Regular readers here know that a portion of my practice consists of working with patients via telephone and FaceTime and Skype. In fact I have been working with people via telephone for more than fifteen years. This past week as efforts to slow the spread of COVID-19, the need for social distancing crashed into the psychotherapy world. It is now the firm recommendation that all psychotherapy be done online or via telephone rather than face to face in person. This has created its own anxieties about what it is like to be in a session away from the therapist’s office. So let’s explore a little.
What is online therapy like?
Some years ago the New York Times published an article on what was then a strange new thing, Online Therapy. And published it in the Fashion and Style section, which might give you an idea of some problems they inadvertently come off as supporting.
When I agree to work with someone who does not wish to or cannot come to my office , I set the same basic frame that I have with people who meet me face to face. We meet at the same time each week, for a set fee, and I expect that as far as is humanly possible we will both be seated in the same place each time, I in my office and my patient in some place where she can expect to be uninterrupted and have privacy. The vessel for therapy conducted by telephone or Skype needs integrity just as that in more traditional settings does. I have often done sessions with my analyst via telephone. When I talked with him, I knew he was sitting in his office in the chair he uses for any session. He didn’t walk around or go off into the kitchen to get something. He was in the same place where I saw him when I was in the room with him. Similarly, each time I sat in the same chair in my house, in space that I knew was private and where I would not be interrupted.
So I was a bit put off by several things in the article like:
“She mixed herself a mojito, added a sprig of mint, put on her sunglasses and headed outside to her friend’s pool. Settling into a lounge chair, she tapped the Skype app on her phone.”
Really? A cocktail and a session by the pool? Is drinking alcohol during a session really a good idea? Does the therapist raise this issue? Does he even know? And what does it mean to do a session out of doors, the antithesis of a vessel, a contained space? Therapy isn’t just another social occasion.
Or this :
“There’s that comfort of carrying your doctor around with you like a security blanket. But because he’s more accessible, I feel like I need him less.”
I’m skeptical. There is even the suggestion that “The anxiety of shrink-less August could be, dare one say … curable?” implying that the pain of vacation breaks need not be felt, much less that working through it might actually be meaningful and helpful.
Different and yet the same
To my way of thinking, therapy via telephone or Skype differs from therapy face to face only in where it is conducted. The rest of the elements of therapy remain the same. My experience has taught me that it is not inferior to sitting in the same room with a patient, only different. Different in that I must rely more on what I hearor what I see on my computer screen than I do in my office, where I have rich sensory cues as well. I have learned to listen to the rhythms of my patient’s speech — changes that come when more difficult material arises — changes in tone, volume, inflection. These cues too are rich but often paid less heed when we have all that visual material available. It is interesting to me that several people who started on the telephone with me, when we switched to Skype, after trying video Skype, opted for voice only. And some simply never want the video element in the first place and find talking on the telephone less inhibiting.
Some therapists will not feel comfortable working outside of the usual mode of patient coming to the office and they do well not to work this way. As a supervisor once told me, we practice what we believe, and it is important that the therapist be comfortable working in and with the differences that come from working online. Good therapy is good therapy no matter whether in person or via telephone and what makes for good therapy is the same regardless.
There is a Chinese curse, “May you live in interesting times”, and we certainly are doing so. If you are feeling anxious and needing and wanting to talk with someone, this is a good time to seek a therapist if you do not already have one. I have openings now — reach me via the contact form on the Home page.
A few years ago I taught a course at our Senior College called Conversations in the Third Act. Among other things we took photos of our hands, as hands show age in ways we cannot cover up as so many try to do with the face. This photo is unmistakeable as one of an older person’s hand. It tells the tale of a life lived.
Living to Tell the Tale
The goal of all life, the end point, death, is what lies in front of us. In the third act of life it looms larger than it has before and is much more a part of consciousness. To be fully alive is to know that death lies ahead.
Between here and death, there is work to be done to deal with things left undone, to reconcile ourselves to our past, to seriously consider the story we have been living with an eye especially toward any changes we want to make in the remaining years.
