Jung At Heart

In my little survey a significant number of responses indicated a desire to tell the therapist about some previously withheld issue but not knowing how. I invited folks to makes suggestions in the comments so I thought I'd start by responding here in the post to the comments.

1. I have found email to be a useful way to disclose the dark secrets to my therapist. In the early days of therapy I would email details... these days, it's sometimes just a word or two as a way of making myself talk about it in session.

Email or snail mail can both be helpful ways to begin to open up an uncomfortable subject. It is important that this disclosure be followed with talking about it in real time. Otherwise, if left unmentioned in session, it becomes another layer of the secret, a hit and run kind of disclosure that may break the silence but not make space to talk about the feelings, the issue and to glean what can be learned from the whole process.

2. I would add that as a patient it was important to me that I had a sense that I shared similar values with my therapist before I told her my deepest secrets. I don't think you have to be of the same religion, etc. ...  

Optimally you learn about the area of shared values as you work with the therapist. That is part of the process of the beginning stage of therapy -- discovering if you and the therapist are a good fit for each other. And goodness of fit really cannot be known upfront before actually spending some time with each other.

Or what if the psychiatrist is amoral? You don't always know that immediately. I was reading a blog, recently, and a person who said he was a psychiatrist explained all the reasons that it's normal and natural for men to cheat on their wives. He didn't think it was wrong at all. I don't share that value. I think it's wrong. Assuming this guy is really a psychiatrist, what sort of impact do those beliefs have on the treatment of his patients? What about the patient who comes in and confides that that their marriage was destroyed because of infidelity? Is the psychiatrist going to minimize it because of his own behavior, and the fact that he doesn't see anything wrong with it? I think he will. What else does that psychiatrist think is okay to get by with? I'm not arguing for finding a "perfect" therapist as I know they don't exist. 

There are those who believe that only someone who has experienced what you have experienced can help you -- this has been especially the case with issues of substance abuse and the like. All therapists have blind spots, because we are all human. It is part of our process as works in progress to deal with these blind spots as they come up and to become more conscious of them. But we can never reach the end of that process as there are always more blind spots to emerge.

There is a difference between understanding infidelity without making a moral judgment about it in general, and dismissing it as a source of pain in our patients. We make an empathic connection based on having experienced pain ourselves even if its source was not the same. So, a married therapist can help someone who never wants to marry or someone who wants to divorce.

My job as a therapist is not to evangelize for my way of life but to listen to my patients and try to understand and relate to them and what they want and need in their lives.

.... Trust is earned. People will talk when they feel trusting enough to do so. My therapist told me that in her experience it's not uncommon for clients to save the most difficult stuff to work on in therapy until the very last.

Indeed the ability to talk about everything develops in the and through the relationship.

3. Here is one of my ways of telling a secret. I realize that this is not a particularly good way, nor is it mature. I wait until there are about 30 seconds left in the session and I say, "I need to say something." Then I tell the secret and leave. That way it is out there, but there is no time to talk about it. By the time the next session comes I am a lot less anxious about it and am able to talk about it. Like I said, though, not very mature.

Hey, it works for you! And it is that following through and talking about it the next time that is crucial.

4. it is dangerous to tell some secrets to the wrong therapist...it can be very dangerous...there is no real and complete confidentiality in therapy and anyone who tells a client that is lying. Therefore sometimes secrets are a very real and sane way to approach a therapist. I've been both a therapist and a client, for the record. In an ideal world of course everyone would have safe and trustworthy therapists.

If you have concerns about what your therapist might do if you disclose a secret, ask. This is an important part of the therapy process. Therapy is a relationship first and foremost.

also, subtle coercion happens in mental health care all the time depending on the bias of the therapist...sensitive folks are much more aware of such manipulations... not saying good therapy doesn't happen but if everyone pretends bad stuff doesn't we're not looking at the whole picture... figuring out how to get clients to spill the beans might not be the right approach...it could be figuring out how we're not letting the client be self-determining and thus creating an environment that doesn't feel 100% safe...

Now, Voyager,  which was scheduled for January 10th had to be rescheduled for February 14th because of technical problems with the projector. On January 24, we will be watching What Dreams May Come. 

