considerateness, I asked him more pointedly - so this is ultimately about you wanting more 'relational space' - by which I meant, more intimate space, to talk about personal matters. He agreed. I asked him exactly how much of this space he would like, and in what form. It was hard for him to specifically identify this, although he clearly yearned for it.
He did identify a number of things he wanted more of - the date night to occur weekly, family outings once a month, taking sufficient time to discuss any pressing issues that arose.
This was good, but I also saw that something missing. He wanted more intimacy - and while these things all contributed, he did not mention anything about having relational space at home, when there was not something organised, or pressing.
This kind of at-home relationship space is an important part of creating the ground for intimacy - time to talk interpersonally, sharing thoughts and especially feelings, raising matters that are not necessarily urgent but nevertheless important.
He immediately agreed this is something he would like.
In his mild manneredness, he found it hard to name precisely, and fully, what he wanted. So part of my support was a mutual brainstorming of this matter, contributing ideas, not only drawing them out of him. Gestalt in this ways is participative, and the Gestalt experiment can equally involve the therapist.
He stated however that he felt powerless to bring this into his relationship. It was not such a priority for his wife; she was always busy with other things, and it took her a long time to get things done, so there was not any time left for this type of intimate contact.
I told Jeremy that I had an agenda, and I would speak to him from that place - this involves being explicit and fully owning my own ideas, and ability to influence. This can be a part of therapy - arising from the power differential - whereby a client will be influenced by our opinions, and - as with most people - we like to give our opinion.
The phenomenological process steers away from such advice giving, or providing directions, working instead with the client's experience, and the 'what is'. This existential approach is  not about exerting influence, but 'being with' someone.
However, in a Gestalt mode, there is space for 'showing up' with my perspectives, as long as I am careful not to push them on the client, and pause to check what is right for them.
So I told Jeremy that I wanted to influence him towards a kind of leadership as a man, in relationship, that was not about a traditional 'male boss' or 'selfish male' domination. Instead it is about leading the relationship towards intimacy, in consultation with your partner, but not waiting for her to do so; rather getting in the drivers seat, and using ones power, influence, organisational ability and focus as a man, to achieve this end.
I checked in with him, and he was happy to receive this 'push' that I gave him. In fact it gave him some energy and direction, so was supportive. The main caution is to ensure that the client doesnt swallow such directions, and that if they have any blocks to manifesting such 'good ideas', then we work in a detailed and specific manner with those impediments.

Saturday, September 27, 2014

Case #112 - The devil says: let go

Serena brought the issue of her jaw. Several years previously she had an infection in it. She had it treated, and there was an 80% improvement. But it hadn't got better than that. It annoyed her - her jaw clicked, it didn't feel quite right, there was some uncomfortable feeling in the nerves. She wanted to see if it could get completely better
I asked about her family context. Given this is a somatic issue, family issues tend to be embedded in the body and consequent problems tend to play out family issues.
Her mother was a strict task master. As she relayed this, her eyes were full of tears, and stayed this way, as we talked about different subjects.
She always came top of the class, from a young age. She pressured herself to get things perfect, and was very distressed if she didn't.
This theme continued with her study - taking on an extremely difficult course, and getting through it by sheer grit determination; then her job - having a boss who expected nothing less than perfection, and managing to find a way to work with him over the years.
She said it was like she woke up one morning and the 'devil had got into my jaw…': she just wanted to 'wake up, and it would be gone'.
This gave us the key, so I asked her to describe how the devil had got in? She said through the back of the head. I asked what the devil  looked like - she said it was a black bat, with big teeth.
I suggested we ask the devil to come out in front of her for now so she could talk to it.
The 'devil' said that he liked playful and rigid people, and that he liked her.
This was interesting, showing that the devil was not actually so hostile, and in fact was there very much because of her core issues - her perfectionism.
She asked the devil - 'why are you here?'
He replied, 'to help you let go'.
This was a major revelation. The Devil was actually playing an important role. The jaw situation was in fact a pointed lesson to learn to let go, clearly related to her perfectionism.
I asked about letting go. She said since the jaw situation she had let go of some things she had previously hung onto - trying to get a promotion, buying a bigger house.
I pointed out that letting go is related in some ways to death, mortality, the end of things. This set up a discussion that could occur another time about letting go as a profound process, raising existential issues.
I asked about what she did for relaxation: not much - she worked very long hours. She did some yoga, hung out with friends, went shopping.
The yoga represented some kind of relaxation activity, but clearly more was needed
I asked what else might she need to let go of.
She drew a blank.
I asked her - 'can you let go when having sex with your husband?' She replied - 'no'
This was also a key statement. It was not just about the sex, but the fact that sex is very much about a cycle of the build up of charge, and release.
She said the held back, as she didn't want to get pregnant.
This gave further information about her holding on, versus letting go. Whilst she was not considering children at this stage, the juxtaposition of this kind of holding on - on a deep organic body level - with the holding on that was clearly at the core of the jaw issue, were importantly related in my view.
Sexuality is a template for much else about our experience - our core organismic functioning. It represents our encounter with primeval forces of life, death, pulsation.
So sexuality can be a potential key  for a profound somatic letting-go that clearly needs to occur for Serena. Her perfectionism is deeply embedded in her body - hence the 'devil' coming to change her course. So part of the answer is a cognitive shift - in attitude, and in terms of a symbolic letting go; but more fundamentally it has to be rooted in a body experience of letting go.

