Getting to “The Good Part” of Therapy
When I was much, much younger than now, my mom would drive me to the airport for my return flight to California after a visit with my family on the east coast. The trip to the airport was about 20 minutes. Inevitably we would get into a very intense and personal conversation where I would share whatever fears and insecurities I was currently struggling with. Sometimes I would even cry because I was sad and had no one to talk to about these things. At that time in my life there was so much that troubled and confused me. My mom would sometimes comment on how we talked more in the 20-minute car ride than we did over the whole duration of my visit. I noticed this too, and I found the conversations in the car to be satisfying but also unsettling. I enjoyed feeling closer to my mom but was also aware that I felt very vulnerable and a little embarrassed. The intensity of these conversations was scary for me. My parents were good parents in many ways but the expression of deep and intense feelings wasn’t commonplace in my family, so the conversations in the car were not typical for me or my mom. In fact, they pretty much only occurred on those trips to the airport! As I got older and more psychologically aware, I realized that what allowed me to feel safe enough to share my vulnerable feelings with my mom was the fact that our contact was limited to only 20 minutes. Once I was out of the car, whatever was said between us was frozen in time. We might never speak of it again, and we each processed the experience in the safety of our solitude, me on the plane and her in the car, without knowing how our words affected each other.
In my work with clients I have had the experience where my client will spend the first forty minutes of the hour relating a lot of details about what happened that week, or about a particular incident. The narrative sometimes has the quality of venting. Then, with only ten minutes or so left in the session, the client will suddenly and without warning drop down into a deeper part of herself, and talk about difficult feelings or a painful memory from childhood. The client may start the next session by commenting on how it felt like “we didn’t get to the good part until it was time for me to go!” Sometimes there’s an implicit or even an explicit plea to help her get to “the good part” sooner in the hour, so we don’t have to waste time talking about less important things.
The phenomenon of getting to “the good part” in the last few minutes of therapy is commonplace. In some therapy circles people call this “doorknob therapy,” where clients express sensitive and important material just as they are walking out the door, with their hand on the doorknob. How do we understand this phenomenon and what, if anything, should or can be done about it?
Therapy clients often come to therapy with a conscious agenda of what they want to talk about, but there is also an unconscious agenda as well. Always, the top item on that agenda is the preservation of safety. For some people, it’s incredibly difficult to feel safe in the presence of another person. In their experience, closeness and intimacy lead to shame, rejection, punishment, or domination. For some people, developing the trust to be fully known by another can take years. Even the most empathic and attuned therapist can feel like a formidable obstacle to a person whose vulnerability has been exploited or disregarded, particularly in their earliest relationships. The invitation to allow oneself to be more deeply known is like a double-edged sword—we long to express our deep, personal thoughts and feelings, but we dread the negative consequences we’re used to experiencing when we do so. I believe that the psyche protects itself by only allowing access to material that has already been processed and is therefore safe to be known. However, as the process of therapy continues and the client repeatedly experiences the therapist as caring, understanding, and nonjudgmental, the psyche’s self-protective defenses begin to loosen. Sometimes it may only feel safe to “know” certain memories and their attendant feeling states for a short period of time, like in the last five or ten minutes of the therapy hour.
I have heard “doorknob therapy” spoken of as something that should be avoided or controlled. I have heard it said that it’s not good for clients to leave the therapist’s office in an emotionally raw state, or that it’s an indication of the client’s “resistance” to the therapeutic process. Clients may feel they are wrong to leave important material for the end of the hour and that they should try harder to access it earlier. While there is value in considering these points of view, I think there is greater value in trying to understand what it means in terms of a particular client’s psychic landscape. Exploring the meaning of the emergence of deeper vulnerability at the end of the session can reveal a lot about the client’s self-protective processes. It can be a barometer of the client’s developing trust in herself and in her therapist. It can be an unconscious way of testing the therapist to see if she can handle the client’s scarier, overwhelming feelings. It can be a way for the client to communicate to the therapist that she’s ready to go a little deeper. Observing and exploring the phenomenon fosters a sense of safety in that there is no expectation for the client, or the therapist, to “do” anything other than what is naturally already happening. Once the meaning of the process is better understood, client and therapist may come to some agreement on how to approach it differently. Or, they may simply anticipate that it will probably happen again, respecting the client’s need to protect her vulnerability.
When therapist and client can be curious and nonjudgmental together when important material comes to light at the end of a session, there’s a lot to be gained in terms of trust, understanding, and tolerance of intense feelings. It’s important for clients to be able to progress at their own pace, because while risk-taking is an important aspect of therapy it can only occur in an environment where the client feels safe enough to take a risk. Sometimes we can only experience “the good part” for short, infrequent periods of time. The therapeutic pair—client and therapist—both trust that “the good part” is always there, waiting to be discovered and processed, and there’s plenty of time to get there.