Therapy for the heavily defended

June 1, 2024 12:11 AM

I would like the benefits of therapy, but I am very good at masking, minimizing, misdirection, and other coping mechanisms that directly undermine the process. I can't turn these off voluntarily. Some modalities—psychedelics, hypnotism—seem like they'd turn them off for me, but also don't seem like they're meant for me. Is there another option?

I've made many attempts at therapy but am very committed to self-protection, and good enough at faking and sophistry that I can always create a smokescreen and waste both our time. My dream would be to undergo therapy at a time when my personal walls have been artificially weakened—so like being high or drunk or partly asleep. Ketamine therapy seems perfect but also seems like it should be reserved for people in serious straits. Hypnotherapy also seems great in theory but is geared towards people wanting to quit smoking or some specific thing, and there's a real slick stage magic feel about it.

Have you tried psychedelic therapy or hypnotherapy as a regular sad person, not in crisis, who wants regular healing and improvement of functioning, not to break a single habit? Or is there some other way for therapy to get past your defenses? I imagine it's possible to have a therapist who sees right through you but I've always been able to outsmart them. (Please don't just tell me to knock it off, as obviously I would if I could.)

posted by anonymous to Health & Fitness (21 answers total)

therapeutic relationships are not about one person "outsmarting" another person, imo. therapists are there to help you. they are specialists in this one specific thing. you may, and likely do, have expertise exceeding theirs in any number of fields. okay. forget about that.

this is not telling you to "knock it off", just forget about everything else. therapists essentially echo you. therapy can only go as far as you are willing to go.

as you wondered about hypnotherapy, i'll share a paper (the public domain review) about one of the founders of that modality, Morton Prince: "Regardless of his motivations, by placing so strong an emphasis on the role of learned habits of association in the development of symptoms, Prince helped undermine the position of social conservatives who condemned whole families, neighborhoods and populations on the basis of hereditary degeneration."
Ketamine therapy seems perfect but also seems like it should be reserved for people in serious straits.
if you think ketamine therapy might be helpful to you, i send my encouragement. don't knock it off, go for it! you may not be in what you consider serious straits, but you know what: you are worth it. take care of yourself
posted by HearHere at 1:02 AM on June 1 [1 favorite]

i can't speak for other therapy modalities because i don't have terribly much experience with them.

psychedelic therapy will cut through defenses like those like a knife through melted butter. though from another perspective, it's not that it cuts through the defenses at all per se, but rather removes your need to use them. for example, in the case of mdma, if you feel truly safe enough that you are able to be completely honest to yourself, healing truly becomes something within your grasp. and in the case of psilocybin or LSD, if you are able to step back and look at yourself truly objectively, without quite so much weight of ego, the defenses you've built up all start to seem like a bit of a silly joke.

worth noting, i would explicitly not recommend psychedelic therapy for someone "in crisis"; it tends to work best when you're in a safe place now, a place where you have space to process things. psychedelic therapy on principle tends to work (metaphorically) by breaking up all the mental knots and letting them "re-settle" into a smoother pattern, so to speak; if someone is in dire straits, it is probably not a good time for them to be doing this.
posted by etealuear_crushue at 1:42 AM on June 1 [8 favorites]

I was like this maybe fifteen years ago, and at that time I despaired of ever finding a therapist smart enough to outsmart all of my bullshit. My attitude and ability to openly share my emotions and challenges in therapy has changed significantly in the intervening time for various reasons.

Firstly, I stuck with therapy on and off over a period of around 12 years. In the early years, I was paying someone by the hour for the privilege of lying to them about how I was feeling. This wasn't ideal for a bunch of reasons, but it did teach two important lessons. One was just getting more comfortable with being in therapy full stop. By turning up and miming my way through therapy, I was laying groundwork for a future version of me being able to engage more holistically. The other was figuring out who was and wasn't a good fit for me as a therapist. In that 12-year period there were three therapists (out of a total of six, I've moved around a bunch) whom I lied to more than I told the truth to. But when I met the first one I didn't instinctually feel like completely lying to all the time, it helped that I'd already had some experience of going through the motions of therapy, I didn't have to learn how to do the process at the same time as evaluating whether someone was a good fit for me.

