Becoming A Patient - Vicki's Clinic

Becoming a Patient

Therapy can bring enormous relief and freedom; new ways of being in the world with others, and with yourself. However, it can be helpful to ensure that your expectations are realistic to make the most of what therapy has to offer.

Any type of personal development, including the emotional growth that comes with therapy, requires us to be prepared and willing to explore the edges of our personal comfort zone…and beyond. This can come as a surprise if we have been sold the idea that emotional difficulties can be ‘cured’ in the same way as physical health problems, as if psychological therapies operate along similar lines to a prescription drug that provides the ‘solutions’ to your difficulties. When we apply this medical model to emotional difficulties, it is easy to fall into the trap of stepping back and waiting for the therapist to ‘do something’; you wait for others to provide the solutions.

Emotional difficulties arise from the complex interactions of multiple factors – including biological factors, such as genetically determined temperament; cultural factors, such as value systems that favour material success over emotional fulfilment; and psychological factors, such as the way we are nurtured and cared for by our caregivers. The way we make sense of all of these factors, the ‘stories’ in our minds, plays a large role in the emergence of emotional problems. Once you recognise that your troubles are driven largely by the stories and meanings that help you to make sense of your experiences, you can take back the natural capacities that lie within you - and take an active role in therapy.

It can be helpful to be aware of possible barriers and fears which can interfere with how you engage in therapy. If you are expecting a straightforward therapy process, it may come as a surprise that therapy can bring up strong emotions or dilemmas. A regular, everyday therapy involves struggling with confusion, new ways of seeing things, not knowing, setbacks, moments of clarity and lightbulbs going off, and more often feeling your way I the dark until you get to the light switch.

It can be helpful to identify possible fears about therapy so they can be predicted, thought about and looked out for; addressing these things is a part of every therapy. Do you have ultra-high expectations of yourself? Might you find it humiliating to be the one asking for help? Do you expect yourself to do every task perfectly on the first attempt? Do you struggle with feelings of boredom or feel easily overwhelmed by your emotions? Are you terrified of being seen and known and fearful that the therapist will judge what they see and find out?

Psychotherapy is about feelings. It is about knowing about all the emotional parts of your ‘self’. You may have coped in the past through numbing, starving, medicating, distracting or minimising your emotions or by chasing more exciting emotions through pursuing power, gambling, spending money or sexual activity. Therapy involves investigating and exploring these manoeuvres in a setting in which you don’t need to numb or excite, so that you can begin to connect at an emotional level with yourself and with others.

Many people have never experienced opportunities to learn how to conceive of much less manage their emotions. Our modern societies are in many ways emotionally-phobic – we often hear the message that showing vulnerability, and asking openly for emotional connection is viewed as a sign of weakness, and neediness. This is in stark contrast to the widespread adulation of self-discipline, self-control, and self-denial, whereby the message is that we should ‘man up’ and be stoic, both in terms of the way we treat our emotions and our bodies. These messages can make us feel ashamed and guilty for experiencing normal human emotions and for admitting to ourselves and others that we need connection, care and attunement in our relationships with others.

Despite these cultural messages, the reality is that it is impossible to experience true connection, intimacy, and freedom without developing a close relationship with our own emotional self and without learning to communicate our emotional needs in clear and open ways within our relationships. As a species, we have evolved to be emotionally attached to each other. The more we deny this aspect of our humanity, the further we become from our own fulfilment and freedom. Through healthy connections, we learn to regulate our nervous systems and generate a state of calm and safety within our bodies.

We are all made up of different parts or ‘modes’. These modes are like different sides of ourselves we are operating in at different times. We all have emotional or ‘vulnerable’ parts of us that experience emotions and need connection, warmth and empathy to feel safe in the world. Having a healthy relationship with these vulnerable parts of us enables us to develop strong and healthy relationships with others.

In therapy you develop the capacity to make a virtual mental space for the vulnerable feeling, needy, seemingly young parts of you will become important parts of your life, helping you get your needs met and helping guide you through choices and to make decisions. It’s very common to experience waves of emotion in therapy that might be stronger and quite uncomfortable compared with what you are used to. Just as we all want to feel more pleasant emotions, it is a natural human response to want escape from difficult or painful feelings.

Nobody likes pain. If we have been exposed to messages that make us feel guilty or ashamed of our emotional need for connection, we tend to adapt and develop defences that operate to protect us from predicted shame or guilt, even in situations in which we won’t be shamed or guilted. These parts of our personality or defences deny us full access to ourselves, to all of our emotional experiences. The goal of these coping modes is for you to be [or at least appear to be] completely self-sufficient. To avoid rejection or hurt, these parts might distance you from others and use avoidant self-soothing coping behaviours as a substitute for close relationships. There are many ways that these coping modes use avoidant self-soothing as a way of escaping pain, such as self-harm, restrictive eating, binge eating, purging, exercise, workaholism, rigid rituals, safety behaviours, zoning out through internet scrolling, sex, drugs, and alcohol. These can never really replace the real thing, and as they tend to lose their effectiveness over time, you will usually end up having to use your self-soothing ‘drug’ of choice more and more to achieve the same effect. Although these strategies bring short-term relief, they also tend to set you up in a vicious cycle, where these short-term ‘solutions’ become problematic and end up causing you more pain and disconnection from others.

In therapy, you develop the capacity to observe how your mind works, analyse its machinations, make more active choices about your life and how you will live it, and create new solutions rather than being guided by old templates about what to expect and how to behave. Its in your hands, now you just have to make an appointment ………