It is assumed that women share a great deal with each other concerning sexuality. Daughters are supposed to be taught about menarche and menstruation from their mothers who unfortunately either say as little as possible or pass along their own coded messages of shame and enduring humiliation. Mothers and daughters rarely speak about that which is of importance. It is almost for certain that girls are never told in detail about their mothers’ first sex or birthing stories. Young women get to find out about these darkly shadowed arenas of womanhood all by themselves. Mistakes are made, sexuality gets hidden, and woman’s chance of becoming whole slowly dissipates into the thin air she continues to breath. 

The co-authors’ extensive experience with psychotherapy and teaching provide them with unique backgrounds to explore a new approach to effect personal change. “Self-therapy” is the term they use to designate this innovative method. It is their belief that this therapy has potential for societal and cultural implications. 

If self-therapy were found to be effective, it could have a profound impact. For example, if it were a viable treatment modality, a great many members of the psychiatric establishment would be without high-paying jobs; however, ordinary people could benefit from self-therapy, psychotherapy having been denied them because they lacked money or connections. Self-therapy would allow for inexpensive, early, and effective intervention. 

Chapter One

Daddy’s Little Girl

If one were to see Eileen Drake as she sat in her spacious apartment on a fall afternoon, one would never guess that she was the dean of women at a small Midwestern university. There was no evidence of the officiousness or authority customarily associated with that august position. Attired in a yellow flannel shirt and old blue jeans, virtually enveloped by her huge, softly-cushioned sofa, she appeared diminutive and just a shade on the vulnerable side. Her bare feet rested comfortably on the coffee table. She seemed content and relaxed. Her snow-white cat Flounder, a constant companion, nestled alongside. The gentle playing of theme music from La Boheme contributed to her sense of tranquility. As day turned to dusk, she was especially comforted by the security of her surroundings. She felt warm and safe in a psychological as well as a physical sense. The approaching twilight hour was very special for her. The developing shadows provided a wondrous backdrop and stimulus for extended meditation and quiet contemplation. She had come to incorporate these moments for herself into her daily routine. At these times, her thoughts were free to roam, their nature capriciously determined by her surroundings, memories, or momentary personal concerns.

As Eileen looked around, she thought once again about how truly satisfied she was with her apartment. She especially liked the high ceilings that conjured up an airy brightness. The decoration of her apartment had been undertaken by a friend of many years. That woman had known a great deal about Eileen’s tastes, needs, and interests. This special understanding found expression in every facet of the apartment’s decor. It was “right” for Eileen. White, beige, and brown tones dominated the color scheme. These provided an eloquent background for the brilliant oil paintings of local artists and the French impressionist prints that she had accumulated over many years. Some might say that Eileen had surrounded herself with swirls of color so as to compensate for a generally conservative lifestyle. She would probably find herself in agreement with that possibility. At any rate, she couldn’t have been more pleased with what she saw around her. 

Her apartment had several glass walls and sliding doors which led onto the two balconies. Each of these provided both access to and distance from the world that lay outside the confines of her protective cocoon. The west balcony overlooked the Chippewa River; the north one, downtown Eau Claire. From her fifth floor vantage point, there were many days she thought that she could see forever in either direction. Each balcony was still filled with her special plants, statuary, and water fountains. Painted by the brilliant sun, these were especially beautiful this late afternoon. She had reveled in their selection and nurturance. The tuberous begonias had been spectacular. All must be brought inside shortly for protection until springtime. 

Next, she returned her attention to the outside world. As she looked over the west balcony, her eyes first rested on nearby rooftops, a familiar steeple, and then were turned toward the distant horizon. It was about time for sunset, an event that always excited her. She never knew what to expect from it. Often there would be a unique confluence of wondrously bright reds, yellows, oranges, purples, and pinks that were brought to a brilliant climax to be followed then by a slow dissipation and eventual darkness. But sunset passed quickly on this occasion. As she looked toward the distant western sky, she saw that a huge storm now dominated the horizon, quickly short-circuiting the promise of her sunset. Enormous, lightning-laden, thunderous clouds galloped in her direction. All of this took place with incredible rapidity. She viewed all of this with a sense of anticipation and increasing excitement from the time she first saw these clouds until the full fury of the storm finally broke upon the building in which she sat.

