Friday, August 20, 2010

Two People Agree

Last week, a childhood friend of mine who writes a wonderful blog posted something about an article she'd read about therapy; the next day I found a copy of this same article in my box at work and figured I needed to read it. The article, called "My Life in Therapy," chronicles the experiences of a chronically depressed woman who seeks the services of many, many psychoanalysts over the course of her life. I read it with great interest and increasing distress: her experiences were just so awful, so invalidating,

The author states from the outset that:
To this day, I’m not sure that I am in possession of substantially greater self-knowledge than someone who has never been inside a therapist’s office. What I do know, aside from the fact that the unconscious plays strange tricks and that the past stalks the present in ways we can’t begin to imagine, is a certain language, a certain style of thinking that, in its capacity for reframing your life story, becomes — how should I put this? — addictive.
This is probably my greatest professional concern: that I will not actually help anyone, but only serve to perpetuate the therapeutic tropes that run rampant in our culture. Come see me, go watch Dr. Phil, go read a book by Dr. Laura--whatever, it's all the same.

She goes on to write about an experience she had with one of her analysts wherein she found herself profoundly bothered by the rules and regulations of the relationship, but simultaneously found it necessary to keep her mouth shut:
Needless to say, I didn’t air any of these thoughts and instead went into my skittish, slightly apologetic, pre-emptively self-deprecating patient mode — intent on sounding like someone who was aware of the pathological currents that ran beneath a life that might be viewed as functional, even successful, if looked at from afar.
I guess you could look at this a couple of ways: as the unending spiral of an incurable neurotic--as most analysts would likely see it--or as the understandable need to portray oneself in a certain way so as not to be labeled prematurely. In my experience, the latter seems disturbingly reasonable: there are a whole lot of pathologizing clinicians out there, people who will diagnose every assertive woman with Borderline Personality Disorder, who start talking about "resistance" when patients start questioning the point of therapy. And speaking of questioning:
All of which raises the question: What exactly is the point? How can you be expected to know when being in therapy is the right choice, to know which treatments are actually helpful and which serve merely to give the false sense of reassurance that comes with being proactive, with doing all that we can? Does anyone, for example, really know what “character change” looks like?...Even to this day, I’m not sure I know anyone whose character has been genuinely transformed because of therapy. If anything, most people seem to emerge as more backed-up versions of themselves.
I felt truly heartened when I read this passage. In fact, this is the point in therapy when I frequently feel the most hopeful: when a client begins to question the usefulness of the whole endeavor. The whole idea of "character change" repulses me, frankly, and I use the moment of questioning as an opportunity to tell people precisely that. The job of the therapist, in my opinion at least, is not to change the character of a person, but to help that person become more fully themselves. Sure, it can be and often is about changing problem behaviors or habits, but the self of the person should remain not only intact but more solid, more whole, more robust. I have come to understand that people arrive at my office with the expectation that I will reveal to them all that is flawed within themselves, then give them the necessary tools to remedy the problems. This makes me immensely frustrated with the whole business of therapy, which is truly responsible for the idea that most people are flawed.

One of the most striking passages in the article dealt with the issue of the therapeutic relationship:
And for all the emphasis on therapy’s being a place of intimate disclosure — for all the times, in between shows of hostility, that I haltingly stated my feelings of great affection or even love for my therapists — none of them ever opened up about their feelings for me other than to convey a vague liking or appreciation for some facet of my personality.
I have to admit a certain fascination with this topic. Therapist transparency is a hotly contested topic, with some clinicians--mostly those of the psychoanalytic persuasion, but some plain old psychotherapists as well--maintaining that transparency or self-disclosure on the part of the therapist only serves the therapist's own needs and inevitably muddies the therapeutic waters, while others--myself, and most therapists of the existential persuasion--believe that transparency is essential to an authentic and intimate relationship. Let me be clear: I believe in strong and healthy boundaries, and while I keep photos of my kids on my office desk and respond geniunely to personal inquiries, while I invite frank discussions about the nature of the therapeutic relationship and frequently express my care and concern for the people I see--despite this belief in authenticity, I am also aware of the threat of self-indulgence, the TMI factor, the thin line that sometimes exists between transparency and non-productive self-disclosure. And I harbor the not-so-secret-anymore suspicion that those clinicians who denounce transparency are somehow uncomfortable with the between-ness of the therapeutic relationship; that they can't quite negotiate the kind of working relationship that's based on true human contact, not arbitrary heirarchies.
I was wary by this point of the alacrity with which I attached to shrinks, each and every one of them, as if I suspended my usual vigilant powers of critical judgment in their presence merely because they wore the badge of their profession. The truth of the matter was that in more than 40 years of therapy...I never developed a set of criteria by which to assess the skill of a given therapist, the way you would assess a dentist or a plumber. Other than a presentable degree of intelligence and an office that didn’t set off aesthetic alarms...I wasn’t sure what made for a good one.
And this, of course, is a major freaking problem. I have no problem stating for the record that there are a great number of very bad therapists out there--I've seen a couple of them myself--and the potential for these people to inflict serious harm makes me gasp for breath. The beauty and gift of the therapeutic relationship is, alas, it's Achilles heel: the subjectivity of the intimate relationship makes it difficult for many people to separate "their own issues" from true and real problems with the practitioner. But here's some real and objective truth:

