Freud famously said that a therapist should be a blank page, a canvas onto which the patient can project their feelings through the process of transference. This theory – and arguably, it is above all a theory, given that even Freud had personal interactions with some of his patents outside of the consulting room – is an increasingly challenging one to put into practice, given how much of our life (and therefore the life of the therapist) exists on the internet these days.
The principles behind Freud’s guidance are sound and designed to benefit the relationship between therapist and patient. Psychotherapy provides the latter with the opportunity to confront and explore the issues that have perhaps made life more challenging. Over my years of therapy, I have greatly appreciated the time and space that my sessions have afford me to do just that. Not only that: my therapist’s consulting room has always been a safe space in which I have felt increasingly able to discuss emotions, thoughts, impulses and relationships in a way that I would have generally felt too vulnerable to discuss elsewhere. Often, we shy away from raising our most difficult emotions with those closest to us, for fear of burdening them with the responsibility of feeling the need to ‘solve’ them in some way. I have always felt that my therapist Alexis – whom I saw over a period of seventeen years until last December – has had the emotional resilience to bear even my darkest thoughts. Furthermore, I have rarely felt the sense of judgement that I might have experienced, had I discussed some of those issues with friends – and where I did feel it, I can acknowledge that it was most likely my own projection, rather than a genuine response emanating from her.
Had I known more about Alexis’ life, politics, opinions, interests and so on, it is inevitable that these would have had a bearing on my view of how she might respond to or feel about anything I shared with her. Not least given my extreme anxiety about how others perceive me, this could have led to a tendency to censor my interactions with her, passing my expression of my feelings and thoughts through the filter of my own perception of how she might receive them, given what I knew about her. For this reason, relationships between therapists and patients need to be (peculiarly) one-sided. It is possible that a patient might share something that chimes with an experience that the therapist has had. Yet while a therapist seeks to create a supportive and empathetic environment in which the patient can freely discuss her concerns, this must not involve the sharing of personal experiences as a means of creating this sense of empathy. Conversely, should a therapist feel antipathy in response to an opinion, emotion or behaviour shared by the patient, she must also seek to conceal this reaction. I imagine that at times this is incredibly difficult, and is one of the reasons that therapists often have their own psychotherapeutic supervisor, with whom they can discuss the details of their work with clients in confidence.
Of course, the idea of a blank canvas is largely an idealistic one, even if one ignores the possibility of uncovering something of the therapist’s ‘outside life’ on the internet. We communicate so much of ourselves in so many ways, and the patient feels able to draw inferences and conclusions. Were they ever to be discussed, many of these assumptions might turn out to be entirely inaccurate, based as they are on the patient’s own subjectivity, value system and wider experiences. Inaccurate or not, the patient will nonetheless bring this putative knowledge of the therapist’s circumstances to bear in how she communicates in sessions, and in how she interprets or anticipates her therapist’s responses. Even without wider knowledge of Alexis’ personal life, I am aware that I drew many conclusions about her from our interactions in our sessions. I think this curiosity is a natural human instinct, and particularly when it concerns an individual who can come to play such an important role in your life. I also became aware over time that I was on the look out for hints in my sessions that might give me further insights into what her life was beyond our sessions.
In a way, it is interesting to consider why this was so important to me – because I think it was. As I have said, I think my curiosity was primarily motivated by my affection for Alexis. My relationship with her has been the most significant and important in my life so far. In a way, it was unnecessary and counterintuitive to want to know more about her than I did. Unnecessary since my relationship with her showed how relationships can develop and thrive without any of the experiences, paraphernalia and indeed encumbrances of daily life outside of the consulting room. Our relationship existed solely in that room – with the exception of the occasional telephone session. Nonetheless, it developed, changed, thrived and existed in as vibrant a way as any other relationship in my life – at least from my point of view. The counterintuitive aspect relates, for me, to my ability dismantle the positive in my life if I am feeling particularly masochistic or self-pitying. There was always the risk, knowing more about Alexis, that I might assume that she would see me in a certain light, or be unable to understand a particular difficulty I brought to her in a session. Equally I might discover something about her that I could find it hard to get beyond. To be more concrete about it, had I discovered that she was a Tory voter or had voted Leave, would my assumptions about people in either of these categories have coloured our relationship, notwithstanding almost two decades’ worth of personal interactions? Who knows. I would hope not!
