Podcast #20 – How therapy transformed me

In this episode

Therapy can be, and often is, transformational. But why? I benefitted greatly from the empathy and attunement offered by my therapist, but over time I also had to adjust my expectations about how change would occur in me. I had to learn to consider what’s really going on when we feel misattuned-to as well. I needed validation and acceptance, but I also needed to be challenged. Here’s the story of how that played out in one particular therapy session, and the question that at first offended, and then transformed me.

Transcript: ‘How therapy transformed me’

Welcome to this episode: ‘How therapy transformed me.’

Recently I was asked this question: ‘What was the biggest transformation of your life from therapy?’ And ever since, I’ve been thinking about it. Not because I don’t know, but firstly because the more I’ve thought about just how transformational therapy has been for me, the more I’ve been filled with wonder and gratitude. It’s like a really lovely daydream that I keep getting caught up in. It’s just amazing to dwell on all the things that have changed for me as a result of the work I’ve done in therapy.

I cannot believe what my life is like now compared to what it was like before therapy and while I was in the depths of therapy. I so wish I could go back to that previous self, my earlier ‘me’, and reassure them that ‘It’s all going to be worth it!’ and to tell them that in fact, ‘It’s going to be better than you could ever imagine!’ At the time, going through it, I couldn’t see beyond the next hour, beyond the next day, let alone years into the future. I couldn’t imagine a future at all. It would have been so helpful to have been visited and coached by ‘time-traveller me’ — although, to be fair, even then I would probably have refused to believe myself.

And of course there’s the flipside too of thinking about the transformation of therapy. There’s the horror of remembering what a bad state I used to be in. I think back and it’s like waves of nightmare-ish memories, almost like flashbacks, to what a dark and desperate time that was: I’m so glad that’s over. So much pain and struggle and suffering: just relentless. To say therapy changed my life is an understatement, and I’m so grateful for it.

So, yes, I keep thinking about this question because it’s an amazing thing to think about. But I’ve also kept thinking about it because I’ve been trying to figure out why it was transformational. Because a lot of therapy, if we’re honest, isn’t transformational. I’ve had a lot of therapy with a lot of different therapists, and it’s not all been effective. And it’s not all been transformational at an equal pace, in equal ways. The more I’ve thought about it, the more I’ve been surprised and confused by it. And actually I’ve come to realise that it’s quite a nuanced thing.

It would be easy to reel off transformations in terms of, ‘I was in a real mess, really traumatised, suicidal, self-harming, dissociative … and now I’m not.’ That’s true, but it’s certainly not been a linear journey. It’s been convoluted and one step forward and two steps back. It’s been full of moments of sheer horror, as you peel back a layer of distress in your life only to feel an even more distressing layer below it. Many times I wanted to quit therapy because it was just too awful to go through.

And there wasn’t progress month on month, or even year on year. A lot of the time it felt like it got worse — a lot worse! — before it got better. And many times I just wanted to go back to the state of numb, dissociative ignorance I’d been in before I knew about the stuff that was too unbearable to know. It was a deeply painful — a profoundly costly — experience to go into therapy and make conscious what was held so deeply unconscious. It’s hard to think of that then in simplistic terms.

And the neat narrative or vector of ‘terrible to great’ also suggests that the principal transformation of therapy is just to stop being a mess. I think that massively undersells it. Yes, it’s the most obvious, the most dramatic transformation, especially on the outside. But it’s not the most powerful. Instead, I think the real transformation in my life from therapy came from what went on at a deep, tectonic level within me, out of sight. That’s been far more nuanced and subtle. It’s been about my sense of identity: how I see myself, especially in terms of my intrinsic value and worth. It’s been about learning to be compassionate towards myself rather than subsisting on shame and self-blame. It’s been about learning to be disliked by people, rather than the relentless striving of always needing to be accepted — a need that felt like a matter of life and death. It’s been about not needing to be a ‘better’ person, but accepting and even laughing at myself as I am. It’s been about becoming ‘comfy in my own skin’. It’s been about being okay with things not being okay. Lots of things that are nebulous and difficult to put into words or explain — things that we sense about ourselves but we can’t point to or easily define.

Because, anyway, how therapy has impacted me has stretched over multiple points in my life, over multiple decades. What was helpful to me right in the moment, right after a session, is very different to what was helpful to me a year down the line, and even now nearly 20 years down the line. Therapeutic change isn’t always obvious, and like a seed it can take time to germinate, time to grow, time to get really planted into our life. When we’re doing the intense work week in, week out and when it’s painful and dysregulating and at times just plain unbearable, it’s hard to feel like it’s doing any good or that we’re making any progress. It’s only when we step back after a period of time — even the longest period of time, like decades later — that we can see what the point of it all was.