A friend of mine, a woman in her mid-70’s wrestles with the conflict between the desire to do and the body that no longer wants to. And with the bubbling up of creative possibilities that she does not know she can bring to fruition. All of us in the third act are faced with having to prioritize in a new way, to come to terms with the certain knowledge that if there is something we want to do, want to create, we have to get down to work now because time is passing swiftly.
How to wrestle with these issues without succumbing to despair or melancholy and regret is a major concern. What does it mean to become old? What is old — 60? 70? 80? How do we come to terms with a body, a face that is not the face or body I carry in my mind’s eye of myself? How do we make sense of the story we have lived and consider how we want to live the last chapters?
Jung wrote in Memories, Dreams and Reflections: “Thus it is that I have now undertaken, in my eighty-third year, to tell my personal myth. I can only make direct statements, only “tell stories”. Whether or not the stories are “true” is not the problem. The only question is whether what I tell is my fable, my truth.”
The story of our lives is our myth. People in mid-life and later often enjoy looking back and spinning yarns about what we have experienced. One thing to keep in mind is that myths tell not so much about the literal part of our lives but how we experience events internally, our perceptions and emotional reactions. These reactions can be radically different from what one might expect based solely on what actually takes place.
Stories are how our ancestors wove the fabric of meaning and existence as they made their way in their lives. Human beings are myth makers, story tellers. We remember ourselves and our lives in stories — stories we tell our friends, family, strangers, ourselves. When someone asks you, “What happened?”,you construct a story to relay your experience. Memory crystallizes into story.This is how we attempt not only to portray ourselves in our lives but also to find meaning. Meaning, or the search for it, has always been at the basis of story. Telling stories is the most human of all acts. Exploring our life story not only provides meaning, but also constitutes a celebration of our lives.
Writing your life story is one way of exploring the meaning of your life and an important one. Another is through depth psychotherapy.
“Owning our story can be hard but not nearly as difficult as spending our lives running from it. Embracing our vulnerabilities is risky but not nearly as dangerous as giving up on love and belonging and joy—the experiences that make us the most vulnerable. Only when we are brave enough to explore the darkness will we discover the infinite power of our light.” – Brené Brown
It looks like I will be teaching a short course on Understanding Your Dreams in the spring at the Belfast Senior College here where I live. And I plan to offer an online dream group later in the spring — stay tuned for news about that. Given that, I thought maybe a small introduction to understanding dreams would whet your appetite.
Jung tells us:
“After the parting of the ways with Freud, a period of inner uncertainty began for me. … I felt it necessary to develop a new attitude toward my patients. I resolved for the present not to bring any theoretical premises to bear upon them, but to wait and see what they would tell of their own accord. My aim became to leave things to chance. The result was that the patients would spontaneously report their dreams and fantasies to me, and I would merely ask, ‘What occurs to you in connection with that?’ or, ‘How do you mean that, where does that come from, what do you think about it?’ The interpretations seemed to follow of their own accord from the patients’ replies and associations. I avoided all theoretical points of view and simply helped the patients to understand the dream-images by themselves, without application of rules and theories. Soon I realized that it was right to take the dreams in this way as the basis of interpretation, for that is how dreams are intended. They are the facts from which we must proceed.” (Jung, Memories, Dreams, Reflections Pp. 170-71)
It is very difficult for some of my patients to get it that I am not the expert on their dreams, that I have no magic wand to wave to magically reveal all that the dream contains. That they themselves are the experts for their dreams is a tough concept as many of them are so used to looking to experts for answers. But this is exactly what I like most about Jungian dream analysis, that we start from the patient and not from the theory.
