“Combing Cotton” in Psychotherapy—Untangling Our Jumbled Minds and Hearts

Psychotherapy, as I say in the article for this month, is not usually going to be understood when we come rushing into it in crisis. Which is where most of us begin. But to know something about the process, in order to help us align us to its particular medicine, is helpful for a number of reasons, especially to understand why it involves pain. But the good kind. So here is a short piece using the image of “combing cotton” to talk about the repetitive nature of therapy, in which we return to the same areas repeatedly, in order to straighten out what otherwise remains tangled in our thoughts and feelings.

Psychotherapy is a thing unto itself, which many of my clients don’t realize when they first come to therapy, and certainly something I did not understand on my first foray into the endeavor in my mid-20’s. Psychotherapy has its own rules and requirements, timelines, frames of reference, and unreplicable rewards, which are not simply givens in our normal, day-to-day lives. There are, for sure, some “what to expect” books out there, but most of us enter psychotherapy like we’ve caught fire and are running into what we hope is a fire station. That is, in crisis, without much time for careful preparation.

And fair enough, since it’s unlikely anyone would enter psychotherapy unless they were, in some way, on fire. Change tends to be driven, at least initially, by unavoidable crisis, which pushes us to find help we cannot find in ourselves, and then engenders changes we would never have deliberately chosen. Such, it would seem, is the path of human progress.

So, one of the core dynamics of psychotherapy is that, beyond the most tactical and surface-level changes (arguably, more of the range of what is now known as “coaching”), it is a process of “combing cotton”. In preparing raw cotton for spinning thread, this is a technique to get the cotton fibers straightened out from their raw, disorganized mass. It involves running a comb-like device repeatedly through the cotton…with the emphasis here on repeatedly.

If we come into therapy on fire—and as I said, most of us do—we naturally want a rather specific intervention, namely: Doctor, put out the damn fire! Which is totally fine and natural, except that when it comes to our minds and hearts, the “fires” are much more complex than in the physical realm. Certainly, the first steps involve making the pain less—and there are many techniques and tools for this purpose—but in order to actually address the source of the fire, the process is longer and more involved than just dumping a bucket of water over the head.

“Combing cotton” as a metaphor for psychotherapy means that to address the pain that brought you into therapy, there is a repeated “combing,” a repeated engagement with wherever the fire is coming from that, pass after pass, session after session, straightens out what has been jumbled up. Meaning: insight is clarified, maps of life are articulated, behaviors are aligned with desired outcomes, and one’s unique desires are described and owned.

We will not like this process initially, because it involves learning to tolerate pain, delay gratifications, and face up to where our attempts to control our lives is futile, and where the cherished stories of ourselves and life are either inaccurate or defensive (or both). Switching metaphors, if you’ve ever had to comb out your, or your child’s, matted hair, you’ll have a visceral experience of what I mean.

But this pain attendant to the process of psychotherapy is unavoidable, if you want the reality of a “straightened” life, where one’s own beliefs and actions are not causing one’s own pain. It’s non-negotiable, which is often a hard pill to swallow about psychotherapy, mostly because it’s a hard pill to swallow about life. But in both realms, it’s important to know going in (or at least to have as a distasteful assertion by a professional that can be tested in the process), because without it, the danger is of abandoning the process because we were not ready for it, or because we believe it’s the process itself that is causing the pain.

In both cases, we do not get the benefits of psychotherapy, which is a terrible and sad outcome, since therapy is one of the great tools of modern life for dealing with, and straightening, the tangled mass of our own minds and hearts. Going into therapy with an expectation of pain, but of the good kind, the kind that leads towards less pain and more efficacy in ones’ life, is a core understanding that can make or break a therapy.