Her intense enjoyment of rainstorms could be traced back to early and continuing experiences in the company of her father. She thought of him now as this storm approached. Long ago, in his wisdom, knowing that young children are often frightened by all the wind, lightning, thunder, and the subsequent downpour, he had chosen to address the problem forthrightly and rationally. It was his way. And he started doing this when she had been a mere babe in arms. At the first suggestion of a storm, he would gather her up and they would go outside together to watch it develop. He would hold her closely and tenderly as he talked to her about what was happening. She still remembered the comfort, warmth, and sense of security that his loving embrace had provided. At times, he would sing to her. Sometimes these would be children’s songs that she knew. A favorite of his was “Where are you going, my little one, little one?” When she got a bit older, he would have her begin to count when she saw a particularly powerful flash of lightning. He knew that sound traveled at the speed of about 1,000 feet per second. By counting until the thunder boomed, she could then concentrate on determining how far away the storm was. In a strange way, this practice accorded her a measure of control that she found most reassuring. In her mind, there was a strong and wonderful association of her father with rainstorms. 

As she grew older, in many other situations, her father would share some of his philosophies with her. Now, as the storm unfolded before her, she thought about one of these times. Although she did not know it back then, he had used some of the same techniques and examples that he employed in his college classes. One of these required a bucket, rocks, pebbles, and an abundance of sand. He began by filling the bucket to the brim with the rocks. “Is this bucket full now?” he had asked. Eileen had replied, “Yes.” Then he picked up a box of pebbles and poured them all onto the rocks. As he shook the bucket, the pebbles rolled into the open areas amongst the rocks. “Is the bucket full now?” he asked again. And Eileen again said, “Yes.” And then her father poured in a large quantity of sand that finally filled in all of the remaining spaces. The bucket was now truly filled. He had gone on to say something like this: “Your life is this bucket. The rocks, pebbles, and sand represent the contents and quality of that life. The rocks and pebbles represent the big and little things that are present in the life of almost everyone. If you settle only for rocks and pebbles, then your life will be very much the same as everyone else’s. The sand, however, represents the little things, those very special happenings in your life, your unique experiences, things that are important to you, your interests, your feelings, and the like. It is the sand that makes you truly special. Without it, your life will not be truly full. Without this sand, you will be pretty much the same as a great many other people. Don’t settle for rocks and pebbles!” Now that was very heavy stuff to talk about with a preteen girl. But she had understood him then. He had known that she would. She understood him now.

As the rain began to pelt down, she said to herself, “What I need in my life is more sand!” As she had long since come to know that sand also stood for grit or determination, the full meaning of the double entendre was not lost upon her. 

While taking pleasure in the storm on this fall night, she relived some of those old experiences with her father. She could still hear his deep voice as he sang opening bars of “Where are you going, my little one, little one?” While she had never read any deep significance into the question as a child, she did so now. As the fury of the storm passed, to be supplanted by a gentle rain, she asked herself, “Eileen, old girl, just where are you going?” 

Her father had always loved and protected her. He had always meant the very best for her. She had always known that with absolute certainty.

But he had fallen short along the way. He was neither omniscient nor omnipotent. He had been far too overprotective. In his well-intentioned efforts to spare her frustration and pain, he had deprived her of the experience, and consequent independence, that would be necessary to wheel and deal in her everyday world later on. She had come to rely upon him completely to show her the way. And he had never done anything that would cause her to doubt him. Sad to relate, this naive pattern of complete trust began to fail her as she grew older. The other people who came into her life, especially the men, were a far cry from her father. She had trusted and depended upon them too easily. She accepted people at face value. She had simply assumed that things would work out alright. And that uncritical reliance was consistently unwise and unwarranted. She had developed no insight into the importance of this trust issue until she had grown much older. By then, some earthshaking events had made this all too clear to her. She had trusted her husband and he had left her for Marie, her very best friend, no less. Her son had died, leaving her saddened and alone. She had trusted God. And He had allowed her son to be taken from her. And even her dying father had abandoned her at a time when she had needed him most. After all of this, the pendulum had swung sharply. As a result of these crises, she had gone from being a gullible individual who trusted everyone to a critic who trusted no one. She had no basis for establishing any middle ground on this issue. 

