Psychotherapy - The Art of the Psychotherapist

Notes on Life Changing Psychotherapy / Pathways to Major Life Changing Therapy

Taken and reworked from the book The Art of the Psychotherapist – by James F.T. Bugental – (who worked closely with and share many of the same views as Rollo May)

Summarized on July 2013 – from a book I borrowed from work, that was donated to the unit, 7 Lane,  by Dr. Curtis Steel – Addition - Rereading this summary in August 2016 – every word, line and concept mirrors and validates my own work, insights and practice application that I have been using with Clients on the Units for the past 10 years in particular. Excellent and important read.

In his previous important work, “The Search for Authenticity" (1965), Bugental summarized the postulates of Humanistic Psychology, often quoted by other theorists:

·         Human beings cannot be reduced to components.

·         Human beings have in them a uniquely human context.

·         Human consciousness includes an awareness of oneself in the context of other people.

·         Human beings have choices and responsibilities.

·         Human beings are intentional; they seek meaning, value and creativity.

The primacy of the, interchangeable concept of the subjective or subjectivity or the unconscious is the focus of this type of psychotherapy. This focus calls for the continual attention to the patient’s inner experience. The prime instrument needed for that attention is the therapists own subjectivity.  In contrast objectivism or the objective has been given primacy for the past two centuries in Western culture, as seen by the ascendance of science.

Our subjectivity is our true home, our natural state. It is the font of all creativity, the stage of imagination and the ultimate heart of our fears and hopes, our sorrows and joys. Too long we have dismissed the subjective and as a result we’ve lost our center and have been drawn to the shallow harbors and aired beaches of the unrelenting objective and objectivity, reductionism and determinism and rationalism. This therapy focus on a paradigm shift to the centrality of the subjectivity. Subjectivity means all that goes on within us privately that which is only partially conscious to us.

In order to have a life-changing experience, that of becoming totally alive, the therapist must take the ‘seeker of the truth and himself’ into the depths of there is subjectivity. No amount of objective manipulation can do the job for either of them. Too often the therapists and merely impersonal, mechanical and detached from their clients, simply too objective.

 This can include practitioners from perspectives as diverse as Jungian analytic psychology, Freudian psychoanalysis, object relations and ego psychologies, existential and humanistic psychology.

Each person must in some way answer the basic two questions of life, “who and what am I?  What is this world in which I live?” Otherwise I will and always remain a “stranger in a strange Land”.

 We answer these questions with our lives, with what we identify with, how we use our powers and how we relate to others, how we face all the possibilities and limitations of being human. We collect the material to do this life work from answers from those who we meet along the way beginning first with our parents up through our teachers, from books, from   the various groups we live and work in. Throughout our lives we from and revise our answers and continuing this process up to the final question which we answer with our deaths. Some of our answers are superficial and transitory, some we are deeply invested in and will defend with our lives. The more central these elements are to our being, the more we resist it’s been challenged or altered. This then is the source of our deepest resistances with which life-changing psychotherapy is concerned with, those beliefs and values that we would defend against with our lives. In Therapy I have called these “life and death beliefs”,  death equivalents, those areas of the client’s unconscious where they are scared to death to approach them to examine them, or change them  in any significant manner.

Life-changing psychotherapy is an effort by the patient and therapist to examine these fundamental “death equivalents”  areas, to make an attempt to revise some of those answers found there in ways that makes the patient’s life more comfortable and thus more fulfilling. The more fundamentally these elements are in one’s life / being, the more deeply into the patient’s subjectivity the work must go.

What is subjectivity?

Subjectivity is that inner, private realm in which we live most genuinely. The furnishings and structures of that realm are our perceptions, thoughts, feelings and emotions, values, preferences, anticipations apprehensions, fantasies and dreams and anything  else that goes on endlessly night and day, waking or  sleeping and  determines what we do in the external world and what we make of what happens to us in the world. For psychotherapy the realm of subjectivity is the near bank of life’s river upon which must be built the bridge, through relationships to others/to the world. The profound truth is that we are all subjects.  We are not objects. We are actors, we act, and we are not simply acted upon, reduced to only reactors. We are to be autonomous human beings that must escape the cages of objective determinism / materialism. We respond not only to outside stimuli as the Objectivists insist but to our own inner stimuli which includes our self-perceptions, self-representations.

