Thursday, August 28, 2008


The Confession (Dicksee 1896)

I am not Catholic, but was brought up Anglican; which is close enough. The two churches' teachings are pretty similar except where it comes to divorce and birth control (and of course we have no Pope, the Queen is head of our church).

While I no longer practice my childhood religion I somehow feel deeply tied to the church and its rituals. It is very strange, because I do not even believe in God, but there is a peacefulness about walking into a church that is only rivalled when I step into Dr. X's office.

The other area the Anglican Church differs from the Catholic is the practice of confession. I have often wondered how freeing a regular, completely anonymous confession, the penance given afterwards, and the simple act of being told you are forgiven must be deeply satisfying and soul refreshing.

I suppose therapy is supposed to be like that, but there are always secrets and fears of what will happen if you open yourself up completely and 100% honestly to your therapist or psychiatrist. Fears about how the other will react, how their reaction will affect your relationship, how, even if there is no outward reaction, a seed of discontent, distrust, or even anger will be planted. The fear that some of those seeds will grow into plants, and the plants will give rise to more plants that negatively impact the therapeutic relationship.

I try extremely hard to allow myself to open up fully to Dr. X. in therapy. The day I met him I sensed immediately he was a person I could talk to. Which was strange as I had so many "man" issues I never really felt safe around men. I think I was extremely open with him during my first interview. Some people entice me to be open, but I am also a fairly open and participative person. A little too much so sometimes. By the time I met Dr. X. I had been in and out of therapy so many times that I understood I needed to let go of my fear of being judged and get everything out of my head in order to receive the help I needed.

There are things though, that I cannot seem to get out, cannot seem to say, to Dr. X, or on my blog, or to anyone. Probably important things, but shame, guilt and fear holds me back. I feel ashamed about things I do, or feel, and the words to explain these will simply not come out, no matter how hard I try to get them out. I think over and over that I should talk about these things, but it is as though I am physically mute, unable to speak about certain things I do or feel.

Often this fear of embarrassment, or abandonment, or punishment holds me back for months, or sometimes years, before I can finally tell him what I want to tell him. Every time I have done that he has reacted in an accepting and positive way. So why do I still find it hard to talk about some things?

I remember reading about this psychotherapeutic phenomenon in Irvin Yalom's, "Existential Psychotherapy". (A book that feels like it was written for me). He gave an example of a patient being terrified to talk about something, Eventually the patient managed to write it down on a piece of paper. When The Dr. read the note it said something like "I pick my nose". Hardly earth shattering, or shameful, yet to the patient, based both on his inability to say what he did, and the lengths to which he avoided saying what he did, it was both of these and more.

I believe my "secrets" are held private for a variety of reasons. One problem is some things I do or feel or sense seem so bizarre that I do not even understand why I do, feel or sense them. It is like someone completely different from the real me is rallying my thoughts and obsessively dragging me into doing things. I worry they will only be proof that I am a bad or extremely weird person. They are not even really earth shattering things, nothing illegal, but I am so afraid if I talk I will be rejected, or seen in a completely different light, no longer cared for, or thought to be crazier than I already am. I know I am being a bit cryptic, but I am trying to prepare myself to get things out of me and this is one small step towards really opening up completely.

Therapy is not like confession. It is not anonymous. The confessor knows their "confessee". The relationship is intensely important to the confessor. There is always a sense of potential instability or loss; a "contrived"genuineness (e.g. What therapist is going to say..."That is the absolute, most bizarre thing I have ever heard?...even if it was?); and an unsureness of the strength of the relationship, in part because while the therapist may love their job and like their patients, therapy is, after all, a financial transaction on the part of the therapist. The therapists are never (I don't think), or can never be as invested in therapy as the patient. The therapist has many patients, but the patient only one therapist.

For the patient there is more at risk in therapy than in confession. We, the patient and the therapist, are mere humans. Thetherapist can say everything is okay; that my thoughts and actions are normal, or symptomatic of my illness, but they may not really believe that to be the case. God, if he exists, is capable of forgiving anything. Pdocs and therapists are mere mortals. People whose feelings get hurt, who reflexively react to some information, who have fears and and joys and belief systems that may or may not conflict with their patients ideas. For me it is sometimes hardest to explain things to people who are most important to me.

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