Despite these potential risks, I am aware that I was on the look out for clues about her life beyond our sessions. I drew conclusions about her origins from the hint of an accent. I made assumptions about her disposable income from her clothes and from the shopping bags I occasionally saw in her flat. In one session, in response to a – for reasons I forget – very detailed account of my latest visit to the Jewish Museum in Camden, Alexis asked me if I thought she was Jewish. I hadn’t until that point, but of course then spent significant amounts of time trying to work out whether I thought that she was. Not that it mattered either way, other than for the fact that it was then a new insight into her wider personal life. I did always assume that Alexis was married – largely because I tend to assume that people are – but I noticed that she didn’t wear a wedding ring. I assume that some therapists choose not to, either so as not to reveal this aspect of their private life to patients, or to avoid placing any form of obstacle in the path of their patients’ ability to share their feelings and worries – might a patient whose anxiety has been brought on by the end of the relationship find it harder to open up to a therapist who they may assume is happily married? I think it speaks to the strength of my relationship with Alexis and the level of emotional support that she offered me that I did not feel inhibited by anything I thought I might know about her personal life. As mentioned elsewhere in this blog, it was often clear in our sessions that our lives were very different – speed dating, chicklit and Pinterest are among the things that I explained to her over the years! Nonetheless, I never felt that our differences precluded her understanding of and empathy for my situation and concerns. For me, those differences were not really relevant in terms of our respective roles in our therapy sessions, whereas they might have been in any other kind of relationship in the ‘outside world.’
I mention the outside world, and have also said that my relationship with Alexis existed solely in her consulting room. This is true to the extent that this was the only place we would meet. The impact of our relationship has had and continues to have a far wider reach. Nonetheless, I have never bumped into Alexis (or my new therapist) outside of our sessions and am not sure how I would feel were I to do so. I imagine that I would feel unprepared, unsure of how to act, and I worry that the awkwardness of any such encounter would have a negative effect on our relationship. Doubtless it would be something to be discussed at length in subsequent sessions! I did catch sight of Alexis walking to her consulting room on two occasions, and both times it provoked an extremely peculiar sensation, a sense of secretly spying on her – albeit unintentionally – of seeing her in her daily life rather than in her role as psychotherapist.
I have to admit that I have ‘spied’ on Alexis more intentionally, through the internet. As is the case with the occasions on which I saw her outside of her consulting room, this is not something I have discussed with her. Perhaps because I was worried about how it would make her feel, and whether she might feel that this quest for knowledge might hinder our relationship, or even suggest that there was something almost unhealthy in my sense of attachment to her – as if I wanted to get closer than it was helpful for us to be in an effective psychotherapeutic relationship. Above all, beyond these anxieties, I think I chose not to discuss my googling with Alexis because I felt I was unable to articulate the precise motivations that lay behind it, and was also aware of what it revealed about my vulnerabilities.
As far as I am aware, it is common practice for therapists to take regular time off during the year. Alexis would usually take two or three weeks at Easter and Christmas, and then just over a month in the summer. I am currently on my summer break from sessions with my new therapist, Sarah. Therapists need time and space away from the psychological and emotional pressures of their work, and the regularity of the breaks is helpful for patients. I think that patients can often benefit from a break from regular sessions too, as an opportunity to process conversations that have taken place, to consider the impact of those discussions on ways of thinking and being, and more generally to allow feelings and thoughts to percolate and shift, and new ideas and emotions to emerge. Nonetheless, these breaks can also be very difficult, and at times the patient can feel the absence of the support that her sessions provide, particularly during more challenging times.
I often missed Alexis during her breaks, particularly over the summer. I think a sense of loneliness was the primary reason I googled her for the first time. I was curious anyway to know what her online presence was, but I didn’t go looking for an answer to this question for a very long time. When I did decide to google her, I suppose I felt that seeing something of Alexis online would make me feel closer to her, and that knowing more about her might serve the same purpose. Perhaps not surprisingly, and in common with many therapists, Alexis has a very limited online presence. Some therapists host websites for their practices, other write blogs or even contribute to magazines and other online publications. This online activity tends to be related to their professional life. In terms of personal accounts, therapists are very aware of the need to ensure either that their privacy settings are suitably high, or that they are aware of the potential wider audience for any comments or posts they make online. As a teacher, I have to be equally careful, in case students or parents stumble across anything I would not want them to see – including the perfectly anodyne, but personal.