Monday, September 22, 2014

Case #111 - Fear of fighting

Lucy was coughing. It wasn't a normal cough. It sounded like a mix between choking and a dry cough of something that couldn't come up. She was also breathing quite heavily. She was in distress, and whatever it was that was happening to her, wasn't moving. She said that she couldn't stand listening to any sounds at that moment.
From previous work with her, the link was very clear: her parents quarrelled almost incessantly, sometimes to the point of violence. But the traumatic effect of this was the result of the fact she only saw them once every year or even two years when she was growing up. She grew up with her grandfather, who preferred her brother. Her aunts likewise preferred her brother. So she felt isolated, unsupported, and unloved at home.
She desperately needed and wanted love from her parents, but instead, she felt embarrassed when they came, because the neighbours could also hear them quarrelling.
As she spoke about this, she was dry coughing, and pinching her throat, which she said was very itchy. The energy was blocked there - in Gestalt we say the energy was retroflected - directed towards herself, rather than outward. So I gave her a cloth and asked her to twist and choke it. This redirected the energy, away from herself, outwards; she started screaming, and sobbing, imploring her parents to stop quarrelling.
I asked a man and a woman to represent her parents, and put them a little distance from her, facing each other.
Just seeing this picture was very provocative for her - she sobbed, screamed and begged them not to quarrel.
Lucy was in the midst of her trauma. This was spontaneously arising, and good in the sense that it gave access to an core piece of unfinished business. However, there was so much trauma that the energy kept blocking (in the form of the coughing), and I had to keep directing her to twist the cloth, which resulted in her screaming some more.
Whilst there is value in the release - better than it being pent up, directed to self, or ignored - there is also limited value in simply staying in the trauma. And it seemed there was no end for Lucy - after some time had passed, she was just as distressed
So I kept bringing her into the present, focusing on my face, the room, breathing deeply and more slowly. This is called 'pendulation' and is a way to work with trauma - moving back and forth from the distress to the present. She would only stay present only for so long, before becoming distressed again.
In some of her distress she said 'I don't know whats the point of living, I just don't suicide because that would hurt others'.
So I asked her to make a 'mission' for herself. We constructed 3 elements - using her experience to help children she worked with; learning from her experience to ensure that when she got married, she did not repeat that; and making sure that when she had kids herself, she did something differently with them.
This created some ground, as otherwise she did not have much solidity, just a sense of trauma.
The experiment I set up was this - the two people who were representing the 'couple' would have a small quarrel. But it would be a 'healthy' quarrel rather than a destructive one.
Lucy was very scared - even suggesting that there would be a conflict was distressing to her. And the prospect it might get out of hand was very restimulating. So I asked her to set some ground rules for the quarrel, which she did. This put her in a power position, and gave her the ability to control the situation in a way she couldn't as a child.
As they started, she needed lots of support from me, by her side, to witness this, and not sink into her trauma again. She did start to scream a few times at the start - she had a lot of terror. But I reminded her that this was part of achieving her mission, and that she needed to be present for it, to learn from it.
So she watched the 'quarrel', including a successful resolution. This was the first time in her life she had seen something like this, so it was a powerful experience. She had needed the space to release her energy, but she had also needed the ability to remain calm, to receive direction, and to have a new experience.
I gave her some homework to watch conflict resolution videos, witnessing people arguing, and then seeing those disputes resolved in a skilful way.