 Through the process of infinite regression, that endless sequence of our entire most important subjective interactions going backwards to our infancy, to the beginning of our experiential existence in the world, we are able to have understanding, have insight into our core of our original identity. Being a human being is worked up from a set of causes, a set of a prior knowledge, a set of instincts. We are not merely the effects of these to all other determinates.   We realize that in the very beginning, our “feelings came first”, there was only subjectivity, the subject / object dichotomy split had not yet taken place.

Further Characteristics of life-changing psychotherapy

 Central importance to such work is on / towards the resistances that they are built around wounds and psychic trauma.  This is through the inevitability of transference and countertransference. The goal is to help the patient experience himself in a larger context and realize his intentionality, otherwise known as his will power. He discovers that he has choice where up to that moment he was only driven by addictions and compulsions.

 The specific goal is to bridge the gap between the two realms of the objective and the subjective.  This bridge will gain access to the inner worlds of those who are committed to self-knowledge, which allows them to actualize their latent potentials eventually arriving at the sweetest of all landscapes, in the land of “To Know Thyself” and yes indeed “The Truth shall set you Free”.

There is a critical difference between attending to the patient’s objective  reports of the subjective experience vs. actually coming into the immediate, intersubjective space, ‘between’ the therapist and person in care, where deep, preverbal communication can occur. This means being open to the intuitive sensing of what is actually happening behind the patient’s words behind the patient’s conscious awareness. The therapist must be ‘present’ in the alliance. The Therapist must be able to deal with their reciprocal effects on the client. There must be a mutual commitment which is essential to living authentically, to have efficacious outcomes in the “encounter” of therapy.

Religion and Psychotherapy

What is each individual’s elusive essence? “To be or not to be? That is the question” Image vs.  Substance, Essence vs. Existence.   Where do all of our particular thoughts come from? Religious doctrum in the various spiritual systems, attempts to answer these questions. God, the Higher Self, Atman, the Cosmic Mind, the Collective Unconsciousness all demonstrate a humility towards that which is evidently so much more than we are.

 We need to move from the familiar world of the objective to the less familiar world of the subjective. The subjective is always something more. It is the world we know little about. The amazing fact is that our homeland is in the subjective. Ultimately we must take what happens in the outer world back to our caves to ponder, to taste it, chew it, reject it or conversely accept and incorporate it into ourselves.  We are endlessly trying to fit it altogether. From that inner world comes our thoughts and inspirations, our creativity our destructiveness, our hopes and fears, goals and apprehensions and the depths of our relationships, faithfulness and commitment, choices and decisions, cruelty and benevolence and all else that gives meaning,  color and value to our being. We need as individuals and in our collectivity, to be more aware of that inner world and its dimensions, its powers of how we can be more at peace within it. We have to discover how we can draw more from it to renew our daily encounters in the outer world.

The failure to be fully present in the moment is the most pervasive way we as individuals avoid bringing our subjectivity into the interpersonal space. Therapist can easily fail if there are only preoccupied with contents, and clues through symptoms to the underlying psychodynamics, thus missing the fact that the client is not present as a whole person in the room. This type of focus can make even the most meaningful interpretation irrelevant reducing the therapeutic alliance to speculative debate, with the client without producing any real therapeutic gain. The most critically important matter is “Presence”.

As a sidebar - Sin or the act of To Sin, this whole traditional religious concept can be looked at simply as “non-presence”.

Presence is the name for the ‘quality of being’ in the situation or relationship in which one intends at a deep level to participate as fully as they are able to do. Presence is expressed by the mobilizations of the inner, the subjective and the outer, the objective, to the situation with the ‘other person’.