Many a time I would leave a therapy session feeling annoyed or dysregulated or even downright distressed. I would feel maybe that the therapist hadn’t quite been ‘there’, that he or she hadn’t quite ‘got it’, hadn’t been ‘on their game’, hadn’t really understood me. They’d said something that, right in the moment, felt sore and insensitive. So right at the end of the session, I would feel, ‘Well, that was a waste of time. That was unhelpful. What’s the point of even going back?’

And sometimes those moments of misattunement were simply just a case of two human beings not being able to connect, and, yes, the therapist sometimes getting it wrong. They’re human too. They’re not perfect. Sometimes they are crass and insensitive. But sometimes it was simply because the supposedly insensitive thing they’d said was in reality exactly what I needed to hear. It’s just that, right in the moment, I didn’t want to hear it.

Because therapy is about change. Therapy is about identifying, ‘This is where I’m at at the moment, and I don’t like it and I don’t want to be here or be like this any more’. And then it’s about trying to figure out how you make the change to get to a different place. You’ve got to define the destination. You’ve got to figure out how you ended up where you’re at right now: how did you come to be here? You’ve got to figure out a route and a method of transport. Therapy is a journey — that’s a cliché — but if we take the metaphor seriously, you’ve got to know exactly where you are, exactly where you’re headed, and exactly which way you’ve got to go to get there.

And so therapy is a journey of transformation. But that transformation doesn’t come about by the therapist agreeing with you in every moment. It doesn’t come about by them simply echoing back to you their perfectly attuned empathy. Otherwise you’ll remain in exactly the same spot, but just feeling less bad about being there. Sometimes, they’ve got to say something that contradicts your worldview. Sometimes they’ve got to say something that pulls you up short, and presents a different vision of a different future. They’ve got to say something that you wouldn’t say, that you wouldn’t even think. And those moments are jarring. They don’t feel attuned. They feel insensitive. They feel ‘triggering’ even.

But gradually, over many months and years, I began to realise that it’s the moments where I feel there’s been insensitivity or misattunement or that the therapist hasn’t ‘got it’ that actually there’s the opportunity, right in that moment, for me to take a different path, to turn the vehicle of my life in a different direction, and to explore new territory.

It’s when I’ve doubled-down on feeling offended and hurt and uncared for that actually I’ve stayed exactly the same, in the same spot. Because all I’m doing there is reinforcing ‘This is where I’m at and this is where I want to stay’. If I hear the same old, same old, I’ll stay in the same old, same old. My offence and my hurt and my annoyance that the therapist wasn’t aligned with me was the same old, same old. If I wanted to change, I had to open myself up to new ideas, new ways of seeing things. That included being willing to challenge the idea that the therapist’s ‘misattunement’ was just a deliberate lack of empathy rooted in judgmentalism, rather than entertaining the possibility that maybe he or she was saying what he or she was saying because it might be helpful to me. Something that’s ‘new’ can feel ‘misattuned’ when we’re expecting the ‘old’.

That misattunement though can feel terrifyingly painful. It feels like I’m alone in the universe. It feels like I’ve not been seen and I’ve not been heard and I’ve not been felt. That’s a horrible place to be. And so over time I had to learn to notice that I was being triggered in that moment — that I wasn’t just reacting to the therapist in that moment being misattuned, but that I was layering that up with all the years of misattunement of all the attachment figures and partners and friends and colleagues I’d ever had. And so there was this massive transference going on, of me reacting to a minor glitch in the moment, but loading it up with decades of prior hurt.

That’s such a common response after trauma. It happens to so many of us. And there’s no shame in it. But what I had to learn to do was to notice that it was happening, and not fight it. Because when I fought it, I thought that the only way through the pain and discomfort of misattunement was to get the therapist to back down on what they’d said that I’d found so challenging, and instead agree and sympathise with me. But if I was going to use it for transformation, I had to put all the eruption of hurt to one side, to re-regulate from it, and then be curious and open about my reaction. So rather than being focused on how hurt I felt at the misattunement, I had to start being curious about what the misattunement was and why it was there.

The more we react to the misattunement, rather than being curious about it, the more we’ll miss the opportunity in it, and the more we’ll discourage the therapist from ever challenging us or saying anything new or surprising or confronting to us. And then we won’t change. Because if the therapist always stays tuned into us on our frequency, the danger is that we stay stuck on that frequency. Sometimes he or she has to move the dial slightly, and draw us onto a different frequency, so that we can move forwards. And it’s jarring and painful when that happens, but I’ve found it absolutely essential to the transformative nature of therapy.