So forget about your books of dream symbols and just be with your dreams. Ask yourself the questions Jung asks in the quote above. Let the dream talk to you. And if you must have a book to help you, here are 2 that may give you some ideas:
When I was nine, we lived in Albuquerque, New Mexico. My mother, not an easy woman, thought I would never become a desirable catch, as I was too preoccupied with books. Her poking, prodding, and criticism did not work, so she enrolled me in a ballroom dance/etiquette course. As it happened, that same year, the University of New Mexico was mounting a production of Euripides’ “Medea”. They needed two nine-year-olds to play the sons, but it was thought that nine-year-old year old boys were too rowdy to take the discipline to be in a play like that, so they came to the dance class to pick two girls. I was one of them.
I remember being fitted for the costume, being taught to walk like a boy and to scream like a boy. I did not know what the story was, but it was fun learning those things.
I finally saw the play all the way through the day of the dress rehearsal. I remember standing in the wings watching. The meaning of the play rolled down the aisle like a dark cloud and swallowed me as I realized she kills her sons. In a moment, I understood what role I was playing. I can remember the hair standing up on the back of my neck and the sinking feeling in the pit of my stomach.
I woke up the next day with a fever and by the end of the day, it was clear I had the measles. I missed the whole run of the play.
Fast forward many years to graduate school. Medea continued to fascinate me so I decided to write my dissertation about her. I was struck by how modern her situation seemed. Imagine Medea as a girl, star-struck by the hero, Jason. Her name means cunning or knowing. She is the niece of Circe, granddaughter of Helios, daughter of a king. A powerful woman, a priestess of Hekate. Yet, when she sees Jason, described as good-looking, tall with long blond hair, a Fabio of his day, she becomes infatuated. Jason represents the glory and civilization of Greece, adventure. In order to help him to survive the tasks given him by her father as the price for obtaining the Golden Fleece, she must choose love over duty. In turn, in order to secure her help, Jason swears to marry her. In choosing Jason, Medea breaks the tie to family and home to go with Jason to a land where he is hero and she a barbarian.
Jason wants her, needs her, in order to successfully complete his quest. He is willing to give her what she wants—that feeling of being wanted and a place to hide her power and control. In agreeing to marry Medea, Jason gains everything—his life, the Golden Fleece, his safe return as a hero. In one version of the play, the Nurse raises the important question: “Why must a woman seek a man who seeks his special gold?”. Men with this kind of commitment, more to their quest than to the woman, seem unlikely to match the devotion of a woman like Medea. But she feels wanted, needed and so surely, perhaps she thinks, he must be the one for her.
I hear variations of this story again and again in my office from smart, competent women who spend their days wanting to be wanted and being disappointed time and again. To a degree I lied it myself when I was a young woman. Too often the women seem to see themselves as trophies or dolls on the shelf and convince themselves that whoever chooses them must be the right one, because after all, he is choosing her. And too seldom see themselves as also in position to choose, not merely to wait until being chosen.
Following from Lacan, who asserted that women want to be wanted more than they want to be loved, women too often seek to be desirable rather than to be fully known. Polly Young-Eisendrath explores this “wanting to be wanted” not as the normal outcome of female development but as a problem in her book, Women and Desire: Beyond wanting to be wanted.
“The compulsion to be desired and desirable undermines self-direction, self-confidence, and self-determination in women from adolescence through old age, in all our roles, from daughter to mother, from lover to wife, from student to worker or leader, whether or not the affliction is conscious.
Wanting to be wanted is about finding our power in an image rather than in our own actions. We try to appear attractive, nice, good, valid, legitimate, or worthy to someone else, instead of discovering what we actually feel and want for ourselves. In this kind of conscious or unconscious arrangement, other people are expected to provide our own feelings of power, worth, or vitality, at the expense of our authentic development. We then feel resentful, frustrated, and out of control because we have sacrificed our real needs and desires to the arrangements we have made with others. We find ourselves always wanting to be seen in a positive light: the perfect mother, the ideal friend, the seductive lover, the slender or athletic body, the kind neighbor, the competent boss. In place of knowing the truth of who we are and what we want from our lives, we become trapped in images.” (Young-Eisendrath, Women and Desire: Beyond Wanting to Be Wanted, p.3)
Q. How many psychiatrists does it take to change a light bulb?
A. None—the light bulb will change when it’s ready.
Well it is actually appropriate in talking about therapy.
