Keeping Secrets from Your Therapist

When people enter psychotherapy, even if they're desperate and deeply in need, they don't fully reveal themselves in the early phases of treatment. As in any relationship, it takes time to develop enough trust so you feel safe making yourself vulnerable. A prudent reserve makes sense: how can you be sure the stranger sitting in the chair across from you won't judge or laugh at you? Sometimes people who struggle with borderline issues will disclose powerfully intimate information right away, but they nonetheless keep some deeply shameful details in reserve. Everyone does.

Like most psychoanalysts, I advise my clients early on to be as candid as possible, holding as little in reserve as they can. I tell them I know it's a difficult thing to do -- no one discloses 100% of their most painful feelings, thoughts and memories -- but they need to do their best. I acknowledge that it will take time to build trust, for them to feel I'm a safe person. As we come to know each other, they gradually disclose the more shame-inducing aspects of their emotional lives. Often their secrets relate to sex.

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Accentuating the Positive

I haven't heard it in a number of years, but every once in a while, a client will ask why we talk only about "what's wrong" in therapy. It's a valid question. Australian blogger Evan Hadkins, who frequently comments here on After Psychotherapy, has chided me for over-emphasizing the painful aspects of the work I do; the occasional site visitor will accuse me of "pathologizing" everything, rather than trying to view certain behaviors in a more positive or "normal" light. I've been thinking about the various reasons why I (and other therapists) don't accentuate the positive in our work more than we do. What follows are a number of explanations, each of which contains an element of truth.

1. Unhappiness Feels More Meaningful

You might recall that Tolstoy's Anna Karenina begins with a famous quotation: "Happy families are all alike; every unhappy family is unhappy in its own way." In other words, novelists don't write books about happy families because after you've described their experience one time, everything that comes after will be repetitive. The intricacies of misery are so much more interesting than satifaction, both in books and in therapy; happiness and contentment, after a time, become boring.

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Shyness and Self-Hatred

Early in my career, when clients would talk about intense forms of self-criticism or self-loathing, I used to make interpretations that focused on the savage and perfectionistic superego. Over time, I'd help them develop the mental ability to withstand this savagery and protect themselves from it. Later, as I described in this earlier post, I began to think more about learning from experience and facing our actual faults: the ways that brutal attacks on the self can represent a refusal to accept who we really are, with all our warts and limitations, which then leads to a cycle of crime and punishment where we repeatedly atone for our "sins" but learn nothing about what drives them. I still believe both of these perspectives have value.

Lately, however, as I've begun to focus more on shame and the defenses against it, I've come to see that self-hatred is a kind of defense in itself. Especially as I delve deeper into the work of Sylvan Tomkins and Donald Nathanson, I'm coming to understand how both shyness and self-hatred are strategies for coping with the shame that comes from rejection. They're both examples of what Tompkins calls the "Attack Self" script for managing the painful experience of shame. From a lay perspective, for readers who aren't familiar with affect theory, this might seem counter-intuitive but bear with me. I need to lay a little groundwork.

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The Healing Power of Humor in Psychotherapy

As much as I enjoy making my video series about psychodynamic psychotherapy, I feel a low level of ongoing frustration beause I don't come across as I do in other situations -- either in a social context or when working with clients. That person in the videos seems so darn serious, in contrast to the way I experience myself in general. I don't think I'm exceptionally witty or amusing but I do have a sense of humor. Yes, I'm a serious person in a global sense but I nonetheless smile quite a lot. Until recently, I've explained the contrast between on- and off-camera Joe in this way: it's difficult to smile and be funny when you're discussing deep pain.

Last week, it occurred to me that this can't be entirely true because I often laugh with my clients. I wouldn't make a joke if someone were crying or describing something especially painful, of course; but lately I've noticed that with someone I've known for more than a month or two, it's not unusual for us to be laughing together. It's not the dominant mood of the session, but at some point, one of us will make an observation that gets a smile or a chuckle from the other one. In times of crisis, the shared humor may disappear. When the work is going well and we're both perceiving progress, we might laugh more than usual; but laughter is a feature of the work I do with every one of my clients.

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Psychological Fairy Tales

This novella is part of a series of re-envisioned fairy tales in which I probe some of the darker aspects of human psychology. I’m also at work on a science fantasy epic that will explore the same terrain. If you would be interested in hearing about future releases, please add your email address to my mailing list. I promise not to overwhelm your Inbox and will notify you ONLY when I have a new release.

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