Reflections on therapy

by Sarah Kay

Relationships are all we have…

As I look back on my time as a therapist and what ‘humanistic’ means to me, I can only reflect with a western perspective on what I’ve experienced in the last 30 years working with clients. I worked mostly in long-term relationships with clients and can unequivocally attest to the importance of the ‘relationship’ being at the core for both parties to gain insight, learning, trust and growth.

Three areas of concern, which for the most part inhabited the therapeutic space, were: the fear of death and dying, the search for a purpose for living including relationships, and dealing with loss and grief. For all these concerns, the humanistic principles of respect, empathy and belief in the possibility of growth and change apply and I endorse them all.

However, these principles also apply to other modalities and philosophies so I’ve instinctively shed (or integrated) labels such as humanistic, integrative, dynamic, and gestalt, amongst others, partly because I am not a purist and have added other strings to the gestalt bow and partly because therapy has evolved in leaps and bounds since the 60s, when the term humanistic became a movement of expansion in a time of possibility. This was in response to people throwing off the shackles that bound them and searching for purpose and meaning. Over time the growth and potential movements have evolved into a humanistic, integrative and dynamic force.

But the world since the 60s has changed and at great speed. We are now living in different times with different challenges. Is ‘growth’ the only answer to ‘potential’? Economists still think so, but environmentalists are focusing on sustainability and resilience in a desperate effort to stop the further destruction of the earth. We have a plethora of knowledge which now has to be sifted out from ‘fake’ news and conspiracy theories. Everything, every emotion, every opinion, every sound bite is out there, on media platforms 24/7 and not only is it overwhelming but it also risks getting cancelled! No wonder people are hyper stressed and anxious.

So, my observations are not just questions for the future of therapy but also for the survival of the planet, for unless we do something very soon about carbon emissions many things other than survival, including therapy, will seem unimportant.

So, with the reality of a climate emergency – how do we face this existential threat to our planet and all who live on it and keep the pressure on our governments to do something about it?

There is a rise in malignant narcissism, sense of entitlement and naked aggression (just look at the current global leadership, states at war and inequalities around the world) – has our work towards self-actualisation been too individualistic without enough thought for society and communities?

Attachment theory talks about the importance of attunement in the development of a child and his/her primary caregiver and it’s bearing on future relationships. We now have a third party involved in this early stage of development: the screen (mobile phones, etc.) Will this have a bearing on attachment theory and future relationships? In relation to screens, many of us will have conducted therapy sessions during the pandemic through a screen. Does this way of working have a bearing on the relationship between therapist and client?

How has the use of social media affected society and our mental health? Can and should social media be controlled? If so, then, by whom?

Therapies evolved on the margins of society in an effort to liberate people from unnecessary suffering and were part of the feminist and anti-racist movements towards equality. As well as the continuing evidence of misogyny and racism, the biggest problem now is financial inequality in western societies where we have poverty rising with food banks and homelessness (due to high rents, basic salaries not in line with inflation and lack of housing). The wealth of the world is in the hands of a very few who get away with paying minimal tax. Ironically but not surprisingly, there is now a very lucrative global ‘wellness’ industry flourishing. Does this industry exploit vulnerable people? Can ordinary people afford therapy? Does our ‘wellness’ training model, which leads to an in-house pyramid of employment, in any way contribute to therapy not being accessible to everyone?

Humanistic philosophy countered organised religion with good reason at the time. However, a spiritual search and hunger for something ‘more than’ entered my practice on a regular basis over the years and needs addressing. I was quite shocked at the humanist wedding of one of my sons when the celebrant refused to say the word God in a well-known prayer the couple wanted included in the ceremony.

Do all systems in the end develop their own dogmas and protect their own interests?

In therapy we do try to deal with reality over fantasy and despair. Reality at present is tough and I swing between despair and optimism. What keeps me grounded and grateful are my many varied and loving relationships. These relationships include a love of nature, animal life and everything that grows so profusely on this earth. What else is there?

Sarah Kay is a retired Gestalt therapist who served on the Editorial Board of Inside Out.

IAHIP 2022 - INSIDE OUT 98 - Autumn 2022