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Watch this terrific psychotherapy thriller if you really want to know what it’s like to be a patient or analyst! Sure, the multi-season HBO series In Treatment is more realistic with its 1 episode 1 session format; but this work of Disney Plus fiction is more realistic in terms of capturing the emotional rollercoaster of the therapeutic relationship.

The writers behind The Patient have both had experiences of therapy and it shows in their compelling opening sequence. The Freud look alike, actor Steve Carell, plays the middle-aged therapist. He is manacled to the floor. The room consists of a bed, commode and table with a tooth brush. It’s a far cry from his book-lined consulting room.

The patient, a thin young man, has kidnapped him. He wants the therapist to cure him. What from? His compulsion to murder people. The therapist pleads with his patient to return to his consulting room. He explains that therapy cannot take place in an atmosphere of distrust. The patient refuses. The therapist is really up against this murderous and compulsive young man. He decides to try and help him. Or maybe he is trying to plot his escape?

In an early scene the therapist tries to unpick the lock chaining him to the floor. But his plastic fork snaps in the lock. The patient picks up on this. His therapist wants to flee. But he cannot. Finally he sets up an improvised office. He asks the patient for pen and paper. This represents the need to think. He has to be able to formulate his thoughts if he is to aid the patient. Or maybe he is deceiving the patient and needs the pen and paper as part of an escape plan?

Just like in real therapy the patient and therapist get more deeply involved. The therapist sets some rules. The patient has to talk to him if he is going to kill anyone before doing it. Notice the therapist doesn’t prohibit him from doing anything. He simply wants to give him a second opinion.

The patient complies. He brings a man home. Normally he would have already killed him. But this time he brings this living problem to his therapy. Just like in a real therapy the problem eventually is constellated in the field between patient and therapist.

I once attended a lecture by the psychoanalyst Neville Symington. He said therapy doesn’t depend on the room, or how many times you meet a week, or the length of the session. These are all merely technical considerations. He argued that psychotherapy existed before psychotherapists, for instance in the healing traditions of many religions. He recounted the story of a taxi driver who had a suicidal man in the back of his cab. His wife and daughter had died recently and he was about to jump off a bridge. The taxi driver locked his doors and listened to this man for two hours until he was no longer suicidal.

Similarly, our beleaguered therapist is having to perform without his technical repertoire. He is unable to make use of his analytical reverie, consult colleagues, or make profound observations. Instead he had to get under the patient’s defences, to have an emotional impact on him. He hates what his patient is doing to him, and others, and yet he has to reach over to him. This is precarious territory as the patient is highly attuned to being deceived. How can this earnest family-oriented therapist enter into the world of this brutalised and brutal killer?

We know there is also perhaps a reachable side of this patient. He is discerning about takeaways which he shares with his therapist. He seems to like his mum. He takes his job seriously. The therapist also appears amused when the patient urinates in the nearby lavatory. He seems to be thinking how can anyone possibly pee for that long? How big is his bladder? He is curious about his patient.

He even manages to arrange a cosy family therapy session including the patient’s mum. This is poignant because we know the therapist is a widower and estranged from his religious zealot son.

But is this enough? The compulsion to murder is strong. Most compulsions overpower conscious thought. As therapist and patient descend further into the unconscious who can say what will happen?

In today’s world, replete with self help books, and guides on how to be your best self, or how to have multiple orgasms, marriage appears to be out of date. A so called bad marriage certainly is out of fashion. Relationship therapists will try and help iron out problems. They will tell you have to communicate better. They will tell you to make date nights, or to draw up love maps. They will aid you in how to make bids to one another, and how to respond creatively to bids. They will tell you to avoid sarcasm, stone-walling and other destructive behaviours. Maybe they will teach you to have more sex? Perhaps they actually think you would be better off apart and you should do an conscious uncoupling.

