On secrets of the heart and psychotherapy: A short reflection

by Matthew Henson

Teccam explains there are two types of secrets. There are secrets of the mouth and secrets of the heart.

Most secrets are secrets of the mouth. Gossip shared and small scandals whispered. These secrets long to be let loose upon the world. A secret of the mouth is like a stone in your boot. At first you’re barely aware of it. Then it grows irritating, then intolerable. Secrets of the mouth grow larger the longer you keep them, swelling until they press against your lips. They fight to be let free.

Secrets of the heart are different. They are private and painful, and we want nothing more than to hide them from the world. They do not swell and press against the mouth. They live in the heart, and the longer they are kept, the heavier they become.

Teccam claims it is better to have a mouthful of poison than a secret of the heart. Any fool will spit out poison, he says, but we hoard these painful treasures. We swallow hard against them every day, forcing them deep inside us. There they sit, growing heavier, festering. Given enough time, they cannot help but crush the heart that holds them…

Quibble all you like, Teccam understood the shape of the world.

(Rothfuss, 2021)

On theory and poetry
Over the last 20 or so years in practice, in my quiet moments and as is my wont, considerable time has been given over to pondering what it is that I offer as an existential psychotherapist. During that time my understanding has developed, shifted, matured, become increasingly nuanced and both more sophisticated and, paradoxically, simplified. However, in all that time, I am yet to find a succinct theoretical definition which encompasses the whole range of my psychotherapy practice in a way that can be understood through abstract description and without direct experience. “How does therapy work?” is still the initial session question I least like being asked. Not because I don’t know the answer, nor because I don’t like answering it, but because so much depends upon what the person sitting in the ‘client’ chair brings to the equation, which makes it an almost impossible question to answer prospectively. The best succinct answer I have is that existential therapy might be thought of as the by-product of a process of phenomenological exploration, which will (hopefully and usually does) make sense retrospectively. An answer that is probably meaningless to anyone who isn’t already well-versed in philosophers such as Martin Heidegger and Maurice Merleau-Ponty; an answer which is less than useless to someone who really just wants reassurance that a therapist can help them with whatever troubles brought them to therapy.

Of course, there are many different scientific and other philosophical bases for psychotherapy, some of which can be fused through technical eclecticism or contiguous integration, and some which are incommensurable with others. The theoretical objectives of psychotherapy are many, varied and ever-evolving. Noting just a few: from making the unconscious conscious, to replacing dysfunctional thought processes with functional ones, to reattuning neuroception, to reducing post-traumatic symptoms through bilateral eye movement, many different scientific objectives are cited under the heading ‘psychotherapy’. We are a disparate profession and all the richer for it.

As a slight aside, CORU should not be envied in its current task to formulate a definition which at once unifies the many strands of psychotherapy and demarcates it as something distinctly different from counselling. We have known for some time that the difference between psychotherapist and counsellor will most likely be established through educational achievements, QQI (2014) levels 9 and 8 respectively, but the professional practice differences (what actually happens in the room) between psychotherapy and counselling, have yet to be determined. We have had draft national psychotherapy education awards standards for nearly a decade (QQI, 2014), but in the intervening period we are still waiting for national psychotherapy professional practice standards.

In the absence of a unifying theoretical definition, and until such time as national practice standards are agreed upon, we might prefer prosaic or poetic definitions. Over the years, I have acquired quite a collection of these and, when I first heard Rothfuss (2012) in audiobook format, I found what might be another wonderfully poetic definition of psychotherapy; one of my favourites. From Rothfuss, we might infer that:

Psychotherapy is a place for secrets of the heart,

or rather, psychotherapy is a place where secrets of the heart might be spoken, either to release them before they crush the heart that holds them, or to allow the healing of a heart already so crushed.

Of course, this definition requires nothing of the person attending therapy; the sharing of secrets is neither obligatory nor an outcome measure of therapeutic success. Many people will and do experience hugely positive therapeutic outcomes without ever going near any secrets of any kind. There is no dictate for clients to fulfil. Rather, this definition can be conceived as an intentional goal of the therapist, to contribute to the co-creation of a therapeutic space which is safe enough for clients to disclose their secrets of the heart, should they wish.

On secrets of the heart as challenge
It would be extraneous to debate here whether there are in reality, any absolute safe spaces in the world (including therapy), or indeed whether there should be any absolute safe spaces (including therapy) when we consider ‘hate speech’ for example, or disclosures of abusive / criminal behaviour. A safe therapeutic space, for the purposes of this reflection, does not refer to the safety afforded when we are ‘amongst friends’; the type of safety required for the sharing of politically, morally, ethically and/or legally dubious thoughts, feelings, and behaviours. Secrets which might get us into trouble with others, a boss, a spouse, the gardai, the church, the taxman, are often secrets of the mouth. Of course, many people bring such private matters to therapy and seek assurance that the therapist will keep these secrets ‘confidential’. This level of confidentiality is not unique; it is shared across many professions where the personal affairs of the client should not be gossiped about nor communicated to others. In Rothfuss’ fantasy world, the secret of the heart carried by Kvothe, the main protagonist, relates not to his later life antics, which he has no difficulty sharing, but his early life trauma. In my experience, the same is true in the real-life stories of people who enter therapist consulting rooms. The transgressions which might result in negative consequences should they become public knowledge, are usually not the things people find most difficult to talk about in therapy. Often, the things that are most difficult to even disclose, let alone discuss, relate to traumatic experiences and / or emotions; matters which might never attract any external sanction.