How much does a person have to want to change in order to change at all? Basically nothing is going to happen as a result of therapy if the person doesn’t want to change. And it is a lot more complicated than it seems. Change is inherently destabilizing and uncomfortable, even when it seems highly desired. So there is a big difference between feeling you want to change and actually doing the changing.
I read somewhere that a famous guru when asked how to stop smoking said, “That’s easy. Don’t smoke the next cigarette.” All the work of therapy lies in that space between the question and the action.
The pattern of beliefs and feelings we have about ourselves, built up over a lifetime often with roots in our earliest relationships and never really challenged by us create the prison we live in. We don’t realize is that this prison has only three walls and no bars keeping us in. We don’t realize this because we stand in the corner looking at the walls in front of us and believe that there is no way out. Therapy is, at least in part, the process of turning around and discovering that we can walk out of our prison. That process is not easy and it can take a very long time, but stripped to bare essentials, that is what we do in therapy.
So you decide one day to go to a therapist to see what she can do to help you. In therapy, no matter how much you may believe you are controlling your responses and behavior, over time your habitual ways of thinking and acting about yourself and your world show up. These are the stories you tell yourself about yourself; they make up your prison. As the therapist questions your habitual responses and views and challenges your ideas about yourself and the world, ever so gradually, you start to change — daring to be more open, to question what you have believed, to try new ways of behaving. It is slow and subtle. The therapist has to be both patient, caring and willing to challenge you, the patient, even make you uncomfortable or upset. And be able to not take personally the feelings you have toward her or him. Gradually the story you tell yourself about yourself changes, not in kind but in degrees. The things that used to be self-defining recede a bit to allow other self-perceptions and beliefs to come to the fore. The more deeply ingrained the patterns, the longer it takes to change them.
The therapist doesn’t DO anything. We listen, we offer observations in the form of interpretations, we may confront but we have no magic to make change happen. It is entirely possible to spend months or even years in therapy without changing at all. The hard work of making the change — or, to return to our famous guru’s recommendation, not smoking the next cigarette — is up to the patient. So why see a therapist? Because it is very difficult to see yourself clearly. Just as a camera cannot photograph itself except in reflection, the kinds of changes that are the heart of therapy need someone to serve as a mirror, as someone who can see and hear you without having an agenda about or for you, someone who can be caring and brutal. I can’t think of anyone I know who has done that without help, including myself.
Got questions about therapy? Leave a comment or email me using the form on the right, and I will do my best to answer. Please keep questions general rather than about your therapy or therapist.
At this time of year we often think and write about things we remember. So this is a good time to stop and think about memory itself.
I read a lot of memoirs. I remember discovering biographies when I was in 3rd grade — remember Landmark Books? I found them and began to eagerly read biographies of people like Clara Barton and Abraham Lincoln. But there weren’t many about women. In fact women’s lives seemed not to be deemed interesting until the women’s movement began to encourage women to speak in our own voices about our lives.
Among the many wonderful memoirs by women I have read in the last 25 years or so are:
Fierce Attachments by Vivian Gornick
A Chorus of Stones by Susan Griffin
Skating to Antarctica by Jenny Diski.
The Shadow Man by Mary Gordon
Devotion by Dani Shapiro
Memoir necessarily engages in the problem of memory. Is what is remembered what happened or a narrative created on a mesh of emotion, images, and sensations? Diski says, “Memory is not false in the sense that it is willfully bad, but it is excitingly corrupt in its inclination to make a proper story of the past.”
Jung tells us: “The function of memory, or reproduction, links us up with things that have faded out of consciousness, things that became subliminal or were cast away or repressed. What we call memory is this faculty to reproduce unconscious contents, and it is the first function we can clearly distinguish in its relationship between our consciousness and the contents that are actually not in view.” (CW 18, p.39)
Now here is an example from my own life that I believe is a memory —
I am old enough that when I was in elementary school, we had a Christmas pageant in school, complete with angels and shepherds and everything. I will always remember the pageant when I was in second grade.
