Freedom and Psychotherapy
Christian Jonathan Haverkampf, MD
Psychotherapy requires a freedom to imagine and think and talk about things that may not be talked about anywhere else. This freedom in communication is a central pillar of the therapeutic process because change is brought about by meaningful communication.
Keywords: freedom, communication, psychotherapy, psychiatry
Table of Contents
Psychotherapy is about change, but it requires a unique kind of freedom to bring about its beneficial effect, a freedom to engage in any thought processes a patient finds useful to engage in. This freedom is unique because not only society limits what it is acceptable to think but patients themselves often tend to be their own staunchest critics and harshest thought police at the same time. It is difficult to accept that a thought is just a thought, which is probably a remnant from a time in childhood where the world was a magical place where we could will something into existence. The more children learn to use communication and interactions with others to make things possible in the world, the less thoughts need to be real, and as one cherishes one’s own inner world, it comes as a blessing that they are not.
Freedom in the context of psychotherapy means that the feedback from the therapist is open, guided by a desire to understand and with the clear objective to increase the patient’s well-being. Increasing the well-being of the patient should guide the process. Thus, the freedom in the therapy session can be greater because the focus is on the patient without specific expectations and with a non-judgmental and accepting attitude. Rather then leading to chaos, this makes it possible for the patient to identify own values, needs and aspirations and reflect on them to gain insight into what is personally relevant and meaningful.
Since communication is the instrument with which we make changes in ourselves and in the world possible and see them through, one has to learn how to use the instrument, which requires experimentation, reflection and insight. And this in turn requires the freedom to experiment. The direction for the experimentation is provided by greater awareness for oneself and one’s basic parameters, such as values, needs and aspirations. The less this process of self-awareness is constrained the better is the outcome and the more stable the direction.
Developing insight into communication also requires the freedom to imagine new ways of forming and exchanging meaningful messages. Learning about the communication with oneself and others are at the focal point of psychotherapy, since change happens through communication and one lives own values, needs and aspirations through communication. Imagining change is the first step towards change. Greater awareness to meaningful messages increases the available information for the imaginative processes. Greater awareness can be practiced in the therapy session.
Freedom in psychotherapy means that there is more opportunity for the self to become visible. The sense of self is a product of information flows, but it also manifests in the communication in a therapeutic setting. This, however, depends on the therapist’s willingness to let the client experiment with communication which then van make the sense of self manifest itself to the client.
The sense of self is largely without shape. It is, however, important as an experienced center to the universe of the client. It is the point to which the client puts everything in relation. This is not a narcissistic phantasy, but actually something an individual suffering from severe narcissism is disconnected from and which cannot be experienced as a result. The sense of self thus feels unique because at this point one experiences only this one self. At the same time, the sense of self yearns for connection with other selves. The reason is that the self exists because it is a high density of information, the point in the body with the highest density of information being transferred and connected. (Haverkampf, 2010, 2017b, 2017a) The emerging sense of self thus requires the freedom of information passing through without any hindrance.
The sense of self, on the other hand, maintains the freedom in a therapeutic setting because it is in the interest of the self, and it thus so through a motivation to communicate as well as building the boundaries necessary to keep the communication process going. When the patient is becoming clearer about the own needs, values and aspirations, this is a sign that therapy is progressing. The next step is that the patient can reflect on them and begin integrating them into daily life and with the sense of self. Here, the therapist should both make the patient feel safe in the therapeutic setting and offer support, which can help the patient to experience the contrast between seemingly more limited options before the therapy and the true range of options the patient can choose from.
Manualized approaches are good to train skills with a patient. However, in everyday life humans have to innovate and come up with new ways of doing things. This requires that they design their own ‘manual’ which fits their interests, values, needs and aspirations. Focusing on communication patterns, internally and externally, in therapy has the advantage of doing both, helping the patient reconnect with the own compass in life as well as experimenting with and reflecting on important skills to make the journey better.
The freedom to imagine helps to arrive at thoughts and concepts a patient may not feel free to think otherwise. Innovation is important to be able to see communication processes differently, which then can bring about change. However, often patients may be afraid to connect with themselves to get a view of their own values, needs and aspirations. Fears can block this. Unfortunately, this can reduce the range of options patients see available to them. Allowing oneself to see a greater range of options makes room for greater innovation. Fears can come from several directions, and the best way to confront them is through a greater connectedness with oneself and others.
