Jung At Heart

A few days ago I read Stephen Gyllenhaal's piece in Huffington Post in which he muses about a dream Sara Corbett, who wrote the long piece on the Red Book for the New York Times, offered. The dream as she related it is:

"This dream was about an elephant -- a dead elephant with its head cut off. The head was on a grill at a suburban-style barbecue, and I was holding the spatula. Everybody milled around with cocktails; the head sizzled over the flames. I was angry at my daughter's kindergarten teacher because she was supposed to be grilling the elephant head at the barbecue, but she hadn't bothered to show up. And so the job fell to me. Then I woke up."

So far so good. Interesting dream. And he talks about how one might make a film of the dream, using it as the image source. Also interesting. But then he starts into a critique of sorts of the response of the analysts Corbett was with when she had and told the dream:

But let's skip an intimate discussion with our journalist and simply recall what happened the morning after her dream as she encountered the Jungians with their tea and muesli: clever talk ("more to Martin than to me," she notes) of wisdom, feminine symbols, the Indian God, Ganesha -- but who among them actually took in the cinema of a sizzling decapitated elephant's head on a BBQ? Who allowed themselves to feel the betrayal that had unfolded and the ensuing anger? Who actually experienced the elephant in the room, aside from our dreamer?

Which perhaps brings us to another elephant. For if all these Jungians were so wrapped up in their world of archetypes and symbols, if to them someone telling them a dream is a "bit like feeding a complex quadratic equation to someone who really enjoys math" and not one of them even explored the almost too-obvious reference of an elephant in the room, then what does it say about the entire Jungian enterprise?

Well, actually it says nothing about the entire Jungian enterprise. My daughter tells of her surprise when she went off to college and she learned that not every family talked each morning at the breakfast table about what they had dreamed; she thought that was normal, given that she had as parents two psychotherapists interested in dreams. But my daughter did not expect that the telling of a dream at the breakfast table would lead to a detailed analysis of the dream, its significance to the dreamer and/or suggestions for working with the dream. She didn't expect that because she knew that telling a dream at the breakfast table is not the same as working on a dream in analysis, in a dream group or even in one's own journal. 

It's a little unfair, I know, to jump onto that small bit of what is a long and interesting piece. But it got my back up a little because it is not terribly unlike things that therapists experience often -- an expectation that we are always wearing our Therapist hat, always experiencing interactions with the eye and ear of a therapist. I have had the experience of having people assume I am analyzing them while we are in social situations often enough to have begun to say when someone nervously laughs at discovering I am a therapist, "Don't worry. I only work when I am paid." I can't forget what I know as a therapist, but I don't employ that knowledge, that kind of listening in casual conversation either. 

The reporter in this case was not a patient. She was at the breakfast table in a hotel with several analysts whom she hardly knew. That is certainly not the setting for looking more deeply into the dream she shared when the question was asked of the group if any had had dreams. And it is not the Jungian way for the analyst to tell the dreamer what the dream means, because in the Jungian framework, the dreamer is the expert about her own dreams. Corbett writes of having continued to think about the dream and of telling it to other analysts as she encountered them. But she doesn't say anything about her own efforts to understand the dream nor does she seem to have asked any of the analysts to help her to understand the dream better -- that would be to deal with the dream in a more serious and less than a by-the-way manner. That she did not get a detailed analysis from anyone she asked and instead was asked rather broad questions, questions she could use herself to explore the dream if she wished seems reasonable.

When someone outside of a therapeutic context asks me about a dream, I too offer rather open questions as a way for the dreamer, on her own, to look at the dream. Questions like the analysts at the breakfast table asked Corbett:

"What do elephants mean to you?" Martin asked after I relayed my dream.

"I like elephants," I said. "I admire elephants."

"There's Ganesha," Furlotti said, more to Martin than to me. "Ganesha is an Indian god of wisdom." 

"Elephants are maternal," Martin offered, "very caring."

They spent a few minutes puzzling over the archetypal role of the kindergarten teacher. "How do you feel about her?" "Would you say she is more like a mother figure or more like a witch?"

They don't tell her what the dream means. They don't analyze it. They ask a few broad questions. And then it is for her to work with the dream herself, or to approach one of them to help her with it in a more appropriate setting, a better container for such work than the breakfast table in a hotel.

Gyllenhaal goes on in his piece making his own interpretation of the dream and the places it leads him and I recommend reading it. And thanks, Stephen, for giving me the opportunity to talk about a pet peeve!

Our favorite television therapist will indeed be back for a third season, HBO announced today.

"HBO has renewed the Emmy®-winning half-hour drama series IN TREATMENT, which will begin production on its third season in New York in early 2010, with debut scheduled for later in the year, it was announced today by Michael Lombardo, president, Programming Group and West Coast Operations, HBO.

    “IN TREATMENT is synonymous with inspired writing and brilliant acting,” noted Lombardo.  “This is the kind of show that could only flourish on HBO, and we’re proud to bring it back.”

    Gabriel Byrne (Emmy® nominee and Golden Globe winner for Best Performance by an Actor in a Television Series – Drama) stars in the series as Dr. Paul Weston, with additional cast members to be announced as they are confirmed."

