What brings people to psychotherapy? Ideally, this is a question that would never be answered in general terms for each person is unique and therapy only becomes meaningful once the client begins to come to terms with his or her uniqueness. The better, indeed essential question is always: "What brings you to therapy?" For only by eliciting reflections based on the actual experience of the client can a strong foundation for therapy be built. As a psychotherapist, then, I avoid making any medical sounding diagnoses precisely because it discourages the development of the self awareness that therapy depends on. Moreover, I don't believe that a medical diagnosis--derived from the Greek, meaning seeing through-- for purely psychological conditions is actually possible. Although I believe that fixed patterns of mental suffering are a reality beyond dispute, the idea that there are discrete disease entities that can account for them has little, if any merit in my view. Still, because there are typical patterns of thought and behaviour for a great range of psychological complaints, having some theoretical understanding of what people commonly experience when they are depressed, anxious or deeply confused is a resource that no therapist can do without. But helping the client to look beyond the symptoms of her particular condition and find the intentional actions that keep that condition in place is what therapy is all about. This almost always involves recalling painful experiences from the past, as well as looking at difficulties and frustrations in the present. And what is often discovered is that at the heart of those frustrations there is often a terrible privation that can be be both mysterious and obvious at the same time. The lack is love.
The idea that getting love is the answer for all the pains and frustrations to the which the self is subject is practically a cliche and every therapist should regard it with deep suspicion. Alas, not all therapists do and many err seriously by seeing themselves as the guardians of their clients' affections. It is common to hear, for instance, of therapists projecting their own material into the client's discontents, imposing their sense of narrative into the living story of their clients. This may be done more or less innocently, but it is almost always done blindly and can only work against the client's need to develop self insight. Perhaps even worse is when therapists explicitly advertise themselves as love doctors who can dispense wisdom and advice for obtaining love and sex. There are certainly good, ethical therapists who deal responsibly with issues relating to sex and relationships. Unfortunately, there are also others who are only too happy to exploit the insecurity of their clients by promising success in love. As we might suspect, this is largely an American phenomenon, but the practice of promising to deliver romantic success happens here, too. The late David Smail, a brilliant psychologist, used to argue that it was a strategy of advanced capitalism to present love as a scarce commodity by convincing people that only the wealthy, famous, intelligent or beautiful are worthy of it. His argument finds validation in psychotherapists who pander to the desperate hopes of the lovelorn by playing on the logic of feeling that a capitalist society promotes. Yet, surely, feeling unworthy of love is nothing new or modern. The complaint of the world has always been that there is never enough love to go around. If some therapists find the shortage of love an opportunity for selling it like snake oil, the problem that therapy will always face is the absence of love. "Why doesn't love happen to me?"; or, even more poignantly, "why didn't love happen in my childhood, when I needed it the most?" are questions that always come up in therapy. Of course, seeing love from a position of deprivation is almost certainly to form a distorted idea of it. It's like trying to imagine life on a planet in a distant galaxy. The possibilities may appear endless, but none are open to direct experience. Fortunately, most of us have experienced love in some form or another. And usually those experiences provide essential guidance for our emotional lives. Yet, although almost any form of love does have a transcendent quality, confining our notions of love to our personal experience of it may be misleading, especially if we think that love obtains only in the people or things that stimulate our affections or arouse our desires. Though we may find security in knowing whom and what we love and the reasons why we love them, we may still be mistaken in closing the circle of our love around them. We forget that love begins as an opening and a discovery that enables us to know others--and ourselves--in a way that no other form of knowledge permits. Consumerism does a booming trade by persuading us that love appears only in erotic or sentimental guises and convincing us to dread the possibility of never getting it. But love depends less on objects that provide reliable satisfactions than it does on keeping the heart open to the experience of others. Those who are advanced on a spiritual path--people we might regard as enlightened--appear almost indiscriminate in the expression of their love. It seems to radiate from them like sunlight. They also seem to know something that the rest of us don't. Their love doesn't need to be gratified--it is already gratified, or rather, perhaps, their love is realised beyond any need to find gratification. Certainly they seem able to give love without receiving it in turn; nor do they seem aggrieved by the lack of reciprocation. But for most of us, love is far more conditional. We are cautious and selective in offering it and we usually offer it only in order to get it. But then, it may be that we really don't see what the enlightened seem to know so clearly. Almost everyone wants love--to give and receive it--but the conditions we impose on it impair our understanding of what love is. And because love leaves us vulnerable to disappointment, we are understandably protective of our affections. So we cling to love as we have experienced it, even when the conditions of that experience may have vanished. So how does therapy help with the lack of love? Certainly not by preaching the virtues of universal love, no more than by shilling the benefits of romantic love. But because love is essential to human experience, it must remain open to personal enquiry. This may not only involve examining the client's personal history of sadness and disappointment; it also involves an imaginative exploration of how love can be meaningful in the terms that her life experience furnishes. Love really is the answer for so many of the pains that people suffer. But sometimes therapy is the place to begin to address the question.
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