More awareness of how one interacts with oneself and others can all reduce fears because one feels more strongly the own efficacy in interacting with oneself and the environment. Humans are born with some communication capacities and acquire important skills within the first years, which they then develop and add to over their entire lives. Unfortunately, some of these resources and the knowledge about their effectiveness can be pushed aside when negative life experiences, emotional conflicts and other psychological stressors lead to withdrawal from oneself and the world as a temporary protective measure. In many cases, this temporary relief turns into a chronic disconnect, which can then lead to anxiety and depression. The freedom and safety provided within the therapeutic setting attempts to reverse this by allowing to reconnect with these resources, to feel more strength to make decisions and to use creativity and imagination to rediscover the breadth of choices available. Even if the choices at the moment seem limited or non-existent, a better connection with oneself and a sense of the own strength and resources help bridge the time it takes to implement any desired changes.
Meaningful communication is the starting point of innovation. This requires the free exchange of meaningful information. It is also important to accept that one does not know where the journey is progressing. Accepting a certain level of uncertainty may be difficult at first, but it can make life more interesting again. The uncertainty leaves room for experimentation and discovering more about oneself, which can help build a greater sense of self-efficacy.
Trying out communication is like a child trying out various new behaviors, such as of standing on two feet, walking or uttering new words. Internal and external communication are really part of the same thing, which also means that practicing one kind helps with the other. Observing one’s own thought processes can help communicate with others because, as one cannot mindread another person’s thoughts, the theories one has about how the mind of the other works begins with the own thoughts and is modified by another person’s directly observable communication behavior.
The imagination is an important part of experimentation because it precedes most consciously willed behavior, including what a person says to another. Emotional associations with values, needs and aspirations can provide significant motivation to implement an idea in one’s thought patterns or as behaviors or activities in everyday life. Since interacting with other and knowing about oneself are important preconditions for getting one’s needs and aspirations met, experimentation should also include communication patterns and styles and the skills to reflect and gain insight into them.
The therapeutic setting may be the only place where a patient can really talk freely with another human being without having to be afraid of judgment or the other losing interest. The therapist takes part in the interaction with the patient but at the same time observes and reflects on it. This is an important skill for the patient to learn as many suffering from anxiety, burnout, depression, OCD and similar conditions have lost the ability to take on the observer role. They get so caught up in an emotion or thought that these assume a reality in the patient’s world which goes beyond that of a mere mental occurrence. This can lead to becoming afraid of one’s own thoughts and emotions. The ability to assume the role of an observer can help the patient to escape from this vicious cycle. It is important to remember, however, that anything which helps the patient to experiment with and reflect on communication activities, internal and external, helps to practice the observer role.
A certain level of anxiety in the beginning can actually also be excitement about the change that will take place in the therapy sessions. If there is a fear that provides significant resistance, it is important to help the patient gain insight into what the fear may be about and to provide support in the process. Usually, fears and anxiety are caused by some conflict or an unhelpful association between a life event and a negative emotion. Once the emotion can be identified and processed, the free floating emotions of anxiety and fear can be bound to a past event, for example, which resolves them in the present. The freedom and the safety of the therapeutic session should make it easier for the patient to work with the emotion, to observe it at first, then to identify it, and finally to reflect on it and develop insight by connecting with one’s situational memory and one’s emotional memory. Both of the latter represent stored information and should not be viewed as distinct, but it can help in developing technical approaches tat are useful and beneficial to the patient.
Freedom to communicate is a cornerstone in therapy. People should feel free to say anything that comes into the mind without recrimination. If it is something that is not helpful to the individual, patient and therapist can together try to uncover its significance.
Feedback does not exist separately from an interaction. Everything that is communicated in an interaction is a response to information about oneself or another. However, feedback means that a message is primarily a response to something the client said. The focus is thus clearly on the client. This supports the client in developing both a stronger sense of self and more insight into the communication processes with oneself and the world around.
The therapeutic working relationship between patient and therapist is stronger and more effective if the freedom to say what comes to the mind and to imagine without limit exists. It creates the strong bond that is important to achieve change, even when the emotional seas within the patient get turbulent. To support the dynamic processes in the patient the therapist needs to offer support in thee form of stability. This should not be viewed as the therapist becoming a surrogate parent but an experienced fellow human being who is an expert in supporting healing processes.
Accepting that both, the therapist and the patient, do not know where the journey is going can be quite liberating, as long as both know they are on a journey. The therapist can help with experience and by supporting the client. One such support is to help the client understand that out of a level of freedom which the client may not be used to something very valuable can develop.
Dr Jonathan Haverkampf, M.D. MLA (Harvard) psychoanalytic psychotherapy (Zurich) LL.M. BA (Dartmouth) trained in medicine, psychiatry and psychotherapy and works in private practice for psychotherapy, counselling and psychiatric medication in Dublin, Ireland. He is the author of fourteen books and hundreds of articles. Jonathan can be reached by email at jo****************@gm***.com or on the website www.jonathanhaverkampf.ie.
Haverkampf, C. J. (2010). A Primer on Interpersonal Communication (3rd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2017a). Communication-Focused Therapy (CFT) (2nd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.
Haverkampf, C. J. (2017b). Self-Discovery.
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