On Being and the Lack of a Cure

Recently, I again picked up Psychotherapy Grounded in the Feminine Principle by Barbara Stevens Sullivan. As I have said previously, this was one of the more influential books that I read while at Pacifica Graduate Institute about doing therapy, though in light of Sullivan’s message of embracing the practice of beingnoted below, saying so (“doing therapy”) is perhaps ironic. In addition to a wealth of other ideas, Stevens explores using the feminine-oriented (more receptive) practice of being with clients rather than the more masculine-oriented (more active) practice doing things with or to clients.

Along with being with clients, using a responsive and inviting approach, comes the idea that the role of the therapist is not to cure the client. The medical model that is the basis of a lot of therapy eduction is often focused on curing the patient. In Sullivan’s conception, the role of the therapist can often be seen as a midwife to the clients self-knowledge. She writes:

“Therapy is successful not when it ends in a cure but when it leaves the patient able to continue growing on his own, when he has learned how to work with his inner pain in vital and satisfying ways. We each need to learn how to make our way on our own through the labyrinth of the psyche, to face the fatal or incurable illnesses that run through the fabric of our lives, to find and hold all of our selves in our self experiences.”

I’ll explore this quote briefly because I believe the ideas it highlights are important.

“Therapy is successful not when it ends in a cure but when it leaves the patient able to continue growing on his own, when he has learned how to work with his inner pain in vital and satisfying ways."

The first half of the quote describes something that I have come to realize in the course of my personal and professional therapeutic work. Personally, there are times that I just need to be myself and feel my emotional states. Trying to avoid this can lead to a worse situation. In the worst cases, I think that they very practice of avoiding your feelings and emotional states can lead to worsening depression, anxiety, or other symptoms.

Professionally, for some of my clients, I have learned that being is a powerful tool. It is often the case that I seem to be not doing anything but listening, reflecting, feeling my own feelings and hearing my own thoughts in relation to the client—being with the client—though this is in face doing a lot. In a class I took on the art of therapy, someone shared a phrase that reflects this type of state: “Don’t do something, just sit there!”

Being the feminine principle, I think that midwifery is an apt metaphor because there are times indeed that I do have to do things, as the midwife does, though much of what I may do involves helping the client do what they need to—and indeed what they only can—do.

“We each need to learn how to make our way on our own through the labyrinth of the psyche, to face the fatal or incurable illnesses that run through the fabric of our lives, to find and hold all of our selves in our self experiences.”

Regarding the second half of the quote, some people may have depression or anxiety as a part of their lives. These may never completely go away though hopefully life is manageable and even fruitful in light of these altered states of mood. That begs the question of whether or not mood disorders (itself, a charged term) are things to be cured or things to be understood and managed to the best of our ability. As I think about it now, it may be that I am saying that trying to cure mood disorders may be impossible depending on your definition of a cure.

For me, a cure is when something goes away completely. If I get an illness caused by bacteria—a sinus infection, for example—a doctor can give me antibiotics, and a week or so later, I am cured of this particular illness. If the illness is caused by a virus, as most colds are, there is nothing the I or the doctor can do other than support the body’s own defenses against the ailment. Also a week or so later, we hope, the cold will be gone even though I did not utilize a cure. (This reminds me of that adage: Treat a cold, it will last seven days, don’t treat it, it will last a week.)

The challenge with the words depression and anxiety (among others) is that they do double-duty and describe a conditional state of being (“I am depressed because my dog died.”) and a general state of being that may not have a proximate cause (“I am down in the dumps most of the time.”) The former is a reasonable reaction to an event and will likely go away over time. Using the analogy above, some viruses do not currently have a cure. We can treat their effects though we can’t eliminate them completely. Chronic depression and anxiety may be like these incurable viruses.

If depression and anxiety can’t be cured, what then? I’m not saying that this is always the case with these mood-related disorders. There may be ways to manage them out of existence, which is to say, to cure them. I believe, though, that this is a less common occurrence for chronic states of depression and anxiety. More common, depression or anxiety that may have defied curing may benefit from a treatment that involves insight, self-refection, and understanding. These ideas are still evolving for me, and I interested in what people have to say about them.

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