Alexis is listed on various therapy directories on the internet. Through one of these, I inadvertently discovered that she has a PGCE, i.e. a teaching qualification. I am a teacher and over the years told her a huge amount about my role, my colleagues, and my experience of the pressures of the profession. When I first made this discovery, it did make me wonder what her own experience had been, why she had left the teaching profession, and also to what extent she could relate on a personal level to kind of issues I might mention in our sessions. I think I also found it rather amusing to think that I had probably explained things to her in terms of life in schools that she fully understood. I was briefly surprised that she hadn’t given me any indication that she had had experience of teaching – though of course, I then reflected that sharing this kind of personal information is precisely what a therapist does not do. Overall, this information was above all a curiosity, a titbit that had no real effect on my feelings about Alexis or my openness with her.
Beyond her listings on online directories, a google search also revealed Alexis’ home address. As is often the way with the internet, I then disappeared down a rabbit hole, a search of a search result leading to a subsequent search, and so on. As is frequently acknowledged in any discussion about the dangers of the internet in the media, most of us would be hard pressed precisely to identify the impulses that drive us to pursue these labyrinthine paths online, moving further or further away from our original point of departure, or examining it in increasingly minute detail and from a multitude of angles. One of the many ways in which the internet consumes our time so effectively, and encourages this almost compulsive behaviour, is the way in which it feeds, and feeds on, our desire to know, and indeed our sense that the availability of knowledge and answers is somehow our birthright, with everything we need available somewhere on the internet. In the days before the world wide web, we contented ourselves either with not knowing, or with having to make a concerted effort to find an answer to our question at a later date. I often think about this shift in expectations when watching a TV programme. I will half recognise an actor, but fail to recall where I have previously seen him or her. A quick search on my phone gives me the actor’s entire biography, filmography and confirmation of which of his/her other work I have already seen. A question posed and an answer found. But why does it matter? It doesn’t I don’t think, but we have all got into the habit of believing it does.
The Alexis-related virtual rabbit hole I fell down revealed her home address, her husband’s name, some of his professional responsibilities, and the psychotherapy body of which Alexis had previously been a director. None of this information materially changed my relationship with Alexis, not least since by the time I uncovered it, our relationship was already well-established. Had I googled her at an earlier stage, perhaps its impact would have been different, or more significant. Nor did it make me feel any closer to her. I came to understand that my sense of emotional proximity to Alexis came not from information that either of us might know about the other, but from our shared experience of our sessions, and from the sense of support that these gave me. I think this is a valuable lesson to apply to all relationships, to realise where the heart of each of them is, to understand what genuinely matters, and what is largely extraneous noise, or superfluous information. Nonetheless, Google brought me if not into Alexis’ presence then into the company of information about her, and these searches became a habit at times when I was feeling particularly low or lonely. In the months prior to her retirement – and particularly when she let me know that she had had to bring it forward for personal reasons – a Google search could feel like a source of comfort. In fact, it often led to a greater sense of upset and despair, as it provoked me to contemplate the looming prospect of life without her support.