Robin Williams and Annabella Sciorra star in this visually stunning metaphysical tale of life after death. Neurologist Chris and artist Annie had the perfect life until they lost their children in an auto accident; they're just starting to recover when Chris meets an untimely death himself. He's met by a messenger named Albert (Cuba Gooding Jr.) and taken to his own personal afterlife--a freshly drawn world reminiscent of Annie's own artwork, still dripping and wet with paint. Meanwhile a depressed Annie takes her own life, compelling Chris to traverse heaven and hell to save Annie from an eternity of despair. 

The images of madness and depression shown in the film are quite compelling. If we view it as a metaphor for the deadening of life following a severe trauma, such as suffered by both Annie and Chris, then the film can be taken as illustrative of  the psychological aftereffects and what must be done to come back.

The film is based on a book of the same name, a book far less satisfying than the film. It is a visually stunning film and won the Oscar for best visual effects in 1999. It is for the visualizing of depression and madness that I chose this film as I believe these images are quite compelling.

Judging from the comments, a lot of readers did not fully understand what I was saying in my last post. So I'll try again.

In Jung's Collected Works, Volume 16, The Practice of Psychotherapy, Jung talks about the pernicious effect of secrets in our lives and says that they prolong our isolation from others.

Secrets, like an affair or a gambling problem or some misdeed or money problems -- the kind of thing we lie awake and worry about, worry about others discovering -- are often a big part of what brings people into therapy and what patients find most difficult to talk about. Shame and fear of judgment fill the room. The carefully cultivated image of respectability or responsibility or moral superiority will surely shatter into a thousand pieces the moment anyone, even the trusted therapist, finds out what is concealed beneath the facade. Each patient with such a secret imagines herself to be alone in the world, unlike and apart from all the rest of humanity, unable to imagine that the therapist has heard similar tales many times before. 

When we carry secrets like this, they become barriers between us and everyone in our lives, cutting us off from real intimacy. Anything which threatens to reveal what we seek so to hide becomes a source of anxiety and must be avoided. Maintaining the facade, the persona which covers the shame of the secret becomes paramount. In Japan I am told there is a saying that first the man takes a drink, then the drink takes a drink then the drink takes the man. The same is true of secrets as the secret comes to own the life of the person carrying it.

Psychotherapy, like the confessional, offers a unique opportunity to break the secret and its hold on the life of the carrier. First comes the mustering of courage to say it, to tell the therapist what has been held in shame, to brave the condemnation and the rejection, the fear of which maintains the grip of the secret. And once spoken, then the work of discerning the meaning of the secret,  why it is a secret and opening to the shadow. 

I hear from people about things they are afraid to discuss with their therapists, secrets they carry and feel shame about. I know how hard it is to open up the dark corners of our lives and let another see in. It feels like a huge risk. But what is the point of being in therapy if, at some point, the secret is not told? If it remains untold and unexplored, the therapy is a very real sense is a lie because it never gets to the truth of the patient's life and feelings.

So we say to patients that they should say whatever comes to mind and mean to include the secrets as well. 

Here are some of Jung's thoughts, all taken from Vol. 16, pp.55-60:

Anything concealed is a secret. The possession of secrets acts like a psychic poison that alienates their possessor from the community.

All personal secrets ... have the effect of sin or guilt, whether or not they are, from the standpoint of popular morality, wrongful secrets.

...if this rediscovery of my wholeness remains private, it will only restore the earlier conditions from which the neurosis, i.e. the split off complex,  sprang.

All of us are somehow divided by our secrets but instead of  seeking to cross the gulf on the firm bridge of confession, we choose the treacherous makeshift of opinion and illusion.

It is by no means easy to let go of our secrets, whether we feel, as in the PostSecret from the other day, that do so would be rude or because we fear being judged or rejected or abandoned. It is hard work and takes time. But it is important to keep at it.

John Grohol has a brief post that touches on this issue today:

1. My therapist is judging me.

A lot of patients spend a lot of time worrying about what their therapist must think of them. That’s because you spend a lot of time sharing deep, emotional and personal stuff in therapy. Some of it may be embarrassing, or some of it may simply be out of the mainstream. Some of it may be things that happened to you as a child, that you had no control of. No matter what it is, you shouldn’t worry that your therapist is judging you. Believe it or not, most psychotherapists have seen and heard a lot of things in their careers. No matter what your story may be, it’s likely they’ve heard or seen worse.

One of the responsibilities and skills of a good therapist is to remain nonjudgmental, no matter their own personal reactions or feelings. Therapists who act or talk in a judgmental manner should be avoided.

Saying whatever comes to mind is a goal and one it takes work to reach. An important part of that work is exploring the difficulty we have in getting there.