Case#45 - How to deal with misery

Betty wanted to talk about her fear. She couldn't identify what it was about, or what it was connected to.

But before I acquiesced to her focus, I wanted to know more about her. I asked about children, marriage, work. She had recently resigned from a job she had held for 20 years, and was in a transition period. Her family life was settled and secure, her daughter beautiful and talented, and her husband loved her.

But as I looked at her, she didn't really look happy. I asked her if she was happy, and she said, no. Everyone thought she had the perfect life, the perfect family. I asked what was wrong.

She said - my husband loves me more than I love him. I am secure with him, but it was an arranged marriage and he is ‘not my type’. I asked what her type was: a strong character, a clear personal sense of vision in life, and good taste. He was none of those.

This impacted me, and I took some time to take this in. The great life, but something essential is missing. I  looked again into her eyes, and could see how miserable she was. I asked her how old she was - 44 . I asked if she would spend the next 44 years with him, she replied, yes.

So that was clear, her choice was to be there. But the cost of that was some kind of basic dysjuncture in her sense of connection in relationship. Some kind of basic need for passion, meeting, and synergy wasn't there. She had settled for a superficially happy life, but somewhere it didn't meet a more profound need.

In Gestalt, we are interested in choice, and this is understood in terms of existential notions. Life throws us into different situations, but we always have choices. Our sense of imprisonment comes not through external circumstances, but by forgetting our moment by moment choicefulness. 

With choice also comes consequences, and a life well lived is one where we take responsibility for the consequences, rather than try to blame others, or spend our lives wishing we were somewhere else.

This was very much what Betty faced. Her choices were clear, and so were the consequences. But she was miserable, so unless she wanted to remain this way, something had to change. 

What was available were different choices within the structure she decided she would stay with.

I spend quite some time of just being with her, seeing her misery, acknowledging thats how it was. This is the relational space, where nothing has to change, there are no agendas, and the focus is on being, being with, and recognition. This is also known as the I-Thou. 

After this, I moved to the ‘whats possible’ question. To go there at the start would simply mean some kind of ‘solution’ to a situation which in a sense didn't have a solution. But after being present for a while in that being space, we could then explore together other choices and perspectives.

I asked if he knew her misery, if she showed it to him like she did me. She said no. So I shared an incidence from my own life, where my partner revealing her misery about something had a huge impact on me. Because he loved her, this could be the start of some kind of change.

I pointed out that he would never be her ‘type’, but that if he was motivated, he could take a few steps in that direction. The ball was firstly in her court to be able to communicate to him her authentic self and needs. The challenge was to do so in a way which would produce positive results.

I suggested she ask him to look into her eyes for 10 minutes, without conversation, and show him her misery. After that, she could communicate to him some small changes that she would like him to start with, that would be meaningful for her.

But this was not necessarily the solution to her unhappiness. The fact was, she was in a situation where her needs were not getting met. So I suggested to her that she actively explore both her creativity, and some kind of spiritual practice. These could help her find a core of happiness which was not dependant on her external environment. 

To suggest such things as some kind of rote solution is not what Gestalt supports. But in the context of a deep sense of contact with personal stuckness, such possibilities become personally meaningful, and there is a profound motivation to move in that direction. If there is an interest, the person can be helped by practical support - a conversation about how it might happen, and the range of options.

Case #44 - The cocoon, and rebirth

Nicole was clearly distressed. She talked about a dream she had, relating the image of a cocoon that she was afraid to break out of, not knowing if she would be transformed, or just die.

I picked the cocoon image. I suggested an experiment on this basis - sometimes its not necessary to get all the content detail, but just to leap off from a clear and strong metaphor that the client gives. In this case, clearly a transformative metaphor, directly relevant to therapy, and one which contained both the desire for change, and the fear of change. The Gestalt Experiment is also termed the ‘safe emergency’, so this is a balance we always strive for - helping the client move forward with their desire for aliveness, and at the same time, finding a way to make it safe enough to take the risk of trying out the new.

So I invited a half dozen people from the group to gather around her as the cocoon. Straight away, she started crying more intensely, and then sank to the ground. I indicated for everyone to sit around her. I told her not to withdraw into herself, but maintain eye contact. Otherwise someone can just regress, pull into their own world, and out of relationship. In that case, the emotion simply continues to circulate in a way which doesn't actually move it.

As she did that, she looked at one of the women and said ‘I don’t like you’. This however was clearly not about the woman - she was reminded of her mother. So I asked her to speak to her directly, to say whatever she would like to say to her.

