Chapter Seven - "Help Me --- I'm Tired Of Feeling Bad"
The Problem of Therapist Pleasure in Regressive Therapy One of the most difficult problems in any therapy which employs touch and holding is the problem of therapist pleasure. Most especially the problem becomes acute when we think of any kind of sexual contact between patient and therapist. So acute, in fact, is this problem that we have ruled out any kind of sexual contact entirely.
Let us spend a few moments rethinking some of our most cherished suppositions in this area.
All psychotherapy brings pleasure to its practitioners; the pleasure and healing of being within an intimate relationship. For the therapist this intimacy is safe. The therapist does not have to risk; therapists are in charge. They know more than the patient; they are set above the patient; and safely set apart. Yet, even from this vantage point, therapists can feed themselves emotionally within the professional relationship. We can do this because patients, at considerable risk to themselves, make the relationship intimate with their sharing.
I put it to you that all of us as therapists can and do nourish ourselves on this kind of intimacy, and do so whether we care to admit it or not. I suspect that we are getting a closeness which we never had as children. All of us have to be careful that we do not allow our own nurture to become primary, thereby damaging the client-centered quality of the experience.
Pleasure in psychotherapy also comes from its voyeuristic aspect. Current works, for instance, caution both patients and therapists to be alert for too much interest in the lurid details of childhood and other sexual encounters. This is especially difficult for everybody concerned since, as I have repeatedly said, traumatic experiences must be re-lived in extraordinary detail for healing to occur. Explicit interest in detailed re-living of difficult life situations, for the purpose of facilitation and healing, can be intuitively differentiated from voyeuristic interest most of the time.
Let there be no mistake about it; a therapist receives pleasure from doing therapy, so does a pilot from flying, or a diver from diving but in the area of psychotherapy the nurture of the professional experience is more direct, more approaching the intimacy in which we should have been originally raised and so seldom were. The speaking aloud of deep personal truths always nurtures the listener. Level Four regressive psychotherapy increases the intimacy and the nurture received by the therapist because it is so much more intense, and even this intensity is increased where skin contact occurs. Now in a therapeutic experience which contains deep emotive material, coupled with touch and holding, both patient and therapist may find themselves deep in a mutual primal nurture. Of course, we, as therapists, cannot let ourselves go and actively search for the same level of nurture that the patient does. The therapist still has an objective job to do. Nonetheless, the therapist is nurtured. In fact, if I am not deeply present and simply lend the presence of my body, patients seem to notice it and will say to me something like, `You're not here today'. So when I hold someone, I have discovered that the nurture definitely flows both ways. During therapy the big arrow in this equation is toward the patient. During one long-term depth treatment, I discovered that, as a by-product, an ulcer that had been with me for eight years was gone. The therapist was also healed. Does not the parent receive as it gives? More than one woman has spoken to me about the deep sensual pleasure of nursing an infant. To put holding and touch at the service of the patient, to make it truly client-centred, requires a level of growth in the therapist that is difficult to attain and represents the end point of a long and difficult journey. It does not come from books. It comes from experience. And because experience is its own teacher, it comes with mistakes. Just as an explorer may be ensnared and held captive by a primitive tribe, so can the difficulties of depth therapy ensnare and subvert a therapeutic journey. Sexual touch, of course, adds pleasure to an already nurturing experience. Is there anything on earth that could possibly keep a therapist more interested in healing than in personal satisfaction? I believe there is in the human being a force equal to this task; I believe that there is an even more powerful motivation than the deep nurture of touch and sexual pleasure in therapy. I believe that having `meaning' in one's life is more powerful than having pleasure.
Men and women from earliest times have sacrificed far more than pleasure for meaning. Men have thrown themselves on hand grenades to save their friends. Women have risked torture and death in resistance movements during times of oppression. The examples could go on forever. All manner of stress has been borne by members of our race to give their lives meaning. It is the decisive and profound edge of meaninglessness that permits a therapist of goodwill to be guided by the client's needs. When therapists allow themselves to pursue their own interests during therapy, meaning ceases.
Can we be client-centred? We have to be. The alternative is nothingness and despair, which come to rule an ever-darkening landscape of the spirit until depression and / or death supervene. Meaninglessness and death are very close partners.
In the end, when all is said and done, pleasure is no match for meaning in a developed human being.
* * *
I had argued that, because of the primacy of meaning over pleasure, where it was clear to a patient that an intervention using sexual touch had come from a health-oriented client need, and had been conducted from a client-centred orientation (not motivated by therapist gratification), this intervention might occasionally bring about genuine healing with no damage to the relationship.
I now believe that this area of experimentation is so dangerous and so easily misinterpreted that it should never be undertaken. Five years of conversations with clients and colleagues have changed my mind.
On those rare occasions in Level Four therapy, when a patient is pursuing a body necessity to achieve congruence with a past event (for the purpose of re-experiencing that event), sexual touch from the therapist must be denied. * * *
In holding an attractive woman there can be, during the learning stages of this technique, what I call a `sexual halo' within the therapeutic experience. It is impossible not to be aware of a woman's body under some of these circumstances. It is not that difficult to negate feelings of sexual arousal. Mature males do have reasonable control in this area.
If I was experiencing this sexual feeling or halo while holding a woman closely, and if this led to some arousal, I could reassure her that this was a physiological response and, as such, not something for her to be concerned about. It does not have to overwhelm judgment or control. In these instances, where there is goodwill and trust, a patient has no difficulty in appreciating that the sexual response is an artifact. It does not have to open a combination lock to disaster. We can acknowledge what is happening and not become involved with it. When we continue with what is healthful to the therapeutic moment, sexual arousal simply dies away. There is no purpose and no goal for it.
If we are not prepared to take occasional risks in providing nurture and physical assistance, we will lose our sense of being therapeutically alive. Some patients who might have been helped will be forever stranded in a devastated childhood from which they cannot healthfully return. They may rebuild their defences but in the end they will be rigid, fragile and anxious. The Central Paradox of Therapy can be avoided but the price is always high.
A Final Word About Nurture
Under normal circumstances, holding someone, while it is a pleasant enough experience, will not nurture and shift the core child. But under circumstances of regression, holding does nurture the core child because the Central Nervous System is wide open. I have called this technique THERAPEUTIC NURTURE.
Patients come to me now because they know that I do regressive therapy and will provide supportive nurture. Indeed with many people, in the context of a regressive therapy, the last fifteen minutes of every session are given over to holding. These are basically warm, deeply meaningful, full body hugs. They occur in the lying down position, therapist and patient lying on their sides. Nurturant holding can occur in Level Four regressive therapy without necessarily being part of a powerful regressive re-living.
One of my patients, the daughter of an alcoholic and highly dysfunctional family, has insisted that I give her twenty minutes of holding at the end of every session. She says that it is this activity which has reversed her alcoholism, her bulimia, her compulsive vomiting and her obsessive preoccupation with suicide. She has stopped writing suicide notes in her own blood. The holding she feels she needs is replacing the nurture she did not get. No amount of discussion will ever provide it.
Over and over again patients speak to me positively about the effects of deep nurture. This will always be a part of deep regressive psychotherapy.
I have no patience at this time in my life with endless psychiatric debates about whether a therapist should shake hands with a patient. The kind of psychotherapy that I, and a few others, practice is so far beyond mainstream ambivalence about holding that the literature is useless to us.
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