Self-Relations Stories

Charles Holton, LCSW

I’ve been a psychotherapist in a county me ntal health center, a staff-model HMO and in private practice since the mid-1980’s and began studying with Steve Gilligan in 1993. I was immediately struck by his use of the aesthetic as a way to describe not only a way out of rigid symptom systems, but as a description of the felt sense of connecting with the unawakened potential of clients and of the unfolding of the therapy process itself. For me this honoring of the artistic, visceral, intuitive qualities latent in therapy co me to life in the practice of sensing the goodness of the symptom and of the therapist’s own neglected self as a precursor to speaking directly to the client’s neglected self. There is danger is this dance, as the magical and hypnotic sensibility they spring from and generate are more than me taphors, but can devolve into concrete and literal regressions when not balanced by grounding in everyday experience.

As often as not, I’ve been surprised by interventions that arise effortlessly from the connection with clients and afterwards remark to myself, “Ah! That was self-relations!” The process feels similar to other collaborative artistic experiences, and involves similar disciplines of mindfulness and responsiveness.

I’m sharing so me clinical vignettes, with the customary disguised client identities, hoping to do more than just illustrate how Self-relations has found a way into my practice in a variety of settings. I want the stories to convey so me thing of the lively flow of relationship when therapy is going well – how it involves more than a clever therapist delivering a well-thought-out intervention. I hope they convey how the relational field between therapist and client creates a third intelligence, and how that feels. And I hope they inspire other therapists to develop their own intuitive art form to balance the conceptual models of professional training. If they do, I will have passed on so me of the inspiration I’ve received from Steve.

1 “Awp. There’s that hypnotic voice again. Cut it out.” My supervisee was wagging her index finger at me in mock shaming while she smiled. We had been exchanging ideas on alternate endings to suggest to a client of hers bothered by trauma-related nightmares. I had gotten lost in imagining my suggestion of her client becoming twice as big as the perpetrator and wondering what she would want to say to him from this position of strength and safety. I was aware of neither the shift in my voice tone as my own consciousness entered a more imaginative state, nor of the inadvertent invitation to enter this hypnotic reverie. My supervisee sensed where my attention was coming from, and held her own position well; she even gracefully and with a touch of humor held the relational field on course in the arena of intellect and conscious intention, where she enjoys processing information and learning.

2 My colleague's client had survived two traumas: sexual abuse by her stepfather, and her mother’s stated belief she brought it on herself by being a sexually provocative child. Both therapist and client were puzzled at what course to take when her granddaughter reported getting slapped in the face by the client’s mother, and begged her to keep it secret. Therapist and client puzzled it out together, listing the plusses and minuses of telling, of confronting, of keeping the secret, of encouraging the child to speak up. Finally, the therapist spoke to her client this way: “I just don’t know what the best solution is. But as I think about what it must be like to be that child, what I would want most from you would be to be able to keep your trust, to be able to have a grown-up I could confide in safely, to know that I would be believed when I told difficult truths, and to know my sense of what I needed would be listened to and valued even when what I said made the grown-up uncomfortable. You’ve given all that to her already, and your presence keeps giving that to her. It’s quite a gift.” The client was silent for more than a minute, eyes slightly downcast. What was she thinking? Finally, she gathered herself, looked up and stated with the earnest firmness of a child discovering her sense of agency for the first time, “I’m going to take piano lessons. I’ve always wanted to.” She did, and enrolled in college, too, asking her therapist, “Is happiness really this easy?” I like to think about this as an example of speaking not only about the client’s granddaughter but also to the client’s neglected self, to the restored relationship between the client’s mature adult presence and her neglected self, naming the healing of that relationship. The safety this creates allows the e mergence of the “child ego state”: here is a place you will be believed. The result is not simply the e mergence of unformed fressen energy, though. Liberated enthusiasm for life is mediated by an adult awareness that holds and blesses it. The client’s adult presence senses the presence of a desire (the connection with the neglected self), and provides three acts of sponsorship of this capacity to know what she wants. She assesses that it’s a good and healthy thing, blocks the usual alien curses, and announces the intention to act: “I’m going to take piano lessons.” The connection of adult and child energy made the decision both responsible and joyful.

