Getting Unstuck in Therapy

Therapy feels stuck when the domains of choice are too restricted or rigid, when the people involved are unable or unwilling to engage in the options each party invites and attempts.

How does the process of being stuck and unstuck proceed? This depends partly on how and whether the therapist and client can engage in a co-constructed improvisational activity. Empathy is necessary; its absence may be why the therapy is stuck in the first place. Empathy is required for therapeutic improvisation.

Some of the therapist’s activity might be seen as setting the stage for improvisation to be possible. A way of thinking about the therapist’s stance of patience, empathy, waiting and toleration is that it serves attempts at getting unstuck.

Improvisation involves an expansion of possibility and requires flexibility. (Your move 1 invites and is incorporated into my move 2, and your move 3 incorporates what has just transpired and so on.) If improvisation is successful, both people have done something they have not done before. They have incorporated aspects of the other’s behavior into their own.

In improvisation, a space is created for moves and choices, spontaneous gestures, that neither party has made before. Winnicott called this the transitional phenomena. Since the improvisation is something already accomplished, it becomes behavior potential, something a person might want to do again. (I am taking for granted that we get something of value from improvisational interaction. At the very least, we now have done something we might not have done before or otherwise.)

Such change may involve fundamental, profound or trivial alterations in a person’s powers and dispositions. Usually of course, the change is slight and hardly noticed to the point of it being, practically speaking, not a change at all. But part of the therapist’s job is to notice and accredit these shifts. This doesn’t need to be said out loud, but it must find its way into action so that it has a chance of being incorporated into the next set of unfolding acts.

Therapy often requires establishing empathy and developing an improvisation with people one would ordinarily not choose as companions. Empathy is easy when the going is easy but that is often not the case in therapy. Therapy frequently involves difficult people under difficult conditions, and that is why these particular people are in therapy rather than successfully working matters out with friends, lovers, and parents.

Therapy brings together people who under other circumstances might not easily understand each other. This is both the therapeutic dilemma and opportunity. An empathic relationship may require a negotiation, a moral dialogue, for misunderstanding to be corrected. Knowing how to accomplish this reaching out in the service of being understood is a valuable, if difficult, skill.

The participants in therapy will be changed when they accomplish something difficult because the players themselves have to overcome the difficulty of getting along. Freud, of course, knew this and saw it as essential for progress. He called it the “transference neurosis.” Working it through may require a change in values, knowledge and competence for each participant. Since one or both players may not already have what is needed, it is unsurprising that they find themselves, from time to time, stuck.

Getting unstuck has a liberating effect. We were lost but now we are again on our way. Given enough opportunities for this to occur, it may establish faith and a set of competencies not present before the therapy began. It is good to know that you can weather a storm.

Getting Unstuck in Therapy