Tales from the Therapist's Couch

'Change is a two-headed beast. We want it, yet fear it for ourselves. We encourage yet envy it in others'

Most people come to psychotherapy because something deeply uncomfortable is getting in the way of their relationship with themselves and their world. It may be an inability to ward off a groundswell of panic with anything other than food. It may be a deeply unsettling feeling that one is not really living, but simply going through the motions of a life. Whatever the specific outward expression of unease, there is frequently a gap expressed between the way people would like to feel and behave, and the way they actually do.

Most people come to psychotherapy because something deeply uncomfortable is getting in the way of their relationship with themselves and their world. It may be an inability to ward off a groundswell of panic with anything other than food. It may be a deeply unsettling feeling that one is not really living, but simply going through the motions of a life. Whatever the specific outward expression of unease, there is frequently a gap expressed between the way people would like to feel and behave, and the way they actually do.

Psychoanalysis is all about looking carefully at this gap, and hopefully over time reducing it. Essentially, it is the gap between our conscious attitude and our unconscious life, or between the person we like to think ourselves to be and the person we actually are. By bringing the hidden and repressed to light, we become more comfortable with who we knowingly are.

Put like that, it all sounds so easy. Yet changing the way we see and do things is excruciatingly hard to achieve. This is largely because of a specific obstacle which sabotages attempts at significant change: namely resistance. It exists within and around us. Let me give an imaginary example.

A woman in her early forties comes to therapy because she has been suffering from depression and insomnia. These symptoms are quite out of character with the image she has of herself, and so all the more troubling. The mother of three children, and wife to a successful businessman, she has for many years run her home with energy and efficiency. The fetching and carrying of school life, the socialising required by her husband's work, together with the endless task of keeping on top of a busy family home have, until recently, consumed all her energy.

Then, about a year ago, things began to pall. She felt empty, tired and sad. By the time she came to see me she had been sleeping badly for several months. She was often woken by bad dreams. I ask her if she can describe these dreams. "Oh yes," she tells me, "it's often the same one. I am by my front door, and someone is knocking. It is a glass door and I can see that it is a woman with children. She is angry and hammers at it with fury. In one dream she smashes the glass, enters the house and takes me to a room I have never noticed before, a small study with books."

Without the space here for anything more than the briefest of interpretations, this woman recognised that she had for years been cramping herself into the wife/mother role and ignoring her own needs. She needed to nourish herself with whatever the room in the dream symbolised for her. Shortly after her marriage she had abandoned a career as illustrator, and she now became energised by the idea of making time for this neglected talent. And yet months were to pass before this desire finally took practical shape. Why? Because of her own resistance. To shift, even a little, the family role she had carved out for herself filled her with fear. Without filling her days as wife and mother, who would she be?

At long last this resistance was overcome and she embarked on an art course. The effect was dramatic. She felt absorbed and fulfilled. But having defeated her own internal resistance to change she now had the task of battling with external resistance. In challenging her own script she had also unsettled that of those around her. Her new and private source of pleasure was threatening. There was barely concealed envy from friends, and regular bouts of fury from her children and husband.

Change is always a two-headed beast. We want it, yet fear it for ourselves. We encourage yet envy it in others. We need people to stay put or we lose our bearings, yet we need them to depart from the script, or life becomes stultified. It is a see-saw between maintaining and unsettling the status quo which we need to be aware of if we are not to betray either our own or others' growing selves.

elizabeth.meakins@blueyonder.co.uk

Elizabeth Meakins is a psychoanalytic psychotherapist in private practice. None of the clinical material above refers to specific cases