I’m sure some of this maybe helpful. But we may wonder if this misunderstands the psychological nature of marriage. If marriage is simply a welfare arrangement, or a wellness deal, then it seems doomed. There are few happy marriages. There are lots of happier ways to arrange one’s living arrangements. Perhaps a commune, or a polyamorous set up? Or living together without marriage. But I would echo the experience of the analyst Guggenbuhl-Craig:

@In my practice I have made the following remarkable observation: the level of difficulty in a marriage, the sum of suffering, irritation, anger, and frustration, also the neurotic and perverse elements which are to be found in a marriage – all these do not necessarily parallel a tendency to dissolution of the marriage. That is to say, outwardly bad marriages are often clearly viable and actual continue until the death of one of the partners. On the other hand, less problematic marriages, those which contain less pathology, often show a tendency towards dissolution; they seem to dissolve more readily than do the more difficult marriages. The observer who sails under the flag of wellbeing has difficulty in understanding this. His tendency is to give those marriages in which neuroses, sexual perversions, twisted relationships, and similar phenomena appear, a bad prognosis.@

This is because marriage is really nothing to do with wellbeing. Just like climbing Mount Everest is not really a pleasant experience. Certainly marriage, considered psychologically, may provide solace and satisfactions, but it is also painful. So why do we do it? Because we are not utilitarians. We are not trying to constantly maximise our happiness. In the Sunday papers we are pressurised to do so. Hack this, tweak that. But we actually seek out difficulty and meaning. Adolf Guggenbuhl-Craig argues that marriage involves sacrificing things we hold dear in our personality, in order for the marriage to continue. This is the opposite of the idea that we can have it all. He argues that marriage, in old-fashioned language, is about salvation. He understands it as mutual confrontation until death. I will write more about this in coming days.

Something peculiar happens in midlife. A certain realisation can strike home. That there are 8,045,311,447 people in the world…or even more…as babies are borne as I type. So in that mass, what does an individual life mean? We buy goods that are dreamt up in a marketing suite. We eat food engineered in a laboratory by a handful of corporations. We find it hard to believe in experts, or religious organisations, or the institutions that used to give us meaning. What does the life of one person in 8 billion mean? If we work in a large organisation, our employment may be terminated, and we may find ourselves without purpose. At midlife we become acutely aware of our flaws and failures. Humiliations and defeats feature large. If we look back at the dreams we had for our life, we may feel painfully aware of how few of them we were able to achieve. Even those goals we have achieved may feel without meaning. Bradley Wiggins, the Tour De France winner, and cycling champion, found himself restless when he retired from road racing. He threw out his medals and trophies. He was unable to look at his medal cabinet and simply enjoy what he had achieved. Suddenly all those achievements didn’t mean anything to him. Without the powerful routine of road racing his mind starting spinning. He tried many new sports. His mind was flooded with images. He shared stories about this violent and alcoholic father, who was also a road cyclist. He separated from his wife. This man, who appeared from the outside, in our materialistic and achievement orientated world, who seemed to have everything, appeared to have a very public mid-life crisis. As Carl Jung, the psychotherapist said,

One cannot live the afternoon of life according to the program of life’s morning; for what was great in the morning will be of little importance in the evening, and what in the morning was true will at evening have become a lie

He noted that we realised that our sun was no longer rising but setting. You can watch @Blue Zone@ on Netflix and imagine you could live to 100. Perhaps you will. Times have changed and we are more vigorous, more active, more creative in the second half of life. Sure, you can complete a triathlon in your seventies. And you may not feel old. You may feel young at heart. However, this doesn’t do away with the psychic fact that our unconscious tells us that we are moving closer to dying than living. That we have less time left on our life clock, than we have expended. This is a shocking and dramatic psychic reality. It is painful. Tech billionaires track their urines and faeces, and log every meal. Some inject themselves with the plasma of younger people in the quest to live longer. But even they will have to face the truth that they will die on day.