‘Why did you abandon me’ she asked. In Gestalt we consider why questions as unhelpful, and ask people to change them into statements instead.

Out of this came her statements - her pain about being abandoned as a child by her mother. Again, I did not need to know any of the story or details to work with it. She was in process, and that was sufficient. 

I had to support her to stay present, to maintain eye contact, to breathe fully. Much emotion arose, for her, as well as for the ‘mother’ representative. 

The support of the circle was important, to give her a feeling of being held in a place where she is normally internally collapsed.

Finally, she was very tired, and just wanted to lie down.

So I got her to lay down on her mother-representative’s lap, and allow herself to fall asleep. 

When she woke 10 minutes later, she felt reborn, and with a sense of warmth and connection in her heart, where previously there had been emptiness and pain.

Case #43 - The Toxic Voice of Mother

Theresa had left a secure job to start her own company. ‘For the challenge’ was the reason she gave.

But she experienced strong anxiety much of the time - except when she knew that something was going to fail. As she approached success, she felt anxious right until the moment when the success was completely secured. The anxiety was also reflected in her personal life.

She didnt understand where it came from, or what she could do about it.

It appeared to me something to do with control - needing to be in control, for things to be a certain way. I asked about her field context. We managed to establish that her mother was very much into control. 

As we were talking about this, she got a headache. It became clear to me that her mother was ‘in her head’. So I invited her to put her mother on the cushion, and talk to her. This is the classical Gestalt experiment - to take intrapsychic dialogues and make them explicit.

I asked her to say something to her mother, then physically swap - sit in the ‘mother’ place, and give reply.

I was rather shocked at the things that her mother was saying. Very shaming, and even worse - for instance putting Theresa down for being ‘ugly’, unlike her beautiful sister; telling her she was a bad person; telling her that she (mother) didnt really want to have children, it was just a duty, and anyway, she would have liked a boy.

This is not just normal poor mothering. It deserves the title ‘toxic mothering’. This is not something that is amenable to dialogue.

I suggested that the mother stop talking to Theresa, and I would ‘interview’ her, to try to understand more about her. 

I did so….and the mother gave various interesting answers, confirming the above ‘diagnosis’. She considered Theresa to be a burden, and was only interested in how her children made her look good. Theresa was a financial success now, so that made her look good, so she was not so annoyed with her anymore.

Now..you might say, this is just all Theresa’s projection. But the statements the mother made to Theresa in this dialogue were actual words she had used to her.

The point is not to pathologise the mother - she obviously had her own struggles. But clearly such devaluing of ones own child is going to be toxic...and produce the lack of confidence which resulted in her anxiety.

So I invited her to speak to her mother, this time putting up very clear boundaries. She started out asking ‘please do not…’. I interrupted her...as this still depended on her mother doing something, which appeared unlikely.

I asked her to rephrase it in a way which came from her.. ‘I will not accept….’. This provided a clear boundary - something that is an important focus in Gestalt.

Making several of these statements was very powerful. She needed help formulating them. Afterwards, she felt more settled, and clearer in terms of what she needed to do to stop allowing the mother voice in her head to undermine her confidence.

This involved use of a classic Gestalt experiment, bringing a stuck internal dialogue into the open, and then providing the support necessary for movement in that place.

Case #42 - Safe and Unsafe

Yasmin had recently divorced. She talked about wanting to mature and separate out more from her parents. She had a lot of emotion in her eyes, which I observed and remarked on, along with various other things about her - a colourful shawls, beads around her neck. 

She said - ‘I feel safe with you’. I responded - ‘in some ways, thats a projection, because I am just me - safe in many ways, and at some point, I am likely to miss you and therefore not be so safe’. She found this hard to hear, and it reminded her of difficulties with her father, and her needing to clarify boundaries with him when she felt confused and foggy.

She said she appreciated being seen by me..and it was something that she needed. She talked about her difficulty of being seen as a separate individual by her parents, and her historical difficulties with them in terms of being loved only conditionally, as a good girl.

As I sat with her, I acknowledged the ways in which I could see her child self, with her needs for approval, acceptance, and care; and at the same time, her adult self, wanting and needing differentiation, being her own person, find her own ground getting clear on her boundaries.

This was profoundly moving for her, to be seen in both those places, and for those to be held at the same time. This was one of those I-thou moments. I talked about how, in this place where I felt spacious and grounded and present, I could indeed create the conditions of safety for her to be able to be both held/supported/attended to, and also released - encouraged to move into her own life, so we could meet as two equals.