Tuesday, September 9, 2014

Case #110 - Hidden aggression

Macy smiled a lot. She seemed a very genuinely warm and friendly person, hard to dislike on first appearance. She seemed to be there for others, and clearly liked to be helpful.
However, in the group, she kept getting into conflicts. She seemed argumentative, and quick to jump to conclusions. Despite her apparent warmth, she would say things that stirred antagonism, and that contained lots of assumptions and reactions on her part.
In one of these conflicts I came in to support her. I guided her to link an observation statement of her with a feeling statement - she tended to jump from observation to interpretation, without really including herslef. Or sometimes, just directly to interpretation - e.g., 'you are rejecting me'. So I directed her to start with an immediate experience, and to name her emotional response.
This proved very hard for her. She found difficulty identifying the feeling, and seemed reluctant to share it, preferring to move to her imagination about what was happening. She was also reluctant to 'check out' her imagination, asserting it as some kind of reality e.g. 'why are you rejecting me'.
In slowing her down, linking statements with feelings (rather than questions), she started to get more in touch with what was happening for her. Reluctantly, she found she was angry; before this, she had been seeing other people as the problem. The strict form of the 'clean communication' I demanded, confronted her with her own darker feelings, which she could no longer put onto others.
I pointed out that she had some embedded shoulds; even though I guided her to express her wants as requests, she was hanging onto underlying prescriptions for how others should behave, and this was fuelling her anger.
The discipline I guided her into - which included limiting her statements to expressions of her experience rather than justifications or explanations - drew her beneath her sunny demeanour and brought up a lot of sadness. It also highlighted her limits - she wasn't able to listen to any more responses from the other person. Again, this dipped beneath the apparent 'conversation', to show that she needed a lot more attention to herself in this place.
When people are confronted - in this case very caringly by me - regarding their controlling behaviour, their 'racket' is up - they can no longer use their focus on others to avoid their own difficult feelings.
In this case the difficult feelings were those of aggression. Many people find it difficult to recognise, feel and acknowledge their aggression. There is a lot of social conditioning people receive about not being aggressive, or not expressing it. This is especially true for women. The kind of support we can give in therapy for this is to create an atmosphere of permission to feel all sorts of feelings, and then a guided way to express them. Especially important is the owning of feelings, and the clear articulation of them in a way which describes one's own experience, rather than an interpretation of the other. This is one of the things that therapists can do, offer help and guidance for people in this place.

Friday, September 5, 2014

Case #109 - Removing the burden

Sally had reported a number of symptoms - a feeling of chaos, some pain in her upper back, and the experience of blushing, which she connected to fear of a lack of acceptance.
I asked her about these various phenomena. She was looking at me intensely. Generally that indicates the client wants something from me. I asked her about this, but she didn't know.
As I was talking with her, I had a sense that there was a parallel conversation going on - our words, which didn't really seem to connect much, and the emotional tone, which seemed intense to me, but unclear.
She reported feeling foggy.
I also told her I felt foggy.
She had nothing in her thoughts.
But there was a lot of feeling expressed in her eyes, though I could not tell what it was,
I simply acknowledged what I saw, and my own experience. This is called phenomenological reporting.
Her back felt hotter.
So I put my hands on the place it was hot. She reported it was very tight and I could feel this. I didn't massage, but just felt into the tension with my hands, so I could get a direct sense of exactly what she was talking about. Again, I want to enter into her phenomenology as much as possible.
I said, 'it seems as if you are being attacked from behind'.
She talked about her father smacking her as a girl, quite a lot. It was 'normal' smacking, but what was disturbing was she never quite knew when it was coming, so it was a shock.
I then applied some pressure on the spot on her back - just direct steady pressure - this is known as 'taking over' in Hakomi therapy - parallel to the kind of intensifying of experience which we do in Gestalt; the result was she was able to relax a bit.
There was still a lot of emotion in her eyes, very intense.
Then she reported that both parents made her wrong - consistently putting her down, calling her 'stupid'.
This was clearly the key.
So I used my therapeutic authority, and the connection we had built up, to 'remove' those burdens from her shoulders, and tell her I was 'taking away' the bad words - stupid etc, and replacing them with good words.
While we generally are oriented around responsibility in Gestalt, when it comes to shame issues (indicated by the blushing, the lack of self acceptance, and the being made wrong), a person may experience themselves as somewhat powerless. So they may need help from the outside - therapist, or group, in order to experience enough support to move out of the place they are stuck.
This was the support I provided, and she was able to take it in. Support comes in many forms; the issue is finding just the right kind of support the client needs, in the right degree, and delivering it at the right time. This requires setting aside our 'helping' agenda, and being closely tuned into the client's needs. It also involves being willing to be present, and notice what occurs for me, as that also helps guide my choices.

© Lifeworks 2012


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