Beginning with her father’s death and especially since the divorce, she had come to realize fully just how ill-equipped she was to operate independently. But if she trusted no one, she had no alternative. What was she to do? Time is a great healer. She knew that. Even though she appeared outwardly serene, her innermost thoughts were characterized by turmoil, frustration, and sadness. Her rare moments of joy invariably surprised her. 

What was her destination? Most of the time, she was probably as happy as she would allow herself to be. She was safe, yet unchallenged, within her apartment. The same could be said for her workplace. Access to it was undemanding; it was within easy walking distance. Her office was secure and incredibly stodgy, reflecting the predictable institutional demands upon her that she could meet with ease. At least her apartment had a bit of a flare about it. But then, she hadn’t much to do with its decoration, had she? The plants on the balcony were the only evidence of any individual initiative on her part. She really hadn’t liked the interior decorator’s choice of a small statuette, but she had come to live with it. Like it or lump it, maybe? Did the same sort of thing hold for her work as well as her play? How much had she given up for security? Had passivity become a way of life for her? Had she come to settle for being an observer of life as opposed to being an active participant? Where was the “sand” that her father had decreed was the necessary ingredient for a full life? “Where are you going, my little one, little one?” These were her thoughts on this dark and rainswept evening. 

Still sitting on her sofa, with the rain still bathing her plants on the balcony, she drifted off to a fitful sleep while Flounder was purring softly. 

 

Chapter Five

Eureka 

At this juncture it may be useful to turn back in time to a relatively recent morning in the life of Dr. Sean Patrick. The determinants of the event that took place at that time as well as what happened subsequently, might sharpen the reader’s understanding of this man and the nature of his problems.

Something of monumental personal significance took place for Sean Patrick at about 3 a.m. on a weekday in early fall 1979. 

As was his custom, Sean had been sitting in his armchair, sipping his coffee. His little Shih Tzu, Suzie, was lying at his feet. Then, suddenly, out of the proverbial blue, a new idea flashed into his consciousness. He knew not from whence it came, but it was suddenly there. A new concept was born; “Self-therapy” came into being. While he didn’t shout in any dramatic fashion, he knew instantly that a personal “sea change” had just taken place. Life would never be the same for him again. 

Almost immediately, he began to check out the meaning of this new thinking. He talked to himself, using the same stilted vocabulary and style that he would employ while delivering a lecture. 

I wonder why no one had ever thought of this wondrously simple and straightforward idea before. Maybe some had conjured up something comparable only to dismiss it out of hand as being preposterous. But this idea and its implications are special to me. The notion of self-therapy helps me focus all of the doubts—and dreams too—that I’ve had for a very long time. 

In the gloom of this early morning, he leaned forward in his chair as he continued to think about the forces and factors that gave rise to his creative thinking. 

I really never knew with certainty what I was really doing while providing therapy. In the course of brief psychotherapy I was forced to employ, I had only the foggiest notion as to the true nature of any patient’s personal difficulties. And this therapy was almost always brief because of insurance policy considerations. Deep personal understanding of a patient was a rarity. How could I have been a willing party to this for so long? Dollars did have a lot to do with it. 

At this time, Suzie got up and jumped on his leg as she indicated an immediate need to go outside. After her chores had been accomplished, he returned to his reverie. 

I came out of grad school with all manner of misconceptions. Naivete could have been my middle name. My clinical internship in the Veterans Administration hadn’t prepared me at all for the hectic “rough and tumble” reality of private psychiatric practice. Psychotherapy was conducted at a leisurely pace in those good old days. 

He continued his thoughts in this vein as he got up for a second cup of coffee. 

I remember a Charlie S. in this regard. I inherited him from a previous therapist who had been seeing him for two years without success. And it was five months before Charlie told me about his long-term incestuous relationship with two older sisters. That revelation came forth because Charlie trusted me. And such an admission was crucial to resolving his problems.

Sean returned to his chair and continued thinking. 

Later on, in private practice, I never came close to achieving that level of trust with the patients I was seeing. I never had time to get to know them well enough. I rationalized my therapy by believing that I was doing as good a job as possible under the circumstances. At least, I was doing as good as anyone else. 

