Monday, January 5, 2015

Case #126 - Moving into the time bomb

I spent some time trying to find what the issue was for Iona.
She said she was not in touch with her feelings. Friends said variously she was warm, or angry, or other descriptions, but she could not really identify with any of them.
I found this a little odd, as I experienced her as full of liveliness, energy and passion. She was animated when she spoke, she was interesting, and appeared engaged.
Of course, many people are out of touch with their feelings, but there was still something more I needed to understand. Then she told me she felt unhappy, a lot of the time. Again... there seemed to be something else going on, more than appeared on the surface.
I asked how long she had been unhappy - she said since her pregnancy, 9 years ago. She had conflicts with her mother in law, and her husband, and these had not really abated.
Certainly, external factors can contribute to someone's unhappiness. But this sounded more deep set. The fact that it came on during pregnancy, and lasted afterwards made me consider depression. She did not appear depressed. But she I enquired into a range of symptoms that tend to go with depression - lack of pleasure in life, lack of motivation, trouble with sleep - she said yes to all of it - it all added up.
Whilst diagnosis can be restrictive and limiting, it can also be helpful to name ongoing patterns, such as depression which indicate something more than passing unhappiness, and which require serious attention.
I explained this to her, and also pointed out that this was something that required ongoing support, and would only shift over time. Its important to give people realistic expectations of what therapy can achieve.
She said she worked hard to mange her very busy life - child, family, work. She felt exhausted most of the time.
It became clear to me that this was what could be called 'high functioning depression' - she is coping with her life, thus masking what she is feeling inside.
Her effort was to not sink into the blackness of her unhappiness. Yet, therapeutically, this is what needed to happen, in a supported way. Without going into the depression itself, she would continue in avoidance mode, and therefore be unable to access the feelings which were stuck.
So I invited her to notice her clothes. Her pants were black, and her top had some bright colour in it. I suggested this as a metaphor for her life - bright slashes of colour, but black and unhappy underneath. She agreed.
So I asked her to look at her pants, and for 2 minutes I would sit with her as she sunk into her blackness. She agreed.
This was important, to go into the depression, but do so with company and support.
Tears came to her eyes, which was good, as her feelings were starting to flow, and she was able to share them with me. But she reported feeling stuck in the throat.
So I asked her to lie down. I held her head with my hands, off of the ground, asking her to let me take the weight. This was a way to support her to feel her 'heaviness' and at the same time, feel held. As I slowly moved her head, it was very stiff. I was careful not to push, but just wait every time there was resistance.
I asked someone else to hold her feet, and pull gently, creating some more space in her body for the feelings.
I then sat besides her. Her feelings did start to come up, in waves, with little sobs. I invited her to let some voice be there, but that was as much as she could manage at that point. After some time, she reported her arm feeling numb.
This was an indication she had done enough.
Its important where someone's feelings have not been accessed, to go slowly, and allow time and space for integration. She had take a big step, and it was enough for now.
She reported feeling worried that she was a 'bomb, going to explode'. I pointed out that if she kept repressing her feelings, this could be true. But with opening up, and getting support, she could allow the 'bomb' of her feelings to release in a safer way.
Its important with major issues such as depression to not got too far, too fast. While Gestalt therapy processes and techniques can quickly take a person into 'their stuff', its essential to move at a pace they can integrate. This indicates long term work - at least 6 months of therapy, if not a year. While this may seem a significant amount to some, the alternative is the 'time bomb', impacts on health and/or functioning, or medication which brings its own problems.

No comments:

Post a Comment

© Lifeworks 2012


Who is this blog for?

These case examples are for therapists, students and those working in the helping professions. The purpose is to show how the Gestalt approach works in practice, linking theory with clinical challenges.

Because this is aimed at a professional audience, the blog is available by subscription. Please enter your email address to receive free blog updates every time a new entry is added.

Gestalt therapy sessions

For personal therapy with me:

Enter your email address:

Delivered by FeedBurner

© Lifeworks 2012




Informed Consent & Rates


Gestalt Therapy Defined





Book:Advice for Men about Women


• English






Greek ελληνικά

Hindi हिंदी








Russian Русский

Serbian српски

Chinese 中文

Japanese 日本語

Arabic العربية

English Bahasa České Deutsch Español Filipino Français ελληνικά हिंदी Magyar Melayu Italiano 한국의 Polski Português Română Русский српски 中文 日本語 العربية

If you are interested in following my travels/adventures in the course of my teaching work around the world, feel free to follow my Facebook Page!


This Gestalt therapy blog is translated into multiple languages. You are welcome to subscribe


Interested in Gestalt Therapy training?

Contact Us


Career Decision Coaching


and here


Gestalt training and much more

For Men

Here is a dedicated site for my book Understanding the Woman in Your Life

The Unvirtues

A site dedicated to this novel approach to the dynamics of self interest in relationship

Learn Gestalt

A site with Gestalt training professional development videos, available for CE points

We help people live more authentically

Want more? See the Archives column here

Gestalt therapy demonstration sessions

Touching pain and anger: (40m)

Permission to feel: (54m)

Marriage after 50: (1h 17m)

Serafina - Angel wings: (45m)

Barb Wire Tattoo: (37m)

A natural empath; vibrating with joy: (39m)

Dealing with a metal spider: (51m)

Interactive group: (1h 57m)