Secondly, I've more recently started doing internal family systems type work. IFS "conceives of every human being as a system of protective and wounded inner parts led by a core Self". Figuring out which parts are doing what work inside me has been incredibly helpful. IFS breaks down sub-personalities into three types of role: exiles (parts so badly hurt or perceived as unacceptable to other parts of the system that they're actively suppressed, because their pain threatens to sink the whole ship, or is too difficult for the other parts to perceive); managers who try to keep the whole ship afloat, often using abusive or unhelpful tactics, to ensure the system can keep moving through the world without getting floored by trauma; and firefighters who deal with negative emotions triggered by the emergence of exile sub-personalities by desperately trying to put the fire out through any means necessary, often via maladaptive coping mechanisms like drugs or alcohol.

My current (good fit) therapist and I have taken to calling my most dominant manager "the inner fascist". It's a representation of my abusive, controlling parents' values more than my own, and has put in a tremendous amount of effort since early childhood to keep me safe and intact by being acceptable by my parents' standards, by repressing the behaviours and traits that it perceives as bringing disgusting quantities of shame and embarrassment to the system as a whole. My strongest exile sub-personality we call "the blob" because it's so pitiful and malformed, the product of a childhood where I was self-conscious about being simultaneously too much and not good enough by the age of five or six.

You say please don't just tell me to knock it off, as obviously I would if I could - I want to counter by saying that I believe you can, even if you don't believe you can. I was able to, and before I developed the ability to I was one of the most closed-off, guarded, repressed people I've ever met.

Doing it requires a raw willingness to look inside at some deeply painful trauma and some deeply painful maladaptive inner responses that have developed as a consequence of your interior parts' non-expert and unsupported ways of trying to manage and suppress whatever trauma caused those roles to develop in the first place. Realising that the strongest voice inside me is a shrill martinet of a dictator trying to keep my behaviour contained within some imaginary boundary that's perceived as safe wasn't an easy thing to do, and it continues not to be an easy thing to sit with (though the discomfort eventually goes from feeling overwhelming to being a powerful motivator for change). It's still not easy to summon up another part of myself to tell that voice to shut up. I'm going into so much detail about how my inner fascist works because your description of your own defences makes me strongly suspect you also have a very powerful manager in your system, and that role is the one insisting you remain gummed up about whatever poison your exiles are stewing in way below the surface, even if your capital-S Self desires healthier ways of dealing.

Realising my deepest child self is a malformed blob because my childhood abuse probably started at birth is also deeply, flooringly sad, but I'm at least capable of getting somewhere in the realm of feeling those feelings these days - fifteen years ago, I didn't even know they were there and was shitscared to find out.

Don't get me wrong, I still feel closed-off and guarded a lot of the time, and I still struggle a lot with thoughts and behaviours that are clearly directed by my interior fascist rather than my actual adult self. I don't yet feel like my heart is a vessel containing plenty, ready to overflow with love and compasion for everyone and everything - but I think I stand half a chance of making it further down that road over the course of my life than ever seemed possible when I was younger. And all I had to do was try, try, try again and keep trying, investing hundreds of hours and thousands of pounds, even when the process felt like it was kicking my entire ass.
posted by terretu at 2:20 AM on June 1 [48 favorites]

I relate to this. If I had more of a taste for therapy (I do not at the moment, I'm just going go around emotionally stunted and braless writing poetry and smoking weed until the pendulum swings to a place where I'm feeling less vulnerable)

If I did work on this in therapy (and I do work on it in my personal life with myself and those I'm closest to--I work hard for honesty) I'd just be open about it--that sometimes being glib or charming is a wonderful way to distract people and keep them at a distance and I'd like to avoid that in therapy because it defeats the purpose, but I would want the therapist to know that I did it and call me on it when they notice.

Jokes, turns of phrase, distraction techniques - they are fun and sometimes healthy ways to play peekaboo with emotions you aren't totally ready to unpack yet or that you simply want to protect for a while. That can be ok. They're not problematic until they're in the way of connecting to others or embarking on meaningful change.

They're rampant among some writers I know - those characteristics, of making the appearance of bravery and openness excellent substitutes for bravery and openness. Like 'I just told you embarrassing anecdote X -- I'm an open book!!!!!!!!!'

I have absolutely had therapists who couldn't keep up with me when I was younger. That's such an egotistical thing to say, but it's less about intelligence in my case and more about my brain being a weird place to live, and a LOT of therapists don't push back on social expectations and conformity as much as I wish they did and that attitude is important for me in a therapist.

I think the knowledge of this (awareness of one's guardedness) is super important.

A lot of people do this their whole lives and never realize they are keeping people at bay and holding themselves back from growth.
posted by A Terrible Llama at 3:01 AM on June 1 [2 favorites]

Ketamine therapy seems perfect but also seems like it should be reserved for people in serious straits.