Sean did what had to be done in his private practice. And he had done it well. But he had always been plagued by the doubts suggested in his ruminations. Over time, he had come to believe that he was a party to an illusion, an occasionally therapeutically-helpful illusion, but an illusion nonetheless. This illusion required that he believed that he, as therapist, was responsible for the course of therapy and the patient’s fate. But Sean had mainly listened as he provided psychotherapy. When he did speak, it was either to clarify something that was said or to encourage the patient to speak. His patients were often helped. And he really didn’t know why. This bothered him. 

Sean needed to know. These important concerns and doubts were never shared with anyone. He knew that to do so would have seriously jeopardized his reputation. 

There was nothing dramatically new in the ingredients of self-therapy. It was Sean’s packaging of them, their confluence, that was innovative. It is generally accepted that if clients were provided with opportunities to talk about themselves, they would be helped. And a patient must have confidence in his or her therapist. If the patient were unconvinced and untalkative, then resistance was an obstacle to be overridden before improvement could take place. If people were convinced that they could be helped this increased the likelihood of success. Belief in any treatment was the key ingredient to its effectiveness. Two vital elements of traditional psychotherapy would be retained and emphasized: the patient and the requirement that he or she talk about personal problems. Another element would be viewed from a different perspective: the therapist is no longer necessary because that belief, vital to effective psychotherapy, had been misplaced. Sean thought that the concept of self-therapy would really unsettle a lot of people. 

He knew that belief was a boarding pass for the plane flight that is psychotherapy. And while both the pass and the plane are necessary to reach a destination, there is a world of difference in their relative importance. Continuing the analogy, Sean knew that the therapist’s professional orientation often determines where the patient lands. But while an airplane pilot is of crucial importance in locating a proper landing site, there is considerable doubt as to whether or not the therapist should determine personal goals for a patient. He cannot possibly know what needs to be known to assume such control. The patient should have an important say in this matter. 

In Sean’s dramatic departure from traditional thinking and practice, he believed that it is often possible for the patient to undertake many successful and productive personal flights without any need for a piloting therapist.

Self-therapy holds that it is the talking of the patient, along with associated thinking and feeling, that is the crucial element in effective psychotherapy. There is no need for the pilot/therapist. Self-therapy states that a therapist may be irrelevant, possibly counter-productive, and most importantly, completely unnecessary in this treatment process. The patient must talk. If he talks, he will be helped. He is to talk about anything and everything that concerns him.  

He should express himself freely; shouting obscenities and curses is highly permissible if there is need. (Sean had done this himself while driving when another motorist cut dangerously in front of him.) He can say things he would not say to anyone, including most therapists. And in saying them, he objectifies them. They become available to him as part of the problem he is addressing. The person has within himself the capacity to address and resolve problems; he can define and realize his personal potential. There is no need for a listener. 

As Sean poured yet another cup of coffee, he said to himself, “God, this is truly far out thinking.” But try as he might, he could find no holes in his arguments. 

On the basis of his readings, Sean knew that good psychotherapists, such as Carl Rogers, have long understood that their silence was very therapeutic. However, even they may not have understood how unnecessary they really were. In Rogerian or non-directive counseling, there was always a compassionate and supportive therapist there to encourage and assist the client. In self-therapy, the patient is on his own. Sean thought that he might run self-therapy by the good Dr. Rogers. What would he think of it? 

While self-therapy may initially appear farfetched, it is a rational, highly defensible, and potentially significant process. If this offbeat idea truly has merit, then many people can treat themselves for psychological problems! A person can help himself, all by himself! And one doesn’t need to have humungous problems in order to engage in such self-treatment. Indeed, if modest problems and concerns were addressed early on with self-therapy, this will decrease the likelihood of developing greater problems later on. If actualization of personal potential is one’s goal, self-therapy provides a way to do just that. But to implement this approach, somewhere along the line, an individual would have to come to have confidence or belief in it. He will have to genuinely believe that self-therapy may be beneficial. And therein, lies the rub. Belief in something new and offbeat comes grudgingly. 

Sean knew that there was nothing new about people trying to help themselves deal with problems and the development of personal potential. Self-help gurus are readily available. Many of their views are based on allegedly deep religious or philosophical beliefs. Libraries and bookstores abound with self-help books. While professionals typically deride self-help efforts, some of these approaches may work well for some people.

