Friday, January 23, 2009

Desert Metaphor

A journey through life, especially if affected by mental illness, can be like a journey through a desert.

You may feel lost or starved. The view may be exactly the same, despite having invested days, weeks, or months, trying to forge ahead.

There may be life-threatening moments of intense thirst, and an uncertainty whether you will make it through the day.

The light of day may be intolerable and oppressive, and you may out of necessity have to work only at night, even though you may fear the darkness.

In psychotherapy, it has often been the common practice to examine the past, as part of a key to escaping the desert. In a desert, there may be some value to examining your past, but on the other hand this information may not be relevant to your immediate needs, and may be a distraction impeding your progress. Furthermore, in a desert, sometimes your "past" cannot truly be known, since the shifting sands cover up your path. The search for "past" can be a frustrating, fruitless diversion, punctuated by misleading mirages.

Cognitive-behavioural therapies, or "here and now" psychodynamic therapies, are more likely to help when lost in a desert. Some kind of desert guide may greatly ease the journey, even if the journey does not become any shorter (here I suggest the role of therapist as "desert guide" or "camel").

An immediate source of water and food helps a great deal too, and so does a good sun hat. The most basic needs have to be met first.

A psychodynamic style of therapy focusing extensively on the past is more likely to be helpful once you are already out of the desert, and are perhaps trying to make sense of the whole experience.

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