Transcription
What were your thoughts about this experience with Tessa?
>> I think it's complex. A lot of a lot of parts, a lot of questions. What was understood? What wasn't? And it's hard to do justice to all of this in terms of um such a brief encounter especially because >> it looked like she was I I thought I was trying to summarize my experience in the end when I had a discussion with her that she was looking for something that would she was looking for an answer. She was looking for transformative experience or >> and um that's a hopeful part of the patient. Uh but it's very very important for her. She she was here for that transformative experience and also for the camera and um those are important things and camera is a transformative experience for her.
>> Yeah. >> But it's also a setup to feel empty. So >> um >> it's a setup to feel empty because >> because ultimately she feels it's it doesn't stick. It >> it helps in the moment but it doesn't help in the long run. So it's it's tricky because she's really working hard to kind of con to to maintain a sense of self the way she wants to do it. And um you know we know that that's something that people can do either internally because they're internal mechanisms of how we maintain sense of self >> or externally then we need some type of external factors that do it and we all have some external factors but we also have some internal factors and what she seems to be struggling with is that internally it's very hard to maintain that sense of self. um even though she has different narratives about who she is and how she is and that's also kind of part of that. But in terms of if she's talking about sense of coherence of sense of self and sense of [clears throat] well-being and safety that doesn't come from the inside that only comes from those external experiences >> and that's a very precarious >> you're saying for her it doesn't come from the inside that it comes from >> It seems like that. >> Yes. >> Yeah. in terms of that feeling of um nothing's real >> or fakeness or that everything drips away.
>> Yeah. >> Is that because there's so much reliance on the external [clears throat] >> that it then doesn't hold with the internal? Like what is the fakeness?
>> Well, that's a fakeness is an internal judgment. That's a narrative. Okay. So I would say that the sense that things are different and they don't match, >> they [clears throat] don't stay is something that needs to be explored. It's not clear. She seems to be very very preoccupied with that question. She said she has a few theories about this and >> and um they're all good theories, a good starting point to think about what gets in the way of of staying with that positive experience. Why does it have to go away? And maybe it's a fragmentation, maybe there are some other factors, but that's usually something people explore in therapy. And look at this. I had patients that explored it. And sometimes they describe like a sense of like it's as if there's an internal shredder that shreds those internal experiences away. And so instead of those positive experiences of being understood and recognized and and cared for, they just kind of disappear. They kind of turn into shreds. and then they're ready for the next round of looking for this and that's exhausting and that's tough. Um, but it also could be happening for other reasons and uh and that's something to to figure out. She is facing a very difficult dilemma here that there is a side of her that wants to feel better and get better and um and she had very real experiences of actually changing and kind of improving and and that's really good. but the other side of her wants to uh feel special because of the difficulties that she's having. And um that's a kind of a real kind of a crossroad for her to kind of that she's struggling with. And so I wonder if that's also part of the contributing factors here for but it's it's easy for me to >> factors for the >> for for this difficulty to stay with the positive because it may >> ah that's interesting right because that would undermine the specialness if >> right >> if oh that's interesting >> but that's a theory and I I would I would want to present that theory to kind of to explore with her together and think about this >> but overall that's a dilemma and that's not an uncommon for a lot of patients and a lot of people think about this from that perspective. Yes, I want to get better, but it's scary. What does that involve? It could mean I'm not going to be as special as I used to be. Uh but it also could mean I will have to function. I'm going to, you know, people going to expect things from me. That's also scary. What if I what if I fail? What if I, you know, what if I cannot do all of those things that I wanted to do when I get better? And those are kind of terrifying experiences that many patients deal with. And that also something to think about. So the dilemma about getting better is is a it's a real one. We always from the external point of view it may seem like people should be unambulently interested in this, but it's just not how it is. And yeah, >> there are a lot of reasons people uh feel very torn around that. Yeah. And >> so from that perspective, that's usually part of a lot of therapies to discuss those dilemmas about getting better or not.
>> Yeah. I mean, I I do remember when I had an eating disorder, >> the fear that the torture that I experienced with it >> generated like creativity. >> Yeah. And that if I let go of the torture, >> I wouldn't have the tension in me that I needed to be creative. That I would just be like like everything's fine and I'm not as complex and whatever. >> Yeah. And that's the binary definition of getting better. That means when people get better that means it's not complex. Everything is so simple and there's no suffering in that. And that's not true. When people get better, they're just a different relationship with suffering and things actually increasingly more complicated because of their ability to recognize ambivalence and complexity of human interactions and also complexity within ourselves, >> right? >> And but from the standpoint of of that journey that people are kind of they're on, they may feel like it's just all great and there's nothing else there. >> Right. Right. >> Which isn't ultimately the case, but it is a leap of faith. right? >> To start to >> let go of the thing that's sort of >> also you've been interested in for so long, right? Because it's been your struggle, >> right? >> And it's like, well, what if I'm not interested in anything else about myself because I've fixed this problem. >> And also, people have only one sense of self, so to speak. They have the sense of self that they have. And the idea of changing is very very scary because it means shedding a known kind of and recognizable and familiar sense of self in service of something that it's unknown and maybe yet to be explored and understood and >> um solidified and it's not something that people kind of kind of deal with easily and they may be curious and open to this but ultimately there is also a fear of getting better >> is um when Tessa was talking about the celebrity against which she or not even against like with which she modeled herself. >> She said that the past self, her past self that she doesn't refer to as an eye. >> Yeah. >> Um >> is like she's done so much sort of modeling and her behavior has been so shaped by the positive reinforcement of that remodel. >> Yeah. >> That she can no longer access her past >> okay >> self. um what happens to that past self? like where is it and what um and and in a funny way when I heard Jacob talking he too was talking about this complete this like >> transformation right this transition >> um so I I'm like wow both of them >> independently they didn't know each other until a year ago are both talking about this thing >> people are sort of working very actively to construct a new sense of self it becomes a project >> and it becomes a project of kind of a shedding old self that feels shameful or unacceptable or disgusting. >> Um, >> and they developing something that they want to present to themselves and to the world and sometimes more to the world and sometimes more to themselves and sometimes both. And so the idea is that there is a sort of a um internal sort of a split between old sense of self that they want to sort of cast aside and get rid of [clears throat] and then there's a sense of self that they want sort of to embody. >> Yeah. >> And that's transformation is tricky because we know we don't really get rid of things in our psyche. It works like computers. We think we delete things >> but everything stays in the computer. Yeah. >> So the brain works in the same way. We think we can get rid of stuff, but it still stays somewhere. So it may be partially dissociated, maybe partially kind of inaccessible, >> but those things are usually somewhere present and then the idea is that they get enacted in some way. So we either enact them without being aware and that we can either enact them by embodying that self or we enact them because we treat others as if they embody that type of a self. And that leads to repetition of the same themes of for example feeling >> that other people might be disgusting or being afraid of being vulnerable or constantly being preoccupied with with building that sense of self that is >> so incredibly important to keep together because if it falls apart the alternative is falling back on that old sense of self that feels unacceptable. >> Yeah. >> And that's excruciatingly difficult to do and that's a lot of work. Yeah. >> And um essentially it leads to difficult accepting yourself and developing better >> right >> relationship with different parts of yourself. I mean I think therapy we could probably say that therapy in some capacity it's an attempt to develop better relationship with different parts of yourself. It could be different emotions. It could be different life experiences. And so that creates a very artificial sort of a split that there are certain parts that we really want to kind of cut out as if it's possible to edit things out the same way that we might be editing things >> on television and things like that, but we can't really edit them in the psyche in the same way, >> right?