How does self-therapy work? Maybe the answer is relatively important. If it works, then go with it. However, Sean would always look for answers. These would necessarily have to be determined up the road a piece. The patient might discover that it is permissible and relaxing to talk aloud about anything that occurs to him, even matters that he had considered to be taboo. If disturbing thoughts and fears were openly expressed, they might lose some of the negative power they have held over the individual and the course of his life. He could identify problem areas, what might have given rise to them, and which of them he should address or ignore. As he escaped from preoccupations with the past, he could focus upon his present. He could come to determine what he can and can’t do in dealing with the problems of his current situation. Somehow or other, talking about these matters aloud makes them real and addressable in a way that is denied the individual in his private unspoken reverie. He could determine his options, develop a plan, and implement it. If a plan didn’t work out, he could talk about why it didn’t. Talking aloud, he could then fashion a new plan and test that one out. He would come to realize that he has a full measure of control and responsibility for the conduct of his life. And while he might find this challenging, he might also find this to be very reassuring. 

Looking back, Sean found it amusing that self-therapy had emerged from the extended ruminations he had encapsulated in his written “Soliloquy of a Saddened Scholar.” After all, a soliloquy is an act or instance of talking to oneself. 

Sean’s revelation did nothing to stop some of his bothersome ponderings. Rather, it focused and deepened them. He immediately questioned the validity of his assertions. He tried to put himself in the position of others who might take issue with self-therapy. It was Sean’s nature. What were the weaknesses in his newly-developed position? Was all of this some self-serving, indefensible “head trip” of his? Or was this approach truly important? 

As Sean continued, he thought about some old jokes that related to his new discovery. One held that the alleged expertise of a professional is unnecessary. “All that you really need to be a successful therapist is white hair for the air of distinction and hemorrhoids for the air of concern.” Was there substance to the statement? Another joke had another person asking, “Doctor, how can you sit there all day long listening to all these people tell you all about all their terrible problems?” The learned doctor shakes his head in wonderment at the question as he replies, “Who listens?” Was there some core of truth in this humor? 

Sean realized that virtually all members of the mental health establishment (psychiatrists, clinical psychologists, social workers, and related disciplines) would brand self-therapy as pure hokum. And it would be unlikely that any of them would be interested in learning about it. With pained expressions, they would probably say that this approach is tantamount to “turning the asylum over to the inmates.” They would remind everyone that talking to oneself used to be considered good reason for having someone committed to an institution. They would cite example after example of people who could never be helped by any such approach. 

And all of this made a great deal of sense to Sean. After all, these professionals had a considerable vested interest in maintaining a status quo. Acceptance of self-therapy as a serious therapeutic approach would rock more than a few of their boats. The establishment liked things the way they were. Some say that if one were to incorporate anything new into the mental health system he or she would create problems similar to those involved in moving a cemetery across town. And they would be right!

Even if self-therapy were all that Sean knew it to be, it would be virtually impossible for it to gain widespread acceptance. But then, he, like Don Quixote, had dreamed the impossible dream. 

The establishment position holds that professionals, by their training and experience, are absolute necessities in psychotherapy. Self-therapy states clearly that this is not so. The professionals would be fools not to fight the premises, promises, and threats of this or any other innovative approach.

It was obvious to Sean that self-therapy was not a panacea. It would not work for everyone. Self- therapy does not pretend to deal with serial killers or those who have developed gargantuan problems of schizophrenia and manic-depressive psychosis over the course of their lives. It cannot deal with the likes of Bernard Goetz, Unabomber Ted Kaczynski, or a Ted Bundy. But then, Sean thought, no other psychotherapy would make a dent in problems like this either. Nor can it address the primary problems of those suffering from organic deficits and defects such as Korsakoff’s psychosis, mental retardation, or brain damage. It certainly wouldn’t work for those who are coerced into psychotherapy by court decree. 

But how well can any approach work? A provocative question should be raised as to whether or not mental health workers typically have the requisite background, training, personalities, and time necessary to understand their clientele as complex people dealing with a complex world. If this question is asked and honestly answered, the response will be, “No way.” Sean knew that this fact of life was basic to his unhappiness as a psychotherapist. 