Intimacy is a sharing of deep and immediate experiencing. It is not expressed in the content of what is said but in the depths of the clients inner awareness and readiness to make that awareness open to the therapist and in the therapist’s own deep openness  to the clients immediate felt experience as it is being expressed.  Intimacy is not a lasting condition rather the client will take this newly acquired inner knowing from the therapy and into his life at large. The idea of presence is to direct attention to the clients own immersion within his own subjectivity.

What are some of the key elements of this new paradigm?

Human beings themselves are the locus of any self-knowledge. To learn anything about ourselves we must also come to know about our inner world. We cannot study the subjective when the objecting of our internal knowledge is fragmented, conflicting and ultimately incomplete.

The therapist must bring their own subjectivity into their work if they are to be sufficiently sensitive to the client’s efforts to reach their own critical subjective core through a deep level of presence. Thus the therapist’s own presence is needed continually to develop an effective therapeutic alliance. The therapeutic alliance is a powerful joining of forces which energizes and supports the long, difficult, and painful work of life-changing psychotherapy. The viewpoint is that the therapist is not a disinterested observer, technician but a fully alive human being in companionship / presence with the client.

Elements of Psychotherapy

There is both power and danger in catharsis. If it is not monitored, the person is not quickly able to restructure themselves and keep themselves together.

The most frequent error of inexperienced psychotherapist is being overly involved with the content of what is being said, missing the real core what is actually going on. Meaning is the ultimate currency of communication and of psychotherapy particularly. Meaning calls for the content, process and purpose to be skillfully and sensitively blended together to preserve the essential message. It is something of an over simplistic idea but whatever a person says has both an affective and cognitive aspect to it.

Emotion in psychotherapy is similar to blood in surgery both are inevitable as the work goes forward, both importantly serve as a cleansing function to foster healing, both must be respected and dealt with by a professional. His / Her feelings about her feelings are often clues to important elements about our lives such as how well the ‘fit’ into our lives, our life context. How we experience ourselves and how we relate to others emotions derived from own experiences. Emotions constitute an obvious and accessible route to subjectivity. Our feelings so clearly arise from the data in our subjectivity. Their evidence is found in the churning and strivings which we can only incompletely verbalize or explain even to ourselves. Subjectivity, the unconscious is our deepest center. As a psychotherapist I have been drawn to work with the inner lives of my clients, I seek to explore the nature of our ‘being’ as humans. This has the potential for arousing the “sleeping possibilities” we all have and can at times bring about a truly major life change. It is the quest for the Truth in our subjectivity that this type of therapy is all about.

The focus of this therapy is directed towards the Defense Mechanisms that serve to filter our perceptions, to optimized our ‘Self- Love” often that is only our fabricated and delusional image of our “Grandiose Self”.  Concentrate on the resistance to full disclosure, not on what is behind the resistance, the repressed material.

Behind this ‘wall” of our various defenses is the repressed material that is actually hurting us. If this material is attacked or approached by draconian methods such as hypnosis, much that might be learned from the client psychological makeup is lost in such efforts as it is almost always wiser to do this work directly with the avoidance patterns, defenses themselves, then to get at the material behind it. When the need to avoid has been fully investigated the hidden repressed material will readily come forward.  When the roadblock within these defenses has been resolved, other areas that would never have been noted begin emerging into consciousness and can be brought into the therapeutic alliance.

‘Individuality’ is a relatively new human phenomenon. For millennia it was only the privileged few that could pursue individuality. Emotions more than Reason has dictated the course of the human experience. This fact is manifested in our dreams, legends and myths all the great arch types.

 Individual client are likely to want to talk about external events, the various forces, people and circumstances that have contributed to their difficulties.  The culture that we live in has taught that Determinism  has insisted on objective finiteness and has held the scales in determining guilt and blame, right and wrong. Individuals all wants to be right and guilt free. Individuals will pay with their freedom for their ability to choose. They will allow themselves to become enslaved, tortured even killed to satisfy this need.