Our orientation towards life has to radically shift. We may experience bodily symptoms. We may go to the doctor with aches and pains, and investigate the magical relief of life insurance, or medical insurance. We may become depressed and find it hard to be motivated. But Jung argued that we need to change gear in the second half of life. He based this on his own personal reflections and experiences as well as his wide reading and clinical work. He delved into the images in his mind and produced the Red Book. It is a fascinating inner dialogue populated with characters that took him to the edge of his own sanity. In fact he had to sleep with a gun under his bed, in case the exploration became too much. He would have to remind himself everyday about his own name and his address to help ground himself in reality. He came out of this period, with the insight that the second half of life is about @individuating@. Societal norms don’t cut it anymore. The ego becomes less important and one has to delve into the self, or the soul, and find out who one is one a more authentic plane. The question Who Am I Really? becomes the pressing issue. To pursue this one has to look inwards. One has to sift through experiences and images, dreams and feelings, which are unique to oneself. The importance of self-reflection becomes more and more important. This can be aided by different things by different people, such as art, reading, film, religion, meditation, sport and the list goes on. Certain activities may aid the process of amplifying one’s inner world.

Like Sir Bradley Wiggins, once we get off whatever bike we have been riding in the first half of life, be it career, raising children, building a home, we will find that we have to embark on another odyssey. Modern culture provides fewer sign posts for this section of life. It will still try and flog us answers that worked for the first half. By all means get botox, or white teeth, and make sure to keep the muscles strong. Keep active and find meaningful outer world activities. But alongside this ensure a space for personal reflections and development. In the first half of life we may choose to jump off a cliff into the water. In the second half of life we have to jump into ourselves. In order not to drown, or lose consciousness, we need aids to keep us afloat in the psychic rapids. Psychotherapy is one such possibility. The routine and container of seeing a therapist can help us explore the inner depths. We could do this ourselves. Indeed Freud never had a therapist as the was the founder of analysis, and he had to analyse himself. But surely, like any inherently exciting and perilous activity we are better off to have a guide into the underworld. This psychic guide can provide footholds, or shine a light when necessary. They may followed similar paths themselves. They can provide a reassuring word, or warn of danger ahead. In our increasingly capitalist and materialistic culture, which is heavily extroverted, everything seems to be measured by outward symbols. But this will not give the psyche lasting satisfaction. The second half is more about divesting, than accumulating. It is more about the inner quest, than the outer quest. We have a choice to either to engage on this consciously, or to be forced into it wailing and screaming, after a catastrophe.

Carl Jung said

“Midlife is the time to let go of an overdominant ego and to contemplate the deeper significance of human existence.”

You can find the full interview and Leigh’s written reflections on Welldoing.org

In the meantime here are some tips for the disorganised and overtrained athlete from Leigh’s article….

1. Be the best at things that require no talent
Before I could develop interventions to maximise my potential on the world record, I had to build a foundation that nourished growth. This required optimising my lifestyle so I could dedicate the maximum amount of time and energy to pursuing my target. I focussed on three areas:

Time management: Structuring a digital calendar to cover every activity including detail about travel time, who I was meeting and what I needed to take with me ensured I arrived on time and prepared to perform at my best. Appointments with non-negotiable times were colour-coded red, empty time in my calendar was populated with flexible tasks from my to-do list and coloured green.

Organisation: To ensure I found my files quickly, I tidied my desktop and structured the folder organisation on my laptop. I did the same for my living space at home, also ensuring I prepared equipment in the evening, ready for the following day. I took this one step further by separating my life into ‘zones’ which included different places for work, relaxing and sleep. Each ‘zone’ was optimised for its purpose.

Sleep: My performance psychologist would often say: “Sleep is the most powerful performance enhancing drug in the world and the least used.” Our record-breaking strategy was based on working smarter rather than longer, and eight hours of sleep every day ensured optimum physical and cognitive function.

I was lucky enough to catch the end of the book launch of Blake’s Job by Jason Wright.  It was held at the Architectural Association bookshop.  The room was overflowing and I caught some of the conversation from the hallway.  The central argument of the book is about moving from a paradigm of exploitation to resonance.  Jason uses the Blake’s images, as well as a range of modern thinkers, and vignettes from his clinical work, to make his point.   There is a music in the way he writes, just as in the way he speaks.  Perhaps this echoes his earlier life in the theatre.   He also includes some of his own rather good poetry in the book.  There is poem towards the end called “Blessing”.  The final three lines are

Suddenly I realise

That If I stepped out of my body I would break

Into blossom

What is remarkable is that alongside writing this book Jason has a very busy clinical practice, working with groups as well as individuals, and he is also an entrepreneur.  He plays a very hands on role in running the group therapy practice Number 42 located in London Bridge.  I have an unpublished interview about his memories of establishing number 42 which i will share some excerpts from soon