The circumstances around Alexis’ retirement also gave me an insight into precisely why it is so important for the therapist to withhold personal information from her patient. Alexis had given me over a year’s notice of her intended retirement date, aware that a lack of certainty was causing me a degree of anxiety. However, in the end, she was forced to bring her retirement forward due to circumstances in her personal life, and there were only six weeks between her giving me this news and our final session. Unusually, Alexis did give me a certain amount of detail about the reasons for her imposed early retirement, telling me that she was finding it increasingly difficult to juggle her work with other appointments, and referring to illness in the family. My knowledge of her personal circumstances led me to wonder whether it was her husband who was ill. However, this didn’t particularly alter the sense of concern I was in any case feeling about the difficulties she was facing. I think what was more difficult was an initial sense that it was or would be wrong for me to express my upset at the relatively abrupt way in which our relationship was coming to an end. I felt that any such admission of my sense of grief and loss might indicate a lack of concern for Alexis’ personal circumstances, might communicate a selfishness on my part or might just be inappropriate. These feelings and concerns were exacerbated by my own tendency to assume responsibility for other people’s emotions as well as my own. I understood that Alexis wanted to emphasise that her decision to bring forward her retirement was not one that she had taken lightly and was one that had almost been imposed on her. I was ultimately grateful that she told me what she did. However, this did not preclude an acknowledgement on both our parts that this revelation had the potential to complicate what was already a very difficult moment in our relationship. Of course, Alexis was able to recognise this and reassure me that there was absolutely still a place for my feelings of sadness in our sessions, irrespective of her own personal circumstances. While six weeks felt like an absurdly short period of time in which to bring such a long relationship to a close, those remaining sessions, while incredibly emotional, were very valuable and remain very precious to me.
Seven months on from the end of our relationship, and I still feel that I am coming to terms with the fact that I no longer see Alexis twice a week. I have been very lucky to find a new therapist with whom I have felt such a positive connection from the start. Nonetheless, I am still grieving the end of my sessions with Alexis. Writing this blog post has reduced me to tears on a number of occasions as I have reflected on what our relationship meant to me. Although I already know what is there, and although it won’t alter the fact of her retirement, I have continued occasionally to google Alexis when I have been at my lowest ebb or when I have particularly felt her absence from my life. This admittedly pointless habit has recently taught me one further lesson about the dangers of Google as far as one’s relationship with a psychotherapist is concerned. One search suddenly threw up a new result, a listing on a directory of therapists of which I had previously been unaware. Rationally, I can understand that this will be due to something related to Google’s algorithms that has changed the order in which results are presented. However, at the time, it was a real shock. My emotional vulnerability and tendency to catastrophise led me to conclude that Alexis had not in fact retired, that this was a new listing for new clients, and that everything she had told me had been part of an elaborate ruse to encourage me to seek out a new therapist. Of course I quickly acknowledged that none of this was the case. Firstly because Alexis would never take such a course of action and secondly because I recognised a paranoid and masochistic way of thinking that I have a tendency to indulge whenever I feel vulnerable or insecure, particularly as far as my relationships with people I care about are concerned. Nonetheless, my discovery caused me a huge amount of upset, if only for a short period of time. A particular danger of the internet is that we often spend time online when we are on our own, or at unsociable times of day when we are less able to reach out to friends for the emotional support that our browsing might lead us to need. We can be left alone with some very complex feelings, whether they are as obvious as those I experienced when I came across the new website, or whether they are the almost imperceptible but nonetheless damaging shifts in our self-esteem or emotional make-up that research repeatedly shows can be caused by internet browsing and social media in particular.
I hope that I have almost learnt my lesson as far as googling my therapist is concerned. I did of course research my new therapist online when she was recommended to me by Alexis. I found her professional biography on an online directory, and it was perhaps helpful to put a face to a name prior to our first session. Some time after we began seeing each other, I did go back to the internet to see what other information I could find. As was the case with Alexis, this was at a time when I was finding my emotions and indeed life in general particularly difficult to navigate, and in a way it was a quest for some source of additional comfort. Even at the time, I could recognise that nothing I might find would bring me the solace I was looking for, and that I my time and energy would be better served looking after myself and my emotions, getting more sleep and just generally allowing myself time to be, rather than seeking distractions outside of myself. My relationship with Sarah is relatively new, and we are much closer in age than I was with Alexis. Both of these facts increase the risk that greater knowledge of her personal life could undermine our therapeutic relationship.
I am now determined not to get drawn back into this unhelpful habit, and in fact will even take the step of joining the Scroll Free September event next month, with the aim of reducing the amount of time I spend specifically on social media, but on the internet more generally. I do not want to do anything to jeopardise my relationship with Sarah. I am also determined to challenge bad habits that undermine my emotional wellbeing and to give more time to those that boost it. Hopefully this will free up mental space, firstly to reflect on the outcomes of my therapy sessions, but also to think about my own path into a potential career as a psychotherapist, on which I have now begun to take my first, tentative steps.