In my class, the best reader was to be made the head angel and would read the Christmas story from the Gospel of Luke. Well, I *knew* I was the best reader because I was reading several levels ahead of everyone in my class. My nearest competitor, Martha S., was a good reader, but I knew she was not the best. So I was absolutely certain that the head angel position was mine.
Imagine my shock, my horror, my outrage when on the day when parts were assigned, it was not I who was to be head angel, it was to be Martha S.! In my mind, this was a terrible injustice. Here I was, the very best reader in the second grade and I was to be consigned to the ranks of the ordinary angels! As it happened, Martha was a very pretty little girl with long blonde hair while I was chubby and brunette so maybe Martha fit the picture of an angel better than I did. Outwardly I accepted this injustice and quietly took my place in the ranks of the angels.
My mother made my costume, complete with glittery wings and a halo. We rehearsed. And then came the day of the pageant.
Martha stepped one step in front of the ranks of angels and took a breath to begin her reading. And then, just one word ahead of her came another voice from the back of the angels, reciting the story perfectly word for word. Martha got flustered but I continued on. Yes, I had memorized the whole story. I knew I was the best reader.
To my mother’s great credit, she did not get angry or make me feel bad. And what I did became the stuff of a story my family told about me.
BUT — is what I remember what actually happened? I certainly wanted to be the head angel. And to this day, I still know the words to the story. But if we could talk with Martha S., would she remember it the way I do? Or is it a narrative developed to fit the story of myself that I was weaving, the story of a spunky little girl who could make things go her way?
The words “memoir” and “memory” come to us from the middle English/Anglo-French word memorie, and from the Latin memoria, derived from memor, which means “mindful.” Russell Lockhart in Words As Eggs: Psyche in Language and Clinic traces it also to an Indo-European root smer– — which in one form refers to grease and fat. How is memory connected to ‘fat’? Think about how difficult it is to get rid of fat. It sticks. It adheres. It won’t leave. It leaves traces. A memory is what sticks, what adheres in the mind. Memory is the fat of the mind. Related words that share the history of memoir include remember, commemorate, memorable, memento, and memorandum. The word mourn also shares its derivations. The same root that gave rise to memory gives rise to mourn. When someone has passed away or slipped away, we mourn that memory. When we are in mourning, we are deeply engaged with the memory of that person. Our mind is full of memories. We can only mourn through memory and with memory. We mourn for what we had and can now have only in memory.
Think about a vivid dream you have had. When you write, it becomes something other than the dream. It becomes a text, an adaptation of the dream, but the dream, consisting of images, cannot be fully and accurately captured in words. The same with memory. The experience remembered is not a record, faithful in every detail. The memory is particular to the rememberer. Even in a family, the same event can and often is recalled differently by parents and children, even by siblings.
A symptom is an untended memory. It is the voice of a forgotten or banished part of ourselves… Memory is the medicine of the psyche – even, and especially when the memories are dark. – George Callan
I used to have a section of this blog devoted to knitting. I am an avid knitter and always have multiple projects in process. Then someone suggested to me that I should focus just on professional material or maybe it was that I was feeling self-conscious. At any rate, I took down the knitting portion.
Then I remembered this quote from Marie Louise von Franz on knitting :
Everybody who has knitted or done weaving or embroidery knows what an agreeable effect this can have, for you can be quiet and lazy and also spin your own thoughts while working. You can relax and follow your fantasy and then get up and say you have done something! Also the work exercises patience…Only those who have done such work know of all the catastrophes which can happen — such as losing a row of stitches just when you are decreasing! It is a very self-educative activity and brings out feminine nature. It is immensely important for women to do such work and not give it up in the modern rush. (The Feminine in Fairy Tales, Spring Publications, 1972, p. 40)
She makes it clear to me that knitting, like painting or writing, has its place in this process of self-discovery that I am so much engaged in, for myself and with my patients.