A good therapist will encourage questioning--at the very least they will not try to make you believe that your questioning suggests a fundamental resistance towards self-reflection. Good therapists will project warmth; they will project caring; they will set a tone of safety and acceptance. A good therapist will have strong boundaries, but won't shame you for making personal inquiries. A good therapist will help you discover yourself and learn skills to help you function better, if that is what you are seeking. A good therapist will admit mistakes.
I thoroughly enjoyed reading this article, and I wish the author well on her journey to find the "right" therapist. Of all the things that struck me in reading this, perhaps nothing resonated so completely as this line, attributed to the psychoanalyst Adam Phillips:

"Psychoanalysis is about what two people can say to each other if they agree not to have sex."

I don't know why I love this, but I do. I really do.

Monday, August 9, 2010

Driving to New Orleans

The first time I drove to New Orleans, it was on a whim. My soon-to-be best friend approached me and my then-boyfriend after class on a Wednesday afternoon and asked if we were interested in heading to New Orleans the next day for this thing called Jazz Fest; she didn't have a car and I did and I said sure, why the hell not? The next day we headed out after class, the 3 of us piled into my Dodge Omni for the 10-hour drive, chugging up I-75 to I-10, across the dead miles of the Panhandle, through the midnight fog along Mobile Bay. We reached a friend of a friend's house sometime after 2 a.m., and one of us--I don't remember who--had the gall to actually ring the doorbell. We crashed there for 2 days, ate some crazy brownies, wandered brazenly through streets we knew not at all, where the drinking age was 18 and we were one year older. I remember Joshua Redman in the Jazz tent, as The Boyfriend worked his way through a pile of tiny lobsters, the likes of which I'd never seen. I remember BB King in the rain, slipping in mud towards the port-o-lets, tracking down friends in the French Quarter--no easy feat in the days before cell phones. It was 1994. I was enthralled.

The next time I drove to New Orleans, 2 years later, it was a planned affair. The Boyfriend and I had spent the year--my second year of college, his last--planning and saving for a spectacular road trip that would take us from South Florida to the Pacific Northwest and back, with an extended stay in the Big Easy. We found a tiny international hostel just off Canal Street, definitely the coolest place I have ever stayed, and spent a week or so wandering the city. My memories of that week are spotty, mixed in with others from that summer of crazy mis-adventure, but what I remember most are sounds and smells, the way the magnolias cast shadows on the cracked sidewalks, the ever-changing smell of the Mississippi river, the steamboats singing, the powdered-sugar smiles we wore when the Japanese tourists snapped our picture at Cafe du Monde. There was a tiny alligator in the pond at the back of the hostel; every morning I'd sit on the back steps, roll a cigarette, and listen to the streetcar clanging a few blocks away. There was music in the streets and the people were rude as hell and I loved them for that--for not pretending to give a shit about me.

It's funny: the night I met Cade, I knew he was the person I would spend the rest of my life with. I felt no urgency, nor did I worry or fret when I didn't see or hear from him for 2 months after. I knew he would be back; I felt connected to him and that connection led to certainty. In the same way, when I left New Orleans for New Mexico in the summer of 1996, it was with the certainty that I would be back some day, and not just for a vacation. I had met my future home.