3 Nancy is a 33-year-old married African-A merican mother of two children who ca me to one therapy session about six months ago and then a second appointme nt two weeks ago. In the second session she disclosed a litany of problems that were feeling out of control: smoking stopped and restarted despite her intense motivation to quit for good; eating binges followed by periods of avoiding food; moody periods of intense irritability; and recently, episodes of taking impulsive one- or two-day driving trips to the beach, out of state, to the mountains, virtually disappearing without explanation from work and family obligations. She reported feeling frightened of the increasing frequency of the day‑trips, and of their impulsive, out-of-control quality. She was also feeling more hopeless and depressed as she repeatedly failed in her attempts at changing or controlling her behavior. She had described a history of sexual abuse in her first session, and wondered if these current problems were the result of this history. The number and intensity of the problems she was reporting suggested to me that addressing them individually would be impractical if not interminable. Besides, her own attempts at using will power and behavior change strategies had not worked. The connection she made with her history of sexual abuse made sense and provided a unifying conceptual approach for explaining the symptoms, but didn't necessarily suggest how to prioritize treat me nt. What see me d the common thread in her story and presentation was her attempt to obliterate various desires (for distance, food, nicotine, escape and assertiveness), and their uninvited rebound into consciousness with ferocity. What see me d lacking both in her historical experience and her current de me anor was any tenderness toward these needy, primitive, somatic aspects of her self. In talking to her about how I was thinking about her difficulties, I maintained a felt-sense of connection with her competent, adult self while holding a sense of tenderness for the deprived and neglected aspects of her self closed down since the sexual abuse. I spoke of the urges and compulsions as wonderful news. All the abuse could have killed her, or killed her spirit, but it hadn’t. She's still alive. The symptoms prove she’s still alive. I talked about supporting the e me rging awareness children have of what they want and their ability to ask directly for it, while lovingly setting limits and guiding them to acceptable choices. "If a child wants cotton candy for breakfast, you can tell her that you're glad she understands that food is to be enjoyed, and that you're glad she knows she likes sweet things, that jelly on the toast and orange juice are sweet things she can enjoy at breakfast. And you can tell her that you're really looking forward to going to the fair soon and eating so me cotton candy, and you know she can also enjoy the rest of the good food at breakfast as well as looking forward to eating cotton candy at the fair." I spoke of the need for her to really touch that place in her consciousness, in her body, that wanted things that wanted what she wanted, and really appreciate it that it hadn't been killed. It had survived. Nancy was nodding in agree me nt. I talked about how we all adapt to traumatic circumstances as kids so we can survive, that we all take on more than we can emotionally handle and so have to shut down parts of ourselves just to be able to make it. I read her part of the Antonio Machado poem Steve Gilligan quotes in The Courage to Love (Norton, 1995): Last night, as I was sleeping, I dreamt – marvelous error! –that I had a beehive here inside my heart. And the golden bees were making white combs and sweet honey from my old failures. I talked about how letting those longings speak brings them into the light of day so that they can find the forms that are useful to us in our adult lives. She liked the ideas, and the tone of the conversation. She lit up, she smiled, and was thoughtful in both receiving the ideas and in wondering how they would turn out to be helpful to her. I don't know if it occurred to her how actively and directly I was communicating with both her cognitive self and her neglected self, but she was clearly reorganizing her attitudes about these "impulses. ”Wanting her to be fully infor me d about available treat me nts, I me ntioned the me dications frequently prescribed to people with trauma-related symptoms to help stabilize mood in the presence of intrusive symptoms. Her face beca me sharp and her voice hard: "I will never again put anything in my body that I don't want there!" I smiled. I almost winked. "There she is," I said through my grin. "You feel her, don't you?" She smiled and said yes. "You know, whenever you notice very passionate responses like that flowing through you, especially when they're kind of 'either/or' responses, or self-protective responses, that could remind you consciously to connect with that young, spirited energy that really knows what she wants. I'm so glad she survived. We don't have to go through a lot of stories about your history to get to that energy. It's in you right now. I expect you're going to have so me interesting conversations with yourself in the next couple of weeks." In this mo me nt of the psychotherapy session I felt myself most infor me d and guided by Self-Relations in that I didn’t talk about her “neglected self” as a concept or interpretively notice that she was angry, or connect the response explicitly to historical abuse. I literally felt the e me rgence of that energy as a wonderful blessing, one weaving protection and individuation and the will to live with fear and hard-earned suspicion. Rather than reduce it to story, history, or concept, rather than reify it into a “part” of her or an “inner child”, I felt its goodness and spoke to her and it, and invited her implicitly and explicitly to connect with it affectionately. Fall in love with the goodness of the symptom first, discover how it’s essential. Set limits on its harmful expression second, while simultaneously cultivating curiosity about how its purpose can blossom in even more useful and helpful ways. When I saw her this week she laughed about her husband teasing her for talking to herself so much lately, and recounted with so me pride the kinds of conversations she was having with herself. She called it "reasoning with herself," but acknowledged an infusion of tenderness and compassion for the wants and needs she was just beginning to be aware of consciously. "Taking a drive would be a good thing, but we should include the whole family on a weekend day like this..." As a result of including more of herself in the conversation, she was feeling less out of control and less depressed. As I thought about the two recent sessions afterwards, it see me d to me that there was another marker of the integration she was accomplishing. The sultry, so me what over sexualized de me anor that was intermittently present in the first two sessions was absent in our last me eting, replaced with a more consistently clear and direct style of relating, a presence I would characterize as quietly buoyant. What seems unusual to me about the work we did was that my direct sponsorship of Nancy ’s neglected self activated her sponsorship of this energetic presence in her consciousness. Although this was combined with a conversation that wove through many the me s inviting changing attitudes toward her feelings and impulses, there was no explicit directive to identify and change those attitudes. And there was no explicit behavior-change work. The shift in her relationship with her impulses and feelings – from “frustration with failure to control” to “delight with success in guiding” – was a funda me ntal one that produced a broad band of healing across mood, behavior, impulse control, and hopefulness.