 The ultimate’s focus of deep psychotherapy work must be this intrapsychic locus, the confrontation with oneself, one’s identity in the world that one has created in this interior space. When someone comes closer to their core centers they find that they have long lived under a burdensome and limiting self-image of who they think they are but have  tragicly they have been deceived and misled and therefore self-deceived.  We had previously thought that this shallow surface is actually who we are but of course it is not our true selves. Our True Selves are much larger than we would first believe to be and includes much more than our self-imposed limits.

The subjectivity of a person is the seat of their uniqueness, their individuality.  When the patient is only the observer of his own condition, he is objectifying himself and that condition. Objectifying oneself in this fashion means to render oneself impotent to do anything about our context of our painful condition. They are not able to take hold of their individual concern through the process of naming. Their hesitance  have the effect of placing  the  issue of their suffering at a distance, implicit in this idea is the notion that’s anyone afflicted by the same malady would be similarly troubled. The individual is now lost into the collective and unable to see his own unique, particular difficulties. “My suffering is somewhere out there, shared by others”. The sufferer is not seen as unique. Causal inquiries into their miseries result in them being only rationalistic, impersonal and mechanical reduced to a sterile cognitive formulation from which no emotional or behavioral change can result.  Freud said that ‘knowing’ alone is not enough.  Knowing is not sufficient to produce therapeutic change in just by the knowing.

Isaac Newton once wrote “I do not know what I may appear to the world others  but to myself, I seem like a boy playing on the seashore, diverting myself now and then by finding a smooth pebble or a prettier shell all the while the great ocean of Truth lies before me undiscovered.”

In the great ocean of Truth, is all that is undiscovered in the subjective.  Instead our lives are sadly us only wading into its shallow waters. We instead only wander along shores and we dare not and will not venture out into the depths of this great Ocean of the Subjective / Consciousness, for we are still children. We do not know much about this ocean although it is our archaic home.  The Subjective is a vast ocean. As we make our first dive into it, we are likely to find our familiar world’s call into question.

We do not truly know our own identities. We are much more than our conscious awareness. We do not know how to access and bring to the surface much that is latently ours. If we can revise our sense of identity to include that which is not conscious.  We may begin to gain access to more of our potential.  Make conscious the unconscious. The runaway preoccupation with objectivity in our times in our culture is a genuine cancer which may very well destroy our species and even our planet. Misery and depression has been the most frequent outcome of the trapping of all the unrealized potential within us. Fully recognizing the deeper more inclusive, more fundamental role of the subjective means establishing a whole new paradigm. When therapy has a goal to be truly life changing, the client feels her identity, her world in short her life is being threatened. Therefore it is not unreasonable that the client resists the therapeutic approach and effort. It is unlikely that Freud was the first to discover that his efforts to help were often deflected by the very person whom he sought to aid. Many have discovered this paradoxical phenomenon. Resistance is a universal, normal and even desirable part of the way in which we deal with our experience. Who does not seek to reduce any threat towards themselves?  Resistance is the impulse to protect one’s familiar identity and known world against a perceived threat. In psychotherapy resistance is those ways in which the client avoids being truly subjectively presented, accessible and expressive in the therapeutic work. In the therapeutic work all challenges to the clients results in resistances as the clients wards off deep immersion of any real therapeutic work by their objectifying themselves and maintaining on a surface orientation. Resistance is a counterforce originating from the pool   of subjectivity solely designed to avoid genuine presence in one’s life whether in therapy or outside therapy. Resistance, so conceived results in an inauthentic being and hence an inauthentic life.

As we think of ourselves as human beings we are continually engaged in trying to make  an effective connection between the two worlds in which we dwell in,  the inner and the outer, the subjective and the objective. One of the ways we do this is through bridges that are developed and that are  continually attended to,  the self and the world by constructing systems.  We become system builders.  These constructs are solidly anchored in both our life experiences, generally work out in a fulfilling way.  If however our systems either internally or externally are faulty, we experience anxiety and other distresses. Our self and world construct system then determines what and who we are in the world in which we live.