On The Fundamental Question of Psychotherapy

The other day a client asked me a question — which is in fact the question – associated with psychotherapy. She asked, “Can one ever get over it?” The “it” in question could be a number of things – essentially, “it” stands for some aspect of the past that was traumatic or at the very least troubling and painful. The “it” may be a single event or years of some sort of chronic suffering or abuse. That is the essential question: can one get over it or heal from such a past?

People come into psychotherapy because of some troubling issues causing them to feel unhappy or unfulfilled in their lives now. In the course of our work, we often find the origins of these issues go back to experiences in their past. An unhappy relationship in the present may in fact have to do with significant relationships in the past (how the person defends against those experiences repeating or in the beliefs that that person has about himself and others). Addictive or compulsive behaviors now may have their origins in ways that people tried to cope in the past with painful events. Sometimes the experiences which create unhappiness now may stem from terrible, unimaginable traumas. Perhaps the person as a child endured ongoing emotional or physical abuse. Perhaps there was a terrible and early loss of a parent. And sometimes the past, while perhaps not traumatic, still had a huge impact on the person. Perhaps one’s family moved frequently, and one could never really establish lasting friendships. Perhaps there was some strife in the family which existed for a long time.

Can one ever get over it? That is a very complicated question; I am not sure that I know the answer. But I do know what my experience as a human being and as a psychotherapist has shown me. The same client who asked that question mentioned an acquaintance of hers, an elderly woman, whom she said still tears up when remembering a painful even from her early youth. I have worked with people for whom the pain of the past is fresh and present sometimes 30 or 40 years later. For these people the past is ever present. However, I have known other clients who can talk about what were very painful events or losses years ago with some emotional detachment now. For them there is not a lot of emotion still connected to these memories.

Two thoughts come to mind in terms of that question about healing. The first thought has to do with the courage and ability to bear what may seem unbearably painful or horrific. Often one result of particularly harrowing trauma or abuse is that there are associated feelings that seem just too much too bear. Our bodies and minds are, of course, ingeniously constructed. There are various defensive strategies which we employ, often unconsciously, to mitigate pain and to “forget” that trauma. (However, the trauma cannot really be forgotten; it may be more likely moved off the stage of conscious recognition but still exerting some influence.) A central principle of psychotherapy, at least as I understand and practice it, is that psychotherapy provides a process by which the unbearable can be bared. Through the therapeutic relationship that is at the center of this work, a person can feel supported and less alone in remembering – sometimes for the first time – the events and feelings associated with a painful past. Of course, those events in the past can’t be changed nor erased. However, what people previously felt to be unbearable can be experienced and the process of healing moved forward. A person can put feelings and memories into words; and that which may have been buried in dark recesses can be brought into the light of day.

The other thought that I have is that another vital aspect of healing has to do with not repeating the past. What is particularly troubling about a traumatic or painful past is not only what happened originally, but also what gets repeated and continues to happen. This was one of the major discoveries that Freud made. He called this the “repetition compulsion” – the compulsion to repeat that traumatic past. In a sense it is a reliving of the past. A person who had, for example, a highly critical parent, for whom he or she could never do right, may now have a well-developed tendency to denigrate himself. Another person, whose past was perhaps marked by unpredictability and insecurity associated with growing up with an alcoholic parent, may be chronically anxious and insecure. A person who may have been physically abused finds him or herself getting into relationships that are abusive. A key goal in psychotherapy is to stop that repetition of the past. While we cannot change that past, we can relegate it to the past so that it is not a part of the person’s present. The person with the tendency to denigrate him or herself becomes more compassionate and understanding, less critical. The person whose anxiety emanates from uncertainty in the past now lives a more confident, less anxious life. And the person who suffered abuse when growing up has a solid sense of self-esteem and pursues healthy relationships.

The question that my client asked is fundamental not only to psychotherapy, but to human life as well. In the end, I believe the answer is yes: yes one can heal from that painful past. Perhaps the memory of that past may still bring tears of sadness or pangs of fear years later. But it may be that those feelings become diminished in strength and frequency, and the individual has more freedom to live an original, not repetitive, life.

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