It's not a non-renewable resource, there's plenty of ketamine to go around and they will give it to people who can pay for it and aren't contraindicated. If that's available to you and appealing to you, well, you are absolutely as worth using it as anyone else. You using it won't prevent someone else from using it, you abstaining will not make it accessible to someone for whom it isn't.
posted by Iteki at 4:36 AM on June 1 [13 favorites]

I imagine it's possible to have a therapist who sees right through you but I've always been able to outsmart them.

A good therapist would never even make the attempt to outsmart you. Therapy is not a game of chess. A therapist is not someone you hire to tame you in spite of yourself.

That said, I doubt you’ve actually pulled the wool over the eyes of any experienced therapist. They’re trying to build an environment in which you are comfortable, and if lying through your teeth is what makes you comfortable then that may be how things are for a while. Providing a safe environment where you never feel attacked is the priority, which makes sense as that is likely the only way the "you" who wrote this question will be willing to engage.

It may help you in the future to think of therapy as someplace that you go to relax, not battle.

———

[as a side note, lies are little fictions that we write ourselves and often offer a clear insight into what we think the world is or what we want it to be. They’re not just deadweight.]
posted by Tell Me No Lies at 6:31 AM on June 1 [13 favorites]

Are you able to [at least partially] get around the masking, minimizing, and misdirection when writing about your feelings in private?

If you can find a therapist who is able and willing to read more than a couple of sentences (sadly, this may be harder than it sounds), you may be able to incrementally circumvent the minimizing by writing out, in advance, a "data-download" to serve as the starting point for each session.
posted by heatherlogan at 9:36 AM on June 1 [2 favorites]

Also here to suggest IFS, because it acknowledges your Protector exists, which it clearly does so what's the point of denying it, and lets it participate in the process. I've only really started learning about IFS in the past year, and have had a very "where have YOU been all my life???" reaction not just on behalf of myself but SO many people I know who bounce off CBT because they are compartmentalized and require that acknowledgement to resolve internal tension before cognitive techniques are going to work.

This is a 18m explainer of IFS from the founder. It really gets me when he says "multiplicity has been pathologized in this culture".

A longer set of explainers that I really like.

Frank Anderson does a lot of work around the neuroscience of IFS, particularly specific to trauma.
posted by Lyn Never at 9:58 AM on June 1 [8 favorites]

My perspective is that if you are so ready to drop your defenses via drugs or hypnosis (two things I, control freak/protector, would be very unlikely to have done or do), you are going to be able to do that either via drugs or because you really are committing to it, even if you don’t know how yet. (If mdma had been around when I was in your kind of locked position, I wonder if we would have tried it. I’m not saying don’t. I’m saying, I see how committed you are to working through this.)

So my biggest recommendation is - keep going.

I have not really done IFS therapy, because we’re a step or 12 beyond that, but I’ve done the dissociative equivalent and I think it’s sound. Rather than seeing your defenses as either a necessity in the present or a barrier, talk to them and explore them. If your current therapist has made a space where you want to bring drugs, that’s awesome.
posted by warriorqueen at 10:52 AM on June 1

+1 for trying IFS. I think somehow by mentally separating the "parts" from "me" I'm much more able to let them say things that I would not be comfortable to say and which can surprise me with information I didn't know I had about myself. Finding a good therapist is important though - you need to feel safe enough to let the parts come out.
posted by crocomancer at 12:05 PM on June 1 [1 favorite]

Right before a session, try and remember that you are doing this to fight for your life. Because you’ve been unhappy. Because you want better relationships. Because you want to heal from trauma that’s dogged you all your life. Because you’re sick of it and you want to be real with yourself. Go to that emotional place, before a session, remember your why. This is serious business and just try and remember that.
posted by cotton dress sock at 5:15 PM on June 1 [1 favorite]

I can't turn these off voluntarily.

don't think that's right. Humans learn vulnerability, and intimacy, and all kinds of behaviors.
posted by j_curiouser at 5:16 PM on June 1 [1 favorite]

For me, with similar defensiveness, EMDR helped. I had a good practitioner, though.
posted by Iris Gambol at 6:13 PM on June 1 [1 favorite]

I can't turn these off voluntarily.

Yes, you can. That said, perhaps this need to stay closed and protected is where you actually need to start in therapy.
posted by Thorzdad at 6:19 PM on June 1 [2 favorites]

Find a smart therapist. Let your gut guide you here. It will know if this person is smart enough to your game, or not.