Cheryl does a happy dance!

I am often asked if it is required for therapists to have been in therapy. And most people are surprised to learn that except in the case of analytic training and a few other programs, it is not a requirement. In fact Casey Truffo cites a survey suggesting that 20-25% of therapists report they have never themselves been in therapy. And I have heard suggestions that therapy should be a requirement for licensure. 

I believe it is important for a therapist to have been in therapy and probably to return to therapy periodically throughout her career. Why? Because I need to be able to sort out my own personal issues from those of my patient and that is very difficult without having done work in therapy. Just as I cannot see my own back without a mirror, so too I cannot see my shadow and blind spots without benefit of the mirror of therapy. It is not a function of how happy one's childhood was because none of us come to adulthood without issues, without shadow. It is matter of the major importance of self-education, the kind that can only come, I believe, through the process of engaging in self-exploration with a good therapist.

Now I actually think the 20-25% figure for therapists who have not been in therapy to be a bit low. Because I know of many more people drawn to the field as problem solvers than there used to be. It seems to me that those who work in a solution-based model or problem solving model, where the focus is on teaching the client techniques for changing behavior or resolving problems are less likely to see any need themselves for therapy -- because, in my mind, what they are doing is not therapy but counseling. 

That a therapist has been in therapy is of course no guarantee of skill or excellence, but at the very least such therapists understand what it is like to sit in the patient's chair and talk. That alone is important.

Perhaps paradoxically I would not make experience in therapy a requirement for practice. I don't that compulsory therapy is likely to make much difference for those who would not choose it for themselves. Robert Langs has an interesting concept called lie therapy, in which therapist and patient collude unconsciously to avoid confronting material and to not engage fully in the therapeutic process. My guess is that if therapists are compelled to be in therapy, many will seek and engage in lie therapy in order to satisfy the requirement without threatening the status quo of their psyches. 

Last week John Grohol posted 10 Secrets Your Therapist Won’t Tell You. For whatever the reason, I seem to feel compelled to respond when I read these kinds of posts. So here goes with this one:

1. I honestly don’t know whether I can help you or not.

Of course this is true. Because whether or not the work we do will help a given person depends on both of us. I have no magic, no guaranteed solutions. What we do works through our relationship and the willingness of the patient to do her part of the work -- reflecting on sessions, acting on insights, be willing to show up and to say what comes to mind. 

Also of course, I wouldn't keep doing this work if I did not believe that I can work with most people with most problems. But I also know my limits -- so I don't work with children or couples, for example.

2. I’m not your friend, but I want you to open up to me anyway.

This is also true. And opening up in therapy is not the same as opening up to even the closest friend. Because I won't tell you what to do and I won't expect for you to listen as I open up to you either. The basic rule of therapy is to say whatever comes to mind. Friends are not so tolerant of that kind of talking, nor should they be. Friendship is mutual and reciprocal. Therapy is a whole different thing.

3. If you ask to see your chart, I’ll probably give you a hard time about it.

I disagree here. I would ask about what the desire to see it is about, because I am certain that is more important than what is or isn't in what notes I keep. And I would suggest that we talk about that first. But my notes are minimal so there would not be much for my patient to see. If, however, she still wanted to after we talked about why, I would agree.

4. I’m not supposed to give you advice, but I will anyway.

I make suggestions -- like writing down dreams, sometimes about keeping a journal. But I don't advise patients about what to do. I don't because those decisions are about my patient's life, not mine, and any decisions made need to come from him or her. I may ask questions that help sort out their options, but I don't give solutions.

5. This is probably going to hurt, but I may not tell you that up-front.

It is not my experience that patients expect therapy to be painless. I do sometimes say that things may well seem t become worse before they become better. 

6. My graduate degree probably doesn’t matter much; neither does where I graduated from.

When someone asks, I tell them where my degrees are from and what my field of study was. And I also tell them that my theoretical orientation is more important for me than for them. There are people who seek me out specifically because I am a Jungian. Usually they have already done some reading in Jung and so we have a bit of vocabulary in common. But it isn't necessary and it is one of my tasks to put what I see into language they can understand and use.

7. If I’m pushing a particular brand of medication, you can likely thank a pharmaceutical company.

It is not my job to recommend medications. If asked or if I believe it useful, I will make a referral to a psychiatrist.

8. I work for you, but battle your insurance company to get paid.

This one is easy -- it is absolutely not true for me because I do not accept third party payment. I don't ever have to battle insurance companies for payment for my work with patients nor send them reports of what we are doing.

9. I will give you a diagnosis whether you need one or not.

See #8. No third party payment and attendant requirements, like assigning a diagnosis.

10. I love my job, but hate the long hours, client’s often-slow progress, and the difficulty in being understood as a profession.

I do love my job. 

I have my practice set up so that I don't have long hours -- I know my limits and I stay within them. For me, 15-18 patient hours in a week is my maximum. 

I do long term work so I don't expect progress to be rapid. It takes as long as it takes. It isn't for me to set the psyche's pace.

I determined a long time ago that I needn't take personally how my profession is understood.

There you go. Ten secrets that aren't really secrets with me.