This didn’t really feel like a What a Shrink Thinks post somehow – more about writing itself than about psychotherapy – of course, as with everything, that gets all tangled up together. I sent it out from my other site: Subtext Consultations – and rebloged it here for those who may be interested.
Shooting with a LEICA is like a long tender kiss, like firing an automatic pistol, like an hour on the analyst’s couch. – Henri Cartier-Bresson
Maybe being an analyst is like shooting with a LEICA. Analysis has to shoot the truth, and open fire upon dearly held illusions. Love sometimes means engaging in aggressive assertive disruptive acts for the sake of the relationship, for another’s sake, for your own sake.
In session I notice that I’m pointing. The knuckles toward the ceiling, my thumb and three fingers curled under my palm, my index finger out – jabbing, poking pecking at the resistance, at the defense, at the cherished illusion that has come between my client and me. I am trying to perforate, to jab a hole in the obstacle between us, or maybe to insert a new reality into the closed off soul in front of me.
Our illusions can entrap and isolate us. We can live whole lives sidestepping the complex truths of who we are, and how we feel, and the impact we have had on others. We can construct false and comforting narratives that soothe ourselves and placate those we love. We can erect firewalls and moats. We can abscess an infection rather than tend to it. We can project distortions onto each other to avoid our own broken and fucked up bits. We can pretend that life is stable and manageable, rather than encounter the inherent insecurities of living.
And we lie.
And we can become lost in the lies that others tell us. We can spin status-quo justifying narratives. We can pretend we are okay when we aren’t. We can scream and aggress to divert from our shame and fear. We can cry and collapse instead of taking responsibility. We can shirk and ignore challenges that we should face and we can fling ourselves wildly at self-sabotaging risks. We can make problems that rightfully belong to others all about ourselves. We convince ourselves that we are the problem when it is outside of us, and we can blame others when the fault is ours. We can believe things that aren’t true, and we can convince others to join us in our false beliefs.
And sometimes all this needs to be pointed out.
Usually, it is better for this to be a gentle process. Our illusions and false beliefs exist for a reason, even the most destructive ones. Shame or dominance will only make them more entrenched. You should never strip away a defense without knowing what it is defending against, without understanding its original purpose, what might get much much worse if the security operation was not activated. Symptoms are sometimes the best available solution to an intractable illness- and to remove a mild symptom can allow a disease to cause greater harm.
So usually, the process of dissembling an illusion should be a slow, respectful cautious incremental process.
But there are times when the stakes are too high, or it has gone on way too long, when the costs are too great, and you’ve tried every subtle sensitive approach imaginable over months or years and both of you have had just about enough and its time for shit to get real. And often, it is seeing my own finger unfurled that points out this moment. The finger in front of me is ready to puncture the illusion before I have consciously registered that it is time.
Sometimes an hour on an analyst’s couch is like being shot with an automatic pistol. Sometimes looking at a stark reality in black and white is like a long tender kiss.
Love is feral. It is not always civilized, subtle or domesticated. It summons us to wild spaces and demands that we look at our most uncivilized selves, or reveal them to another.
Sometimes our defenses need to be cracked. Sometimes our illusions need to be destroyed. Sometimes old covenants need to be broken for new ones to emerge. And sometimes we do this out of love, and for love’s sake.
Sometimes the most loving gesture is also the most violent: to show someone the truth as you see it. To demand that they encounter you, or encounter themselves or the effect they are having on others.
(These are often all the same thing).
And sometimes – disappointing, upsetting, frustrating, annoying or enraging the other is really just disrupting the illusion they have created that tells them that the status quo is sustainable. Sometimes the people we love are living in a dream about who they are or who we are – and attacking this illusion is really an invitation to leave their illusion behind and join hands with you in reality. An urgent, frightening invitation.
Authenticity is a wilderness. Reality is feral and untamable.
Sometimes, being an analyst for an hour is like letting other’s take stark, unflattering black and white photographs of you and holding them up for you to examine. Sometimes being an analyst is like being shot with an automatic weapon – absorbing aggressions that you did not instill or create but that you are called upon to survive and accept as your client’s reality, as the truth of where your relationship and alliance actually stands or fails. Sometimes being an analyst is like being surrounded and filled with a warm, dizzying tenderness.
(These are often all the same thing, and all of these things can be love, even if it doesn’t feel like love at all.)
Sometimes when you feel you are being attacked you are actually being loved, wildly and more authentically than anyone has had the courage to love you before. Sometimes we need to point harsh truths out to each other for love’s sake.
And love can be an hour on an analyst’s couch facing realities that are too stark to encounter alone, that can be as terrifying as a gun shot, as tender as a kiss, as clear and focused as photograph.
You can’t shine a light in one corner with out the other three corners becoming darker.
Who said that? Jung maybe? Or some Jungian? I have no idea – but we’ll go with that… it sounds Jungian enough.
And nothing makes this clearer to me than when I am pressed into large groups of psychotherapists, social workers and psychologists. Nothing makes me want to leave my profession more than listening to other members of my profession.
And being terrified that I am hearing myself.
I am usually either lured in by the wish to hear a specific author speak on their area of expertise, or forced (grousing the entire time) by professional mandate to maintain licensure or certification.
And if I can just sit quietly and read a book, or listen to music or embroider before the presentation begins – if I can close out the chit chat, and the jockeying for status and position, if I can just ignore all the narcissistic injuries and the needs and the hungers that seem to be pouring out of all these well-scrubbed people in glasses, with their expensive sweaters and sensible shoes, if I can just get to the part where there is a teacher who is going to talk – and who might even say a lot that is useless for me- but who will hopefully leave me with one or two gems – just a single lovely, good, and useful idea, one new thought, one interesting insight into one case – I will be good. It will all be worth it. If I can just toss up my filter to screen out everyone around me except the person far away on the podium…
But sometimes I can’t. Sometimes my filter is down, or I forgot my knitting bag, or my phone battery is on 12 percent. Sometimes the presenter wants us to break into small groups, or introduce ourselves to our neighbors on either side, or worse: wants to lead us in an exercise.
Then it is inescapable and I see the marks that this profession has left on all of us, the starvation to share our perceptions, to have our work acknowledged. I hear how needy and hungry it makes all of us. How all our profound insight can leave us blinded to each other and ourselves outside of the consultation room. Used to hiding behind our professional persona we are too accustomed to our utterings being treated as the Words of the Gods and are annoyed and agitated when they are not greeted as sacred pearls of wisdom by our peers. In love with our clients, enthralled with their growth, and drunk with the fantasy that we have done something “right” to facilitate their transformation, we overshare uninteresting self-congratulatory details of our client’s therapeutic successes – like way too many baby pictures – patting ourselves loudly on the back because as private practitioners it is unlikely that anyone else will. We forget to seek out what may be actually useful or universal in the story we are telling. We forget that those around us are contending with the exact same starvation we are and may not want to feed us. At all.
Spending our days on the wrong side of our client’s projections – we cannot bear to be mis-perceived, or understood in inexact ways. Or invisible.
Heads nod. Tongues click. Brows are empathically furrowed as case material is laid out. Hands shoot up in the comments and questions portion of the presentation. Points are made. Exceptions are taken. Opinions are expressed. Expertise is demonstrated.
And disagreed with.
“In my experience…”
“But don’t you think….”
“I’ve found that when….”
“I worked with a similar population and one of the things I found to be very effective was…”
Yet somehow nothing at all is being said.
No one says:
“This work is lonely sometimes, do you find that too?”
“This client scared the shit out of me for a long time and I didn’t know what to do- I felt really lost – but then one day they started opening up, started trusting me, started feeling better and I was so relieved…”
“Sometimes I want to be an expert and I feel frustrated when my clients don’t respond to my years of professional experience and training – and then I remember that I am a broken fallible human being too – and it is so much more reliving when I quit thinking of myself as my ‘role’.”
“I don’t know what the fuck I am doing half the time – that is what intuitive work feels like – like wandering in the dark together until we stumble onto something that feels helpful – but it is hard to feel so lost so much of the time with clients who feel lost too.”
“I worry that my world view, or my methodologies are becoming outdated – in the face of new realities how much are my perspectives as a professional at mid-life or beyond really worth? I want to stay open to this world that is moving so fast, but I worry that I am falling behind…”
“I want to be seen as smart and perceptive. I want to say things that my peers and clients will value. I want my career to keep building – I’ve been feeling stuck lately, like I may have hit the top of my capacities”
“I want to appear to be healthier and more appreciative than the rest of the people in this room, so I want to personally thank you for a wonderful presentation that I’m sure spoke to every single person here.”
“What have you accomplished? Is it more than I have accomplished? Should I walk away from this brief interaction feeling superior or inadequate?”
No one says anything like this at all. But I can’t stop hearing it.
No one speaks from their own wound. It isn’t safe enough and we don’t know each other. We speak only from inside our suit of armor and the noise we emit echoes and clangs and deafens.
Our profession casts a dark and reaching shadow, one that can wreak havoc with other’s lives, often claims to accomplish more than it can and regularly appropriates the healing processes of others as our own property.
We are all so aggressively empathetic and such competitively good listeners.
But, I hope, more of us are in touch with our own woundedness when we are safe in the confines of our own workspace, in brokered relationships with clients that feel safe with us, and with whom we have earned some degree of safety for ourselves.
However we talk, or fail to talk about the work in public, in enforced mandatory community – I hope we are able to tell ourselves more humbling and humiliating truths about our work and our professions in private, and in the safe supervisory and peer relationships that we have built as way stations for ourselves on this lonely path.
And as much as I hate it when my filter is down and I am surrounded by darkeness on at least three sides: Later I will gather myself and hope that somewhere, it may mean that others are shining a very bright light in their own small corner of the universe.
I recently attended a workshop for continuing ed. focused on oral narrative, narrative therapies and trauma – It reminded me of this case, and this paper I wrote about integrating narrative therapy and Winnicott a gazillion million years ago – probably in the late ninties (and published in the New York State Society for Clinical Social Work’s Metropolitan Forum – mailed out on paper – from the time before everyone had a website and there was no such thing as a digital newsletter)
I still use writing, narrative, and storytelling as part of my clinical practice – and in my own processes, (as this blog obviously demonstrates.)
What follows below is a Winnicottian case study using writing therapy with a client who had suffered trauma and attended a daily out patient program for adults with psychosis. The client’s name, the client’s stories, and identifying data have been changed and disguised to reflect the spirit of the work while protecting the client’s privacy and confidentiality.
THE STORY OF ROBERT ALONE:
At the time I began seeing “Robert” – fresh from social work school – I operated on beginner’s instinct with little theoretical grounding beyond a vague understanding of ego-supportive process. I saw myself as lending patients my ego strengths; as undermining maladaptive defenses and supporting adaptive ones in hopes of forestalling rehospitalization. Working under a medical model, I reluctantly began to view my patients as a mass of ego-deficits and developmental failures.
A deeper exploration of object relations theory, and Winnicott in particular, provided me with a far more meaningful and useful model for work with psychosis, allowing me to reorganize my understanding of the completed work. What follows is a summary of my relationship with Robert, conducted in the spirit of fearless idealism only readily available to new clinicians. A discussion of Winnicott’s model reveals the phases of Robert’s emotional development, his capacity for creativity, his use of transitional phenomena, and of the importance of play in the therapeutic relationship.
IDENTIFYING DATA AND PSYCHIATRIC HISTORY
“Robert” is a thirty year old man from the Virgin Islands. His skin is clear and dark, his eyes black, and the gray at the temples of his curly black hair makes him look somehow distinguished if you catch a glance of him in a still moment. He is rarely still, Parkinsonian symptoms and Tardive dyskenisia twist and jerk him about; his tongue juts in and out past his teeth, his head falls forward as though a hinge in his neck has come loose. His fingers splay open and shut when he is excited or agitated. He speaks with a heavy island dialect.
