Reflecting on... Sex

In 2012, it became acceptable to talk about sex. ‘Mummy-porn’ transcended economic and educational status and everyone was talking about BDSM (bondage, domination, and sado-masochism). The new normality diminished people’s defenses and awkwardness. It facilitated communication and experimentation. It freed people up. The similarities to therapy are noteworthy.

 

Inevitably, Fifty Shades of Grey¹ began to filter into adolescent’s therapy sessions. I found young readers’ responses uncomfortable. They weren’t fazed by depictions of BDSM because they’d been there, done that. Fair enough. While sexual experimentation is to be expected, whatever form it takes, of concern is the idealisation of the ‘Fifty Shades’ relationship and its effect on adolescent liaisons.

Fifty Shades is essentially a romance between 22-year-old graduate Ana and 27-year-old businessman Christian. Adolescents can aspire to this without stretching the realms of possibility too far. It’s akin to the crush-on-a-teacher scenario; a naïve partner seduced by a sexually experienced authority figure. Christian is obscenely wealthy and turned on by controlling Ana, a physically and emotionally pliable virgin who is sexually up for anything. Their story depicts a common fantasy.

But many adolescents slip unwittingly into roles carved out by controlling partners, and into sexual relationships which are abusive. Social learning theory conditions them into believing that if they consent to whatever fantasy their partner suggests they will be rewarded with a grown-up, stimulating relationship. Christian is gorgeous, rich and powerful and uses his assets to stalk and control Ana who, despite her reservations, gives in easily. My clients give in easily too. I’ve heard from many who allow themselves to be controlled, sexually or otherwise. For them, the power imbalance and sense of danger is a turn-on. They have a dysfunctional and damaging model of relationships which tells them they must control or be controlled.

When I discussed my anxieties with a colleague, they were horrified. Not by my clinical observations, but that girls as young as 13 were indulging in ‘clit-lit’ and BDSM. We can’t pretend this isn’t happening; ignorance is not bliss. Young people view porn and read erotica. This forms part of their sexual education. We have to be ready to explore and reflect with them about all kinds of sex and relationships. We must not abuse them further with judgement or ignorance but rather acknowledge their defences and manage their awkwardness (and our own) in order to free them up and facilitate communication, however uncomfortable this might be.

1.     E.L. James, Fifty Shade of Grey, 2011, Vintage Books

Published in BACP Children & Young People December 2012

Reflecting on... Faith (in the process)

I remember being advised, as a trainee, to have faith in the process of therapy. I trusted my mentor wholeheartedly but this thing she called ‘the process’ was an enigma. Gradually, I began to disentangle the content of therapy from the thinking-about therapy, although initially, most of my processing happened outside of the consulting room. With clinical experience, the doing and the thinking-about became reconciled, so that for me, the process has a unique identity which is linked to, yet also distinct from, the content. This is a difficult concept to explain, and one I have struggled to illustrate to patients who are finding it difficult to ‘have faith’ just as I did.

Non-believers come in all shapes and sizes. Examples from my clinical practice include the child who wants me to set the agenda; the concrete-thinking father who draws me into philosophical debate and is reliant on logical argument in lieu of emotion; the abused adolescent who perceives each interpretation as an intrusive attack; the mother who screams ‘there is no such thing as the unconscious!’ right in my face; and the boy who yells ‘why do you have to analyse everything I say?’ These clients are focussing on the concrete content of the session and finding it difficult to consider the process. Perhaps they don’t know how. Perhaps they would find it too unbearable.

Non-believers can be colleague-shaped too; professionals from other disciplines who ask: ‘what do you actually do in therapy?’ A fundamental part of what I do is notice, name, digest, highlight and, perhaps most importantly, have faith in the process of the therapeutic relationship, as it alters and develops over time. As psychodynamic practitioners we understand the value of the therapeutic relationship in its own right as, what Winnicott called a ‘good-enough’ experience of maternal preoccupation. This is the process of therapy. In this we must continue to have faith.    

  Published in BACP Children and Young People June 2012

Reflecting on... The hate in therapy

The business of therapy and counselling involves empathy, nurturing, care and love. As therapists we are often on the receiving end of loving projections from our clients and this makes us feel good about our work and about ourselves. I think this is particularly apparent when our clients are children. So we reciprocate by loving them back, in the maternal, nurturing sense, so that we and they are enveloped in a circle of love. Love matters; it enables children to thrive and to survive out there in the big bad world. Therapy provides the perfect (aka ‘good-enough’) model of a loving, thoughtful relationship, incorporating maternal preoccupation and infant gratitude. How wonderful to make a career out of loving and being loved!

But just as day needs night, love needs hate. So where is the hate in child therapy? We love children therefore we can’t hate them. If we did we would be hated back and that wouldn’t be very gratifying for anyone. I think hate can get split-off and lodged in our peer relationships at work; unconsciously and in a disguised form of course. Hate gets played out in office banter, rivalry, dysfunctional meetings, ignored suggestions and cancellations. It is implicit in the invitation that goes out to all except one, and in the Christmas card that one colleague ‘forgot’ to send to another. 

These all-too-familiar experiences are subtle forms of attack and could provide clues about the [dis]location of hate. They are reminiscent of playground bullying which feels infantilising or empowering depending on our perspective. They re-enact the experiences of our clients so that our system replicates theirs and becomes just as chaotic and hateful. They cause us to feel unloved and taken-for-granted, resentful and suspicious. When we recognise that we are under attack we retaliate; we fight like with like, we hate back. Or, we retreat into absence from work. Or maybe we do something else. We might try to acknowledge the hate, name it, own it and take it to supervision where it can be given a fair hearing in a loving, thoughtful environment. Just the same as when our clients bring their own experiences of hate into the therapy room for us to know about on their behalf.

 Published in BACP Children and Young People April 2012

Reflecting on... When is the right time to end?

It might seem paradoxical, and perhaps a little perverse, to be thinking about ending as I begin my first column for CCYP. But reflecting on endings during beginnings, and vice versa, seems pertinent. Endings are something I struggle with in general and I find therapeutic endings difficult in particular. They don’t follow the same rules as ‘normal’ relationships which end when they go bad or when they no longer gratify whatever need they were supposed to. Good relationships don’t end. Therapeutic relationships are different.  

I recently ended with a patient I’d become very fond of, who had been coming to see me for four years. I’d spent about half that time wondering when we should end. Whenever I considered ending, something got in the way; either external issues – his, or internal dilemmas – mine; ‘how could I abandon him?!’ And then something changed. The adolescent boy in the therapy room regressed into the little boy I’d met years earlier. I became aware of re-emerging themes I hadn’t seen since his early sessions. It felt as if he was leading me back to the beginning.

I was reminded of a poem which was read aloud towards the end of my training by a favourite tutor in her rich Irish brogue. The poem was T.S. Eliot’s ‘Little Gidding’ and the quote I was reminded of is this: ‘What we call the beginning is often the end. And to make an end is to make a beginning. The end is where we start from.’

 

My ending with the boy, like the poem it brought to mind, was quite beautiful. It reminded me that therapy, like writing, is a creative process which is beyond control and may never feel fully complete. Both follow themes and boundaries, such as time/word count, but they must also be allowed space, because nothing stifles the creative process more than rigidity. And so, I will continue to challenge supervisors and commissioners (and frustrate editors) as I wait for my endings to make themselves known.

Published in BACP Children and Young People January 2012