Changing Minds in Therapy by Margaret Wilkinson

Author:Margaret Wilkinson
Language: eng
Format: epub
Publisher: W. W. Norton & Company

Third Stage of Therapy: A Sense of Safe Relationship

Why and how did Clare come to experience our relationship as safe? I think Clare would reply that it was the experience, over time and on many occasions, of a nonretaliatory other who sought to understand her apprehension rather than condemn her before she started. It seemed that through the medium of nondirective psychodynamic psychotherapy she was gradually able to encounter me, another person, separate but with whom she could engage at a deep affective level and with whom she was gradually able to experience a sense of safely rather than of threat. Gradually new neural pathways began to build that permitted more comfortable and comforting states of mind. I gradually found my eyes meeting not eyes that slid away but eyes that seemed to peep up at me, at first timid, and then, after a while, I became aware that I had lost the sense of a smaller person. Gradually I noticed hints of laughter and humor in eyes that dared to hold my gaze as an equal and in an adult way. The eyes have been shown to be the most direct route for recognition of mental states and emotions in others (Baron-Cohen et al., 1997, Baron-Cohen et al., 2001; Hirao, Miyata, et al., 2008). This is often particularly true for patients who have learned vigilance through repeated traumatic experience; the young child may learn early to read the mind of the abuser in his or her eyes. A child or indeed an adult patient with this sort of early experience may need to be able to look and look away, to gaze and be free to break the gaze. I have chosen here to write briefly about the eye contact that Clare made with me at this stage, about the eye talk that leads to “I” talk (Solomon, personal communication, 1999). I could equally well have written of changes in body language, changes in the content and emotional tone of the material the patient chose to bring.

Evolving symbolizations may emerge in a series of pictures or dream images, which I understand as emergent metaphor, one thing gradually being revealed as standing for another and carrying with it the capacity to enable change into a more mature state of being (metamorphosis). Such metaphors stimulate brain activity in a more thorough way; such processing, utilizing as it does brain plasticity, brings with it more possibility of change than any other form of human communication (Pally, 2000). Sometimes a series of images will emerge close together over a very short period of time. As such they seem to indicate a crucial point in the therapy, usually where a difficult emotion, previously held only in the body, is beginning to be able to be known as a recognizable feeling for the first time. Sometimes the series will be spread over time and will contain frightening images which as the therapy progresses metamorphose into something more human and accessible. In Clare’s case what started

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