The treatment relationship took place in the context of a therapeutic milieu, five days a week from 8:30 a.m. to 2:30 p.m., where he received a variety of services including: psychosocial, medication, group and individual therapy. We began at the day program the same week . I left the agency and transferred Robert to a new therapist in three and a half years later. I met with Robert twice weekly for individual treatment, twice a week in group therapy, as well as informal contact throughout the day on the treatment floor.
Robert had been hospitalized many times for paranoid delusions and auditory hallucinations. He reported hearing up to seven different voices, both male and female, who he insisted were “real people in from home.” He was also preoccupied with intrusive, obsessive thoughts, which he called “dangerous stories” He would “listen and watch as they play through my head.”
Robert is one of the middle children of twenty-one siblings by one father and three mothers. He describes his father as having had three families: each living in a separate house built on adjoining property. He remembers falling asleep while his father told all of the children bedtime stories. His father died when Robert was eight years old.
His mother, the second wife, began experiencing psychotic symptoms sometime before his father took on a third wife, and was hospitalized, intermittently throughout Robert’s childhood, latency, and adolescence. He was never told where she was or why she was gone. Her children were absorbed by the other two households during her institutionalizations. Robert remembers being beaten by his older half-siblings when he misbehaved.
In my first months with Robert, I felt invisible to him, without a therapeutic partner in the session. Communicating with him was nearly impossible. His world consisted of slips and slides, bizarre responses and loosened associations. The past and present jumbled together in a tangle of primary process. His thick accent further obscured his illogical statements.
In the countertransference I experienced an overwhelming ennui, a numbing, rhythmic, almost dizzying boredom. This quality of boringness is at the core of Robert’s illness according to Winnicott; more debilitating than the hallucinatory symptoms associated with schizophrenia (Winnicott, 1971, p. 66, & Winnicott, 1972, p. 1).
Yet, I sensed that Robert was attempting to share something important about himself with me; a frightening gift, which I was, in essence, rejecting. Unable to tolerate the chaos, I would cut him off, hoping to find surer footing by soliciting details of his day to day reality. Robert’s “essential lack of true relation to external reality” creates initial transference difficulties, in Winnicott’s view, which must be dealt with in order for the therapeutic relationship to proceed. In infancy and in adult illness, hallucinatory fantasy is seen as an attempt to gratify primary needs which external relationship have failed to fulfill (Winnicott, 1992, p. 152 ). Like a child who prefers the thumb to the mother’s breast – Robert’s stories disrupted his relationships to people and to daily reality. Nothing of the present could exist once the stories began, not me, my office, or his fellow group members. They were truly the stories of Robert alone, and unrelated.
One day , I tentatively asked Robert about his hallucinatory world, releasing a flood of content and rapid pressured speech. He began telling me a dangerous story that “starts up in his brain” – consuming him entirely. He demanded that I write the story down verbatim, serving as his scribe with a day-glow green pen which he had selected for the purpose.
Queasily reviewing the pages of green ink, I felt even more disturbed by the glimpse of Robert’s internal life. It was clear that no external connection to me or the group could be as compelling as these hallucinated relationships. The stories were too psychotic – full of disjointed nightmare images of broken doors and angry dogs. The voices were too vivid, frighteningly alive and defined personalities. I wondered if he could be hospitalized; I wanted to put him away from me, and cast these entities out from my office. I felt frightened, revolted, and sick to my stomach. Robert had left me in a fragmented muddle, a countertransferential experience of madness (Winnicott, 1965, p. 147).
Across the top of my notes, Robert had written in his perfect elementary school printing “THE STORY of The Man Who Protected Robert.” The disjointed third-person tale that followed told of Robert and his close friend “Haad”. At the center of the story, Robert finds himself in trouble. He has lost the night deposits of an office where he works as an errand boy. Only his friend Haad comforts him: “‘It’s all right. I know the boy.’ I know the boy. This is what Haad said to me!” At the story’s end – Haad is killed in a car accident – and Robert believes that he is not dead – he is alive and protects Robert from all danger. The final words are: “It is finished” written in Robert’s own hand.
His struggle to formulate a consolidated identity seemed central to Robert’s story. He had created the story to say: “I know the boy” protecting him from an even deeper sense of fragmentation. By viewing his ability to organize the story as a developmental achievement, I could support the story’s ability to consolidate a sense of Robert’s own thoughts, feelings and impulses.
The creative impulse is something which can be looked at as thing in itself, as something that is present when anyone – baby, child, adolescent, adult, old man or woman – looks in a healthy way at anything or does anything deliberately, such as making a mess with feces or prolonging the act of crying to create a musical sound (Winnicott, 1971, p. 69).
The next session Robert made it clear to me that we were on the right track. He asked me to tell the story back word for word. Robert was particularly concerned that I understood the story to be true, not made up, and not crazy. He stated, “This is True. This is what happened, Do you believe that this is a true story?” I said I trusted that Robert had told me exactly how it had felt to him.
He then regretted telling me the story. I might tell the insurance company, I might send him to the hospital, the dangerous story could be stolen by those who might hurt him. He also worried that I might be injured somehow because I knew the story. I reassured Robert repeatedly that I did not want to hurt or hospitalize him. Moreover, I had to demonstrate to him that I was strong enough to contain and protect both of us from the aggressive impulses within his story. We would only approach the stories in a way that made us both feel safe.
I offered a suggestion. Perhaps we could close the story by stapling or folding it and then locking it in my file cabinet. After testing the lock on the cabinet, as well as my locked office door, Robert appeared convinced. The story could be left safely with me; it would remain in the therapeutic setting, and would not emerge to surprise, hurt or frighten him outside of the program.
Robert’s internal relationship with Haad, both historical and hallucinatory, reflects his yearning for protective holding. He used to sense Haad’s protective presence “all around” him, in the walls of the room, in the air that he breathed. Haad provides Robert with a holding “environment mother” who has formed an attuned identification in order to soothe and regulate the environment (Winnicott, 1965, p. 33).
As Robert’s and my relationship progressed, I began to take on Haad’s holding functions. I literally held the stories, the locks on the drawer and the office door serving as concrete symbols of the protective holding environment. He began to look to me as an environment mother, warding “off the unpredictable” and actively providing “care in handling and in general management” (Winnicott, 1965, p. 75).
Moreover, the environment mother is needed to “to continue to be herself, to be empathic toward her infant, and to be there to receive the spontaneous gesture and to be pleased” (Winnicott, 1965, p. 76). These are the very functions that he could not find in his own psychotic mother; a mother unable to regulate the environment for herself or her child; a mother who was not able to be reliably there, due to her own illness and hospitalizations.
The reliability of the treatment environment, and the structure of the story work, held Robert suspended safely, as if in a medium, “like the oil in which the wheels move” (Winnicott, 1972, p. 188). This holding started off fairly simply, as a consistent time, my general empathy and attention, allowing Robert’s story to emerge. Perhaps my ability to face and survive Robert’s projected psychotic anxieties distinguished me as a mother who would not breakdown and abandon him. In the weeks ahead, Robert began, very slowly, to tell a “more dangerous” story to me, as I wrote it down.
PROCESS: STORYING AND RESTORYING
The Story of Robert Alone
Robert’s sister said to get a job. Robert went to a department store. He applies to be a porter, putting out the garbage. The form asks why he left his last job. Robert thinks of the insurance company and writes: “Because of the deposit bag.” He didn’t want to go to the bank at night because this is too much for him.
One day, a lady who worked in the office said Robert to pick up the empty bank bags. This was too dangerous, like before with the insurance company.
He was all alone: no father no mother no brother and no Haad.
Then the manager told Robert “Its cold out, bring your hat” and Robert thinks of Haad. There must be danger if Robert needs protection. Robert quit this job. It was too much.
Robert has honesty.
It is finished.
Eventually, Robert told me all of the dangerous stories that had consumed his attention. The process repeated itself each time: telling, scribing, repeating. The stories were always locked in the file drawer at the close of each session, and he would check the locks before leaving. Winnicott predicts that this holding “steadily becomes extremely complex, yet remains just the same, a holding” (Winnicott, 1965, p. 228). This was demonstrated in Robert’s increasing demands that I mirror him word for word, that I enact a protracted complicated ritual around closing the stories, week after week, without error.
When I first met Robert he was entrapped hallucinatory omnipotence, with no real experience of me or of his external environment. This also speaks to his inability to retain good enough internal objects, as evidenced in the Story of Robert Alone, with “no father no mother, no brother and no Haad;” no internalized object to rely upon for comfort or safety.
Haad, says “I know the boy” representing Robert’s attempt to maintain a distinction between Robert and not-Robert, to identify himself as unique and embodied.
Our relationship could be said, in Winnicottian terms, to reflect Robert’s recent development of the capacity to be alone, his progress from ‘I’, to ‘I am’, to ‘I am alone’ (Winnicott, 1965, p. 33). In this phase of our relationship, and the story work, Robert and I formed a relationship which, in hindsight, can be seen as a good example of Winnicott’s ego-relatedness: “Ego relatedness refers to the relationship between two people, one of whom at any rate is alone; perhaps both are alone, yet the presence of each is important to the other”(Winnicott, 1965, p. 31).
If Robert could not come out of the story to meet and relate to others, I would have to go in and join him there. Maybe he would eventually trust me enough to follow me out into the present. In short, I would have to convince Robert of the real advantages of accepting external reality – that despite its many failures and frustrations, it offers many real consolations and comforts. In Winnicott’s words: “Real milk is satisfying as compared with imaginary milk (Winnicott, 1992, p. 153).”
Robert arrived one day complaining of “heat in my head” because the story had not been locked up securely enough. I suggested that if I told him my own story about the department store, it might help. Robert agreed, and sat down to listen. What follows is my re-storied version of The Story of Robert Alone.
The Story of How Robert Took Care of Himself
Soon after Robert moved to the United States, his family wanted him to get a job, and he wanted to get working again too. He applied for a job at a department store. He tries to tell them on his application that he doesn’t want a job that has to do with errands or bank deposits. He had a job like that before and it had been too scary, and his thoughts had gotten all confused. He sure didn’t want to go through that again. He asked for a job as a porter and he got the job. He was very happy about it.
One day, they asked him to run an errand at the bank! Robert felt terrified that he would be hurt or mugged, or get in trouble again! It was scary for him and he felt alone and overwhelmed.
While he was upset like this, the manager told him that it was cold outside and reminded him to dress warmly. The past and the present were getting all mixed up for Robert, and he thought the manager asked him to bring his friend Haad along for protection. But the manager couldn’t know that Robert had a friend named Haad in because he had only known Robert a short time.
And his friendship with Haad will always be with him in his heart and his memories
Robert wisely recognized that this job was too much pressure for him, and he quit the job to keep himself healthy and safe.
He had been able to take care of himself all on his own, even with no father no mother, no brother and no Haad.
He had made a good decision and he felt proud that he was able to protect himself with out help from anybody else.
Robert behaved like an honest and responsible adult.
Robert’s response to this story was a large grin:
M: What do you think of my story?
R: Its good. Its true too. I like your story better.
M: What is it that you like about my story?
R: Your story has all of my feelings in it.
He went on to say that this story of mine was a safe story, with nothing too bad happening in it, only bad feelings. In the next few months Robert would take in several of my re-stories. The stories and re-stories constituted our entire process for a period of approximately twelve months. For the remainder of our work together – our relationship traveled well beyond these stories – but would occasionally revisit and review them when they asserted themselves during times of stress or when they had been triggered by external events.
