Disintegrate, Reintegrate

 I had a therapy session where 'nothing in particular happened.' On the train back home, I sat with the feelings of the session, wondering if I wasn't as good of a therapist as I wanted to be. Maybe I was colluding with a part of her that didn't want to get better? Were we talking about 'easy things'? (this implies that therapy should only contain 'difficult things). I thought about this, and in the context of our previous session (an emotionally-rife one), I am figuring out that sessions sometimes are mostly disintegrative or reintegrative. Let us explain.

The typical therapy we're used to in psychoanalysis is a disintegrative one, a catharsis of repressed drives coming to light via interpretative mechanisms. Making the unconscious conscious feels a certain way, unleashes certain emotions, and this inherently destabilizes the mental apparatus. This unlocks energies that have been suppressed and pushed down - it is this energy precisely that can now be used, finally, in living creatively and richly. At this point, however, it remains labile, chaotic, and unrestrained to any repression or likely to any aim. The shunned off/shut off part of the psyche, now alive and allowed out, is ready and waiting for harnessing, for its honing in on physical-psychical action.

Here a reintegrative session, or a session that contains reintegrative elements, is vital for the settling of these newly arrived energies and feelings. A session where 'nothing in particular happens' is of key importance - there is a rejigging of the mind, there is a coming back to earth and a reestablishment of default mental networks. In these sessions, the psychotherapist ought see the value in such 'mundane' activities. Doing the laundry may be a boring task, but its central to keep the house in order.

However, there are parts of today where I feel I didn't have an idea in my mind, or a formulation. Part of me feels, at parts, I was operating without a frame - allowing the client free rein of my mind, and that, I feel, isn't in the service of good psychotherapy. To formulate and to wonder about your client is an active process, a process that alongside listening and meaningful links, are part-and-parcel of effective and fulfilling therapies. To operate without a frame, or to cease wondering about the deeper parts of your client, is to abandon them just as they have had to abandon parts of themselves. Without a frame, we repeat the trauma of their abandonment of themselves, as we abandon thinking about them and they keep only wishing to get better.