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Sep 07

What IS Therapy, Anyway? Part 2

Once clients have addressed their original, presenting issues, it’s time to move into deeper waters. Inevitably, new challenges will continue to emerge and it’s important to explore the unconscious processes that are fueling self-defeating thoughts and behaviors—and causing depression and anxiety. Although few clients pursue long-term analysis anymore, therapists generally spend some valuable time exploring early attachment and family-of-origin issues for patterns and clues to their clients’ psyches.

An example: a female client who had a domineering mother marries a domineering man and in addition, takes a one-down position in most of her other relationships. She can’t say “no” and is a people-pleaser. She accommodates herself into oblivion and becomes depressed. A therapist can help her see that she is playing the same role she had in her original family. As a child, she had no choice; to stand up to her mother was not safe. But now, as an adult, she must stand up and develop a voice in her own life if she is to thrive. The therapist re-frames her depression as a powerful wake-up call, an opportunity to take charge of her life. Human beings unconsciously choose the familiar, no matter how negative, until they can gain the insight to act on their own behalf.

Then there is the question of meaning. This is twofold: the meaning clients assign to different experiences/situations; and life meaning—what makes their lives meaningful. When clients confront obstacles or have any kind of experience, they automatically assign a meaning to them—usually, positive or negative. But such “meaning” is subjective and doesn’t exactly represent reality. In the same way, the life stories clients tell therapists emerge through such a subjective—and often distorted—lens. The therapist’s job is to challenge the meaning they are assigning to particular experiences (especially if it’s causing a roadblock), and eventually help clients deconstruct their life narratives and re-create them in a more objective and empowering manner. Clients who were abused, neglected or bullied as children, for example, can begin to heal once they’re able to perceive themselves no longer as victims but instead as resilient human beings—survivors.

Finally, regarding life meaning and purpose, there is the ultimate existential question: Why are we here? Do clients have a passion that gives them a compelling reason to live? This is not about hobbies like hiking or gardening—though these pursuits can certainly promote well-being. To paraphrase the late Viktor Frankl from his concentration camp memoir, Man’s Search for Meaning, man comes to the meaning of his life in three ways: through good deeds or meaningful work, through love and relationship and especially through what he calls “transcendence”—transcending oneself to help others. He said that he and others survived the camps by reaching beyond their own misery to lift up their fellow prisoners. That is to say, they had a purpose greater than themselves.

Contemporary spiritual leader Rick Warren says virtually the same thing. In his best-selling book, The Purpose-Driven Life, his first line embodies this philosophy:

“It’s not about you.”

When I work with clients, we generally confront this spiritual material once we have been working together for a while`. And admittedly, life meaning and purpose become more critical for clients as they move into middle age and beyond. As Jungian psychotherapist James Hollis says in his book, Finding Meaning in the Second Half of Life, humans spend the first half of their lives growing up and setting up the structure of their lives—pursuing an education, establishing a career, building a family. People often don’t have the bandwidth for deeper meaning and purpose—beyond family and career—until they have settled into their lives and perhaps even launched their children. Obviously, therapists have to meet clients where they are developmentally. When individuals are in the second half of their lives, says Hollis, they are more contemplative and hence more receptive to the “soul knocking on the door.” When the same angst keeps coming up again and again, they must eventually answer the summons if they are to move forward.

Although some fortunate people have meaning and purpose built into their jobs (think: doctors, nurses, teachers, writers, artists, etc.), many others must find a purpose outside their 9-5s. Obviously, marriage and parenthood—families—serve much of that need for many. But when human beings are older and back to themselves, so to speak, they must find or create meaning and purpose all over again. Changing careers, retiring and pursuing a long-forgotten talent, traveling and volunteering are all possible avenues. A hero in this vein is former President Jimmy Carter, a brain cancer survivor at 93 who is still volunteering, building houses for Habitat for Humanity. He is the very definition of Frankl’s “transcendence of self.”

Again, regardless of life stage, therapy can empower people to stop running maniacally on the psychic hamster-wheel. Instead of recycling the same thoughts and behaviors, committing to this deeper work can liberate clients to jump off the wheel and out of the cage.