Therapy: Demolition or Archaeology?

As a therapist, we are always working with people’s defence mechanisms be that denial, repression, projection or any other of the host of defences we all use. Sometimes we meet a patent who is particularly well defended and who does not want to hear our observations or thoughts. (Which always raises the question of why they came to see us in the first place. But that’s a whole separate story.)

I find these individuals bring out the demolition man in me. I get irritated and frustrated. Here I am week after week listening to you, hearing all you say and don’t say. Sharing my experience of you and how I understand this encounter. After all this time, I think to myself, we should be further forward that we are. I can see very clearly what your issues are, how they arose and how they are holding you back.

Session after session I try to find a way of saying these things that you might understand. And session after session I have to encounter the same defences and the same stories. Frankly, I wish you’d give up this idea of therapy. Or find another therapist . But you keep coming. This is where my inner demolition man starts to get restless. “Give me one chance,” it says “and I’ll knock those defences into oblivion.”

This is where our hatred comes into being, which is always a problematic feeling for us. We’re supposed to be caring people. But as Winnicott put it "Above all, he must not deny hate that really exists in himself" (Hate in the Counter Transference: 1984). If I can acknowledge my hatred of my patient, then I can hopefully prevent myself from acting out-which is where my demolition man comes into play.

I wish to demolish my patient’s defences, not out of love for them bur out of my hatred. I cannot bear the way they make me feel. So if I destroy all their defences, I can avoid my hate because I can then do my job of helping them get better! “I’m doing this for your own good” is how we justify our destructive instinct. (Walter Scott understood this when he wrote: “O, what a tangled web we weave when first we practice to deceive.” Marmion 1806) I remember as a student nurse pushing a patient to answer a quiz question which I knew he knew the answer to. Several times he told me to leave him alone. But I persisted. His reply was simple. He picked up a chair and threw it at me. I knew what I was doing. I was furious at this man for not taking part. So I pushed too hard out of frustration and hatred. It was a valuable lesson for me at least.

So what is the alternative to the wrecking ball approach to therapy? Archaeology. Gillian Hovell observed that the work of archaeology is to “discover how to visit the past and bring yesterday’s stories into our lives today.” Psychotherapy endeavours to do the same. We try and take our patients on a journey through their own pasts, drawing attention to details often forgotten or overlooked but which play an essential part in the development of their current selves.

• When was this structure erected?
• What was the purpose of that bit of work?

We slowly we go back and discover that, in truth, “ the past is myself” to borrow from Christiana Bielenberg (The Past is Myself :1988). Archaeological digs are of variable length. (When Tutankhamen went on display in 2007 it was 85 years earlier that Howard Carter had begun work. (Which makes even the longest personal analysis seem short!) Many of my patients ask me “How will long will this take?” My reply is always “I have no idea!” Unlike CBT, which works with a fixed number of sessions, analytic work is much more open-ended. Some of my patients leave after two months while others stay for several years. I have yet to find a way of predicting who will stay and who will go.

So here we have two different models for doing 'people -work'. One to be a demolition expert. The other an archaeologist. If I were a patient, I know who I would go to for help. (And it doesn’t involve a wrecking ball!)

I began my professional life as an R.E. teacher but left after two years. I thought that there must be more satisfying ways to earn a living that spending two hours on a Friday afternoon trying to teach a class of 14-year-olds about St.Paul’s missionary journeys. So I retrained as a psychiatric nurse. Nobody ever asked me about St.Paul’s missionary Journeys- although after spending an eight-hour shift nursing a ward of severely disturbed patients, I occasionally wondered if I’d made the right decision! After 30 years I think that I did!

I did my counselling training at Westminster Pastoral Foundation and Birkbeck College, London. I followed this up with an M.A. in Psychoanalytic Studies at the Tavistock where I did my dissertation on The Lion, The Witch and the Wardrobe from a mainly Kleinian perspective. (My degree was chiefly an excuse to watch stimulating films and read good books.) I left nursing altogether about six years ago, having been a nurse lecturer for the previous five years. The move to private practice has been “challenging” but thoroughly worthwhile (I don’t “do” organisations very well!).

I currently live in a 300-year-old listed building in Aylesbury which I share with my wife, two dogs, an Aga and lots of dust. It’s hard, but somebody has to live it...

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