It would be important in any discussion of Winnicott, but especially in this case, not to overlook the concepts of the transitional space and transitional objects. Robert’s stories are explicit examples of transitional phenomena, comparable to an infant’s babbling, or an older child’s songs and nursery rhymes (Winnicott, 1971, p 2). They come from within Robert, but the same time they come from with out – he passively watches as they omnipotently play through his mind. This passivity reveals pathological use of the transitional object, which feels as though it has a dominating external vitality of its own.
Winnicott describes transitional phenomena as an attempt to bind fears and sorrows: “a word, or tune or a mannerism – that becomes vitally important to the infant at the time of going to sleep and is a defense against anxiety, especially anxiety of a depressive type” (Winnicott, 1971, p. 4).
Denial of loss and separation plays an important role in the pathological aspects of the transitional space (Winnicott, 1971, p. 5). The first story “came into” Robert after Haad’s death, a loss which was devastating to Robert in itself, but also reactivates much earlier, overwhelming losses: his father’s death and his mothers’ frequent long, mysterious absences. It is likely, that Robert began relying upon such fantasying far earlier in his life, perhaps at the time of his mother’s first hospitalization, or following his father’s death.
Perhaps Robert’s stories served as a stand in for his father, and the safety Robert experienced as he fell asleep held in his father’s stories. As Winnicott points out: “A need for a specific object or behavior pattern that started at a very early date may reappear at a later age when deprivation threatens (Winnicott, 1971, p. 4).
One day Robert reported that his stories were changing. My stories had been “mixed up good” with his, and he would remember both stories together. He said that his stories were safer now, not as angry. When Robert relived these old memories, a newer memory of telling them to me, of my listening, writing, and responding, had become a part of his story.
Psychotherapy takes place in the overlap of two areas of playing, that of the patient and that of the therapist. Psychotherapy has to do with two people playing together. The corollary of this is that where playing is not possible then the work done by the therapist is directed towards bringing the patient from a state of not being able to play into a state of being able to play (Winnicott, 1971, p. 38).
Re-storying served to promote relatedness in the transitional space, without challenging Robert’s “neutral area of experience” through playing with the stories – passing them back and forth between us , allowing the story to change, and to change us as well. Ultimately, the stories allowed Robert to move from a place of hallucinatory omnipotence and merger to being in relation to myself and the group.
When Robert started at our program his only relationships were with Haad, and the other “story people” Eventually he formed several close friendships at the program. He says that stories and the voices are “no bother” now, although they remain in “the back of my brain.” As instances of imaginative play and creativity emerged in Robert’s daily life – at first a giggle, then playing with riddles and funny stories, and eventually developing into full fledged mischief- became as breathtaking and moving as they had once been rare. In this light, Robert’s stories can be seen not a symptoms, but as an emergence of the True Self, a spontaneous, creative gesture that was waiting to be met.
During our last week of work together Robert passed the US citizen examination, which he described as a commitment to “live life in the present, instead of the stories.” – an acknowledgment of his wish to maintain an attachment to external reality, rather than psychotic fantasy. Through the course of treatment, and this course of study, I have adjusted my expectations, my goals, and my understanding of the task at hand with regard to this and similar cases. The job is much simpler than I thought, but also much harder. It is I think; to wait patiently, to watch very closely, and to try not to miss an opportunity to celebrate the client’s capacity, however fragile, for creative living.
Winnicott, D. W. (1965). The maturational processes and the
facilitating environment; studies in the theory of emotional
development. Madison CT: International Universities Press,
_________ (1971). Playing and reality. New York: Tavistock
_________ (1972). Holding and interpretation; fragment of an
analysis. New York: Grove Press
_________ (1992). Through pediatrics to psycho-analysis: Collected papers.
New York, NY: Brunner /Mazel Inc.
Macbeth: If we should fail?
Lady Macbeth: We fail? But screw your courage to the sticking place, And we’ll not fail.
Macbeth, Act 1, scene 7, 59-61
Committing psychotherapeutic acts takes extraordinary courage.
Facing down anxieties, digging down underneath painful symptoms, revealing vulnerabilities, casting out demons, seeking salvation, asking forgiveness, challenging abuse, severing damaging relationships, examining your failures, flaws, weaknesses, revealing your shames, contending with guilt, grieving, preparing to die, coming out, fighting for intimacy, encountering emptiness, apprehending your own murderousness, and the depths of your hungers and desires, setting limits and boundaries, saying “no”, tolerating exposure, baring your soul, withstanding the pain, changing your life, telling the truth…
Telling the truth.
These are terrifying acts.
I can think of no psychotherapeutic action that does not require courage.
I cannot think of a single split second of the 30 years I have spent engaged in the psychotherapeutic process, as a client or as a therapist – that did not require extraordinary bravery – and sticking to it week after week after week.
There are thousands of moments when one or both of us in the room wants to run, in the presence of awful, awe-filled, awe-some realities and potentialities.
Choosing to face reality – really looking at yourself, and your life, at the world around you, at those you love, at those you hate – should scare the shit out of you.
Of course Mr. and Ms. Macbeth were preparing to murder for status and power …which we would obviously, never condone.
But be warned that telling your truth to another person in a confidential office can kill off quite a few comforting illusions.
If it doesn’t, you may be missing something essential.
Some people suggest that anxiety is an entrenched, immutable biological response and that courage has nothing to do with it.
I could debate that idea in a million ways – but I don’t want to feed that notion, because it negates the flabbergasting acts of courage I watch take place in my office every single day.
My therapist would sometimes ask: “Do you want to talk about __________?”
“No.” I would say. “Of course I do not want to talk about that. I don’t want to talk about that at all.”
Screw your courage.
“Do you think we should talk about it?”
“Yes. Of course we should. But if you ask me if I want to I’m going to have tell you ‘No fucking way’.”
I’d leave therapy drenched in sweat. As if I’d fought a dragon barehanded. Or wrestled with an angel all night long. I never understood why I’d leave so damp from exertion until I sat in the therapists chair and watched my clients, one after another, search for their sticking place and screw their courage there committing staggering acts of bravery. Of will, of strength.
For some the sticking place is the therapeutic relationship itself, the trust built, brick by brick, between therapeutic partners.
Other’s find their solid ground by imagining the parents their child deserves, or the partner that they hope to be.
Some are able to summon their bravery when they think of what others have sacrificed for them.
Some find their line in the sand through religious promises or moral mandates.
And still others will locate their courage by honoring a relationship lost.
Or by wanting to protect others from the horrors they have survived.
And sometimes, it is simply the commitment to authenticity, the wish for wholeness that lets us stick and stand strong in the face of challenge, conflict, distress, sorrow, pain, fear.
Sometimes bravery sounds like this:
“I just couldn’t any more”
“It just came out of my mouth before I realized”
“I didn’t feel like I even had a choice. I just had to.”
Sometimes it is even more elemental than that.
Bravery can sound like this:
“I hate you.”
“I love you.”
I am afraid too. We can at least be terrified together, and maybe find our sticking place there.
And if we should fail?
But screw your courage to the sticking place and we’ll not fail.
It’s you I like,
It’s not the things you wear,
It’s not the way you do your hair–
But it’s you I like.
The way you are right now,
The way down deep inside you–
Not the things that hide you,
Not your toys–
They’re just beside you.
But it’s you I like–
Every part of you,
Your skin, your eyes, your feelings
Whether old or new.
I hope that you’ll remember
Even when you’re feeling blue
That it’s you I like,
It’s you yourself,
It’s you, it’s you I like.
It’s You I Like
~ By Fred M. Rogers © 1970
I’ve been re-reading a lot of Ronald Fairbairn’s works lately. An object relational psychoanalyst- writing through the 1950’s – a man who worked with abused children, “shell-shocked” war vets and introverts. He was number one on my theorist hit parade for many years, but dropped off of my radar after reading and re-re-reading him – I must have decided that I’d digested his message completely (foolish of me) – and incorporated him into my infrastructure.
I didn’t forget his amazing contributions to psychoanalytic thought: His most seminal contribution is a construct known as ‘The Moral Defense” : the way children, especially abused or neglected children but also all children, find their parent’s destructive aspects so intolerable – while they remain so dependent and for years beyond – that they take the burden of their parents’ badness onto themselves. Maintaining primal attachments at the greatest cost by talking to themselves in the parents’ bad voice, believing that if only they were “good” inside or at least better Mommy or Daddy would love them more, or at all.
I didn’t forget his ideas or even forget to give him credit for his perceptions. I forgot him. I forgot his writers voice, the way that he never stopped advocating for “unanalyzable” clients in the face of the traditional Freudian analysts who had historically rejected anyone who has sustained a real psychological injury, or blamed them for manufacturing their own ills. I forgot his loyalty to sexually abused children and adults, and his belief in them and in their stories of trauma. I forgot that he thought mandating clients to lie down on the couch to be coercive, and potentially retraumatizing, and really just a way to protect analysts from the clients’ relational hunger and legitimate needs. I forgot his unceasing willingness to stay near his clients – to let them look him in the eyes and to look back – as they talked about their most personal private thoughts and beliefs – about their bodies, about sex, about defecation, about God. I forgot how his belief that clients come to therapy to seek salvation – forgiveness for their sins and freedom from the demons that haunted them – meant that he was committed to seeing them as loveable in the face of their darkest deeds and secrets, how it meant that he would try never to flinch in the face of their most traumatic memories, and how he would allow himself to be hated, to withstand the full force of his clients hate, so the hatred could be released and modulated.
I missed Fairbairn, as a voice, as a teacher, a role-model, a surrogate.
I realize that when I’ve described myself in the past as a theory-wonk, that is not exactly true: I am really just a theorist-wonk, a psychoanalytic groupie. A goofy geeked-out fan-girl, nothing more.
As a young child I was crazily devoted to Fred Rodgers. (If you don’t know who he is, or if you do you should really read this. Really. Do it. I re-read it all the time.) I kept my secret devotion hidden well into upper elementary school and beyond. I had his song books and read his gentle lyrics over and over basking in their paternal kindness. By junior high I had transferred my crushing to Carl Sagan, to Walt Whitman. By high school, George Bernard Shaw, Oscar Wilde, T. S. Eliot. By college: Ibsen, Checkov, Kant, Hegel, Keirkeggard, Buber, Freud. Graduate school led me to Fairbain and Winnicott, and Kohut.
I realize that one of the reasons that I don’t read as much fiction as I should is that I don’t want to read about imaginary character’s relationships to each other – I want to be in imaginary relationship to the philosopher without a fictional middle-man separating us.
Fred Rodgers would sit down and break the fourth wall of my television screen to show me new things, to tell me about something he learned that day, or something he had thought about. To tell me that he liked me just for being me, to tell me what might come next, or not to be afraid of having “scary bad wishes” because wishes don’t make things come true. He spoke directly to me, giving me guidance that led me through the spiritual thickets of my childhood.
Post-graduate studies brought me many more such guides -Searles, Sullivan, Guggenbuhl-Craig, and most influentially, Jung.
There are women too, a good handful: Mahler, Miller, VonFranz, Anna Freud, Klein, Bebee, Ornstien, Stevens Sullivan, – but clearly these imaginal compensatory relationships skew toward my daddy-issues more than my mother-complex.
