Psychotherapy As Art
Posted by Dr. Vollmer on January 27, 2015
“On the day, some decades ago, that I sent off the manuscript of what would become my sixth published book, I was suddenly possessed — there is no other word — by the desire to leave this world, and to do so by stepping in front of an oncoming bus. I walked to the edge of the sidewalk, stepped down, hesitated, let the bus go by, and decided to go home, where, if one of my children, then ages 4, 2 and 1, defied me in any way, I imagined picking that child up and throwing the child against a wall or through a window.”
“I came, slowly, not merely to remember experiences and feelings, but to relive them. And this turned out to be not unlike what I did while writing fiction: I gave myself up to my own life and feelings in the same way that, when inventing characters, I gave myself up to what my characters felt and experienced. By imagining an experience back into existence I came closer not only to what had happened and what I’d felt, but to what I’d forgotten, or had not felt, or not seen, or might have felt. I became lost and frightened the way characters in my novels became lost and frightened, and I found ways of surviving in ways my characters did. Like my writing, psychotherapy enabled me to make sense of a world that often seemed senseless.”
These are quotes from the article for the New York Times blog, entitled the couch. The author, Jay Neugeboren describes the process of psychotherapy as similar to writing fiction. By imagining himself as a character in his book, he could then develop sympathy and empathy for himself. With these feelings comes the ability to feel sad for what he did and did not get throughout his life. This sadness is the journey of mourning, and like mourning the death of a loved one, it is a journey of fits and starts, a journey of waves coming in and then receding, but ultimately with an acceptance of the loss and an ability to re-invest in new relationships. Psychotherapists, psychoanalysts, help people imagine themselves in the third person, and in so doing, the patient can begin to feel his experiences with consciousness and depth, rather than lapse into denial and superficial thinking. The art in the work is that the journey is not mapped out. The journey evolves over time.
This critical distinction is why I rail at time-limited therapies, since one cannot put a time on personal exploration, because, as the word implies, it is personal. If we then accept psychotherapy as an art, then we have to accept that there needs to be an open-ended approach in order for it to be deeply helpful. At the very least we should acknowledge that open-ended therapies are the gold standard, and so when modifications need to happen, we need to modify with the understanding of what is useful, is the ability to go on that journey of self-exploration, with a concerned professional, is useful. We cannot prescribe the journey, we must let it unfold. Thank you Jay Neugeboren for articulating my point.