When Psychotherapy Works, Then What?
What lies on the other side.
These posts, and some to follow, are part of ongoing conversations about psychotherapy. The questioners are real people. The questions were really asked. These reflections are my answers.
Q: I'm sure your patients are getting better. But never 100%, right?
A: I don’t know what 100% better means. At some point, as my patients emerge from desperate pain, or self-constructed prisons, or endless looping of the same painfully bad film, there is an inflection point in psychotherapy, not necessarily a joyful one.
Then arises the question: If not that, what?
The illusion of perfection collapses. If life is no longer defined by crushing depression, fear, or inhibition... then what?
We cannot cure the condition of being human. We must still struggle for meaning, purpose, connection, intimacy, love. We will still struggle to meet our needs in this world and bear the pain when we cannot. We will still confront aggression and hate, in others and in ourselves. We will still face illness and injury and infirmity and, in time, death.
We cannot cure the condition of being human.
Psychotherapy cannot help us escape the human condition. When psychotherapy is successful, it frees us to face it.
Maybe this is what the Zen master meant when he said, “Before enlightenment, chop wood, carry water. After enlightenment, chop wood, carry water.”
Sometimes a patient will say it aloud. “Now that this is behind me... what do I do now?”
My answer is generally, “Anything you want.”
Sometimes I’ll say it aloud, but more often, I’ll convey it wordlessly, with the hint of a shrug or eyebrow. Sometimes, the words distract. Some meanings are better elaborated in negative space.
My answer may sound like a cop-out, but it isn’t.
We don’t have answers for how another should live. We can’t tell them the meaning of life. We can’t promise joy, success, or love. We can’t lead them to nirvana. We can’t protect them from life’s blows that must, inevitably, come.
What we can offer, when psychotherapy goes well, is the chance to make a new start.
Anything else would be to promise illusion—and cross the sacred boundary that separates the psychotherapist from the would-be guru.
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Sounds like Freud’s quote, “…much will be gained if we succeed in transforming your hysterical misery into common unhappiness. With a mental life that has been restored to health, you will be better armed against that unhappiness.”
Though I like Jung’s better, “The principle aim of psychotherapy is not to transport one to an impossible state of happiness, but to help (the client) acquire steadfastness and patience in the face of suffering.”
Beautiful