I read and re-read and revisit these men’s and women’s words over and over – grateful for their mentorship, for the kindness and generosity in their voices, for their willingness to speak their thoughts out directly, unfiltered. To hear of their patience, and their warmth, their limitations, their forgiveness of themselves and others, their willingness to press or even fight against the prevailing models to be sure that the client population they served would be considered, to hear them talk of “real relationships” and “life-long self-object needs” – to watch them debate respectfully and civilly even when they disagree vehemently or hold personal dislikes or even hatreds. To watch them battle against practices that they believed re-traumatized or damaged or omitted too many. They are all limited, bound by their histories, pathologies, narcissisms and their own era, but their commitment to psychoanalytic love, love with out using the word, still shines through their jargon and their own woundedness.
To hope to be as brave and clear, committed and creative in my own small way.
To try to give of myself as generously – and not only to my clients – but to offer my own voice – to break through that fourth wall and talk through the screen to anyone who needs to feel forgivable and worthy of patience, and deserving of kindness.
To say, as all these guides have said in their own language, through their own filter and stance – as Fred Rodgers said to me through the TV screen (as I try to repeat each day in session after session) over and over, each week, without fail:
“There is no one in the world just like you. And I like you just the way you are.”
A good friend is visiting, a friend who has a potentially terminal cancer – which is also a potentially survivable cancer. This is a friend who has helped raise my kids, and helped care for my ailing mother. And she needed to talk about death, frankly, explicitly, and very few people in her life are able to talk about it with her without becoming distressed and uncomfortable.
So, if you read this blog – you know I have written a fair amount about death and bereavement. My mother died of cancer a few months ago after a long period of dependency and disability, and before that my grandmother-in-law died (she was very old, almost 102 and we had taken care of her for a long long time) A few years earlier, on the same weekend while I was at Disney World my father (a fall/ head injury secondary to narcotics dependency) and one of my two oldest and best friends (AIDS), both died. My father-in-law passed away (after a seven year cancer process) – about thirteen years ago: I know this because it was in the middle of the adoption of our first child, and we paused the adoption process for our mourning and bereavement. And a few years before that – just after I became a social worker – I lost my my “best” friend from high school & college (AIDS).
Other than that: My mother-in-law died (cancer) a few months before I met my husband and his family in fresh bereavement. I’ve lost all my grandparents and their peers by now of course – And I lost many mentors and teachers and my step-father as a result of the AIDS crisis.
And I’ve had many clients die, and clients who come to my office to talk about deaths that have transformed their lives – deaths that annihilated their former ways of being and forced them, unwillingly and forevermore into a new world. And clients who talk or fantasize about their own deaths, their fear of death, or their terminal – or potentially terminal diagnosis. And those who cannot talk about it. I’ve also sat with people – in and out of my office – as they have talked about terminating their own lives– sometimes as part of a conversation about terminal illness and “death with dignity” and sometimes because they were in the throws of a pernicious, torturous depression and contemplating suicide.
And I’ve had too too many clients in the throws of perfectly healthy bereavement processes come to my office simply because no one around them had any willingness or ability to sit and talk and listen about death.
This isn’t just my job, to be able to talk about death. It is everyone’s work. If not yet, soon. If not soon, eventually. We will need to find the words and the capacity to listen and to face our fears for those we love. And for our own sakes.
But believe me most won’t do it until they are forced to. And they will do anything they can to get away from it, using every tactic in the book: denial, avoidance, minimization, magical thinking, victim-blaming, death-denying “power of postive thinking” and sometimes even aggression and just plain rudeness when all else fails.
I’ve watched this phenomenon throughout my mother’s dying – people in stunned silence when I would name what process we were all immersed in. I see it in the face of some (not all) of my new neighbors when they ask how my recent move went – and I tell them bluntly and directly it was actually crazy traumatizing because my mother began dying in the middle of it all.
I watched people I was generally friendly with – who knew what was happening to us, kind people, “normal” people, refuse to name or acknowledge or ask about or incorporate the reality they knew was upon us.
I felt the extraordinary relief when my mother’s hospice workers arrived who knew how to talk this talk. Explicitly. Without beating around bushes.
It is not a hard language to learn, it really isn’t. You just have to be brave and take a deep breath. To refuse to let fear drive you to abandon those you care about.
You just have to say: “I’m glad treatment is going well and I’m sending you all positive thoughts – but if you ever feel frightened I can always listen”
“I’m with you, and right behind you no matter what lies ahead – either way I’m sticking right by you”
“You never need to worry about burdening me – I don’t need to be protected”
“Lets get together and shoot the shit! And if you ever need to talk about the harder parts of all this – my ear is always open”
I don’t love the boilerplate: “Oh, I’m so sorry” – although of course I have used it myself – because I have experienced deaths that I was not sorry about at all. Not one bit. And even when I am sad, the statement makes me feel like an object of pity. Pity offered instead of actual support.
Bereavement and dying processes can be a relief, a liberation, temper tantrum, a trauma, a terror as well as – or instead of – a sorrow. There is no one size fits all response to death. Your experience with death is not mine, and mine is not anyone else’s.
And if you ask “So how are you doing?” with furrowed brows, be prepared to actually listen without requiring that those who are contending with death, in one form or another, confine themselves to your preconceived notions about how they are supposed to feel.
I have a wish that more people could be brave for each other when death emerges on the scene. It is not a conversation that anyone wants to have – but if we fail to have it, we abandon those in our community who are (or might be) dying, in their hour of greatest need. It is so much worse to have to hide it, to press it out of polite conversation, to have it silenced and shushed. To be isolated in it for the lack of anyone willing or able to talk frankly and openly.
We have to learn, and re-learn, as a culture, how to be braver in the face of death. To stare down the primal existentialist dilemma for the sake of each other.
Death isn’t a failure. It isn’t shameful. And it isn’t impolite. It can be frightening but it is a moral imperative to be courageous for those we love and care for.
It isn’t “negative” to discuss death. It is healthy and self-regarding – especially when it is on the table as a potentially imminent event. We need to develop, as a culture and as individuals, a basic literacy about death, to learn death-talk, so that we don’t have to leave people alone in the hard process of preparing to say good bye.
The best sexual education curriculums teach people how to communicate about sex and sexuality. It is vulnerable, frightening, uncomfortable, exposing to talk about sex, yet – we generally understand that it is healthy and necessary to do so. We have no common curriculum to teach lay people about how to talk about death and dying.
We all need to practice forming the words in our mouths, and listening to threatening content. If you are reading this I encourage you to challenge yourself, challenge others. Initiate frank conversations with your parents, your partners, your children, your friends. Learn how to say the words, learn how to name the fears, learn how to move past the terrors – the fear won’t go away, but it needn’t control us. Practice telling others about losses you have survived or are negotiating. Ask others to practice listening. Let other people talk about their losses, their health or lack of it, their fears. Practice being braver so that those immersed in death and dying processes don’t have to protect you on top of all the other hard hard work on their plate.
It will probably always be necessary to have “experts” – hospice workers, thanatologists, chaplains, clergy, psychotherapists who will speak and listen into these conversations, but this work should not be reserved for experts. To live in authentic community with each other, we all need to speak this language.
It is one of the most pervasive manifestations of ableism – the way we refuse to face our discomfort and anxieties and subsequently abandon those who are facing down death and dying. It didn’t use to be this way. This didn’t used to be a professional specialization.
It is one of the shadow-aspects of psychotherapy as a profession: that as these conversations are relegated to the therapist’s office, everyone else gets to abdicate their responsibility to withstand these conversations for themselves. We allow our listening skills and capacity to lay undeveloped and atrophied. We’ve professionalized this conversation so that the rest of us don’t have to face down these anxieties for another’s sake:
“Let me give you my therapist’s card: You really should talk to someone about that.”
Why should people in healthy bereavements need to see psychotherapists at all? Only because no one else thinks it is their job to withstand those fears and listen.
I wish we were more willing to be disturbed for one another’s sake.
I used to be fascinated by mediums and their hokey TV shows, because – cold reading or not, con or no, they could talk openly and frankly about death – which I suspect was as relieving to their clientele as any “message from the beyond” that came forth.
And skeptics mock those who turn to psychics to seek comfort – but really how many spaces exist for those who are being transformed by death and dying ? Mediums, clergy, some psychotherapists, bereavement counselors – Almost everyone else wants to avoid the subject.
And too often the dying can’t even talk to their doctors about it, because doctors are afraid as well.
Such a cruel double bind.
When we don’t let fear control our response – we are rewarded with each other’s intimate company, with presence, with connection and with surprising joys and closeness.
Let’s practice. Let’s get to it. It is the one great universal – it is the single experience that we must all contend with and it has the power to connect us as nothing else can.
Let’s us all take it on as the normal work of life.
Ellie Conant, who I wrote this piece for, died on Jan 1st 2016.
It is a great happiness to me that this post was explicitly helpful to her – she shared it with friends and family to help them talk with her about the realities she faced.
(And I should also mention here, that she mocked me mercilessly when she uncovered my guilty secret: saved episodes of John Edwards and the Long Island Medium)
Part of our job as the survivor of a loved one is to integrate their life lessons, their core values and manifest them in the world. This is grief work.
In that spirit: I am attaching a request to this popular post:
Before her death, Ellie spent time thinking about her legacy, the causes and the people on this planet that she most wanted to support – projects that would serve as extension of her core values and passions. She decided that her memory would be most honored by caring for LGBTQ youth in Korea. With the help of Astraea Lesbian Foundation for Justice we are able to direct donations made in her memory toward a shelter in Korea for LGBTQ youth, as well as other projects.
Please help her extraordinary and nurturing spirit continue to work for change, compassion and liberation in this world.
Please share this post and follow this link to the Astraea donations page, and be sure to indicate that your donation is in memory of Ellie Conant.
Donations will be accepted through June, 2016–both the month of Ellie’s birth and the annual Pride celebration she loved so much. How fitting that we support her in spreading Pride into the world.
Myth has portrayed the rainbow as the highway over which the psyche’s supernal emissaries bring their messages to consciousness. ~ The Book of Symbols: Reflections on Archetypal Images, The Archive for Research in Archetypal Symbolism
The soul-spark, the little wisp of divine light that never burns more brightly than when it has to struggle against the invading darkness. What would the rainbow be were it not limned against the lowering cloud?
~ C. G. Jung, the Structure and Dynamics of the Psyche, On the Nature of the Psyche, 8. General Considerations and Prospects paragraph 430
A dream, not mine (mine will come later). This is Jung’s dream:
Only the gods can walk rainbow bridges in safety; mere mortals fall and meet their death for the rainbow is only a lovely semblance that spans the sky, and not a highway for human beings with bodies. ~ C. G. Jung Psychology and Alchemy pp. 58, Chapter 2, paragraph 69.
I don’t know how to tell this story, or if this story can even be told.
Maybe this is a story of the things that we cling to through dark times, or maybe it is a story of new worlds that emerge from disasters, or it could be a story of omens and portents – or just as legitimately one of superstition and magical thinking. Or maybe it is yet another story about how the psyche and our dreaming life can offer care and consolation. Or maybe it is simply a story written to thank someone for a deeply cherished gift, when I have no other way to demonstrate my gratitude.
Whatever kind of story it is, it starts a long long time ago and I have to reach all the way back to tell it.
Winter, 1988: New York City
I don’t remember much about that visit except that we hadn’t gotten along very well. We were clearly on each other’s nerves the way that only friends in their mid-twenties who have known each other since they were fourteen can. And we didn’t hide it either. I was hanging around with a bunch of Yalies – smoking filter-less cigarettes -and discussing the history of German expressionist film and theater over neat scotch. I could see how disappointed he was in what I had become.
Tommy arrived fashionable and fabulous and ready to go dancing. He wanted to see musicals that I, with my new found pseudo-sophistication, now considered mainstream and pedestrian. He refused to see the subtitled foreign films or performance art pieces that were on my must-see list. (Why didn’t I just get us tickets to see Ludlam in The Ridiculous Theater? That would have been so delicious for us both.) He wanted me to look preppy and middle class instead of depressive and thrift-store revolutionary. He wanted to dress me up so we could go HAVE FUN and meet cute guys.