This resonated at many levels with her. I spoke to her as an adult, recognising both the boundary between us, and the connectedness as two seekers. I then invited her to speak from the child place, to name what she wanted from me.

She said that what she longed for from her father was acknowledgment that she was important to him. I said I was happy to shift into ‘father’ mode - I had grown daughters of my own...and could speak from that place to her. So I spoke ‘as’ her father, telling her how precious she was to me.

She then asked to hear that she was loved no matter what. I reiterated that, stating that although I might disagree with choices she made, or even not like aspects of her, that my fundamental ground of family relationship was the connection of love.

In this way, I could respond to a profound need she had to be see in this place. In the nature of the therapeutic process, I wasn't actually her father, but the impact was almost the same.

This is a result of establishing a strong and deep relational ground in the therapeutic process, which then allows such statements to have a transformative effect.

She felt more whole, and able to bring together both adult and child parts of herself. 

Case #41 - The disturbing client

Francis was coughing, in a way which really grated on me. She came up to work, and I brought it up - I said, ‘well, you certainly got my attention with that cough’. She said ‘yes, she tended to disturb people’. I replied ‘well you disturbed me with the cough’.

So we explored ‘disturbing’. I explained that there are also positive ways to disturb people - for instance comedians do that. And revolutionaries. And people who disturb the status quo in a group - they are also needed. I wanted to frame ‘disturbing’ in other ways, to widen her sense of choices available to her.

I invited her to ‘disturb’ a few people in the group. She playfully pinched one person’s cheeks, and then she lay across someone else’s feet.

These were light and fun actions she spontaneously performed, and immediately gave her a sense of being ‘disturbing’ in a different type of way.

I asked about her context - who was disturbing in her family. She said she had just found out that her mother was currently having an affair. As I learned more, it appeared that her father had been having affairs for years. 

This was obviously unsettling to her, but I didn't want to get too much into the business of what her parents were doing. She said she felt guilty...as if somehow her mothers affair was her fault, because she had moved out of home.  I said, ‘well, its not up to you to be carrying responsibility for your mother’s actions’.

I wanted to bring the focus back to her. So I said, ‘you are looking at me with a lot of intense focus - you have my attention right now’. She said that was something missing when she was growing up - her parents were so busy with their problems and conflicts that she didn't get much attention. When she did, it was often reactive. She talked about wanting loving attention, not critical attention. I pointed out that for children, negative attention is better than no attention…by doing this I was acknowledging the choicefulness somewhere of being ‘disturbing’ in her adult life to get attention, even if the kind of attention she then got wasn't so nice. 

I asked her to notice in the present what it was like to have my attention, and the attention of the group. She noted small changes in the attention of the group - a few people were distracted. I could see how attuned she was to the dynamics of where attention was directed in the group.

So I said, ‘ok, I want you to really be present with the attention I am giving you right now’. We sat there for a while. I noticed that I felt very flat...normally things occur to me, creative experiments, insights, awarenesses. I just felt completely flat with her, like an empty landscape.
So I reported that, and she said yes, she got that feedback from her husband and others...and that she also felt flat.

So I acknowledged this shared space, in an I-thou moment. Often such moments of intimacy and connection are understood as being full of deep feelings. But the sharedness here was of a kind of bareness. I said, ‘its hard for me, like I have lost all my creativity, I am not used to that’. She sparked up - liking the word creativity. 

She said, ‘I want to do something disturbing and daring to you’. I invited her to go ahead. She kissed me on the cheek. ‘Ah’ I said, ‘a splash of colour against the landscape!’

It was a moment of bright contact, in the context of a deep moment of sharing. As a result there was  profound shift in her, something had become freed up.

This was the outcome of a non-linear process of following the flow of awareness as it emerged between us - the theme of attention and disturbance. In Gestalt we do not so much work in a linear/goal focused manner, more like the flow of a river, moving with the current, immersing ourselves in the phenomenology of the client, and noticing our own responses. The end result is integration, or what could be called embodied insight.

Case #40 - Needing support, needing independence

Martha had tears in her eyes, and was biting her lip. I observed this and she said she was trying to hold back her feelings. I invited her to breathe, and be present… and then the tears flowed more.

She told her story, a long, and painful story, accompanied by a many tears. Her father worked in another city. Her mother, sister and self had moved to a small town while he was away, and had to stay with her mother’s parents. But the grandfather bullied them all...if the children made too much noise, he threatened to throw them out of the house, and actually did put their suitcases outside on several occasions. Previously to that, her sister had lived with the grandparents, and whenever she and her mother came to visit, the grandparents would find some fault with Martha, and play her off against her sister.