4 His wife had alerted me he wasn’t coming back after this session. I had been working with her off and on for three years, and although her waxing and waning depressions had responded to supportive and cognitive interventions, she had never been able to confront her verbally abusive husband about the impact of his critical and intimidating style on her, and now her depression was back with a vengeance. Even his six children cutting him off one by one had not driven him to look at how his manner distanced and alienated those he loved. But he agreed to co me in and talk for a few sessions to find out how he could help his wife with this most recent depression, characterized by her sleeping most of the day away and having little energy for interaction, and barely enough for chores. Initially I had handled his guardedness and hair-trigger “Oh, there we go again -- it’s all my fault!” exclamations with a mixture of easy friendliness and a serious, intellectualized approach to discussing the systemic dynamics of their marriage: how his emphasis on discipline and structure and her emphasis on connection and pleasant interaction had polarized over the years into his tyranny and her conflict-avoidance. This had helped him feel less resistant to the therapy process, but allowed him to tell their friends that I had explained how the marital problems and cut-offs from the children were actually her fault, not his, for not being disciplined enough. So much for the liberating power of intellectual inquiry. So in this session, being very attached to the outco me of his working on being less verbally abusive, and forewarned it was my last chance to work with him, my confrontation may have been a bit shrill, and my energy a bit desperate. I me t his “Oh, so it’s all my fault!” with “No, only the parts that are your fault.” I improvised a me taphor to de-focus the conversation from bla me and emphasize changing behavior productively: “If you were trying to spear fish and didn’t understand how light refracts in water, you’d keep stabbing away at the fish and never catch one. I’m telling you if you thrust your spear over here instead of where the fish appears to you to be, you will actually catch a fish instead of starving. Your children have all but disowned you, and your wife would leave you if she didn’t feel obligated to stay. She sleeps the day away and dreads your outbursts when she’s awake. I’d say you’re on the verge of starving.” I just knew I’d gone too far, and was nearly floored when he asked if I would see him individually. During our first individual session I spent most of the hour waiting. His defensive review of how reasonable all his decisions had been as a father (“Don’t children need so me kind of limits?”) was generating in me irritation, disappoint me nt at the backslide, and a resistance to offering support for this shoring up of his defenses. I did not want to act from this quality of relationship with him. Then, about forty minutes into the session, his eyes beca me moist and his speech beca me soft and gentle. “I just worry that years from now,” and I knew he me ant after his death, “my kids will want to have a relationship with their father and it will be too late.” I knew somatically this was an opening of his soft, tender center, and felt a deep and genuine sense of connection with him. I could speak from this place well. “I really sense how deeply you love your children, and your wife. It seems to me a great tragedy that throughout your life, they have only been able to sense it as control. I have certainly sensed it as control before, and I know they have. But just now as you talked about your children’s lives after your death, you had only their well-being in mind, not one iota of selfishness or control. And their loss opened up your sadness, for them, not for you. That’s real love. It’s so terribly sad that they have always experienced that as control. It’s such a loss for all of you.” When I saw his wife the next day she told me he liked my “soliloquy on love.” She thanked me for helping him beco me more patient, loving, and less abusive and controlling. “It’s just less and less an issue between us.” She was profuse in her thanks to me , and I deflected the praise with an emphasis on how it was his work that made the difference, but she was stern and firm in her response. “Look here. You made the difference. He was abusive for forty years before he started seeing you and he’s not now. You are the only difference that mattered.” It was nice to hear her so decisive, and I moved my discomfort aside to accept the praise. I beca me aware as we talked of a great sense of relief, a burden having been lifted. I was realizing that it took all my skill and experience to help this family; and we had, in a sense, just barely made it over so me minefields. The relief I felt was my own adult self letting myself off the hook for not having pulled of a similar kind of healing in my own family when I was a kid: if it took a grown, experienced therapist to set this broken bone, no wonder I was unsuccessful as a kid, try as I might. And before this mo me nt I was not even aware it was an issue for me . It was one of those mo me nts when the therapist gets therapy from the client. I felt close to tears myself, and well blessed.