Archive for April, 2009

Ten Things a Good Therapist Should be Aware of

Sunday, April 26th, 2009

Therapy is an unparalleled situation between two people of unequal power which can produce considerable anxiety for the client. Over the years, I have become aware of many things that make me nervous of which my most excellent therapist is not aware – unless I tell her. We’ve discussed these things with much amusement and considerable insight into the unique world perceived by each and every client. Not all clients think in the same way, but chances are each long-term client has their own idiosyncratic way of responding to therapy, the therapist, the room, other clients, the interactions and nuances of other staff and the general therapeutic environment. A good-enough therapist will always respect and respond to her client’s whims and wishes as best she can.

1. Seeing your therapist in an untherapeutic space.

I always arrive half an hour early and park up the street, so I can chill out in the car and listen to the radio, read a book and think about what I need to say. Sometimes, my therapist arrives after me and parks up the street behind my car. On several occasions I have seen her in my rear-view mirror and I’ve slunk down in my seat with my sunglasses on till she’s past. To see her staring longingly into other people’s gardens or stumbling on the uneven pavement with a ham and salad roll in her hand is so out of context I break into a cold sweat and my heart starts thudding rapidly. On one memorable occasion she came out of her office, walked down the street and disappeared around the corner, ten minutes before my appointment time, which immediately put me in touch with my abandonment issues.

2. Therapists’ receptionists and waiting room.

My therapist has some lovely, caring staff in the office she shares with many other different health professionals. However, I’m very conscious of the fact that the same staff have been there for thirteen years, the same amount of time I have been coming to see her. So, after a year long break from therapy once, I got a comment from one of the receptionists, “Hi Sonia, haven’t …

The Odd, Angry Email

Friday, April 24th, 2009

A Freudian slip is when you say one thing but mean your mother. So when I emailed my therapist to wish her a wonderful holiday, it came out as “you’ve abandoned me, yet again.”

It’s not the first time during my battle with depression and anxiety that I’ve fired an odd, angry shot in the form of an email, not just to my therapist but to others as well. So I’ve put a rule in place. Twenty four hours before replying to anyone’s email if I feel it has a heavy, emotional content. That takes the immediate sting out of the situation. An email sent straight away is a completely different one a day later.

I hurt my therapist with my email. I have email privileges with her, not email rights. She said later to me in session, with firm eye contact and in her usual quiet, respectful and dignified tone that I “had achieved what I’d set out to achieve.” Those words wrapped around me and stung like a spineless jellyfish, but were far more effective than screaming and accusing ones.

Her deceptively simple sentence made me think, reflect, process and revise.

Email in haste, repent at leisure.

The Thinking Client's Therapist

Friday, April 24th, 2009

The best part about therapy is that even after thirteen years, unlike your marriage, your relationship with your therapist will still be in the honeymoon stage.

Therapy isn’t the real world. It’s a fantasyland where you, the client, are the center of someone’s undivided attention. But however seductive that is, it’s a means to an end, not an end within itself.

Fantasyland is also where fantasies happen. And all of a sudden you find yourself wanting to be your therapist’s best friend. This sort of attachment is beneficial as long as it never occurs.

In fact, for a long time I thought my therapist was only one-dimensional and didn’t actually ever leave her office. In the evenings she just filed herself away and appeared like magic the next morning, bright, ready and alert.

You don’t need to know that your therapist probably wanders around Target wearing a daggy Fleetwood Mac t-shirt, arguing with her overweight, chain-smoking husband and obnoxiously behaved children.

My therapist, wearing a cool pin-striped power suit, was assigned to me during a hospital stay for postnatal depression with my third child, now thirteen.

Seeing as I used to rank psychologists slightly below used car salesmen, politicians and journalists on an integrity scale, I didn’t hold out much hope.

The first psych I ever saw asked me if I was breast or bottle fed and the second one told me there were people far worse off than me. The third psych went psycho on me and I couldn’t get out of there fast enough.

But my fourth psych seemed to be made of sterner stuff. She was nice enough, but it used to annoy me that all she ever wanted to talk about was my mother.

It wasn’t until she told me a very lame fart joke that, in my eyes, she gained any street credibility. Up until that point I thought she was a bit of an Ice Queen, possibly based upon the fact that she was so competent at her job.

Most of my friends had therapists and we’d go out for lunch and compare and contrast. I was always smug because …

Over The Borderline

Tuesday, April 21st, 2009

Wild mood swings, emotional promiscuity, depression, mania, intense relationships characterized by extremes of idealization and devaluation, feelings of rejection or abandonment, identity or gender issues, impulsivity, irritability, emptiness, paranoia, dissociation, self-harm, suicidal ideation, great difficulty controlling intense anger and even psychosis: These can be the symptoms of bipolar and borderline personality disorder. This is also the average day in the life of an emo-teenager.

An emo-teenager is overly emotional, continually introspective and reflective, is drawn to books, movies and music with passionate and stirring themes, has a fondness for black attire and cosmetics, can be very pessimistic and self-hating, and worry about their life, the world and where it’s all heading.

But being emo is not necessarily a bad thing. There’s a better than even chance that proponents of the Romantic movement in 18th-century Europe, with its focus on the arts and irrational emotions, were emo-philosophers. (In contrast, the Enlightenment period was more rational and scientific.) Existentialist philosophers such as Soren Kierkegaard and Arthur Schopenhauer were sensitive, creative and suffered from depression and suicidal ideation. Marilyn Monroe and Princess Diana were both posthumously diagnosed by the mass media and the psychiatric profession with borderline personality disorder.

There’s not much difference between bipolar disorder, borderline personality features and general emo-teenage behavior. Psychotherapy with a good therapist can help the bipolar or borderline client, and caring parents, once they’ve separated normal teenage behavior from borderline traits, can guide the immature brain in the right directions. But it’s not an easy job.

It’s also difficult being an emo kid, straitjacketed by lustful, raging hormones, contradictory and unreasonable parental rules and regulations, sadistic, menopausal teachers and ever-increasing schoolwork, psychopathic bosses needling you in your part-time job, brutal, remorseless peer pressure and nagging internal voices telling you that you are just not good enough. Sometimes a sneer from a peer can send your self-esteem plummeting for weeks. I shudder when I think of all those lonely, unhappy emo-hours I spent in my bedroom wondering why so-and-so didn’t like me.

Being an emo-teen means swinging wildly on a fraying, thin, slippery rope from zero to suicidal ideation when …

Welcome to Therapy Unplugged

Tuesday, April 21st, 2009

We’re pleased to welcome Sonia Neale to Therapy Unplugged. Sonia is planning to write about many mental health topics here, ranging from her experiences in therapy, with raising three teenagers, depression, anxiety, personality disorders, and just generally trying to demystify the process of psychotherapy and therapists.


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