Her mother moved out of the house finally, into her own place. But she was a beautiful woman, and often men from the shop where she worked would come to the house, seeking her out. She would send them away, but one time she allowed a man in, and started having an affair. Martha was always scared when he came in the house.

When the affair was discovered, her mother was publicly shamed in the small community they lived in. And Martha was shamed by the kids at the school. Then her father came back, the grandparents beat her mother up...the traumas just went on and on. 

This was a story full of pain and suffering. During it she reached out for my hand, and squeezed it tight. We sat like that while she unburdened herself. 

There are different kinds of stories in psychotherapy. Some are old, dead, and repetitive, only serving to reinforce helplessness, and perhaps gain sympathy. Those stories need to be brought into the present, brought alive through embodied experiments, and breathed-through emotions. 

But this story was alive, had been sitting there needing to be told for 30 years, and in the right circumstances it came out, flowing, releasing, integrating along the way.

As she settled, I let go of her hand, staying next to her.

Martha did say there was light along the way. The intimacy she shared with her mother and sister, even though they only had bread and beans to eat. And the boyfriends she had, especially the first one, who was loving and supportive to her throughout her family ordeals.

This support continued with her husband, who she was close to, and they had a very loving relationship. All good. Except that after 20 years, with their children grown, she was no longer enamoured of the workplace that had been her shelter when she first exited from the painful family scene.

She was looking for a new direction, for personal growth, and for a career change. But her husband was holding onto her hand, as it were. Their relationship had worked because she needed support and he gave it. But now, she needed independence, and he was still holding on.

I pointed out the parallel with the session. She needed me there during the time of traversing the trauma. But by the end, I could let go of her hand, and she just needed me next to her, not holding onto her anymore. 

I outlined to her the kind of statement she could make to her husband, helping him understand and be able to deal with the fact that she needed to move into the world more independently, and perhaps to help him deal with his insecurities about that. In turn, that would give her the support she now needed from him - to be comfortable with her coming and going.

In arriving at this place in the session, she was able to see how to proceed with her maturing and differentiation, dealing with the changing dynamic in her relationship and her position in her life.

Case # 39 - The strong florist

When I asked for volunteers, Fran jumped up. I noted to her that previously, she had been the first one to ask a question. 

Rather than ask her questions, I started with the points of connection I already had with her - things I recognised, and then my response to those aspects of my experience of her. 

She said that she was often the first one to volunteer, and I shared that was true for me as well. This immediately built ground between us. I asked what work she did - a florist, but she said she wanted to open her own florist shop, and she was determined to make it a success. I could see that she was a bright confident young woman, and told her that when I listened to the way she shared her plans, I believed her. 

Again, this is laying the relational groundwork, and recognising what stands out, in process terms.

I asked about her favourite flower (to find what was figural for her). A sunflower she replied. I related how I liked them, and what I liked about them. She said she liked a variety of things - they were happy, bright, strong, tall…

The way she said ‘strong’ was with emphasis, so I asked her about the ways in which she experienced herself as strong. She explained that she was indeed strong, and she was happy about that quality, though she felt that when she got angry she could be destructive.

So I invited her into some ‘therapeutic wrestling’, where we stood opposite each other, and pushed against each others hands. This was fun, and allowed her to feel the full force of her aggression in a safe, playful and contactful way. The experiment also showed her that her anger and aggression could be positive, not just negative. This built more ground between us.

I pointed out that strong women are not always appreciated in society, naming some potential contextual factors to see how that was for her. She said sometimes she thought she came on too strong, and overwhelmed people. I asked for an example, and she talked about a taxi driver who didnt want to use the meter, and she yelled at him. I could understand her reaction, and pointed out that I might do the same. Still, she said she was unhappy when she went out of control. 

So I asked about her context, her family, and who in her family was out of control. She said that her father would often display strong emotions when she was growing up. But rather than be scared by that, she became like that herself...and so she didnt like being out of control with her anger, as reasonable as it might be in the taxi case.

I could understand that, and suggested that now she was grown up, perhaps she could choose what of her father’s qualities she wanted to take on, and what she didnt. So I placed a chair in front of her to represent her father, and asked her to ‘talk to him directly’ about this, helping her articulate phrases that made it clear what she appreciated and wanted to retain, and what she wanted to let go of, and so not follow in his footsteps.

She felt relieved after this, and more able to be comfortable with her aggression as a force that she could make choices around, rather than something that she felt bad about, or defiant about.

This is what we term ‘integration’, and occurs not only cognitively in terms of insight, but especially somatically, so its really a body-based shift.