Walking the Tight-Rope in Therapy

by Carol Campbell, MFT

Everyone in a serious psychotherapy treatment will eventually bump into feelings, ideas, thoughts, memories, and beliefs that for some reason or another are well defended from being known clearly. Psychodynamic and psychoanalytic therapists are charged with the delicate task of making the therapy experience safe enough that these embarrassing, humiliating, frightening, or otherwise scary mental phenomena can be accessed for understanding. When the unconscious can be made conscious, we have a lot more choice about how to respond to what is happening in any moment.

For the patient, the process of bringing the unconscious to light in therapy can sometimes feel like walking a tight-rope. The situation feels highly charged. Falling off on one side would be going back into denial. Falling off on the other side could be a tumble into bad feelings. Not walking on the tight-rope at all is like not having a place to stand with the therapist's help to look at the situation calmly.

Often the work of therapy involves a few steps forward on the tight-rope, and then seemingly touching a live wire that halts progress for that moment. What seemed tolerable to the patient suddenly morphs into something that feels irritating, hurtful, scary, or otherwise discombobulating. Instead of describing what is happening in a way that helps the patient feel more deeply understood and therefore safe to explore this troubled territory, the therapist has hit a hot button. The patient now feels criticized or attacked.

What has happened? Does this mean there is a bad therapist? An uncooperative patient? Evidence that both should throw in the towel?

I don't think so! What is called for is some patience, compassion for both parties, and a willingness to simply be with the feelings. What words sent the patient spinning? What is the nature and tone of the ensuing feelings for both the patient and the therapist? What memories or thoughts are they linked to? What comes to mind when the patient lets himself experience the discomfort? When these questions can be gently explored, the puzzle pieces can be defined and moved around to discover where they fit exactly. Over time the picture gets clearer and more complex. The bad experiences and traumas from the past can be safely brought to life again in the present moment in the safety of the therapist's presence. Not being alone with the bad feelings is what allows them to finally dissipate, and healing of debilitating old wounds takes place.

In this way, therapy leads the tight-rope walker across the dangerous chasm and onto safe ground and a brighter future. The journey is challenging, but the outcome is well worth the effort. Both the therapist and the patient will be better people for having gone through the therapy experience together. They have different roles to play in the drama, but both will be affected by the experience.

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Carol L. Campbell, MFT, is a licensed marriage and family therapist providing psychotherapy and psychoanalysis for individual adults and couples in Palo Alto, California. She has degrees from Brown University and Santa Clara University and has been licensed since 1991. Carol is a graduate of the Palo Alto Psychoanalytic Psychotherapy Training Program sponsored at Stanford by the San Francisco Center for Psychoanalysis and was a candidate at the Psychoanalytic Institute of Northern California in San Francisco from 2010-2011. She is also a clinical member of the California Association of Marriage and Family Therapists and the Northern California Society for Psychoanalytic Psychology.