It was the first time that we had been in the same place without being able to come together. We were 24 years old, totally cocky and completely insufferable. And our life paths were diverging in a way we could never have imagined in high school.
It wasn’t as though we never fought. Rooming together in Los Angeles had not been conflict free. I was a slob – an Oscar to his Felix -and we’d had our share of squabbles about joint finances, household chores and plenty of expressed and unexpressed disapproval of each others’ boyfriends.
Winter, 1984: Los Angeles
We lived in “off campus” housing together. We threw great parties. Tommy would dress me up – find something for me to wear – usually mixing and matching out of my deplorable wardrobe and his. And we would go dancing. He’d sneak me in into the boys town clubs in West Hollywood since I didn’t have a fake id, and he did.
And we would dance – we had been dancing together since we were fourteen – partnered in high school musicals and summer stock. We would go home too late, buzzed and flushed, sweaty and swing by a little bakery in Glendale, grab a carton of cold milk and a bag of warm apple fritters fresh from the oven at 2:00am – and sit in the living room watching old movies licking the sugar off of our fingers until we fell asleep on our thrift store couches.
This is what adults did, we thought.
Later that year Tommy came down with a mysterious fever – Now it would be diagnosed right away – the fever, fatigue and swollen lymph nodes that signal the “primary HIV infection syndrome.” In 1984 we thought it was some weird flu. Or sun poisoning from at day at the beach. I called campus health services – who told us to administer aspirin and Tylenol every hour. I wrapped him in a damp cool sheet – put him in my bed – and sat up all night checking on him.
We planned that if he ever got what was at the time a mysterious “gay disease” that we would empty all the cash out of our savings accounts and we would travel around the world with whatever time he had left.
Summer 1982: Small Town Southern California
We forged our friendship over musical theater: we were “triple threat” actors/singers/dancers and usually paired together like matching salt and pepper shakers. We danced and sang crawling all over each other -completely safe with each other’s bodies with no sexual threat to separate us. I remember sweltering summers – dancing on hard cement getting shin splints while choreographers hollered: – “Again! No! Stop! What are you doing my dear! ?! Again from the beginning!” Tommy would grab me and throw me – spin me and catch me – high up in the air on a tottery platform three feet wide and twelve feet high in the sky and I was never frightened.
He would never drop me. He would never let me fall. It never even entered my mind. I could trust him like my own breath.
Fall 1994: New York City
I had been aware for several years that Tommy’s lifestyle involved more substances than were healthful, especially with his HIV status- that he partied too much and stayed up too late and in general was not caring for his precarious health. He’d reassure me: “I look great!” He’d met (another) really really cute guy, he was making a lot of money, he got a new print modeling contact – he had a cute new studio apartment… I always hung up more worried than comforted by his cheer.
Today on the phone his voice was totally different. He was vulnerable – unraveling – He told me that he missed me – he said he had no other friend like me (he’d never said anything so overtly affectionate or emotional about our friendship and that frightened me even more.)
He asked after my mother – and told me that he wanted me to thank her for him- he’d often thought of her kindness and affection for him – He began crying after a while – panicking. He told me he felt contaminated – “There is something inside my body that is trying to kill me!”
I pleaded with him to get to sufficient medical care – people were surviving now with these new meds, protease inhibitors, why wasn’t he taking them?! – My urgency or directive advice shut him down. His tears cut off, he said he was just being silly and dramatic and he hurried to get off of the phone.
I wish I had listened quietly and better, and maybe told him that I was scared too – that I didn’t want to accept death as a possibility either – I needed him to be in this world with me even if we had grown apart – just to know that he was there – That the thought that he had a fatal illness was almost as intolerable to me as it was to him.
I had no way of knowing that this would be my last and only chance to ever share these feelings with him. I couldn’t know that he would never call me or let me know his whereabouts ever again. I didn’t know that this was my only chance to say goodbye.
Spring, 1996 : New York City
When I received the call informing me that Tommy had died- I couldn’t breathe. Those in our closest circles had not heard from him in too long. The silence told me it was coming – and he had died a only a two weeks before we began to fan out to find news of him. Yet it was still so horrible, inconceivable – I knew many people who have died of this disease – patients, friends, colleagues – and many more who were now surviving. But I always hoped – somehow believed – that Tommy would be exempt – that I simply needed him too much for anything like this to really happen.
For many weeks I carried around an unspoken nonsensical fantasy that Tommy had actually met some handsome older man, fit and wealthy and graying at the temples – who was keeping Tommy in the lifestyle that he aspired to. And that Tommy was just too aware of how judgmental I would be about it to call me. I could almost convince myself that this “death-thing” was a ruse to cover his tracks so the truth wouldn’t be found out.
I comforted myself with the picture of the first moment I met Tommy:
Fall, 1979: Small Town Southern California
We are sophomores in high school – neither of us native Californians. It is an audition/talent show to determine placement in drama classes the first week of school. We are the only people in the room who are not tan. The other boys his age are bigger, hairier and more developed – and he is still a boy – skinny, pale – with freckled skin and graceful fingers. He is wearing a red-checkered shirt like an Italian tablecloth – and a straw cowboy hat. He looks ridiculous. He gets up on stage and I can’t remember what he does – A silly country song? A comic monologue? But I laugh – really hard. Because he is really funny- and I tell him so when he gets off stage near me.
I’m heading up to the stage next to embarrass myself too. I am sick to my stomach stage fright. I start talking loudly into a pretend telephone and I look out in the audience for the boy in the checkered shirt- who’s name I do not know – and he is laughing. Really hard.
The terror dissolves and I am safe.
Sept 13th, 2001 New York City
Three days earlier I had watched, along with millions of other New Yorkers, 3,000 people burn to ashes in front of my eyes. I ran straightaway to a hospital where my husband worked, and volunteered there for the day at the hospital gates – as thousands and thousands of people queued up – to ask about missing friends and family members. I cross checked the names of the missing with a single sheet which listed maybe seventeen names attached to a clip board, a shockingly short list of ER admissions considering the scope what we had all just witnessed. It was unfathomable to consider, that soon after the collapse, that so many thousands had disappeared into smoke and dust. The world had flipped upside down since breakfast. It was only just past noon. I told every single searcher that their loved one was had not been admitted. And the crowd continued on in shock, in single file, winding their way further uptown, toward the next hospital.
Pliny said that the rainbow foretold a heavy winter or a war. ~ Funk & Wagnalls Standard Dictionary of Folklore, Mythology, and Legend
When cell phone signals were rerouted away from the great shattered antennae, and the phones began working again, I called my psychotherapy clients, those who worked or lived downtown first: A teenager whose elderly frail father worked in the courthouse, a child whose non-custodial father owned a business on the subway level of the trade center, a woman who had just started a new job in the financial district. Along with every other New Yorker who lived downtown, I tried to ignore the relentless un-ignorable smell, a stench that would persist for months – the smell of burning jet fuel and melting iron, the smell of flesh and death and shattered glass that hung in the sky, a bright orange haze at sunset, covering everything with a layer of glass twinkling dust and ash.
Tibetean Buddhism speaks of the rainbow body – in which the body dissolves in rainbow colored light – leaving only hair and nails behind.” ~ The Book of Symbols: Reflections on Archetypal Images, The Archive for Research in Archetypal Symbolism
So now, three nights after the attack, after seeing what clients I could in this upside down world – I put on the stereo and stretched out on the living room floor as the sun set and I began to dream:
I am matronly, white haired, in my 50’s living in a large old house, with a porch and a garden out front. I am still married to David, still a psychotherapist. I am a mother of a teenage boy, although I only see his dark head passing by in the periphery.
I am myself – but more so. There is an ease about me that is elusive to me at the age of 37. I am plumper, softer. The sharp and brittle aspects of my personality have been worn down and burned away. I am mellowed, wiser maybe than I have known myself to be.
I answer the doorbell and I see Tommy is visiting, who has been dead for the past five years. The realizations about mellowing and settling in to myself are recognizable to me only when Tommy comes in. I feel these things as he sees them in me.
I am initially nervous about how he will view my corny, Quakerly life. But he is not bored, or disappointed or contemptuous I can’t stop hugging him – even though I know he still not the “huggy” type – it has been so long since I have seen him. And although I know he is dead, this visit feels vivid, crystalline, more real than waking life. I grab his arm. I sit next to him on the couch. I am aware that this can only be a brief visit. He can only stay for an afternoon.
He is still goofy and hilarious. Mugging and wearing a foolish hat for effect. He’s still fussy about clothes and accessories, still cruising for cute guys, still full of hedonistic hankerings. But in the dream his appetites and love of pleasure are not self-destructive but relieving, refreshing life-affirming.
In dream-time I am now many years older than he is, more settled down and my capacity for abandoning myself to play has grown rusty. But being near him makes me laugh harder than I have in a long time, tears streaming down my face, gasping for the next breath. I relish my food and drink more, feel more beautiful, more alive.
He seems happier, more grounded and giving, more empathic and more whole since his death. He is more sensitive to his own sadness, and the sadness of others.
He tells me he has made us an appointment for a manicure. I resist and tell him I have never had a manicure in my life and moreover I have never wanted a manicure. He drags me off to the salon anyway: “A manicure WILL make you feel better.” I’m overwhelmed with love and gratitude for the effort he has made throughout this visit.
I sense his loneliness. And I know, although he doesn’t say it, that he didn’t come only for me – but because the bridge between the living and the dead has opened wide as thousands of souls walk across it – and he came over to comfort himself a little too.
I relish his visit I feel loved as we can only in the presence of our oldest friends – relieved – and then he is gone….
A big dream. An unforgettable dream. A dream that feels more real that waking life. A dream that persists and is carried in my heart for years and years, that I return to, that I share with others who also grieved his loss. A dream I recount to my mother, who also loved this young man and had supported him through his tumultuous coming-out processes and had celebrated him and watched him grow.
A dream, that in my more superstitious moments, made me wonder what linked this projected future to the days following September 11th? Was it a warning? What would happen when I was 50? Would the road of the dead open wide again when I reached the life-stage shown to me in the dream? A disaster? My own death?
Or was the function of the dream to comfort me? To show me myself as I hoped to be one day, in a life I had not yet begun to imagine for myself: – A mother, living more gently, with a garden, in an old house away from the city?
A dream that I would return to over and over and wonder about as my future unfolds – as I grow white-haired, and plumper. As I become an adoptive parent to a dark haired boy.
A dream that comforts and guides me for decades about who I have the potential to become – as life chips away at my brittle bits, and breaks the sharp edges off of my capacity for self-righteousness and petty bitchiness. A dream that teaches me something ineffable about death and mourning and the connections we can sustain with a lost-life that we have cherished. A glimpse of the treasure that might await me at the other end of the rainbow.
A daughter joins the family.
My practice grows.
My marriage deepens.
Friendships emerge and recede, new ones blossom.
Family members and friends die and are mourned.
My mother joins us in the city, increasingly disabled and fragile.
I watch my dark headed children out-grow our city lives.
“Like two trout in a goldfish bowl.” my husband says.
We find a home outside of the city – an old house with a porch for my husband and a garden for me, a climbing tree for my daughter, a work-shop for my son, an accessible and private space to convert into an apartment for Grandma.
And the greatest luxury for a die-hard New Yorker: bathrooms for all.
