Getting Help & Quality of Life
I am a strong believer in the value of making conscious and informed decisions about how we conduct our lives, and there is a wealth of self-help literature out there, offering perspectives and practices that have been helpful - and in some cases transformational - for any number of people.
But I think it is important to take any self-help approach - and, indeed, any therapeutic modality - with a grain of salt. In this post I want to explore the different ways we use self-help, and how we might do so with more curiosity and compassion.
Most therapists are familiar with this situation: you’re in session with a client, and a thought flickers through your mind: ‘this person could really benefit from long term therapy.’
Of course, this person is in long term therapy. With you. This is it. You are it.
And you have a vertiginous feeling, familiar from the archetypal anxiety dream where you’re sitting an exam you haven’t revised for.
You don’t know what you’re doing.
You want to be rescued, and you want this for your client, too.
Surely, someone else out there must have the answers.
When you bring this to supervision, you first of all consider whether your client is presenting with issues outside of your clinical competence that require a specialist referral.
But you also consider whether something is being enacted from the client’s relational history.
Is it common for them to be told their needs are too great, too complex? Are they used to being passed on, fobbed off? And how can you avoid recreating that situation in therapy?
And is it possible that you are both in thrall to the fantasy of a perfect solution, or a quick fix?
The lure of the quick fix is potent.
At the end of the day, what most of us want is just to get on with our lives - the stuff that feels fun and satisfying and meaningful - without snagging all the time on obstructive thoughts, feelings and behaviours.
On the face of it, this doesn’t sound like a wildly unreasonable wish.
And no decent therapist wants to string their clients along. We feel pleased and proud when our clients feel they can take it from here, and don’t need us anymore.
But if there were a sure-fire ‘cure’ - or at least a reliable palliative - for the things that trouble us in our emotional lives, we’d know about it.
When we seek out self-help material, we tend to choose approaches that buttress the beliefs we already have about ourselves. And these beliefs generally focus on our perceived deficits.
Whether we think we need...
greater discipline
healthier habits
deeper intimacy
greater authenticity
total equanimity
more confidence
…we can always find books and experts to advise us in those areas.
But it’s important to pay attention to the mood in which we are engaging with self-help materials.
Are we in the grip of a repetition compulsion, whereby we return again and again to approaches that have not worked for us, further entrenching the idea that we are hopelessly flawed?
Are we hyperfocussing on the things we like least about ourselves, as a form of psychological self-harm?
When we are doing this, it can be a sign that we are feeling helpless, deskilled, disempowered.
We might long to turn ourselves over to the care of a kindly authority figure. Or to submit unquestioningly to a stern disciplinarian who will knock us into shape.
As a therapist, when you experience the wish to be rescued, part of your task is to hold yourself steady enough to navigate complexity, ambiguity and intractability together with your client.
Your client may sorely need the experience of not being fobbed off or passed on - even when you feel as helpless as they do in the face of the difficulties they’re dealing with.
You can model the possibility of tolerating feelings of helplessness or despair; you can help them understand that they themselves are not intolerable because of these difficulties.
It can be helpful to interrogate the assumption that ‘life’ is the getting on with things - the fun stuff, the satisfying, meaningful stuff - and that unpleasant thoughts, feelings and behaviours are aberrant experiences to be eliminated.
And sure, it’s no fun to feel anxious or depressed. But nor is it a character flaw or moral failing, or a problem that must be fixed before life can continue. Life is continuing all the time, anyway.
So how can we return, with curiosity, to the task of finding meaning, satisfaction or comfort even while we are living through or living with difficulty?
Exercise: Quality of life
I attended training in somatic trauma therapy with Babette Rothschild some years ago, and in our first session she said that the aim of this approach was not to ‘resolve’ the trauma. If we focus single-mindedly on ‘resolution’, we run a very high risk of re-traumatising the client.
Instead, she said, our aim should be to improve the client’s quality of life. And attention must be paid to what this means, specifically, for each person.
Thinking of a difficult situation you are living with, what might improve your quality of life?
What expectations of yourself could you let go of in order to free up energy and headspace?
What skills might you like to develop that could support your quality of life?
What help might you realistically expect from others, if requested?
There are always new skills we can learn, that might make our lives more comfortable, efficient, or interesting.
If we can hold this learning lightly, with the aim of improving our quality of life - rather than self-purification, self-mortification, or ‘bettering ourselves’ - we can take what is useful and leave the rest.
We are less likely to abandon ourselves to dogmatic approaches or idealised experts. We will learn much more about how to support ourselves through difficult times, and feel more capable of doing so.
As a therapist, when a client doesn’t need you anymore, it’s not because they are fixed, or all their problems solved.
It’s because they can trust themselves to take it from here.
If this has been helpful to you, consider checking out my free mini-course on the topic of Compassionate Productivity - where, among other things, we look at ways to recognise what help and support we could benefit from.