Don’t assume your therapist doesn’t see through your bullshit. A good therapist entirely does. They see you defended, and lying to yourself. But they also understand that you yourself have to come to a point of feeling safe enough to allow yourself to feel your own feelings and be honest with yourself.

So find a smart therapist you trust and tell them on day one that you’re hiding from yourself and that you want to dig deeper but you’re scared. Then, commit to speaking as slowly and as honestly as you can every session (not the quick mind answer but the gut feel honest answer). This is what will get you there. Allow yourself to feel ashamed as you give the honest truth.
posted by St. Peepsburg at 7:19 PM on June 1

Please don't just tell me to knock it off, as obviously I would if I could.)

it is not obvious. I don’t tell you to knock it off, because what’s it to me? but most people who choose to storytell their psyches and recast difficulties as perverse strengths in this particular fashion do so for a reason. they keep doing it because they get something from it they like better than whatever they imagine they would get from stopping. asking yourself “why can’t I?” is a ticket to self-punishing stagnation, which you seem to see. but clever therapists will try to get you to wonder, instead, “why don’t I?”

because if you approach it in the right mood, it’s an interesting question, not a depressing one. and not one the cleverest therapist can answer for you.

I am clever but not a therapist so I can just say straight out that you don’t knock it off because that would mean sacrificing something you value more than you value “the benefits of therapy” — whatever those are, whatever you think those are. maybe you are right to value it more.

all I know is acute self-awareness isn’t good for anything if all you do with it is describe yourself to yourself.
posted by queenofbithynia at 7:39 PM on June 1 [5 favorites]

It’s very common to be “heavily defended” in therapy. Most people seeking therapy likely are. They may not lie, scheme, etc. intentionally, but neither are you, really. You’re as much a victim of your unconscious motivations as anyone.
posted by stoneandstar at 9:21 PM on June 1 [3 favorites]

Consider looking for people who are trained to do somatic work, and skills based work (I personally hate CBT because I think it's terrible for resistant intellectualizers like you and me) like ACT or DBT. It's a lot less talking and a lot more doing. It's much harder to lie about anything if you are practicing moving your body in a different way that helps process a feeling, or physically going and trying a different action (usually after a worksheet but eh). Especially if you are resistant to feeling feelings or feeling them with other people, I have found that action-oriented modalities help me break past some of that "this is all bullshit and why am I wasting everyone's time" response that can happen. That has sometimes even helped me finally get real with myself and my therapist about what's going on inside. It also lets me feel like I'm accomplishing something, which can be so important when you're down. Also, sometimes journaling between sessions.

But also, if you are able to at least be honest with yourself on the inside about what's going on, and are willing, a good therapist/client for matters more than any of the other stuff. I did a whole-ass structured interview process with about five different therapists when I selected my current one and I have grown so much more with her in nine months than I did in twenty years of intermittent therapy previously. Because we clicked, and I trust her professional judgment and just HER as another human. It took a long time and a lot of work to find that chemistry but research really shows that fit is more important than any modality.
posted by bowtiesarecool at 9:24 AM on June 2

*therapist-client FIT. Dang it.
posted by bowtiesarecool at 9:25 AM on June 2

As a ketamine patient: It's not that you couldn't use ketamine if you ultimately wanted to or I'm shaming you here or anything, it's that ketamine is indicated as a treatment for treatment resistant, severe depression, often people who are experiencing acute suicidality. It's not always being used that way nowadays, but that's what it's clinically for. So if you have any other options to try beforehand that are easier on your body and mind, I would check those out before going straight to ketamine. (And right now there's plenty of ketamine to go around but that isn't always the case and shortages have had a huge impact on the patient community in the last few years, as have clinic closures as the consumer landscape changes.)
posted by colorblock sock at 9:25 AM on June 2

I thought of you when I was listening to the Labyrinths podcast talking to the author of The Modern Trauma Toolkit: Nurture Your Post-Traumatic Growth with Personalized Solutions, which actually does touch on several of the modalities discussed here - IFS and somatic experiencing - as well as psychedelic therapy, and addresses the issue of traditional talk therapy (especially CBT) being kind of terrible for people who are first cracking a trauma shell because it's just all wrong as far as mindset and trust relationship and just sometimes you don't need to Talk About It first, you need to learn nervous system regulation first. Which is a lot more like going to physical therapy for an injury before trying something invasive like surgery.

And worth noting, stress and trauma are different points on the same nervous system spectrum. So maybe you do not have some major trauma shell to crack, but we all have shit gnawing on our nerves.
posted by Lyn Never at 9:47 PM on June 3 [1 favorite]