Let me give you an example. A few years ago I was in a therapy session, recounting an incident with someone in which — to put it in the broadest terms — they had been a bit crap towards me. Nothing major or heinous or evil, at least not compared to the abuse I’d suffered in childhood, but just one of those relational things that we all need to unpick from time to time. And I was telling the therapist the story of what had happened, how I’d gone to this person’s house and been there all afternoon and all evening and how crap it had been. And underneath the headline narrative, I was telling the real story of my hurt and outrage. And then the therapist, after a while of this, said, ‘So why did you stay?’ She meant, ‘Why, when you were being treated at best poorly by this person, why did you stay at their house all evening, rather than get up, make your excuses and leave?’

I didn’t get it. I didn’t get why she was asking the question. I thought that she didn’t get what it was that I was saying — that I was hurt and upset by this friend’s behaviour to me and that I needed to express that in order to feel better. The friend was at fault — not me for staying! How could she suggest such a thing?! It felt like I was being blamed: ‘Never mind about your friend’s behaviour. It’s your own fault for being there.’ I felt judged and criticised and blamed, and so I changed the subject, and sulked privately. Afterwards I felt pretty furious about the whole thing, and that my trust in the therapist had been damaged by her lack of empathy and her apparent blaming of me.

But later on, during the week, as I was picking the scab of the hurt I felt, suddenly it jumped out at me. That it wasn’t a stupid question or an insensitive question or a victim-blaming question. It was actually exactly the question I needed to be asked. Why had I stayed? Because there was the pattern, right there — putting myself into questionable circumstances with questionable friends, and then just playing out a passive, helpless victim response. I would suffer it silently at the time, and complain about it afterwards. Why was I doing that? Why had I stayed? It wasn’t an accusation. It was a genuine question. It was a genuine attempt to help me get curious about the ‘why’ driving it all.

And the answer to the ‘why’ was complex. The answer involved layers of trauma that had habituated me to me firstly being treated badly by people and secondly to me doing nothing about it. I felt powerless to object, to stand up for myself, to act — that’s the fingerprint of trauma right there: that inability to take action to protect yourself or to improve your circumstances. And instead what I’d done, what I so often did, was to remain stuck and trapped and powerless, and then afterwards to feel hurt and upset, and to complain about my feelings. What I was looking for in that session, in therapy, was for sympathy and understanding from my therapist. I wanted her to get how painful it had been. I wanted to show her how powerless I’d felt, how stuck and trapped. I wanted her to ‘get it’. I wanted her to say, ‘Oh, it’s so hard to be you!’ Because that would have made me feel better.

But instead of showing that she ‘got it’ — even though she absolutely did — she asked the one question that could unlock the change that I needed, but which I didn’t even feel was possible to make. It hadn’t really occurred to me that I could change this pattern of relating. It hadn’t really occurred to me that I could expect more from my life than just being in bad relationships, being treated badly, and feeling bad about them afterwards. I was stuck in the belief that all I could hope for was for a therapist to empathise with me about how much that sucked. I didn’t expect that I could actually change the dynamic of what was going on for me — so that firstly I wouldn’t need to suffer, and secondly so that I wouldn’t need to complain about the suffering afterwards.

Because ultimately the question of why I stayed drove at the heart of my trauma response: a response of freeze, of powerlessness, of not daring to assert myself and say, ‘Hey, this scenario isn’t working for me right now, so I’m out!’ Because I didn’t believe that that option was open to me, and I didn’t believe that I would be relationally safe if I did that. Extricating myself from a social situation in which my needs were being overrun didn’t feel to me at that time like the ‘right’ thing to do — it felt absolutely the ‘wrong’ thing to do, the ‘worst’ thing to do, the ‘rude’ thing to do and even the ‘dangerous’ thing to do. Rather than recognising that it was the other person who was being rude — and being willing to confront them with that reality through my actions of leaving — I just allowed myself to believe that I would be the one who was being rude if I left.

That one question — ‘Why did you stay?’ — led to an explosion of insight and understanding and to all sorts of massive changes in my life over the next few months. But it wasn’t the transformation I was expecting or looking for. I’d been looking for transformation solely through feeling understood. I was in the first instance offended at feeling misunderstood. I was offended at being challenged. And if I’d continued to feel offended, I would have missed all the richness within that question.

