by Deirdre Mannion Carr
Somebody Else If I was not myself, I would be somebody else. But actually I am somebody else. I have been somebody else all my life. It’s no laughing matter going about the place all the time being somebody else: people mistake you; you mistake yourself. Jackie Kay
After twenty three years in the chair it was time to rest. Life insisted on a move away from Ireland and as a peace offering opened a space that allowed a sabbatical to happen. Otherwise would I have dared to take it? It would have been harder.
The sense of responsibility in this job is huge, as all of you reading this will know. There is never a right time to stop. We hold people’s lives in our hands, their struggles and vulnerabilities. We accompany them on their journey in all its myriad complexities, twists and turns, frights and terrors, joys and sorrows. When is it right to take a break? It is not easy to let people down, to say “I think I will stop now”. We are not good at disappointing or upsetting or failing. In fact it can provoke extreme anxiety in us. It keeps us awake at night. Most of us try to be “good enough parents” for our clients. In my lexicon of rules that included never adding any burden to a client’s life of my own making. I am sure it is the same for you. We know our own lives will include birth and death, illness and change, yet we hold a taut line of protection around our clients. We carry this stoically for so long it becomes normal for us. The unconscious masochism of the therapist allows us to endure much. This is the best and worst of professions. Few others hold such challenge or depth. Where else in life do you get to work with people in this most extraordinary of ways? It is the most privileged and personal of jobs.
However we need to take care. What price do we therapists pay? How dangerous is it to even ask that question? Do we minimise the personal cost because it is not all right to have any? Are we busy serving the god of denial, year after year being heroic parents, because the collective profession colludes with that? The most that people complain of is tiredness, stiff backs, and sore necks occasionally. When was the last time you talked to your supervisor about burnout, rage, weariness of spirit? When was the last time the I.A.H.I.P. hosted a weekend on “Caring for the Therapist”. And if it did would you go, or are you too busy minding clients or recovering from the week.
Working as a psychotherapist is dangerous to your health. It asks the deepest possible things of you emotionally, physically and spiritually. The price is cumulative, one year builds on the next as the toll of the work seeps into your muscles and bones, your heart, your digestive system, your dreams, your way of seeing the world. It is insidious. We do not respect what we do enough. If we did we would look deeply at the profession of psychotherapy and ask what needs to come good to make that career a healthy vibrant viable option. People struggle on their own, trying to find creative ways to combat the fatigue; reducing client hours, teaching more, going half time on a wing and a prayer and hoping that great uncle Tom will leave an inheritance!.. etc. We glean the information about what others do surreptitiously. For a time I tried to integrate sabbatical time into my working week, and it helped somewhat. But as we all know no matter how the resting is structured we carry our clients anyway. Once the therapeutic contract is established clients acquire an entry visa into a place deep inside of us. Holidays and yoga don’t change that.
So what is to be done if the very essence of the work is based on this deep interchange that asks so much of us? How are we as a professional body going to address the serious professional issues of burn out, tiredness, dispiritedness etc? Is early retirement the only answer? What questions need to be asked? How do we create a space to step out and see the wider picture? How do we give ourselves permission to say openly what we carry privately? We are all conscientious, responsible, dependable people. What is our strength becomes our downfall. The wave falls back on itself. To be a psychotherapist in the first place you have to have a penchant for suffering!
I do not have the answers but some thoughts come and go. This is not a vocation, it is a profession. We may have felt called to it, but it is also a career. We need to give up our allegiance to the Hero myth. We need to have space to say it hurts. We need to be disillusioned and sad. We need to support each other. What is the point in doing life transforming work with others if we consign the serious questions about this profession to the cellar? Why are psychotherapists left to deal with the professional fallout in private? Why is their no career structure? Why are senior psychotherapists with years of experience earning the same fee as fresh graduates? Why are people having to put in so many hours just to earn a living so that they are too tired to attend workshops, too tired to write, too tired to bring their substantial wisdom to influence policy change within society. We confine ourselves to our rooms and learn the most profound things about what it means to be human, yet we don’t move out of that space with that learning in any coherent professional way. One or two carry the flag. So wisdom like sawdust gets scattered and lost.
Any profession is a living growing organism. Psychotherapy was founded in the Feminine Principal and has all the richness of that embodiment. But all mothers need to be saved from their children and it is the father’s job to do so. He interrupts, helps separate mother and child from a blind and devoted union. He helps with order and structure. He represents the Reality Principal. He assists maturation and growing up in a way mother can never do on her own. It is time for the Masculine Principal to enter Irish Psychotherapy in a more meaningful and consistent way. It needs to be invited in. The Feminine Principal has been too dominant for too long. She, I fear, is growing weary in the absence of protective realities. It is time for the struggle of a new marriage and that means giving up some of the old secure myths. It means the challenge of a new shape and a new space. It means stepping out of the therapy room to address wider professional issues such as career structure, money, the place of psychotherapy within present day society, etc. It means taking debate and dialogue, mutual support and openness to a new level. It implies we match the rigorous attunement and standard of excellence that we give to clients with a similar stance about our own lives.
Can we create an atmosphere in psychotherapy practices, supervision sessions, training courses that allow the humanity of the therapist to be deeply cared for? Can we make this as essential as professional development or supervision? Can the esteem, standing and perception of the profession be sufficiently raised to ensure a fee structure that gives therapists quality of life without working themselves to the bone. (Most therapists I know base their fee on what they feel people will pay, not on what they believe their expertise or commitment deserves.) Can we charge enough to guarantee a sabbatical every six or seven years and ensure that we rest deeply and replenish ourselves? Can we prepare and educate clients for the essential necessity of this? Can we spend time on the issues that are seldom addressed? We cannot go on blindly ignoring these critical realities. The Emperor has no clothes.
I have been resting for five months now and of late I feel a change, the world has got lighter, my heart is more buoyant, my dreams are less dense. I laugh more. Of course there could be a million reasons for this and we could analyse them all. I did not know anything was wrong before. I did not know what I was carrying. I like not carrying it! (“Shoot the traitor”). I think of psychotherapy in Ireland a lot. I loved my practice dearly. Today I made carrot cake, took a yoga class, squandered two hours in a gardening centre and listened to the radio, after all that my husband still did not manage to get a home cooked dinner! It is magic to waste time. It is wonderful not to be responsible or productive. It is brown bread for the soul. (It had overdosed on poetry and needed the bread). Perhaps I got this all wrong, maybe all of you are way better than me at minding yourselves and girding yourselves for the long haul. But maybe not.
The Peace of Wild ThingsWhen despair for the world grows in me and I wake in the night at the least sound In fear of what my life and my children’s lives may be, I go and lie down where the wood drake rests in his beauty on the water, and the green heron feeds. I come into the peace of wild things Who do not tax their lives with forethought of grief. I come into the presence of still water. And I feel above me the day-blind stars waiting with their light. For a time I rest in the grace of the world, and am free.
Deirdre Mannion Carr has worked as a clinical psychologist and psychotherapist for 23 years in Monkstown, Co Dublin. She has been involved in training and teaching and is currently on sabbatical.