I was very pleased to interview world record holder Leigh Timmis recently. He has just published a great book about his experiences called The Race of Truth. It took him five years to write. The interview will be published tomorrow and I’ll post a link. What a modest and thoughtful man as well as a remarkable athlete. It astounds me where he gets his energy from. He has the world record for the fastest ride across Europe, and also the most miles ridden in seven days. These are certainly astounding physical feats. He didn’t simply take minutes or hours off the previous record, but days! His body has to be robust enough to withstand the intense training required. It has to be sturdy enough to survive the incredible pressure he puts on it during the record attempt. However, he is also able to go deep into his mind in order to find the psychological resources required to push himself beyond ordinary limits. The book goes into great detail about his struggles and difficulties and how he overcomes them. He is able to achieve a sweet spot, where mind and body are in tandem, that enables him to achieve these remarkable records. He is able to contain incredible energies without breaking down.

He is also able to use what we might term a secondary container, in the form of the team around him. His nutritionist, sports coach, psychologist, logistics expert and extended team seem to absorb many of the pressures on him. He is able to make use of his team, and turn around what could be destructive, into something creative. This secondary container can ensure he is given just what he needs, just when he needs it. This could be a phrase from his team, which resonates with him, such as “what’s the view from the balcony” which helps him to visualise his own achievement as a spectator. Or it could be more concrete nutrition, in terms of a sandwich he likes.

The team around him are interpreting all the messages he is sending. Not just the computer read outs about his speed and cadence, heart rate and tyre pressure, but all his unconscious messages. How is he speaking? What is the music of his voice like? How does his body look on the bike? How are his moods? They are constantly seeking to work together to digest and make sense of his powerful emotions and to give him back something useful. The analyst Wilfred Bion spoke of how a mother may take the dread experienced by a newborn baby and somehow absorb it, and make the baby feel safe. The mother may act to psychologically digest such experiences and give back something more soothing to the baby. Well, I wonder, given the pressures he puts himself under, such intensity, such extremity, that he may feel states of dread and hopelessness. There are times he writes about when he thinks of giving up. But he is adept at using his team, and that allows him to weather primitive and extreme emotions.

Leigh spent a great deal of time picking the right people for his team. He sought out people that he clicked with. He was attuned to the chemistry. He was also mindful of the chemistry between people. He must have intuitively known how much he would need to depend on them. And how much communication, some of it unconscious and through his body, would be going on. He had faith that his team would be able to work together to interpret his messages, and to figure out how to get him to the finish line.

Alex Honnold, the incredible climber, and star of Free Solo, is due to have a baby with his long term girlfriend, now wife.

As i stood in Yosemite, a mere tourist, i gazed in awe at “El Capitan” a rock face he had climbed with his bare fingers.

Now he is a father to be will he continue to tackle such extreme challenges? What level of risk can be absorbed by a couple? What are the limits?

Clearly, each couple is different. For some driving at 21mph in a 20mph zone is a step to far! Events such as the birth of a child may result in the redrawing of a boundary.

A life with no risk or danger may feel dead, or inert. Too much adrenaline may feel sickening. How do different people, joined together as a couple, negotiate this dilemma?

I will observe Alex H and his family and be fascinated to see how they evolve…

Some couples enter therapy like they are entering Eurovision. They are competing. Or one person in the couple wants the therapist to adjudicate,to act as ref, to awards points. Is the person who earns more money right? Or the person who puts away the laundry? Or the one who has more friends? Or is it the party with the least problems? Is it the better looking person? Is it the person who wants more sex, or the one wants less. Is it the person who is faithful, or unfaithful. Is it the person who loses things, or is it the person who finds things. Is it the victim, or the aggressor?

Who is good and who is bad? After a the long summer holiday reset, couples may feel they have been able to move onto a richer perspective. Or they maybe thrown into a binary logic, split, divided an uncomprehending. Their differences may be woven into an intricate tapestry, or it may shatter their union into a thousand pieces.