Dr. Sean Patrick felt that he could pique fellow professionals a bit further with some additional questions. If they belittle the self-therapy position that no listener is necessary, could they define and defend the nature of their contribution? Specifically, what do they set out to achieve, in what manner, and how do they demonstrate that they have accomplished the specified goals? Answering these questions would require a level of accountability that is unknown in the field of mental health. The existence of the mental health establishment is predicated on the basis of enormous societal needs to deal with many pressing personal problems, not on how well those needs are being met. 

Some members of the establishment already utilized a close cousin to self-therapy called “Journaling.” There were many schools of psychoanalysis, such as Freud, Jung, Adler, all of which emphasized the importance of catharsis, the expression of personal fears, problems, or complexes. The Catholic confessional may be another good example of the benefits of talking aloud although you’d never find a priest who would entertain the possibility that both he and God were irrelevant to its benefits. Other religions vary widely in the extent to which they permit or promote talking or testimony as part of their worship. Seemingly meaningless, “talking in tongues” is advocated by some. 

Good results have been forthcoming from group meetings which require participants to speak. Alcoholics Anonymous and Narcotics Anonymous are prime examples. Typically a meeting requires an attendee to introduce himself/herself and then make some commentary, either about the topic of the day or something more spontaneous and personal. Sean could point out that none of this requires the presence of a professional.

There are common denominators running through many of these very diverse therapeutic efforts. All involve “belief” in some system and require “talk” on the part of those seeking help. If people believe that talking will redound to their advantage, then they will talk, and they will be helped. Will any old belief do as well as another? To Sean, this seemed to be a real and tantalizing possibility. Talking, per se, was the key to constructive personal change. 

There would be a real problem in convincing troubled individuals that talking was the crucial element in effecting personal change or salvation. This belief required a level of faith and trust that was not easily achieved. In a strange way, the fact that this self-therapy was cost-free would probably make it more difficult for people to accept.  

Sean wondered if he had the energy necessary to promote this cause.

Given the great challenges and his own limited resources, how could Sean realistically move ahead in implementing this “Last Hurrah” of his, the accomplishment of something that others would recognize as noteworthy? Reporting positive research findings at professional conferences and scholarly writing were appropriate and traditional venues for such a goal. But neither of these approaches had worked for him before. He had found that publishing in professional journals was an incredibly demanding exercise in futility. Such articles invariably ended up in some dusty archive, unread and unrecognized. Only a few people had ever showed up for his well-researched presentations at regional and national conferences. Those who did show up were inattentive and restless.

Maybe he should abandon any traditional efforts to educate and influence the establishment. After all, fellow professionals would be antagonistic toward him and the self-therapy he professes. If he were right, he would be a serious threat to them and the positions that they hold. In an exercise of grandiosity, egotism, and vindictiveness, he occasionally pictured himself as bringing the establishment to its knees. And in his heart of hearts, he knew that he would truly relish something like that. While he would like to think of himself undertaking this venture because of some altruistic motives, the harsh reality was that helping people came in second as a driving force in doing whatever he needed to do. Personal recognition was of utmost importance to him.

Maybe he should try to go directly to the public, legislatures, or funding organizations. Popular magazines, newspaper articles, or TV/radio talk shows might be appropriate forums. All of this would require a new set of strategies. Learning these would not come easily for him. Charismatic speeches, spontaneous give and take, and politicking were alien to his style. But if he was attempting to gain prominence by changing the system and society in a major way, then he should be willing to change himself. The more he thought about it, the more confident he became that self-therapy might just provide him with what he really wanted, a rendezvous with destiny, his moment in the sun. Was this really a worthwhile adventure for him? The answer to this question would require considerable thought. 

On that distant morning, the creation of self-therapy had buoyed his sagging morale to an incredible degree. Dr. Patrick had a spring to his stride and a purpose in his life. He was truly happy and enthusiastic for the first time in many years. But he failed to move ahead. He kept putting things off. Nothing ever materialized in the form of any follow-through in testing and promoting his creation. There has been no effort on his part to work so as to change himself personally and do what he knew must be done if self-therapy were to realize its potential. Sad to relate, by the end of a year, all of his fire had died, albeit slowly. He was very much back to where he had been before, a pompous, pathetic figure who was convinced of his great importance despite the lack of anything to justify it. Self-pity ruled supreme. It was as though he was waiting for the arrival of a crowd of cheering enthusiasts who would hoist him to their shoulders and carry him off to some hallowed hall where he would get the adoration he so justly deserved. And this would never happen.