When people come into therapy it is usually with the wish or hope for something to change. If not, they want help with adapting or stabilising following a major change.
It is a paradox that change is such a constant in our lives. As we age our bodies inevitably change and if nothing else this makes living itself a profoundly transitional experience.
Changes in our lives can come in many forms. For example, there are key developmental milestones at various life stages – adolescence and mid-life are perhaps the most discussed of these.
Significant events in life can also impact and bring about profound change in ourselves. These changes always involve beginnings and losses and can lead to crisis. Crisis too can bring about change. Even positive changes – like getting married or starting a new job for example – are often cited as highly stressful, so societally we very much recognise the equation of change and crisis.
Psychotherapy and psychoanalysis have had huge influences in how we might understand changes and crises in life stages and events.
For example, Elliott Jaques, a Canadian psychoanalyst, coined the term ‘midlife crisis’ in his 1965 paper (1). Jaques wrote about how this crisis repeats earlier intense transitions from adolescence and infancy and explored what he saw as a tendency for the individual to lose or discover creativity as a response to this life-stage.
And it is largely due to Winnicott’s seminal work (2) that we understand the level of intense feelings that typifies adolescent transitions, when the young person is caught in a fraught conflict between childhood and adulthood.
In psychotherapy we think about therapeutic change, meaning an internal change for the better. I think most people come into therapy welcoming this idea of inner change and certainly those who are assessed as being suitable for psychotherapy will partly be so on the basis that they recognise the need for some internal change.
Initially in therapy, changes are often experienced as positive. Being heard and supported and gaining insight generally increases confidence and a sense of self. At the same time people can find quite that more negative feelings towards themselves seem less extreme. These changes are important and real. However, deeper changes that take place in therapy, in my experience, are not always so welcomed. This is partly because of the disruptive nature of change and its relationship to crisis.
Undergoing the kinds of powerful changes that therapy can offer can feel destabilising and bewildering. As mentioned earlier, change always involves loss of some kind. What might need to be given up may be experienced – consciously or more often unconsciously – as vital to the person’s sense of self. Even unwanted aspects to one’s psyche and behaviour are still familiar and what is known is experienced as safe, even when it is also recognised as harmful and self-limiting.
While we might recognise the likelihood, even perhaps inevitability of crisis in change, experiencing this in therapy can, for some people, feel understandably counter-intuitive.
Many people who come through therapy find a way of tolerating and working through these unsettling if not disturbing experiences of therapeutic change. But some become too frightened or overwhelmed and may then leave suddenly.
In my experience, those who stay are able, with the support and help of the therapist, to recalibrate and restabilise – much as after major life stages and events. As things settle, they can then experience and enjoy the positive benefits of the internal work and changes they have undertaken. However, inevitably and necessarily, in time the problematic process of change will be repeated.
Further reading by Claire Barnes –
Death and the Mid-Life Crisis. Elliott Jaques, 1965
Contemporary Concepts of Adolescent Development and their Implications for Higher Education, from Playing and Reality. Winnicott, 1971