Now, if the therapist had been asking that question judgmentally, then I probably wouldn’t have been helped by it. If she’d been saying, ‘Why did you stay?’ and it had been layered through with criticalness, like a kind of ‘What is wrong with you and why are you so pathetic that you stayed and put up with that?!’, then undoubtedly I would have stayed offended — actually because I would have been right to be offended.

But that’s not how she was asking it, even though that’s how I heard it to start with. Instead, she was asking me the question to get me to think about the dynamics of what was going on for me. Why did I find myself in a relational situation where someone was riding roughshod over my needs, where they were using me, where they were totally insensitive to me, and why did I then fail to do anything about it?

It was a brilliant question: why didn’t I do something about it? This then led into weeks of reflecting on how this pattern played out repeatedly in my life: of post-traumatic powerlessness, of needing to please and appease, and never asserting my own needs in a relationship. I’d been focused on feeling hurt that people treated me poorly, and a continual bewilderment that they didn’t ever stop. Instead I needed to figure out how to protect myself from it and what steps I could take to change the dynamic. In other words, I had to focus on how I could change, rather than on how the other person needed to change.

And that’s just one example, but it’s one example of many where I thought transformation would come from being understood, but where the transformation came from me taking back control over my circumstances (and a lot of the hurt and pain in my circumstances) by taking back control over my responses to those circumstances. That’s what reempowerment looked like for me, and it was truly transformative.

Importantly, though, as I’ve just said, in order to be able to cope with challenge, I absolutely needed a therapeutic relationship where I didn’t feel judged, and where I felt treated with unconditional positive regard. We’ve got to believe, deep down, that this person is for us, not against us, and that they’re not shaming us when they point out how we’ve been impacted by trauma, but that they’re doing it so that we can stop being impacted by trauma.

That’s what was so fundamental for me — to realise that, when the therapist said, ‘Why did you stay?’ she wasn’t asking it to be mean. She wasn’t asking it to blame me. She was asking it because it encapsulated my entire trauma response. And once I recognised that, I could change it. And once I changed it, I wouldn’t then suffer the relational pain and heartache that I was seeking sympathy for. In other words, she was looking to unlock the root cause of my presenting problem, not just make me feel better, or feel supported whilst remaining in the problem.

And that’s so true of the whole of the transformation I’ve experienced through therapy. I’ve had to be willing to get below the surface of my feelings, or my sense of unfairness, or my hurt or pain, and really dig around in the roots of what’s been causing me to feel like that. And it’s taken a therapist — or rather a series of therapists — who have been willing to pull me up short and in effect to say, ‘Are we going to focus on the ‘what happened’? Or are we going to focus on the dynamics of why it happened in the first place, what your ongoing response to it has been, and how to stop it happening again?’ That for me has been life-changing. I’ve not been in therapy for tea and sympathy. I’ve been in it to step back from the moment-to-moment distress, to understand what’s going on, to locate my power, and then to change the entire environment of my life that allows that distress to flourish.

And so therapy for me certainly wasn’t all about sympathy. Some of the most helpful interventions I had were ones based on a steely, lean-forward, look-me-in-the-eye challenge — challenge to be better, challenge to change, challenge to be honest with myself, challenge to grow, challenge to stretch forwards beyond the suffering rather than just sitting looking for support in the suffering.

It’s such a fine balance to get right, to be able to offer unconditional positive regard and validation and empathy on the one hand, and then challenge on the other. I have always felt shortchanged when I’ve only received the first half of that equation, when there’s been empathy but no challenge. Yes, I need to feel heard and seen and felt, but so that I can process the pain or the trauma or the suffering or the situation I’m in, and move through it. Empathy has a point to it, and the point is to change.

So I hope that’s been helpful. I’ve looked there not just at the transformation I’ve experienced in therapy, but one of the ways in which that transformation has been facilitated: not just through empathy and attunement, but through learning to consider what’s really going on when we feel misattuned-to as well. Sometimes it’s just because it’s two human beings communicating imperfectly. Sometimes it’s because the therapist is doing a bad job. But mostly for me it was because I needed to be challenged out of my quest to feel better, my longing for perfect empathy, by a question that painfully revealed what was going on beneath the surface. I hated those moments, and I grew to love them too (although sometimes not for months or years afterwards).

Therapy is transformative, but sometimes we need to let it be by adjusting our expectations of how that transformation will come about. That’s been a massive journey for me, and it’s a journey I’m still on. But I hope some of what I’ve said has been helpful at least a little, and at least to some of you. See you next time.