Psyched in San Francisco: Boats Against the Current: Psychotherapy and Learning to Row Against the Past

These words are also inscribed on the tombstone of F. Scott Fitzgerald and his wife Zelda Sayre. Gatsby is, of course, a novel about the inevitable pull of the past, the impossibility of escaping it. While the character of Gatsby has seemingly escaped his impoverished upbringing and lives in newly minted wealth, the past, as represented by Daisy and his enduring love of her, cannot be completely escaped. This great theme is of great interest to me as a psychotherapist. It speaks to the practice of psychotherapy: a practice of examining that pull of the past, the currents, and then together, therapist and client, figuring out what best strokes to use to propel the journey (the client’s life) forward.

Inevitably and ineluctably the past pulls on us in many ways. There are the experiences of the past, sometimes traumatic ones, which remain sources of deep sorrows, regrets and disappointments. These experiences linger as unhealed wounds; their pain very much felt in the present. Often the focus of psychotherapy is to talk about these experiences, to mourn losses and move through the lingering emotions by feeling them. I often hear from clients how, when these experiences first occurred, they felt alone and were not able to turn to anyone for support or sustenance. This time, as clients relive these painful experiences, they are not alone, and through the relationship with the psychotherapist they may be comforted by the presence of someone who cares, who bears witness and endeavors to understand.

The past also influences us in the way that we tend to repeat it. This was one of the great discoveries that Freud made. Freud maintained that often the memory of troubling experiences, particularly traumatic ones, is repressed. While one may have “forgotten” the events and the corresponding emotions, these experiences, while out of conscious awareness, still influence one’s life. He maintained that while they are forgotten, they are subsequently acted out, sometimes over and over again, through many years. Here’s how Freud put it: “…the patient remembers nothing of what is forgotten and repressed, but that he expresses it in action. He reproduces it not in his memory but in his behavior; he repeats it without of course knowing that he is repeating it.” The example he gives is of someone who grew up with an antagonistic relationship towards the authority of a parent. The patient now acts out that relationship in response to authority figures (or perceived ones including the therapist). The process of psychotherapy is essentially the process of remembering. In essence, the goal is to bring the painful experiences to conscious recognition so that they can be mourned and worked through and not unconsciously repeated.

The past gets stored in us not only as memories, but as patterns, blueprints in our mind, by which we organize our notions of ourselves and of the world around us. Past experience helps to form operating principles by which people live their lives. If, for example, one’s past, particularly early and formative years, was marked by neglect, by a sense of the caretakers’ indifference or abandonment, the template that may form in one’s mind may be that of others as uninterested and uncaring. A person may thus tend to avoid intimate relationships as they are seen as only painful and unfulfilling encounters with uncaring others. And when that person does allow for some contact with another human being, time and time again he may experience the other as unloving, disinterested, or abandoning. The power of the template dictates how one experiences one’s reality.

If one’s early experience was marked by overt criticism and the absence of a sense of being loved and accepted, the blueprint that may form in the person’s mind may be of a critical other, one who is rejecting and cold. One may see oneself as helplessly subjected to that harsh criticism and judgment from others. Again a person (as in the example above) may reject relationships so as to protect himself from that experience of rejection. The governing belief for such a person is that he will not ever be loved and accepted. He may even believe that through some fault of his own, he is incapable of receiving or giving love.

Or perhaps one’s experience within one’s family was characterized by sibling rivalry, a competition for attention and nurturance. The template that may govern this person’s life now may depict the untrustworthiness of others (their ruthless competition to prevail at any cost) and the limit of resources. This person may see only a deficit of supportive people in his life and feel deeply alone. He may feel that there is no one other than himself to rely on. The world is an unfriendly place and others are not to be trusted.

An essential goal of psychotherapy is to understand and reveal those internal blue prints and templates by which one lives. An unconscious map, influencing the course one takes in life, cannot be changed until its existence is made clear and the experiences it is drawn from are made known. The therapist and client set out to discover how to move differently in the world, how to revise that internalized set of expectations. Through understanding and insight, the psychotherapeutic process helps to make conscious what has been unconscious and unknown. But it also helps create change through action -- the actions that take place between client and therapist in the here and now. Over time, a person who defends against intimacy in order to protect himself may come to trust the therapist and in so doing create new templates to follow. Over time the therapist can prove to be trustworthy, interested and caring. The experience of the therapist’s imperfections (therapists like all human beings fail at times) also provides the opportunity for the client to develop new pathways of empathy and tolerance for the other’s shortcomings. A new map then begins to form in the client’s mind for the possibilities of relationship. Through the psychotherapeutic relationship, one can make headway against these currents that try to pull one back. Sometimes headway comes in the creation of lasting and nurturing relationships in one’s life outside of therapy. And sometimes headway is found in a meaningful course through life, a life of purpose and satisfaction, the client now pursues.