Life of the mind

It gets worse before it gets better
May 22, 2013

It was about a year into my five times a week psychoanalysis (yup, on the couch Monday to Friday at 7.30am) that I stopped knowing what to wear. I couldn’t decide if I liked whoever I’d arranged to see and wasn’t sure what I wanted to eat, or if I was even hungry at all. I remember getting ready to have lunch with a friend and pulling some high-heeled boots on. “What?” I wondered. “Am I trying to seduce him? To intimidate him? Castrate him?” I looked at my face in the mirror. “Lipstick? Why?” My grip on the trappings of life, the way I would normally present myself to the world, was getting looser.

This is the trouble with finally facing reality after years of pretending to be coping marvellously—pretending not to be panicking, not to be lying awake all night, not to be drinking too much. Suddenly, in a classic reaction to analysis, without my missile-proof defences I wasn’t sure how to… well… be. Refreshing, in an exposed kind of way, but a catastrophic loss of my sequins-and-feathers excuse for an identity nonetheless.

Undergoing analysis is a compulsory part of my two-year training to become a psychotherapist. Last week I asked a patient of my own to fill in a background information form—basic questions about age, parents, siblings, major life events, sex, relationships, what brings you to therapy. She returned the form quickly, her answers thoughtful, her style excited. Then, a day later, she emailed to say that filling the form in had got her thinking and she had at last spoken to her partner about her issues. He had been so supportive that she no longer needed therapy.

A lovely thought, but ultimately unlikely.

Feeling better the moment we make the first appointment is quite common. Simply knowing that we have taken action can unleash optimism. (I asked an eminent psychoanalyst at a party recently about technique. He sloshed his wine with an expansive gesture and said; “Oh, you just create a space and they get better themselves.” Glib, but true in part. Having space in someone’s mind might be therapeutic in itself.)

But however well it starts, one thing therapists make clear to new patients is this: “You are likely to feel worse before you feel better.” This does not convey the half of it.

If you go for therapy you seek change, but that change is unpredictable. In essence, and this can be couched in language complex to the point of incomprehensibility, therapy is an attempt to face reality. We have likely spent a lifetime avoiding it. So, if I have coped by seeming dynamic and attractive (high-heeled boots) in an effort to disguise a feeling of being dispensable and alone, I must now admit that my behaviour has been a cover. A cover that will begin to slip in ways that may be terrifying.

Spouses are often worried by their partner’s decision to start therapy. They are right to be worried. The strange half-lives that protect us from an unbearable truth do disintegrate in good therapy, often taking a toxic relationship with them into the dust. The fantasy is that a phoenix will rise from the ashes, but the questions the would-be phoenix faces can be bizarrely mundane—what kind of boots does this scraggy fledgling phoenix wear now that she has no need to castrate anyone? And can she bear to hear the cleverly cruel conversations she might once have started? Answers in 15 years.