We prepare to leave the city we have called home for thirty years
April 4, 2015
Tommy visits while I sleep again, and although I dream of him often, this dream has the weight and stunning clarity of his earlier visit:
I am looking through a lens or viewfinder. Zooming through a fancy lobby – of a hotel or an office building. There are large signs pointing to what is ahead and I ignore them. I am certain I know where I am headed. The viewer travels toward annex off to the east – it opens into a small – tiny amphitheater- behind the stage is a river, and deep valleys.
When I reach the stage Tommy is performing. He is singing a lovely, well-rehearsed number – at first I think it is “Over the Rainbow” but I realize that it is a different but similar song “Look to the Rainbow.”
“On the day I was born, said my father said he,
I’ve an elegant legacy waiting for ye
‘Tis a rhyme for your lips, and a song for your heart
To sing it whenever the world falls apart…
Look, look, look to the rainbow,
Follow it over the hill and stream.
Look, Look, look to the rainbow.
Follow the fellow who follows a dream.
So I bundled my heart, and I roamed the world free,
To the East with the lark, to the West with the sea.
And I searched all the earth, and I scanned all the skies
And I found it at last in my own true love’s eyes.
Follow the fellow, follow the fellow
Follow the fellow who follows a dream.”
He was a good singer in life, I think to myself, but better since death, his voice fuller. And something about the song, which I’ve always though of as trite is suddenly moving and lovely, haunting.
I tell the woman sitting next to me that I have seen this before. It is one of my favorites. I tell her that this performance runs perpetually.
Tommy finishes the song and says “This is a important song to listen to and contemplate when you can’t find any comfort around you and you need to pull inward.”
Tommy’s performance is over but he is still nearby –and I recall the specific sensation of waiting and milling around backstage for someone after the show to emerge from the dressing room. The woman next to me tells me categorically that Tommy is dead. I become enraged at her: “Of course he is dead, but he is not ‘dead’ at all in the way you think. I can “tune into” him anytime I like. I can TALK to him ANYTIME I LIKE and I DO, and I tell her that it is not in anyway her place to tell me anything at all about my ongoing relationship with my oldest friend whether he is dead or not.
I carried the dream and the song around inside of me for several weeks – like a smooth cool stone in my pocket, a worry bead, turning it over and over – even though I couldn’t know what was coming, or how much comfort I would need in the weeks and months ahead.
“A rainbow is to be used as a bridge. But one must go under it, and not over it. Whoever goes over it will fall and be killed.” ~ C. G. Jung Psychology and Alchemy pp. 58, Chapter 2, paragraph 69.
A house for sale.
Packing up our home, my children’s lives, my mother’s home.
A move to transitional, temporary quarters.
For the Arawak of South America: When (a rainbow) appears on land it is an evil spirit searching for a victim. ~ Funk & Wagnalls Standard Dictionary of Folklore, Mythology, and Legend
My mother’s rapidly and violently collapsing health
The horror of a terminal diagnosis.
Coordinating care, battling doctors,
Refusing nonsensical and contraindicated procedures,
Preparing for end of school and end of life.
Managing hospice care and final family visits,
Morphine, vomit and shit,
Sleeplessness, fear, exhaustion,
Relentless panic at the intensity and volume of the tasks ahead of me,
Resistance and rage,
Primitive denial and collusion,
Securing medical and end of life support in a new state, a new community
Frustration and tantrums,
Hypervigilance and unfathomable overwhelm.
Doctors incapable of naming the truth, death, that is staring us in the face.
Insufficient insurance and financial anxiety,
Obstacles to basic care.
And the grief of children: as they leave the only home, friendships, and community they have ever known, as they complete their diorama’s and year end projects on Viking ships and the Norse Gods, their grandmother will die away a little each day as we are all sucked up in a spinning cyclone.
They will lose almost everything at once.
Except us. Except each other.
Among the Semang of Malays the places where a rainbow touches earth are unhealthy. ~ Funk & Wagnalls Standard Dictionary of Folklore, Mythology, and Legend
And their Imo, a cherished chosen auntie/sister, a woman who selflessly and lovingly helped to care for my mother during an earlier phase of illness and disability would discover that she too was contending with her own difficult to diagnose, hard to treat cancer.
And while this all unfolds we must close on an old house and a new one, put our belonging in storage, tour new schools, interview babysitters, pay the bills, and act like psychotherapists.
Our household will be strained beyond anything we have ever known.
The bridge collapses under the destructive weight of the giants – and the gods are unable to preserve it ~ John Lindow, Norse Mythology; a Guide to the Gods, Heroes, Rituals and Beliefs
I will encounter my own limitations and my insufficiency on every front: as I face down the impossibility of caring for my children, my parent, my friends and my clients. I will spend most of my time trying not to feel wholly failed as a mother, a daughter, a friend, a psychotherapist as I stumble and stagger from one challenge, trauma, crisis, grief to another. I must contend with my utter finiteness through this whirlwind of crisis– attempting to address all these needs, and leave profound needs, all around me, unfulfilled or overlooked.
Including my own.
And I will try, usually unsuccessfully, not to tear myself apart about the things I cannot do.
Underneath the rainbow I’ll peel away my skin
And when I’m done with peeling I’ll let you back in,
Somewhere under the Rainbow.
Underneath the black clouds
There’s sunshine on my floor
And with my nails I’m peeling it
To use it for my skin
~ Somewhere under the Rainbow lyrics – Stephen Jones
When you pass underneath the rainbow everything you have ever come to know about yourself and the world around you will be challenged.
“In Europe it is believed anyone passing under a rainbow will be transformed, man into woman, woman into man.” ~ Funk & Wagnalls Standard Dictionary of Folklore, Mythology, and Legend
I am consumed. I cry and rail and fret at the relentlessness of if all. I don’t know how to do this much, for so many people, for so long, on top of all of my own core-maternal-conflicts – my mother, my motherhood, my children, my childhood.
As a psychotherapist: I am cancelling appointments as medical realities and legal, contractual demands shift on a dime, with little notice. I am logistically less reliable than I have ever been before. I am noticeably exhausted. My bandwidth is narrow. My energies for penetrating interpretations are limited.
But: the hours that I spend in my office are the sweetest and most relieving – I have no decisions to make. I must do nothing but sit and be present for the people who have come to me. I am stripped of anything superfluous. AlI have to give is my time and my presence. I can do that. That is all I can do. I can care, and listen, and breathe and nod, and remember. That is it. I can go on being, with and for my therapeutic partners. And nothing else. Nothing extra.
There is nothing else.
Some clients feel abandoned. Some are enraged. Some feel fearful or annoyed. Some worry about me. Some ask. Some don’t. Some are patient, cutting me a break, and others can cut me no slack at all without harming themselves. Some I tell. Some I protect. Some I don’t trust, and with others we are intimate enough that I don’t trust myself to name what is occurring to me in a detached, processed way. Most offer me an escape into a world of stories that are not my own, that relieve me and give me solace from the mountain of impossibilities and unknowables that flood my own life.
I am hanging on to each moment with white knuckles. Every minute of every day I must negotiate the simultaneous pressures to fall to pieces and to function at the peak of my capacities.
I may have ignored the early signs but in just a few weeks the meaning of the dream had become crystal clear: I would have to sing myself some internal consolation while the world fell apart.
I download Dinah Washington singing Look to the Rainbow and listen to it, or sing it to myself in an endless loop – as I move and work, and change soiled linens and pack and un-pack boxes, and coordinate care and contact care managers and evaluate our finances and try to figure out what to do if she collapses into total medical dependency sooner than we think, or lives longer than we are prepared for needing more care than we can provide or afford.
I am simultaneously my best and my worst at all times. But I know that what offers me the greatest comfort is to be in authentic relationship. It is the deepest comfort I know- whatever I can or cannot do for my mother, my children, my clients I can at least keep my heart wide open – and thankfully, it is also what is most required of me.
The second I step out of the office and back into life, or am pulled out by an emergency: I am humming, or singing to myself, or listening to Dinah:
“So I bundled my heart, and I roamed the world free,
To the East with the lark, to the West with the sea…”
Rainbows are bridges between this world and the next.
In Norse mythology, the rainbow is Bilröst, or AEsir-bridge: separating and connecting the “world of humans and the world of the gods or between earth and heaven” ~ John Lindo. Norse Mythology: a Guide to the Gods, Heroes, Rituals and Beliefs
In the Prosaic Edda the rainbow bridge makes the “best of” list – it is the very “best of bridges”:
Asked about the path to heaven from earth, H’ar tells Gylfi/Gangleri that it is made Bilröst, that the gods made it, and that it may be called the rainbow… it is very strong, and made with great skill and knowledge but it will break wheh the sons of Muspell (Giants) ride over it. Nothing can survive the harrying of the sons of Muspell, and describing the end of times, Ragnarök, Bilröst will break.~ John Lindo. Norse Mythology: a Guide to the Gods, Heroes, Rituals and Beliefs
I am reminded of these mythic tales by my kids – as we work together in in our temporary, transitional housing – as one lifetime collapses out from under us and we fling ourselves blindly toward a new world – as I help construct Viking ships of balsa wood and proof-read school reports on Rangarök, the end of times.
The rainbow is a potent, burning transitional place – a shimmering fiery Third created at the intersection of two distinct realities, two disparate worlds.
A synthetic Hegelian Third perhaps, or if you prefer, a vibrant manifestation of Winnicottian transitional phenomena.
For Winnicott transitional phenomena are first seen in early infancy, in our first attempts to self-soothe – by sucking our thumbs, by ruthlessly loving a blankie or teddy bear. Or by singing ourselves songs:
An infant’s babbling and the way in which an older child goes over a repertory of songs and tunes while preparing for sleep come within the intermediate area as transitional phenomena. ~ D. W. Winnicott, Playing and Reality, pp 2 Chapter 1 Transitional Objects and Transitional Phenomena
Winnicott is not particularly interested in the object itself -but in the ways that we instinctively use such transitional objects – as a bridge – to transcend the empty space between the absent omnipotent Comforter and our small, finite distressed selves.
Transitional phenomena lead us to a third space: “an intermediate area of experiencing, to which inner reality and external life both contribute. It is an area that is not challenged, because no claim is made on its behalf except that is shall exists as a resting-place for the individual engaged in the perpetual human task of keeping inner and outer reality separate yet interrelated. – D. W. Winnicott, Playing and Reality, pp 2
~ D. W. Winnicott, Playing and Reality , Chapter 1 Transitional Objects and Transitional Phenomena, Figure 2
The Brihadaranyaka Upanishad articulates a similar construct:
There are two states for man – the state in this world, and the state in the next; there is also a third state, the state intermediate between those two which can be likened to a dream. While in the intermediate state a man experiences both the other states, that in this world, and that in the next.
In some form or another most of us rely upon transitional phenomena throughout our lives. Dreams and creative processes are in themselves a transitional phenomena, as is psychotherapy. They simultaneously rise up from within us, but they feel as though they exist outside of us as well. Transitional phenomena bridge the gulf between worlds – between our unconscious selves and consciousness, between brain and mind, between this world and the next, between past and present.
Dreams, and songs and rainbows (and teddy bears and blankies and all other transitional phenomena) are objects of a certain kind – objects which seem to our perceptions to almost have autonomy from our will, some inherent agency.
“It must seem… to give warmth, or to move, or to have texture or to do something that seems to show it has a vitality of its own” ~ D. W. Winnicott, Playing and Reality , Chapter 1 Transitional Objects and TransitionalPhenomena, pp, 5
Was the song I was given as a transitional object a gift from my own psyche? Or a message from a friend long dead? Was I merely processing some subtle intuitive awareness of my mother’s impending deterioration and death by focusing instead on the death of a childhood friend?
Was the dream that produced the song an external or an internal event? A subjective experience or objective reality?
