The real deal

By Howard Atkinson


So, performance is the psychotherapeutic flavour of the month. And why shouldn't it take centre stage. With the high tide of postmodernism swelling into the academy and mounting pressure to get things done more quickly and efficiently, the time has never been this right to surf the performance wave.

But just make sure you give a sterling performance when you invite your clients into their new roles, darling.

Just do it. Act it, then believe it. Beef up your performance. Rethink your role. Ah, what the hell: Break a leg.

Does it work? Apparently, yes. At least for the patients.

Well, if it works for the patients, why not for me, the therapist?

After nearly a decade in private therapy practice, frankly, the performance thing is neither new nor appealing to me. Not because it's not enchanting enough, nor because I find the postmodern abandonment of the "real" too anarchic. The reasons are more personal and more subtle. They sound like this:

Earlier today, when I saw an anxiety-ridden medical specialist, I was an upstanding, reserved, eloquent and professionally contained therapist. I was dispensing, after considered attention to his plight, a considered and professional opinion. I was neither frivolous, nor overly psychotherapeutic, aware as I was of his distaste for the more ephemeral fads of the world of psychology.

Only a fleeting hour earlier, I had been trading cool talk with an adolescent incinerator, railing against the conservatism we faced from institutions of control. "Joining", I recalled some dusty textbook labelling my apparently therapeutic role adoption. I had taken some private pride in my own rebellion as I observed myself speaking a language I thought I hardly knew.

Earlier in the same day, I had sat quietly with a deeply depressed woman, moved by her pain but immobilised by my fear that I might sound dismissive or inadequately understanding of her struggle.

For God-knows-what-reason, more and more often these days, my mind floats during therapy sessions to a client with whom I had terminated a few years earlier, after several years of difficult, grinding therapy. "I pay my money and you just sit there and listen. I like coming here but this is so far from real, it makes me sick," Andrea had challenged me one day.

"Yes," I had acceded, "like emotional prostitution." It didn't help. Sporadically, for months on end, Andrea had returned to her disagreement with the unreal nature of our relationship. I would take the role of concerned other for a lonely, socially isolated and embittered woman, she would explain to me. And, in return, she could spill her guts like she'd have loved to do with someone she believed really loved her.

Typically, I'd fall back on boundary excuses: "You know that this relationship has boundaries like no other. And, while you hate the boundaries at times, I suspect you find some comfort in their containment of the potential hurt which may result if we didn't have them. That hurt seems to have characterised so many of your other relationships."

At times, I believed the explanations myself. Mostly, though, I had grave doubts. I knew they kept me from having it out with her, telling her in uncensored, cathartic indignities what I really thought about her aggressive, unrelenting devaluation of the relationship we had been trying to develop, of her insistent devaluation of all her other close relationships.

After a few more months of sparring, she announced one session that she'd had enough. She was not able to continue to an inevitable end of therapy, filled with hurt and a deeper dissatisfaction that she had invested so much in a relationship which was so "unreal". I never saw her again.

But I still think of myself as having a therapeutic relationship with this client for some reason, perhaps because she left so much with me when she went.

And, to be honest, this was the first time in years I felt real. This was no role, no joining banter, no slick, image-enhancing exchanges, no tacit collusions of silence over the transparency of client and the murky invisibility of therapist.

And now, as I sit with my paranoid surgeons, my teenage nuclear bombs, my immobilised middle-aged depressives, I think of Andrea. And I think twice about my role, my performance and how cleanly I'm delivering the dialogue that is now second nature.

"You're a powerful, intelligent, professional. I'm feeling a pressure to impress you in your language," I confessed to my surgeon earlier today as Andrea glided almost imperceptibly past my consciousness.

"You talk as if nothing's special for you," I noted to my teenage hell-raiser. "I feel like to be cool and get on with you I also have to trash everything. But I know that there are things that are special and precious for me and I suspect there may be things like that for you too."

"You seem so desperately sad, it almost immobilises me," I confessed to the woman as she sobbed her way through the blow-by-blow of another tragically disappointing week.

This, I thought, is the real deal.

Howard Atkinson, a contributing editor to New Therapist, is a psychotherapist and writer based in London.



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