Saturday, September 19, 2015

Case #156 - Interrupting the shame cycle

Tracey and Samantha were talking about some unfinished business from previous times in their relationship, a conflict they had where Tracey had reacted to Samantha, and they had an argument.
Tracey made an authentic statement about herself, and her experience with Samantha. Samantha listened, but then turned away and said nothing. It seemed a somewhat disconnected response.
Tracey pursued the topic - she was not satisfied with the response. Samantha then replied, sharing that Tracey was right about her concerns, but that Samantha couldn't really accept this part of Samantha, that Tracey was giving her feedback about.
Tracey wanted to talk more, and tell Samantha how she felt about this.
I interrupted Tracey.
Samantha was giving a clear indication that she felt shame. The inability to accept parts of ourselves comes originally from those parts not being accepted by important people in our lives, caregivers. That leads to a sense that these aspects of self are unacceptable, and are therefore put out of awareness. When they do come back into awareness, there is generally a sense of shame connected.
In that place of shame, there is little or no capacity for dialogue, for rationality or reasonableness. There is deep pain, and generally a sense of hiding. The fear is of the same rejection and exclusion occurring…and it often does, in a tragic repetitive cyclic sense.
In most relationships this occurs at some point, and it generally goes downhill from there. Neither person feels heard or met. The one in shame often doesn't recognise the shame - they just feel terrible, and shut down, react, or shame the other person back. The person raising the topic generally doesn't mean to have that effect - they may be genuinely raising an issue of concern. However, the more they raise it, the more the other person goes to shame, and down the cycle goes.
What is necessary is the recognition that shame has arisen, and for one or both people to pause, and shift gears. This is hard, but essential.
In this case, I came in as the 'hand of God' to interrupt the situation, taking care of both people in the process. I explained to Tracey that her concerns were completely valid, and that her desire for dialogue was positive, but that Samantha simply wasn't available in this place - she needed her shame addressed before anything else would shift.
I told Samantha that her sense of nonacceptance of that part of herself was a place where she needed and deserved support, and that this needed to occur before she could be available for any further dialogue.
Many relationships come up against this point, and the understanding and recognition of shame is essential to get through it. There also needs to be knowledge of what is necessary for both people - for the one in shame, things need to pause, they need to find their ground, reduce exposure, and if possible declare their fears. For the other person, they need to get that they are not going to be met in this place, and although their needs are perfectly valid, nothing will happen until the shame is addressed. So they may need to go elsewhere for support on the issue, and themselves in that place.
Couples therapy can provide support to both people, and its also possible with sufficient insight and awareness, to use this knowledge oneself in a relationship.

Monday, September 14, 2015

Case #155 - The softening expression

Betty came forward to work. My previous experience of her was that she was quite a card. Funny, dramatic; she talked about a variety of problems she felt quite hopeless about.
She started to mention a few of them.
I made a choice not to engage with her about the detail, nor to parley with her about 'the madness of it all'. I resisted the temptation to be playful with her or create a Gestalt experiment where she could exercise her drama, and where we might explore something related to that.
Instead, I was interested in something deeper with her.
But I knew that pretty well whatever I said, or whatever I did, I would elicit her standard responses. I had been around that cycle several times with her before.
In response to her 'I'm not really sure what to do with my life but its sure a problem' story, I cut through and said 'you are pretty good at avoiding'.
This remark is potentially shaming - exposing her in the very heart of her defence. So I also included myself - 'I am pretty good at avoiding as well'.
I was upfront with my agenda, and told her I would ask her a 'trick question': 'what are you avoiding Betty'. Her answer: was that she 'didn't know'.
So I tried another 'trick'. I asked her to give me a clue. What did she know about herself in the place of avoidance? Blank again.
We sat for a while, silently, looking at each other. I was looking to find a way in, to a deeper place. I knew words were of little use. Then, for a moment, an expression came over her face, her eyes softened. Then she quickly shifted back to her usual cheeky look. I said - 'tell me what just happened, something shifted, what were you feeling'. Again, she was blank.
I knew now what I was looking for, and it was that - that openess to contact, outside of her normal entertainer or 'tired of life' self.
But I could also see that we were not going to get there directly, or easily.
I said - 'fair enough, why should you trust me? I am just a therapist, you have no demonstrated reason to let go of your avoidance'. This was in order to validate her reluctance to go deeper, and her holding onto her avoidances.
So I started sharing with her about my own avoidances.
Then I stopped talking - I didn't want to have too many words get in the way. Again, we were silent, looking at each other. I was looking for the Betty underneath the avoidance, but I also became conscious of my own avoidances - my energetic ways of not being fully present. So I let her see me underneath my avoidances. She started to soften, to drop the crazy look in her eyes, and there she was, present with me, I with her. It was like dropping down a well. Down we went, silently, just present with each other, fully.
I added a few words, just to articulate my experience, to acknowledge her. But I was careful not to use too many, not to distract from the intensity of the contact, the recognition.
Betty remarked it was like I wasn't the therapist role, and this was kind of true. I let myself be vulnerable as well, and in that place we met as equals.
This is something characteristic  of the gestalt approach -- the transparency on the part of the therapist, creating the ground for the client to be able to ''drop down''. We may note a client''s ''defenses'' but we cont dont push them,  we work with them, acknowledging them, and also finding other ways to make contact, especially ones that not about probing, but about increasing the depth and vulnerability of the relationship.
words can be useful., but they can also get in the way of therapy, of really being present, which is by far more powerful as a means to therapeutic change.
Noticing the micro changes of the client is essential, as otherwise we can miss very subtle signs of important emotions which the client themselves may not be aware of, the softening expression for instance.