In a reflection published in the Irish Journal for Humanistic and Integrative Psychotherapy, I am not going to list the many ways emotional trauma occurs, how to identify trauma when it presents or how to work therapeutically with it; we are all experts in the field, even those of us who don’t have the words “trauma informed” on our certification. Instead, I will offer only a gentle reminder that trauma attracts shame like a magnet attracts iron filings and talking about traumatic experiences, as well as often being necessary for healing, is often also re-traumatising. The greater the initial trauma (and any subsequent re-trauma), the greater the shame, the greater the need to keep secret, the greater the need for therapeutic safety.

In the past decade or so, the historical stigma associated with psychotherapy has pretty much dissolved. Today, people are usually just as happy to be seen in a psychotherapy waiting room as they are to be seen at a GP surgery. Confidentiality today is not quite so much about hiding the fact that someone is *whispers* “going to counselling”. It is easy to achieve the safety required for people to share their private affairs with a psychotherapist, as they might with a GP, a solicitor, an accountant, and for this to be written into professional codes of conduct. It is another thing altogether, once someone is in the therapy space, to achieve the safety required for the sharing of secrets of the heart, these most painful and most deeply hoarded traumatic treasures. Secrets of the heart require next-level safety and it is this requirement that perhaps sets psychotherapy (and counselling, maybe?) aside from other professional relationships.

And of course, therapeutic safety does not begin and end with confidentiality. The many boundaries we hold with, and for, our clients all contribute to therapeutic safety; that probably goes without saying. The same is true for the codes of ethics we embrace, implicitly and explicitly, through membership of accrediting bodies. We avoid dual relationships, for example, (particularly the personal kind) not only to protect our clients from potential problematic power dynamics within the secondary relationship, but also to protect the integrity of the primary relationship, to protect the integrity of the therapeutic space itself. Secrets of the heart need to stay in the therapeutic space, they cannot subsequently be taken to the pub, the tennis club, the boardroom or the bedroom; this is why we forsake the possibility of other personal or business relationships once we embark upon a therapeutic alliance. Everything we do, professionally as psychotherapists, from the maintenance of ‘hard boundaries’, to the ongoing development and refinement of our interpersonal and relational ‘soft skill-set’; from our efforts to ensure calm, quiet and interruption-free physical and online spaces, to the meditations and practices we use to clear our emotional energy between sessions; from reading and writing books and journal articles, to attending CPD workshops; from supervision, to our own personal therapy; from those judgement calls about when to say nothing, to those judgement calls about when to make personal disclosures; everything, one way or another, assists us to co-create spaces that might be safe enough for secrets of the heart.

It follows that if we are not striving at all times to co-create this level of safety, then perhaps we are not practising psychotherapy at all?

On secrets of the heart as reward

You go rummaging around in other people’s lives. You hear rumours and go digging for the painful truth beneath the lovely lies. You believe you have a right to these things. But you don’t… When someone tells you a piece of their life, they’re giving you a gift, not granting you your due.

Patrick Rothfuss, The Wise Man’s Fear

Whilst the market value of psychotherapy is perhaps quite far behind some other professions with comparable knowledge base and skills-set requirements, there are of course, many non-monetary rewards. Secrets of the heart are top of my list. Alongside my own direct experience, I have learned more about the world through listening to the people I am honoured and privileged to call my clients, than I have through any other means. I love books, movies, songs, and these, together with much less loved sources of information such as, newspapers, documentaries and social media, are all great places to learn about life. But I learn most from the real conversations I have with real people, when real life experiences are shared through the simple act of talking and listening in spaces that are safe enough for secrets of the heart.

Our clients pay us money for therapy, and at the same time they reward us with the gift of stories of their lives. Through these gifts, we get to see the world as it truly is, not as a series of abstract concepts, but at a visceral, ontological, and deeply meaningful level. What it means to be human, what it means to be alive, what it means to be in the world; the shape of the world as it is actually experienced through embodied felt senses, is never revealed more fully, nor at greater relational depth, than when a secret of the heart is shared. We have no right to these treasures; we strive to earn them, and it is always a privilege when we succeed.

Secrets of the heart are both the challenge and the reward of psychotherapy.

Concluding thought
It occurs to me that whatever future direction our evolving scientific knowledge base and our regulatory bodies take us in, psychotherapy might always be defined as a place for secrets of the heart. Or, for those who favour more technical descriptors, perhaps we can at least agree that a space safe enough for secrets of the heart is inherently safe enough for any form of psychotherapy, however we choose to define it.

Acknowledgements
Thank you, Patrick Rothfuss, for the first two King Killer Chronicles. Please publish the third.

Thank you, Indra Henson, for the image of a zipped heart. Your (he)artwork just gets better!

Most importantly, thank you to everyone who has shared a secret of the heart in my therapy room. My life has been enriched by each and every one.

Matthew Henson is an existential psychotherapist, psychotherapy trainer and group facilitator in private practice. He is based in Kinsale (and online). He is a fan of the fantasy novel genre and a fan of Patrick Rothfuss in particular. www.matthewhenson.ie

References

Quality and Qualifications Ireland (2014) Awards Standards – Counselling and Psychotherapy, Retrieved 1 June 2023 from https://www.qqi.ie/sites/default/files/2021-12/counselling-and- psychotherapy-qqi-award-standards-2014.pdf

Rothfuss, P. (2012) The Wise Man’s Fear (R. Degas, Narr.) Audible. https://www.audible.co.uk/ pd/The-Wise-Mans-Fear-Audiobook/B007Q36VFC?qid=1684270761&sr=1-3&ref=a_ search_c3_lProduct_1_3&pf_rd_p=c6e316b8-14da-418d-8f91-b3cad83c5183&pf_rd_ r=CF6SVHQ9BV596Q5WGSER&pageLoadId=XBhLq2UXV7W0GnvX&

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