Each person may be wedded to their viewpoint and seek for the therapist to decide who gets the moral high ground. We are all self obsessed to varying degrees. We are all able to understand others to varying degrees.

I guess the independent perspective of the therapist, who is sympathetic, but doesn’t take sides, may allow new ways of thinking to mutate and emerge for the couple.

Many of the emerging patterns and difficulties may be rooted in family scripts that run back many generations. Many unique issues will be constellated by the unique material and dynamics that the couple generate together. This is extremely complex and world’s most powerful psychic microscope or telescope, if there was such a thing, wouldn’t be able to pick up everything.

Couples therapy may provide a living laboratory to explore, examine and reflect on these various scripts. Each party may move away from getting out their score card, grudge list, or kompromat. It may be difficult to put down well used psychic weapons, and shields, which have served a good purpose in relationship combat. Yet, a truce, an atmosphere of dialogue can work wonders in releasing new energy into a relationship. Incredibly, repair and restitution becomes possible, and new scripts can emerge.

Lady Gaga and Bradley Cooper are onto something when they sing about being out of the shallows and in the disorientating depths of the psyche

Shallow

Tell me something, girl
Are you happy in this modern world?
Or do you need more?
Is there something else you’re searchin’ for?
I’m falling
In all the good times, I find myself longin’ for change
And in the bad times, I fear myself
Tell me something, boy
Aren’t you tired trying to fill that void?
Or do you need more?
Ain’t it hard keeping it so hardcore?
I’m falling
In all the good times, I find myself longing for change
And in the bad times, I fear myself
I’m off the deep end, watch as I dive in
I’ll never meet the ground
Crash through the surface, where they can’t hurt us
We’re far from the shallow now
In the sha-ha, sha-ha-llow
In the sha-ha-sha-la-la-la-llow
In the sha-ha, sha-ha-llow
We’re far from the shallow now
Oh, ha-ah-ah
Ah, ha-ah-ah, oh, ah
Ha-ah-ah-ah
I’m off the deep end, watch as I dive in
I’ll never meet the ground
Crash through the surface, where they can’t hurt us
We’re far from the shallow now
In the sha-ha, sha-ha-llow
In the sha-ha-sha-la-la-la-llow
In the sha-ha, sha-ha-llow
We’re far from the shallow now

Therapists around the world are cranking back to work. After the long and sometimes idle days of summer, it can be a shock to the system to get going again. However, too longer in the paradise of summer has its down side too! Too much inactivity, food, drink and sun can make the body cancerous and inert. The fantasy of being on holiday forever, is just that. A holiday forever rarely if ever delivers what it promises. As Carl Jung said, we need problems. Without problems we atrophy, stagnate, and get bored. The human mind and body need a gradient to work against. Too steep and we get demoralised. Too flat and we fail to get stimulated. But if we find the right gradient we are onto something. The Kenyan marathon runners who run hills know that. They develop muscles, they train their bodies to work against something. Athletes who go to the gym know you need to lift weights. Weights provide stimulation to the muscles and bones spurring growth and repair.
Weights even stimulate bone growth. Sometimes we may wish for weightless days of summer, carefree, downhill, and freewheeling. But that only makes sense if we can return to the gravity of our lives. The weight, sometimes burdensome, is also essential for our psychological and physical development.

As we change gears, and the days become incrementally shorter, and cooler, it may be a good time to reflect where we are going. The blue moon is pulling the tide this way and that. Tropical storms are battering the world. Traffic control systems are breaking down and leading to chaos as people criss cross the world. Whilst psychotherapists are increasingly interested in external weather systems, and climate catastrophe, they are equally attuned to our internal weather systems. What is the climate inside us?

As we pack away the sun tan lotion and get back to reality, what have been avoiding, what do we find in our psychological inbox? Are we feeling replenished and revitalised? Are we able to approach difficulties with new vigour and flair? Or are we faced with the same old dead ends? Can we bring some of our holiday spirit to our work?

There are times to go into hiding, and times to emerge and face the world. As August draws to a close, new possibilities emerge. As i find myself transported from the sunny climate of California, to the grey September clouds of south London, the change is inescapable.