This is exactly the paradoxical nature of transitional phenomena. The rainbow is a bridge that is simultaneously substantial and insubstantial. Transitional phenomena are Both/And, not Either/Or.
So, I don’t concern myself with whether or not Tommy came to visit, with whether or not my psyche dredged up the lyrics of an old Broadway musical I had once danced in when I was young,
I only know that it offered powerful consolation during a protracted period of labor and distress.
“Should an adult make claims on us for our acceptance of the objectivity of his subjective phenomena we discern or diagnose madness. If, however, the adult can manage to enjoy the personal intermediate area without making claims, then we can acknowledge our own corresponding intermediate areas, and are pleased to find a degree of overlapping, that is to say common experience between members of a group in art, or religion or philosophy. ~ D. W. Winnicott, Playing and Reality pp 14
I make no such claims, and find such claims – in either direction – to interpret such experiences as merely subjective or merely objective to miss the point entirely, sucking away the mystery and consolation of transitional phenomena.
Jung resisted making such claims as well and interpreted his own dream of the destruction of mortals upon the rainbow bridge as reminder to remain humble and grounded in the face of seemingly “spiritual” experiences:
We should not rise above the earth with the aid of “spiritual” intuitions and run away from hard reality, as so often happens with people who have brilliant intuitions. We can never reach the level of our intuitions and should therefore not identify ourselves with them. Only the gods can pass over the rainbow bridge: mortal men must stick to the earth and are subject to its laws. ~ C. G. Jung Psychology and Alchemy pp. 114, Chapter 3, paragraph 148.
This June, at age 51, a white haired, softer, plumper, me, a mother to two dark-headed tweens, moved into a large old house with a porch and a garden out front.
A few weeks later my mother peacefully, with great consciousness, acceptance and clarity crossed over the bridge that the rest of us had passed under.
Now may it not be that, under certain conditions, something quite new, different from anything that one knows, may come over the mental horizon, something as dazzling and splendid as a rainbow…? ~ C. G. Jung, Symbols of Transformation, Appendix The Miller Fantasies
And the very next day, the Supreme Court of the United States declared the Defense of Marriage Act unconstitutional and the world, as I knew it, exploded in celebration of legitimized enfranchised love – a day that Tommy, who had contracted HIV at the peak of the AIDS crisis under a president who ignored tens of thousands of deaths for six years before mentioning the word AIDS in public – could certainly never have imagined. A day where he would have been present in my heart and in my thoughts even if he had never sung to me in my sleep.
…Follow the fellow, follow the fellow.
Follow the fellow who follows a dream…
A day of uncanny consolation as I walked through a world that was suddenly (and would remain so for weeks) completely enveloped in rainbows.
And I am for ever changed by the labors of those who have traversed the road of the dead in both directions and grateful to my oldest, dearest friend for sending over a gift of such unsurpassing love and comfort.
~ Look to The Rainbow, from Finnian’s Rainbow, Lyrics by E.Y. Harburg
We are all breakable. Or maybe it is more accurate to say, we are all broken, each in our own way.
And our attachments to each other are no less fragile.
They can be broken outright and permanently.
Humpty Dumpty sat on a wall,
Humpty Dumpty had a great fall;
All the King’s horses, and all the King’s men
Cannot put Humpty Dumpty together again.
Therapeutic alliances can fail, collapse under their own weight. Sometimes the death of a clinical relationship happens so slowly that it is imperceptible – the poison, so diluted accumulates incrementally, so neither therapist nor client can detect it until the connection has withered away. Hopeful attatchment shriveled into something dry, thin, brittle.
Other times therapeutic relationships can erupt, explode – felled by a single, violent event.
A therapist can destroy relationship out of their own limitations, unprocessed injuries, or simply because they are knocked off their pins by events in their own lives.
Sometimes therapeutic relationships are completely devoured by a client’s insatiable hunger that no psychotherapist can ever (nor should they attempt to) fill. And sometimes it is because the therapist sat back and didn’t try and they should have at least tried and failed. Or because they tried too hard, foolishly, and frustratingly when they should have left well-enough alone.
I do not like thee, Doctor Fell;
The reason why I cannot tell;
But this I know, and know full well,
I do not like thee, Doctor Fell!
Sometimes you can make sense of it all later – and sometimes it will never ever make any fucking sense at all.
In Restoration of the Self Heinz Kohut asks: “Why does one layer become actively engaged in the therapeutic work, while the other sinks into darkness and remains out of sight? ”
When I first began this work, as a therapist on an outpatient day treatment unit for adults, most of whom were diagnosed with schizophrenia by psychiatrists, I had a dream, that still makes me hold my breath when I recall it.
A kind, twinkly, toothless older woman, who who I believed I had a warm, amiable alliance with knocked on my apartment door. I greeted her happily, and began following her down the apartment stairs. At the next floor landing she turned to face me – and I saw a look in her eye that terrified me: She had no idea who I was. No understanding or trust, or even memory of who I was at all. Her look was suspicious, paranoid, rage-full – I saw that I had somehow, without realizing it – become her enemy. My intentions, my labors on her behalf, the real and positive effects that had come from our work together – a new and supportive living situation, a lowered medication regimen, a romantic partnership that was stabilizing and growing sweeter – all lost – entirely. Deleted. Erased.
Horrified, I realized within the dream, that not only was she unable to retain a consistent sense of who I was – but that she was also unrecognizable to me. Perhaps that she was even unrecognizable to herself. She was not at all who I had understood her to be, and our relationship had instantly dissolved because we could not now comprehend who the person was in front of us.
In waking life our relationship remained stable enough – but I’ve seen, over the course of my work on that unit, in this field, in my own therapy and in my life – this dream play out many times, as repressed, or minimized shadows suddenly race forward from the far horizon to the looming foreground.
The shadow relationship – the one that lives on the other side of the looking glass – can reach through, can take over. And then the relationship you thought you were in seems to disappear entirely, and often over a trifle.
Molly, my sister and I fell out,
And what do you think it was all about?
She loved coffee and I loved tea,
And that was the reason we couldn’t agree.
The greater our hope that we will never be disappointed the more assuredly we will be. The more we yearn for someone to be All Things, Abundant, Unlimited, the more injured we will be by their inevitable failures.
Psychoanalytic theorists might talk at this juncture about lack of “object constancy” – as the child struggles to keep the depth and force of their hate from contaminating their admiration and love of the parent.
Winnicot might talk about the “good enough” parent needing to engage in a commensurate process in order to metabolize and guard the child and themselves from their maternal hate. A primal hate called forth by the depth of the infant’s hate and frustration.
When the force of our hate has not been metabolized and modulated – we fear that our hate and sadism could:
– annihilate our loved ones
– destroy their love for us
– or ruin our own ability to love them anymore.
So often (but not always) a client’s attempts to destroy the therapeutic relationship are pre-emptive strikes – attempts to drive the therapist away – rather than wait to be abandoned or injured when they are unprepared.
But that is not always the case.
Clients may be trapped within an obedient, compliant, pseudo-alliance. And then lashing out may be healthy: self-respecting emotional violence. Rage, aimed squarely at the therapist, may be the most authentic gesture they can muster.
And sometimes clients know, better than we do, exactly what they need to survive or heal –
and it is not us.
And the only way they can sever the weighty attachment and the unrelenting pressure of your good intention is to break it off,
to break you off, to break you into pieces.
There was a little girl who had a little curl
Right in the middle of her forehead;
When she was good, she was very, very good,
And when she was bad she was horrid.
In Kohut’s words: “While a rapport between patient and therapist may be established, the diseased, or potentially diseased sector of the self does not enter” into the therapeutic relationship. ~ Heinz Kohut, Restoration of Self
Sometimes hatred and sadism are unleashed upon the therapist because it is the first real relationship where it is safe to do so – rage and destructiveness cannot be calibrated or modulated without someone to be injured, to survive the injury, to forgive and to accept reparation.
You tolerate your client’s illogicality, unreliability, suspicion, muddle, fecklessness, meanness, etc. etc., and recognize all these unpleasantnesses as symptoms of distress (In private life these same things would make you keep at a distance.) ~ D. W. Winnicott, The Maturational Processes and the Facilitating Environment: Studies in the Theory of Emotional Development
And lets face it. Sometimes we just deserve it. Certainly, we all know that psychotherapists can be totally fucking insufferable. But hopefully not always unforgivably so.
But still, there are many instances where you are damned if you do, damned if you don’t. Absorbing, deflecting, reflecting upon, and attempting to survive hurtful, destructive rage is unavoidable as a psychotherapist because unmodulated, rage is often, precisely what has brought the client into therapy to begin with – expressed as dysfunction in relationships, or internalized and disguised as nihilistic, suicidal despair.
A client’s rage can activate our own – just as maternal hate can be triggered by a child’s rage.
There were once two cats of Kilkenny.
Each thought there was one cat too many;
So they fought and they fit,
And they scratched and they bit,
Till, excepting their nails,
And the tips of their tails,
Instead of two cats, there weren’t any.
It is then that the psychotherapists job is to buckle up, hang on for dear life, try not to defend or retaliate – absorb the blow, protect ourselves against the sharp bite, become curious about the cutting contempt, or go home and have a good cry and try to put ourselves back together again so that we can return to session ready to connect again, to sort out abuse from necessary corrective experiences, sadism from developmental maturational process, angry breakthroughs from pointless, relationship destroying temper-tantrums.
You accept hate, and meet it with strength rather than revenge. ~ D. W. Winnicott, The Maturational Processes and the Facilitating Environment: Studies in the Theory of Emotional Development
It is not easily done. And often you rotate though a series of attempts at empathic guesses, hunches, theories and formulations before you find the one that might transform destructiveness into connection.
If you can find the one that fits. Before the relationship breaks.
Before the client breaks. Before you break.
Before your capacity for on going concern is broken. Before their faith in you is lost for good.
But none of this teaches therapists what it feels like:
I pull over into a roadside attraction. There is a large hand painted sign, of a wolf with a vicious mouth – dramatic “all the better to eat you with” teeth, and the words: SWIM WITH WOLVES. The doors open on to a large indoor pool, where a pack of wolves are swimming like a school of fish. There are “experienced guides” overseeing the experience but they do not actually get in the pool with you – and as I inch into the deep end I realize that they will be of little use if this actually starts to head south. I wonder what I am doing, and why the hell I am doing it. But the wolves are wild and gorgeous, and I am drawn into the waters by their fear, their vulnerability, (they are profoundly out of their element after all) by their beauty, and power and by their exhaustion as they swim and swim in circles. I am concerned for them, I want to help to keep the wolves afloat. I want to be near them, to be accepted by them, trusted. Do I want to tame them? Not necessarily, but I surely want be seen as their ally. I swim in deep. One, so exhausted it is near drowning, lets me hold it afloat while it gasps for breath and takes in oxygen. Yet, I must also be skillful enough to let go the split second that the wolf regains its full energies – because I am supporting it before it can possibly have any reason to actually trust me. I smell its hot breath, I feel a low growl gathering deep in its belly I feel its dog-paddling legs gather strength and I swim away before it can go for my jugular. I hear it SNAP just milliseconds after I have kicked toward the far side of the pool. I look at the old, white-haired, experienced guides – who are gathered drinking coffee and see that they are all scarred, and have survived many deep and tearing bites. It is part and parcel of the work.
I get out of the pool, exhilarated to have been of use, to have been close to such an extraordinary creature, grateful that the wolf, and I have both survived.
Therapists can be seduced by the client’s idealization – or by the therapists own inflation and narcissism in to enjoying their own prowess and brilliant interpretations – We can over identify, assume that we understand what we do not, we can wander, unwittingly into a minefield – believing the relationship is on solid ground when it is not.
