Allowing the Therapy Speak for Itself

By Kevin Murphy MSc.,
Psychoanalytic Psychoanalyst,
Dublin, Ireland.


Two separate clients decided to finish up their treatment at around the same time recently because each said they were feeling better. When I asked how they felt at the end of treatment compared to how they felt when they started, the first client said the things that were worrying them when they first came weren’t a worry anymore. These things hadn’t gone away and yet for some reason over the course of the treatment they had ceased to be a major, all encompassing worry in their life.
The other thing this client said was that before they started treatment they could not imagine a future in which things got any better for them or improved in any way. They said they had felt destined to live a life that was pretty much stuck in the same way of dealing with things, getting hurt at the same situations, at the same negative ideas that occurred to them, and they had become resigned to nursing themselves through life with practically no sense of self belief or joy in what they did.
By comparison, this client said that they were now experiencing optimism for the first time in a long time and that the future seemed to hold out a range of different possibilities and opportunities for improvement.
When I asked this particular client what they thought it was within the therapeutic process that had brought about such a change, they replied: ‘I don’t know.’
The second client I referred to had come to treatment because a particular compulsion was taking over their life. This particular compulsion had put their main relationship under pressure and it was threatening to make life difficult in terms of family and work relationships.
When this second client decided to finish up treatment I asked the same question about the difference between before and after. Before treatment this client had tried to hide the compulsion, disguising its effects in all sorts of ways from their partner, and had become obsessed with the negative implications it held for them. A lot of worrying and stress was carried out in private in case anyone should find out about it.
At the end of treatment, the client said they were no longer compulsively engaging in this behaviour and had stopped completely. Needless to say, I had not made any suggestions in this regard during the therapy. The client also said their main relationship had improved hugely and their sense of relief and self-belief had returned.
When I asked the same question about what they thought had taken place in the therapy to bring this about, they gave the same reply as the first client. They didn’t know.
It’s nice to see therapy work. But it is not always possible to say why it works, particularly from the client’s perspective. Not that it matters to someone very much if they manage to pass from fear or compulsive behaviour or whatever, to a more balanced, optimistic position.
But it points to the essence of what goes on in therapy. Psychoanalytic theory is rich in explanations and theories as to what the process does: it lifts repression, restores inner energies to their rightful places, brings into consciousness new understandings and meanings, undoes some of the damage of faulty ideas or imagined notions and concepts, allows us reconfigure past experiences that have remained unresolved, and places it all in a current context that allows us get on with our lives, right here, right now.
But from the client’s point of view, there is no direct experience of these things. There is often no putting a finger on exactly what it is that has made the positive changes take place. The experience of therapy will have felt like simply talking. And sometimes it will have felt like talking about the most random, most trivial aspects of one’s life. And yet somehow this activity contributes to a gradually improving sense of one’s self.
The act of speaking, in its fullest sense, in the choice of what one chooses to speak about, in the choice of words one uses to describe those things, in the way the thing spoken about before that or immediately after that might signal a connection or no connection at all with anything else. It is in these things that meanings make themselves felt, not always and exclusively between the client and the therapist because frankly not ever therapeutic session ends with a neatly wrapped up set of meanings that flood the client with insight.
No, it is more a gentle accumulation of meanings within the clients themselves, often not recognised at first, but over time these newer meanings insist their way into the person’s way of thinking about the world and their place in it.
It is not an obvious process. It creeps up on you before you realize it. That’s why the two clients above could point to definite improvements in their quality of life but were unable to say why it had taken place.