2. Am I doing it right?
The relationship between patient and therapist is unique, not least in its exclusivity. It will always be one to one. If you have siblings, when you were growing up you got to observe how your parents interacted with them and compare it to how they treated you, and vice versa. You will never (unless something goes very wrong) have an experience of observing your therapist with another patient. There are a couple of scenarios that might seem like they come close. You may run into your therapist “in the wild”; she may be with other people, and this may stir up all sorts of emotions and curiosity – but she will not be “doing therapy”. You could have a therapist who has a public profile and/or publishes articles about their clinical work, which could make it feel like you have a window into how they are with other patients. But even that isn’t a window, not really. It’s a snapshot curated and presented by the therapist for a particular purpose.
There is at least one good reason why your relationship with your therapist is a hermetically sealed thing. This is one of the conditions that allows you to really bring yourself to therapy (even if sometimes this means not actually being yourself, but being who you think you’re supposed to be. This, paradoxically, reveals something important about your inner world). You have no model to copy, and in psychodynamic or psychoanalytic psychotherapy, you have no rules and no real structure to hide behind, apart from what Freud called the “fundamental rule”:
Say whatever goes through your mind. Act as though, for instance, you were a traveller sitting next to the window of a railway carriage and describing to someone inside the carriage the changing views which you see outside.
For those of us who have spent a lifetime picking up on subtle and not-so-subtle cues, reading micro-expressions and self-censoring, this can provoke great anxiety. What are we supposed to be doing? What should we be talking about? Are we doing it right?
Many people who show up in therapy have struggles around perfectionism and people-pleasing, rooted in much deeper anxieties about inadequacy, need or aggression. It is often when the attempted solutions they have created (overworking, worrying etc) become problematic in themselves that they reach out. But then therapy (re)presents the very anxiety they need to deal with, and the familiar ways of coping show up in response. As you begin to see these patterns, it can feel exposing and shameful, as if these long-trusted ways of coping are bad. But it might be more helpful to try to see them as neither bad nor good, but as tools that had their uses but are no longer needed now.
In other words, a worry about whether you are doing therapy “right” can mean a whole range of things depending on your history and consequent anxieties: Am I boring? Am I too much? Am I not enough? Am I as entertaining/worthy as the patient before/after me? And so on. The important thing is to be able to give voice to these worries when they come up, and be willing to think about what is behind them. The consulting room is one space (rare in the world we live in) that is not about performance, targets or comparison. It can take a long time to really feel that on a deep level – but the matter of how long is a subject for a future post.
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