When Psychotherapy Stops at Christmas - Is it a Needed Break or an Unwanted Separation?
For many people and for various reasons, Christmas can be a difficult time of year. For those who have been seeing a therapist, taking a break from therapy over Christmas can feel like a loss, albeit a temporary one, of a much needed relationship and sense of connection.
How do you react when your therapist announces that for a couple of weeks over Christmas and New Year she or he won’t be available for your regular appointments?
Noticing and becoming aware of your reactions to this break in your therapy may be helpful for your therapy once you return to it after Christmas. You may recognize familiar reactions, you may see a pattern or theme in the reactions you have, or indeed they may be totally unexpected and come as something of a shock to you.
To help with this awareness, I highlight some common reactions to this interruption to your therapy as well suggestions of some possible meanings to these reactions and ways to reflect on them:
For some people, therapy can feel like hard work. Painful feelings can emerge and talking about difficult situations can feel hard. So the prospect of a break from weekly, or regular, therapy sessions can feel like a relief. If it does feel this way, it might be useful to think more deeply about how therapy is going for you. Is the pace of it helping or would you like that to change? What about your relationship with your therapist? Is that OK? Is there anything you feel you need to talk to them about?
Perhaps it doesn’t really matter to you one way or the other if you have a break from therapy over the Christmas and New Year period. Having this reaction may be an indication that therapy isn’t making a difference to you. In such a case it may be useful to reflect on why you sought therapy in the first place? How do you feel about your therapist? Have your feelings about the therapy or your therapist prevented you from talking about something important?
You feel angry about the disruption to the working through of issues in therapy. In this case, it might be useful to reflect on how you generally cope with disappointments, and perhaps what it is that you feel you will be missing during the festive break.
Perhaps being unable to meet with your therapist during the break feels traumatic. Perhaps the relationship and regular meetings with your therapist have become an important part of your week. You rely on your therapist for support. It is perhaps the most significant relationship you have, and even if not, it helps you cope with difficult feelings or situations. A familiar sense of abandonment may surface. You might feel rejected or not important to your therapist. You may fear that your therapist is permanently ending your therapy, that she or he won’t want you to come back.
Having this break can perhaps be an opportunity to work on some of the things you have been exploring in therapy and it can also help you look beyond the relationship with your therapist (as it will be necessary one day to do) and to look at other tools, resources and relationships which can feel supportive for you. In essence, the questions here are about how you can soothe yourself during this time and how can you take something from this break which you can be useful for your therapy when you return in the new year.
Essentially, whether welcome or unwelcome, a break from therapy at this time of year can offer space to reflect on how the therapy is going and what might be useful and important to address in the next phase.
In addition, while the Christmas break may feel like being left alone, it also may provide opportunities to to work through issues such as disappointment, frustration, separation and abandonment. Yet comfort can be taken from the fact that the break is only temporary. Therapy can resume again in the new year and may feel even more helpful than it was previously with the experience of this temporary break to draw on.
Living Life Anxious
Being anxious can be described in many different ways: as tension, feeling on edge, nervous, insecure, or worried.
Other words used to describe anxiety include uncertainty, vulnerability, and feeling apprehensive, scared or insecure.
Describing the experience of anxiety, a fairly common expression is “Anxiety is an inevitable part of life”. Or, there might even be some comfort taken from a diagnosis of anxiety. A feeling of reassurance may be provided by a certainty of having an “anxiety disorder” Yet, there might also be a normality to being anxious. Erich Fromm, for example says that: The experience of separateness arouses anxiety; it is, indeed, the source of all anxiety.
The Emergence of Anxiety
Taking Fromm’s view, we might consider how feeling anxious can begin at birth with an experience of a primal separation from our mother. Being attached to her feels safe and secure, and separated from her as danger and threat. Later in life, the polarities between separation and attachment, and being at risk, insecure, or under threat may lead to a constant sense of danger. But danger of what exactly? Melanie Klein, according to this line of thought, considers that anxiety signals danger in the relationship with our internal maternal object (the internalised image of mother). The loss of this object, this image, or relationship is feared.
Perhaps there is also fear of a more generalised loss – loss of control, of all relationships, of identity. Fear of a ripping apart, perhaps, because while anxiety may begin at birth it also may have many triggers, arising not only from internal sources, but external ones too – our own neurobiological makeup on the one hand and our life experiences on the other.
So, we might say that anxiety reflects our state of self, the extent of development of our internal structure, the state of our relationships, and our sense of security and satisfaction. Perhaps when anxiety is present and overwhelming there may be deficiency in one of these areas.
Yet, anxiety is not simply a thing that exists. It is dynamic – both a signal of danger and an initiator of a defensive response. It may signal danger to our sense of self, of wholeness, or of completion. We may fear destruction, engulfment or fragmentation and we may seek to control or to avoid a range of circumstances or situations.