Tuesday, September 8, 2015

Case #154 - Don't overestimate me

A therapy session can, from a dialogical point of view, start with the therapist's experience and feelings first. When this is in the form of a relational statement, it can be an excellent beginning to a session.
So sitting with Miranda I told her that my experience with her contained two elements - warmth, and caution.
I asked her about her experience with me…she spoke of feeling uncomfortable.
As we explored that, the figure that formed was she was uncomfortable with the thought that I might misunderstand her.
I wanted to know just what that might mean, between us. As we explored this, it became clear that she was afraid that I would expect too much of her. This was related to the family she grew up in, and the expectations that were often unrealistic and created a great deal of pressure for her.
So the synopsis statement that I helped her come to was this 'don't overestimate me'.
This then made perfect sense to me - as I realised my caution was related exactly to this - I was aware that the way she presented did not always represent her actual capacities. It would be easy for me to come to believe that she had more capacity than she actually did, because of her confident manner.
So this was a statement of her vulnerability, her creative adjustment (to over-promise, and over extend herself), a core relational issue, and a very grounding request.
Gestalt can work very quickly in this way, arriving at core issues by using a combination of present centred awareness, non-directive enquiry, and relational exploration.
It also points to the importance of not over-focusing on the client's experience. The experience of the therapist is an essential ingredient in a dialogical exploration, and we don't have to 'make sense' of it, but rather just notice, and then perhaps report it.

Wednesday, September 2, 2015

Case #153 - Underneath the face mask

Belinda laughed and smiled a lot.
I told her that I enjoyed her friendly manner. And I also wondered what she was feeling.
She said she felt fear, but tended to hide it.
I asked further..
Fear of rejection was her issue.
So I invited her into an experiment, to support her in authentic expression.
I asked her to pay attention to what she felt in her face.
I asked her to do her best to relax her face.
This took her some time - she was not used to that. When she did relax her face, she started to look sad. I gave her this feedback.
She said - 'well, I don't see the point of showing my sadness - I feel it inside, but at least if I smile I don't bring other people down, or have to explain myself.'
I understood, and pointed out to her that showing her true feelings might not change how she was feeling, but it changed the impact she had on others: when I only saw her smiling face, then she only engaged the part of me that is warm and friendly in response to her laughter. She deprived me of responding to her sadness - I explained I felt a bit gypped.
This was novel to her - in her state of fear, she hadn't really thought through the relationships she was creating as a result of only presenting her sunny side. Her relationships lacked depth, there was no chance of her getting care in the place of her protecting herself from rejection, she also stopped people getting close.
The trouble was, the acceptance she was getting from people was more to do with how she presented herself, than how she truly felt.
So, having the experience of showing me her sadness, and feeling acceptance in that place, had a big impact on Belinda. She understood that by being fully who she was, she had a better chance of getting true acceptance. The risk was real - of being rejected for her sadness, as she had been historically in her family. To become more authentic in relationship required taking that risk.
In Gestalt, we support and encourage people to take risks. We ask 'whats the worst that can happen; and can you take responsibly for that'. This confronts what Fritz Perls called 'catastrophic fantasies', which people use to hold themselves back.
The Gestalt experiment provides a 'safe emergency', which sets up a situation of taking a risk, doing something new, something more authentic, in a way which is relative safe. This is an ideal learning setting, and provides people a new experience. The insight which flows from this is embodied rather than just cerebral.

© Lifeworks 2012


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