Oct

4

2023

Breaks in Therapy: A Therapist’s Personal Account

Breaks in Therapy are a core part of the therapeutic work, and impact both clients and therapists in different ways and at different times.

The following article is written by Linda Cundy who along with Charles Brown and Professor Joy Schaverien, will be one of our expert speakers for our upcoming workshop: Breaks in Therapy: dynamics, losses & opportunities on Friday 10th November 2023, via Zoom from 10am to 4.30pm UK time (with catch-up available).

Winnicott: Hate in the Countertransference

Photo of crying baby.

You may be familiar with Donald Winnicott’s influential paper, Hate in the Countertransference (written nearly eighty years ago and available as a PDF here). In it he outlined many of the reasons why a mother may at times resent her child. These include the fact that she “has to love him, excretions and all…”, that he “refuses her good food” and that “the baby is an interference with her private life…”. Winnicott draws parallels between parenting a demanding infant and being a psychotherapist who “has to put aside other interests in order to be available and to be punctual…”.

Therapist Frustration

Image of frustrated lady in front of laptop

We may say there are many occasions when a therapist such as myself may feel annoyed – certainly inconvenienced – by her clients. If any of my clients happen to read this, I do hope you will not take it personally – I am referring to the very structure, ethics and rules of the psychotherapeutic project rather than a reaction to any individual. Here are a few causes of frustration:

  • No matter what is going on in my own life, I must consider the needs of my clients, act responsibly, perform complex equations to resolve the dilemma of whose needs should be prioritised
  • I have to put tomorrow morning’s clients first and turn down an invitation to a social event out of town or tickets to a show that finishes late
  • It is a great inconvenience for a therapist to fall in love, get pregnant, become ill, or if a close friend or family member needs support, or to be bereaved
  • Holidays must be planned long in advance, with time to prepare clients for the separation – spontaneity is not permitted.

While Winnicott claimed that the traditional analytic fifty-minute hour is a legitimate expression of the analyst’s “hate,” where he or she claims ten minutes for themselves, most of us also need holidays, sabbaticals, occasional sick or compassionate leave. And these spaces can disrupt the process of feed / rest and digest.

Client Reactions to Going on Holiday

Photo of closed sign

I can imagine many of my clients saying, “It’s ok Linda – you take your holiday. We don’t mind.”

How to understand the true meaning of such a comment? Perhaps, for some, it translates as:

  • “Don’t you worry about me. I’m going through a painful time but you go off and enjoy yourself”
  • Or: “Well, you’ve not been on form lately so you clearly need a break”
  • “I know I’m too much for you to cope with and you want to get away from me…”
  • Or maybe: “I know you work hard and you’ve been there for me reliably for such a long time. You genuinely deserve to do something lovely for yourself.”

The responsibility is greatest for those who, like me, work in private practice.

Perhaps there is a particular characteristic in our personalities that draw us to this kind of work – providing a reliable, consistent, welcoming and respectful therapeutic relationship, often over long periods of time. (A Kleinian interpretation may be that this is atonement for our over-abundance of selfishness!)

The fact is, I know who I will be sitting with at half past twelve on a Wednesday two years from now (the same person I was sitting with at that time two years ago – except that was online due to Covid). However, the rhythms of sessions, the element of predictability within which unpredictable things can emerge, have a structuring function much as regular mealtimes help to regulate appetite and encourage digestion. The spaces in between appointments provide vital processing – and living – time. Can you imagine living 24/7 with your therapist?! Surely even the most enmeshed individuals would not long for that…?

A Good-Enough Mother MUST Sometimes Fail

Image of mother holding a baby

Having an attachment figure nearby is fundamental to survival in early life so separation anxiety is woven into our fabric. Clients settle into the routines of sessions and periods in between. But disruptions to the pattern will evoke clients’ attachment systems and defences against separation. If we are ALWAYS there as anticipated, “available and punctual,” we may not get access to this useful material.

Winnicott again: a good-enough mother MUST sometimes fail. This is one factor in the equation of when to take my holidays and sabbaticals. Not only are vacations good self-care but they provide opportunities for new insights.

Very occasionally I wake up feeling under the weather. If only I had an office job where I could easily call in sick (and still be paid!) Instead, I think through my list of clients for the day, weighing up the current needs of each of them. This one has just returned from a holiday; the next is going through a messy divorce and was very tearful in the last session. Client number three travels a long way to see me (preferring in-person to Zoom) – she may already have left home. And so it goes on, trying to look after my headache while holding each person in mind. Potential unplanned breaks raise different anxieties. It seems it is not so much “hating” clients as caring about them – loving them even.

And if you want to know more, you will need to sign up for Breaks in Therapy: dynamics, losses and opportunities.

Upcoming Workshop: Breaks in Therapy: dynamics, losses & opportunities

Join us for our upcoming workshop: Breaks in Therapy: dynamics, losses & opportunities on Friday 10th November via Zoom (with catch-up available) with Linda Cundy , Professor Joy Schaverien and Charles Brown.

In this workshop with our three expert speakers, we will explore the meaning of breaks in our therapeutic work, and the spectrum of reactions we might receive in response to a pending break in therapy.

We will consider safety and security issues, the experience of those for whom trauma by separation is central to their narrative, profound experiences of loss in the absence of the therapist and creative opportunities for self-development while the therapist is away.

We will also notice the subtleties of different types of breaks: the space between sessions, the therapist’s holiday, ill health of the therapist, breaks due to pregnancy, sudden and unplanned breaks, as well as noticing the difference between in-person and online work.

There will be ample time for questions and discussion, and for us to also examine how breaks in therapy affect the therapist too.

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