5 years later, I drove to New Orleans with everything I owned stuffed into my Toyota Tercel. My friend--the one who talked me into coming for Jazz Fest the first time--had landed a job at a yacht company in the East and another friend of ours from college was moving down from the Northeast and I had been looking for a reason to get the hell out of Florida. The house was one half of a shotgun double on State Street Drive. We went to Venezia that night and the next morning I got up and ran a few miles, trying to find Audubon Park and failing miserably. Somewhere around the 3rd mile I knew I was home. I can't explain it, though I've tried so many times in the 9 years since. The best explanation I can come up with is that I didn't get lost that morning; I didn't find my way to the park but I knew exactly where I was the entire time, and I am not one blessed with a keen sense of direction. And when I got home and got dressed and we headed to the Quarter for breakfast and HOT DAMN, it was Southern Decadence, well, that just sealed the deal: I was never leaving. I was home.

Last week we took a trip to Orlando to visit my family. As we drove across Mobile Bay I remembered, as I always do on that bridge, the first night I drove to New Orleans, when we crossed through the midnight fog, my friends dozing in their seats while I hunched over the steering wheel to get a better view. I had no way to know it then, but on the other side of that fog was a tranformative experience, and I'm not talking about a one-time thing.

Living in New Orleans is a tranformative experience. In many ways I feel like my life really started when I moved here. I was happy before, and I had accomplished much, but what I experienced that first morning on State Street Drive was a sense of being fully alive. And that's what keeps me here, that's probably what keeps a lot of people here, that feeling. Sometimes, when I spend a period of time in a place like Orlando, where the grocery stores are amazing and everything works and is clean and the kindergarten teachers come for home visits before school starts and you can drive 15 minutes and get out of your car and walk directly onto a beautiful, unblemished beach--sometimes I start to think about how hard things are here in New Orleans, I start to think about what life might be like if we lived in a place like Orlando. But that is utter nonsense, it's a moot point, because here's the thing: I would get lost a lot. I would feel homesick, and cut off from my real life. Fridays would be insufferable, as everyone around me would actually be working. One Tuesday out of every year I would have a severe existential crisis. I would have to stuff this exuberance away, this belief--no, conviction--that life should be lived every single goddamned day.

It's both wonderful, and terrible, to live in a place you love with every fiber of your being. It's wonderful for obvious reasons; it's terrible because, damn, what happens if someday you have to live somewhere else?

Wednesday, August 4, 2010

To Evan, On Your 2nd Birthday.

My sweet, sweet boy--I have struggled for days with the content of this letter, not because there's nothing to say but because there is so much, because every time I think of you I go into emotional overload and the part of my brain responsible for logic and rational thought and organization just kind of shuts down. I've found some quiet time here in Florida, while you and Sydney play outside on the swingset at Grandma's house, to try my best to put into words how much joy and laughter you've brought into our lives, what an amazing little person you are, how much we love you.

So much has happened this last year. You started to walk, then talk a little; you discovered trucks and diggers; you developed the ability to play with your sister (much to her delight, and chagrin). The Saints had their miracle season and you were there every step of the way; now, if you see a Fleur de Lis, you point and shout "De Lee! Saints! Who Dat!!" and if you hear the "Stand up, Get Crunk" song, you drop whatever you're doing and dance with the whole of your tiny little body. You had a wonderful year with Ms. Gwen at Abeona House, and have cemented your reputation as a pint-sized Lothario--you adore the little girls in your class, and are unfailingly gentle, smiley, and attentive. If this keeps up, Mommy is going to have to beat the girls off with a stick one day (and believe me, she will).

You have beautiful golden ringlets that Mommy just can't bring herself to get cut, even though she doesn't like long hair on boys. You have big blue eyes and those big, full Roux lips. You are very, very social--you love to mimic what the bigger kids are doing and you love to repeat everything you hear. Despite your gregarious nature, you love to play on your own and could play alone for hours if we let you. Of course, no one ever wants to let you play by yourself, because you are just so much fun to be with.

When you were first born, you did not like to sleep in your crib, so you and Mommy spent the first few months of your life on the couch downstairs, where you slept nestled in the crook of my arm. We'd sleep for a few hours, you'd wake up to eat and cuddle, then we'd snuggle in for a few more hours. The world was quiet and it was just us two, in our sleepy cocoon, and I'm not sure I've ever been happier. I loved those precious early days, and I've loved watching you grow into such a loving, joyful, smart, sincere, and funny little boy.

We love you so much, Evan, and cherish every moment of this life with you.


Mommy, Daddy and Sydney