“Is this self-indulgent?”

This is a question that often comes from people who are making good use of psychotherapy and enjoying it. The fact that they ask this question indicates that they have achieved a certain kind of conflict. One voice inside says something like
“I am finding this useful and even enjoying it.” “This is frivolity and luxury, a specious good to which you are drawn out of vanity,” is what a second voice says.

Or at least something like that. These voices are subtle and changing, so that it is hard to characterize them exactly. There is an important inner challenge to the
legitimacy of being in psychotherapy. This challenge has wide implications for how
a person goes about using and developing that person’s resources of mind and heart.

When we first meet it, psychotherapy is strange, a very distinctive cultural ritual. Psychotherapy involves a different use of words. It asks for an exteriorization of inner monologue and inner dialogue. As one very skilled psychotherapist used occasionally to say to a patient whose silence was stretching out, “Do you think that you could do some of that out loud so that we could both hear?’

This seems like a simple enough question, but it is deceptively powerful, because it asks for a change in the terms of experience, from a single person’s interior field to a genuine two person field with all the possibilities of interchange and altered perspectives that that imply.

An extremely intelligent man in his forties said, “I have said all these things that I’m saying to you in my head hundreds of times. There’s nothing new about them. Yet something about saying them out loud to you makes a difference, although I’m not sure how.”

I suggested that it might make it possible for him to overhear what he said in a different way. In psychotherapy, we are presented with a rare opportunity to eavesdrop on ourselves as we talk about ourselves, as we talk with ourselves and to ourselves as well as with and to another person. But I was no more certain about how this works than he was. Sometimes our loneliness with only ourselves inside ourselves is very painful .

Sometimes we are so crowded inside that we have serious trouble making room for ourselves. A young woman patient said, “In order to live as myself, I have to redefine everything that I have known. “ In order to be her own person she had to make a new internal world, one in which terms like “loyalty” had changed meanings.
Of course, there was grief and alienation as well as discovery and freedom in this
effort. Is what we might call self-renovation self indulgent?

Psychotherapy may challenge the lock of certain kinds of value judgments on how the patient conducts the patient’s life. I have heard patients say things like, “I don’t think I could ever have considered that this perception of mine was really right even though I’ve known since I was a little girl that it was right. I knew it but I couldn’t let myself know it.”

When we wonder whether psychotherapy is “self-indulgent”, we have to ask a few more questions, one of which is whether it is the current self that is being indulged or the possibilities of the current self, that is to say, the construction of future selves that have more flexibility, more strength, more imaginative capacities. It is easy to see that this is not a simple question.

Is “self-indulgence” bad? Is there “self-indulgence” that is good and good for us?
Is there “self-indulgence” that is not simply selfish?

There is, for example, the case of the elderly man who comes to therapy because he is appalled with how he has been treating his wife over the past five or ten years. His therapeutic efforts are not only on his own behalf but also on behalf of his wife and his grown children. His path in therapy leads him to deep grief over the loss of a beloved child early in his life. Is this self-indulgence in the sense of vanity or an indulgence in a more constructive sense?

It is worthy of notice that while we have a term, “selfish”, with a pejorative sense,
for putting the self first, for failing to consider the needs of others, we have no term with a positive spin for taking care of the self in a way that may not just be beneficial to the self but also to others. A term like “selfy”, the one I have put to use in this positive sense, might be very helpful and conceptually.

Some actions which are often seen as “selfish” are in fact “selfy.”

A patient in her forties who has had a very difficult life including childhood abuse
and struggles with substances is at last spending time on herself, doing the things that she is moved to do to get a grip on herself as her own project. This involves a large step back from her family of origin and even a changed relationship to the family she has made. She feels this is essential, but it is not easy, because an internal accustomed self, modeled on the expectations of those around her growing up, keeps objecting.

This produces a very intimate conflict: In order to be herself she has to stare herself down. In order to embrace herself she has to withdraw from the embrace of some parts of herself. She talks about how new life involves new death, too. It takes a certain quiet courage to withstand this conflict.

A very gifted and sensitive nurse who has recently experienced a tragic loss, describes her method of conducting herself as follows: “I go into a room and I see where the need is and I try to meet it.”

This is a completely convincing account of how she lives and what makes her extraordinarily useful to others as a balm and a succor.

“What about your needs?” I ask quietly.

There is quite a long silence in which her body, too, is in a posture of great and grave stillness. She can even be described as dumbstruck

“I’ve never thought of that. It doesn’t enter my mind.”

Remarkable as it is, I believe this avowal. She was selfless in the positive sense of being able to pay attention to other people’s deep needs and selfless in the negative sense of not being well enough acquainted with her self to provide herself with so much of what she needed.

If you have not made the acquaintance of your needs, then it is going to be very hard, indeed, for you to do a good or even adequate job of meeting those needs.

This issue has a great deal to do with why, in the face of her enormous loss, she found herself persistently suicidal and barely goes on living.

We are not static, but rather have elements of continuity and of discontinuity. We are and are not same person as teenagers and as persons in our fifties who have a vastly larger and more complicated storehouse of experience, not to mention, quite possibly, new and different responsibilities to and for other people.

From developmental stage to developmental stage, we require adaptations, a second look and then perhaps a third and fourth look at aspects of ourselves. In order to be able to deal well with the world, we must be able to deal with ourselves, as we were and as we are.

Perhaps it could be said that we are not indulging ourselves when we pay attention to ourselves and do necessary maintenance and repairs on ourselves in psychotherapy any more than we are indulging our cars when we take them in for servicing.

A patient says, “I was in therapy twenty years ago and I worked all this through and I can’t believe that here I am again with the same set of problems. Did I not work it through? I sure thought that I had. Am I just indulging myself sitting here with the same old complaints.”

What is not so clear to this patient is that he is not quite who he was twenty years ago. The world has changed and so has the world inside him. Life now makes different demands on him and he asks somewhat different things of himself and of the world. As a result he comes at the old problems from a slightly or more than slightly changed angle.

So the old problems have a new look. His way of looking is changed , too. So his psychological troubles, his aching quandaries are the same but different, maddeningly familiar and newly vexing all at once. The old insights have their place, but they must find a new context.

The fact that psychotherapy worked for him two decades ago is a positive prognostic sign, despite his worry that it is nothing but self-indulgence. Actually, it could be argued that his not coming to therapy, but instead bottling up his concerns inside and denying them, would be a more dangerous form of self-indulgence.

Allied to the worry that psychotherapy is only self-indulgent is often a hint or more
than a hint of grandiosity. The notion of a self-sufficient self, a way of being in which need for interchange with others in the areas that are
problematic for a person does not exist, is at once a grandiose notion and a form of self-starvation.

We are built to need. We are built to communicate. We are built to be interdependent. We are built both to have problems and to have possibilities.
The benefits of other minds and other hearts are essential to us.

Psychotherapy, at its best, is a selfy process that is tailored to the realities of our situations as human beings who are small, suffering, confused, but also very resourceful. If it indulges us, it indulges our actual natures and helps us open up new developmental pathways.

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