Knitting, among other things, is one way I understand my work and my life. My office is at home, in the middle of my domestic life. I have a basket of yarn in my office — because I think it is beautiful. I also have there art supplies on the table I use when I attempt to paint. I used to fantasize having a house that had a big kitchen with a fireplace and I would see my patients there, in front of the fire, sitting at the table and drinking tea. Because for me the kitchen is the place of transformation. There are things in my professional life that I want to explore more deeply. But those things have grown out of ordinary life — aging, figuring out what it is to be a woman, working at my story, embodiment, dreams all of it.
When I was in my 20’s, in the heydays of second wave feminism, I always felt I had to hide my interest in things domestic. To acknowledge having a domestic life — cooking, knitting and the like — was all but a betrayal of what we women were striving for: to be taken seriously as thinkers and doers and not be relegated only to hearth and home. I don’t think my friends in graduate school then even knew I loved to cook or that I knitted and crocheted and sewed. And when I got married, it was a point of honor that I do half of the work around the house and not a bit more.
But that was then. And in the course of growing older and growing up more, I seem to have lost that need to split my life as I did. Maybe this is the gift of third wave feminism to women like me — that we can bring the parts of our lives together. And in mending the splits in our lives, perhaps we can move toward mending splits in our husband’s and son’s lives as well.
As Jung says:
Individuation means becoming an “in-dividual,” and, in so far as “individuality” embraces our innermost, last and most incomparable uniqueness, it also implies becoming one’s own self. We could therefore translate individuation as “coming to selfhood” or “self-realization.” (C.G. Jung, CW 7, para. 266)
It is often the case that at midlife and beyond life calls us to look again at who we are, what we have done, what we believe in. This is prime time for discovering what is the story we have been living; as Jung put it —
I asked myself, “What is the the myth you are living?” and found that I did not know. So…I took it upon myself to get to know “my” myth, an I regarded this as the task of tasks…I simply had to know what unconscious or preconscious myth was forming me.”
Human beings are narrative makers. We remember ourselves and our lives in stories — stories we tell our friends, family, strangers, ourselves. When a new patient comes to me, I say “tell me about yourself” and await the story of this person’s life and how it has brought her to me. And if we work together for some time, that story will change so that the story she tells at the end will be recognizable as hers but different in some ways from the tale told at the beginning.
“The universe is made of stories – not atoms” — Muriel Rukeyser
So, we swim in a sea of stories — our own and those of the ones around us. And we shape our lives around the story we tell ourself is ours, the story that we live. Think of a person you no doubt know whose life could be summed up in the song title, “I would do anything for love” — can you begin to see the story he or she is living? And how might that person be able to change the course of the story, write a new chapter if only she knew it was what she is living?
“The story I am writing exists, written in absolutely perfect fashion, some place, in the air. All I must do is find it….” Jules Renard
Exploring personal myth is one way to discover the story.
In the last 20 years or so, a number of books have been written on the subject of personal myth. Of the lot of them, 2 stand out for me as better than the rest:
James Pennebaker: Writing to Heal — Pennebaker, a social psychologist, has done considerable work examining the healing potential of writing.
Sam Keen & Anne Valley Fox: Your Mythic Journey — this book encourages the reader, through writing and reflection using question drawn from the work of Joseph Campbell, to uncover our story and explore its meaning.
I am never entirely happy with self-help books. In order to appeal to a large audience, in my view, they lose bite in favor of what is palatable and likely to engage masses of readers, rather the same way that the food from Taco Bell is suggestive of Mexican food but lacks the complexity and range of real Mexican food. So think of these books as a way to do personal myth, lite. Digging into one’s life, looking at Shadow as well as Persona, takes time. Plus all of us are at best reluctant to look into the corners and under the rocks where our darker or less acceptable aspects lurk. That said, these books offer a palatable way to begin to look at personal myth and may whet appetite for looking deeper.