Psychotherapy for Anxiety
The good news is that psychotherapy can help.
It can do so by, first of all, by understanding the individual history of each person’s anxiety. If we take the view that who we are, and who we are becoming, emerges from our anxieties, then the first task is to understand each person’s history of anxiety. Then, acknowledging and understanding the protective role of anxiety may be important. To see anxiety as the best strategy for coping with what has been felt as scary or uncertain. Then, perhaps to work through, or re-work through early relational histories, and the insecurities (feelings of not being safe) that may have emerged in these. All of this is possible when the therapeutic environment is felt as safe, and is experienced as a place for curiosity and exploration. A space can then emerge for new feelings, new reactions and responses, and a reframing of the lens through which life is experienced. It may not then be one of psychological danger, but instead one of safety and security.
If you feel ready to begin therapy for anxiety, or want to explore the possibility, please visit the Online Booking Service page on my website for information about how to get started.
Courage and Vulnerability in Psychotherapy
It is often said that it takes courage to begin therapy, to begin to open up about personal material, and to reveal your innermost thoughts and feelings. It can feel frightening. Yet, in the context of a safe and supportive therapeutic relationship, particularly one like a relational transactional analysis approach, which believes that profound and deep change occurs in response to relational experiences, there is the opportunity for you to work through these fears.
To work through fears of criticism, of shame and even fears about exposing or revealing yourself. You might also fear feelings and be fearful about bringing into the open various aspects of yourself and your life.
Indeed, these fears may be so great that you might feel safer to stay with the difficulties that brought you to psychotherapy in the first place, rather than to take chances to reveal yourself. As Brene Brown described her fear ‘not knowing whether I could literally physically withstand the criticism’.
Fears and the Courage to be Vulnerable
Yet these fears can be worked through in psychotherapy. Here, in this safe space, there are opportunities for change. Opportunities for new beliefs to emerge and new stories to be created. The rewards are potentially great. However, relinquishing relational armour is necessary in order to reach them. Letting go of the urges or pulls to keep parts of yourself hidden and stepping into an arena (in this case a psychotherapeutic one) where you allow yourself to be seen.
Courage and the Possibility of Change
This is an act that provides possibilities to create new life stories (or scripts). Perhaps changing the story you tell yourself.
Here then we have a courageous act, an act that requires a willingness to be vulnerable - there is uncertainty, risk and emotional exposure and yet the rewards are potentially great.
You want change. You want something different for yourself and your life and yet perhaps you also want to stay in the darkness. You may be afraid to let yourself be seen and also to see people, even to see yourself.
Yet this change, this different thing is possible, despite the struggle.
. In psychotherapy trust and vulnerability evolve together. They begin with you bringing and sharing your story - a story that is treated with honour and respect. You bring your courage. It is a privilege to witness.
New Life Stories (or Scripts), Relational Experiences and Change
Later that original story merges into the background as the new here-and-now story in the therapy room evolves from the relationship between you and your psychotherapist.
'Not Another Headache
The pain of migraine is physical. It is a sensation that ravages and incapacitates.
Does your day often begin with you saying to yourself 'Not another headache!' Do you perhaps take painkillers? Often? Every day even?
Perhaps you find that sometimes they help and sometimes not. For many people their headache is diagnosed as chronic daily headache. For others frequent migraine is the bug bear.
Yet medication is not always the answer. Frequent use of pain-killing medication can lead to overuse headache (rebound headache) and perhaps even make your headache pain worse. You may also wonder whether your problem is really a biochemical one.
Is taking a pill really the answer? Might your problem be more than a physical one?
In fact, it has been known for hundreds of years that emotional distress triggers headaches. Being angry or sad. Even being happy or excited can trigger a headache.
In 1743. Junkerius talked of migraine being caused by suppressed anger. Other, less common reactions, linked to emotions have also been identified as root causes for headaches, such as resentments, dissatisfaction and anxiety.
There are many factors which may combine to give an embodied experience of an emotion or feeling. The 'real' pain is perhaps an emotional one, which is hidden, or embedded within an experience of headache or migraine. This can be due to some, or all, of the factors in the following short list:
An alternative way of describing these kinds of headaches, then, is as a conversion headache, the explanation being that psychological distress is 'converted' into a more manageable physical symptom
So whether headache can be attributed to the inability to manage difficult emotions (such as anger or anxiety), or to alexithymia (the inability to identify emotion), what seems to happen often is that some sort of converted, or embodied emotional experience lies at the root of chronic headache and migraine
The good news is that these experiences can be unravelled in psychotherapy or counselling. Headaches can be investigated. Emotions can be explored.
If you have tried all of the medications and still are in intense pain on a frequent basis from your migraine, it may be time to explore the root of your migraine as being not only biochemical but also psychological and emotional.
If you would like to begin to explore migraine and work through the pain of migraine in psychotherapy please using this form or by calling 07891 613580