A wise old owl sat in an oak,
The more he heard, the less he spoke;
The less he spoke, the more he heard;
Why aren’t we all like that wise old bird.
As clients we can come to believe that we need to find therapists who are perfect mirrors of ourselves, and therapists can also attempt to cull clients who are the very easiest for them to treat.
Birds of a feather flock together,
And so will pigs and swine;
Rats and mice will have their choice,
And so will I have mine.
But are psychotherapists really fulfilling our moral commitments , are we truly engaged in the work if we restrict ourselves to the most domesticated and shallow end of the pool?
It is the therapists job to pace themselves – to alternately invest and divest – step in and step-back – in order to preserve their empathy for their client over the long haul. To do all they can make sure that resentment never accumulates or toxifies in any way that could undermine their ability to continue to empathize with the client’s experience.
But not every relationship makes it that far, and some last for years and still end before they have begun.
In all these respects you are, in your limited professional area, a person deeply involved in feeling, yet at the same time detached, in that you know that you have no responsibility for the client’s illness, and you know the limits of your powers…..” ~ D. W. Winnicott, The Maturational Processes and the Facilitating Environment: Studies in the Theory of Emotional Development
For every evil under the sun
There is a remedy or there is none.
If there be one, seek till you find it;
If there be none, never mind it.
Never mind it?
Maybe. One day.
But not anytime soon.
DEATH be not proud, though some have called thee
Mighty and dreadful, for, thou art not so.
~ John Donne, from The Holy Sonnets, Death Be Not Proud
When I met my husband, his mother had been dead for four months. After a short time, he took me to meet his father, and to see the home that he had grown up in, the home that he had moved back into during the the last year of his mother’s life.
When he opened the door, and I stepped into the foyer, I had the sensation that comes when you walk into a room that someone else has just left seconds before. A palpable electromagnetic wake – the air molecules moving in eddies behind some recent but unknown activity. A purse plopped in the chair near the door. A gum wrapper folded neatly and placed in a decorative dish. A sweater with a tissue peeking out of the pocket slung over the arm of the couch in the living room. She was still there. Her presence, in her absence, remained everywhere, in every nook and cranny of the house.
For, those, whom thou think’st, thou dost overthrow,
Die not, poor death, nor yet canst thou kill me.
~ John Donne, from The Holy Sonnets, Death Be Not Proud
A cook book with a page booked marked in the kitchen. A paperback novel, its spine cracked, pages splayed faced down on the coffee table.
It would be several more months after that, long enough for our relationship to consolidate, and for me to understand more about the family’s grieving process, before I would ask David and his father politely and tentatively, if it would be helpful to them in anyway, for me to pack up her things. Yes, they said, it would be very helpful. They were clearly emotionally and logistically at a loss.
When his father was away for the weekend – I spent two full days boxing up a woman’s life while David hid out, painting and listening to Frank Sinatra on the radio up in the small spare bedroom that had been set up as a studio. He had worked hard enough trying to support her through a long and painful dying process.
I began on the lower floors, collecting the objects that were most obvious to me whenever I entered the house. Her purse. Her coats, scarves, mittens and hats. The minty scent of her purse and the perfume lingering on her scarves and coat collar were the first visceral initiation into the profoundly intimate act that I had undertaken.
After gathering the downstairs items, I took them upstairs to set up base-camp, assembling cardboard wardrobes and packing boxes in her bedroom. I opened her closet doors, and discovered her sense of style, her clothes and shoes. I saw that she kept her things carefully and in good condition and had thrown nothing out for many many years – dresses from the 1950’s, 60’s 70’s and 80’s hung throughout the closet, all in the exact same size. She was long, slim, tall, small-breasted, large footed. Her shoes were comfortable and expensive. She wore dresses primarily. Some slacks, but not so many. No blue jeans. Her smell grew stronger, more personal, closer to her skin as I sorted through the clothes.
She liked bright colors, nice textiles, weavings, hand knitted sweaters, clothing embellished with folk lace-work, needlework and embroidery from every culture and tradition. She had formal wear and cocktail wear that was clearly required by her life and her husband’s life in academia – but most of her clothing was beautiful, simple, comfortable, useful, special, one of a kind. No designer labels. Nothing frilly. Never fancy.
Her wardrobe and everyday jewelry showed signs of her Czech-Hungarian upbringing, her familiarity with Europe, the many languages that she spoke, as well as her extensive world travels and time spent living in Israel, in China. Pieces of tile, or hand made ceramics set in silver or mounted as pins.
And collections. Never just one of anything but many: a drawer filled with embroidered handkerchiefs, chests and closets in every room filled with hand woven fine fabrics and textiles. Hand hewn wooden bowls, baskets filled with delicately painted eggs from all over the world, another with hand made painted tops, another with ceramic mushrooms. A box filled with hundreds of carefully wrapped tiny blown-glass animals. Decorative boxes everywhere, painted, or carved, or upholstered in silk – one filled to the top with jade rings in every size. Another with tiny turquoise pins.
I threw nothing away. I placed items that might not want to be saved or given away, in their own marked boxes for her sons and husband to look through for themselves. In this box I placed her tooth and hair brushes, make up lotions, perfumes, powder deodorant, razors and tweezers. The pill bottles from her long sickness. Her under-the-sink-things, her feminine hygiene products, her underwear, slips, socks, bras and panty hose.
I was told to set anything aside that I might want to keep for myself: I selected some textiles and scarves, a yellow linen dress with flowers embroidered around the yoke, a terry cloth housecoat from the 1950’s that was in the back of the closet and had clearly not been worn much at all and not in many years. A short black dress, with a white satin collar and cuffs, also from the late 1960’s, a blue and aqua hand knitted cardigan that fit me perfectly, and that I knew from her basket of yarn and the buttons in her immaculately organized Swedish sewing table that she had knitted herself. They offered me her 1947 Singer Featherweight 221 sewing machine, which is, to this day, my most prized possession.
As the intimacy of these items and this act revealed itself to me, I realized that although I had begun these labors to support those who were grieving: David, his father, I was really doing it for her. This thoughtful meticulous dignified woman, never met, who would have wanted her things collected, regarded, distributed, sorted, as thoughtfully and carefully as she had selected and tended to them in life. Who would have wanted to protect her family from the overwhelm and sorrow of packing her life away.
I imagined who I would want to wrap up my my unfinished business one day, and how I would want them to tend to it.
There is always an aftermath.
And although I do not believe that grief should be pathologized as a diagnosis or a medical condition, there is no psychotherapist who does not contend with the life-long implications of death or the processes of bereavement in some form every single day.
Memories of a weekend spent with the personal effects of the dead woman who would one day become my mother-in-law, are activated whenever I find myself professionally involved in the shockingly intimate processes of supporting people as they mourn the death of people that I have never met. And my mother-in-law’s specter spurs me, as it did that long ago weekend, to remember that in order to support the bereaved, we must, on some level enter into an internal relationship to the deceased ourselves, to understand who they were, to clean up the mess and the grief, to contain the emptiness and tie up the loose ends left behind with the living.
Over the years I’ve sat with parents grieving children, and children grieving the loss of parents, sometimes both at once. Adoptees mourning the death notices of first family members never met. I’ve listened to the unfolding evolving eulogies of siblings, grandparents, extended family, partners, best friends, classmates, chosen family, colleagues, neighbors, acquaintances, friends of friends.
And soonest our best men with thee do go,
Rest of their bones, and souls delivery.
~ John Donne, from The Holy Sonnets, Death Be Not Proud
We can mourn total strangers too. Death impacts many people who may not ever know the names of those they mourn: eye-witnesses, doctors, nurses, soldiers, first-responders and psychotherapists can be changed forever by intimacies with those who have left their bodies behind.
I hear these sorrows and traumas too.
And although I remain firmly agnostic about such things – I have on more than one occasion had the sensation that the dead have led a client to my office, so I would care for the the good and bad, light and shadow, that they have left behind in the hearts of others.
And as I support the bereaved, I inevitably wonder: What would the deceased wishes be – how should they, would they have wanted the person in front of me cared for? How would they respond if they were here to witness what I am seeing? How would this client’s mother want me to deal with the rage and pain her death has left behind? How would that dead man want his son treated? How would a deceased husband respond to his wife’s relief at his passing? What might that young woman feel if she saw how her brother suffered after her overdose? How would the dead want me to understand them through the things they have left behind? How would their best-self – or their worst, most-defensive aspects – respond to their survivor’s anger, betrayal, relief, sorrow, terror, pain?
I don’t work from a distance. I frankly don’t know how to – the only way I know to support those grieving and bereaved is to try to learn about the size, shape and feel of their loss as specifically as possible. To use my heart and imagination to understand as much as I can about the person being mourned. To sit with those who mourn by entering into relationship with the dead myself. To allow myself to be affected by their life, their absence, their death.
To be caught in their wake.
I’ve listened to death-tales of suicide, murder, illness, accident, chronic self destructiveness, heroic sacrifice, masochism, police intervention, terrorist attacks, and statistically improbable, impossible deaths, as freakish as lightening on a sunny day.
Thou art slave to Fate, Chance, kings, and desperate men,
And dost with poyson, warre, and sicknesse dwell,
~ John Donne, from The Holy Sonnets, Death Be Not Proud
I’ve learned how they faced death, who they were before death struck and the consequences that followed their lives and deaths through entire communities of people known and unknown to them.
Loss and life spreads out in concentric circles – in waves, in ripples through time and across communities.
This has happened several times, maybe more times than it should:
I have listened to people, who do not know each other and who do not know that they all know me, as they sit in my office and describe the life and death of the same person. Like the proverbial blind men describing the portion of the elephant that they can touch – I hear from one what it was like to be an eye-witness to the accident, from another what it was like to miss them in an exercise class, from a third how it feels to lose the most important relationship in their lives, from a fourth the shock of hearing of the death of a professional colleague, from a fifth sorrow of losing an old college friend.
And like my mother-in-law, I have come to know them intimately, through their most personal details, their character and their residuum.
We all cut a broader path, leave a larger wake, send out more ever widening rings than we can ever realize.
I imagine such circles of inter-connection surround us all the time. Perhaps I have as many interconnections with the man at the deli, the crossing guard, the woman in the high heels in the elevator who smells of strong perfume. If my job were not to sit still in my office, and listen to what emerges, unmasked, unfiltered by social convention I might never consider this.
And when she buries a man, that action concerns me: all mankind is of one author, and is one volume; when one man dies, one chapter is not torn out of the book, but translated into a better language; and every chapter must be so translated;
~ John Donne, Meditation #17 From Devotions upon Emergent Occasions
The dead have taught me lessons I could learn from no living person.
Just as my mother-in-law departed before I entered the family, many years later my father-in-law died, just four months before our son came into this world. They never met each other either.
Shortly after my son came home I had this dream:
I was staring into a fireplace – watching the flames, and the logs spark and crackle. My father-in-law’s voice is behind me, a voice-over really- he is present and not present simultaneously. An accomplished scientist, pioneer in artificial intelligence, a biological reductionist my father-in-law believed in nothing romanticized or spiritual about death. Brain and mind were the same thing -and souls were non-existent. And as I watched the fire his voice said: “When you teach the boy about death, or when your own comes it is just like this: The fire converts the composition of the wood into another form of energy. See that spark? It breaks away from the body of the log, is carried upwards in the waves of heat and warmth, it burns out, and seems to disappear. But the warmth stays with you, is absorbed by you and those who are near, you inhale the carbon, the charcoal with all is uses remains long after the fire goes out ”
And poppy, or charms can make us sleep as well,
And better then thy stroake; why swell’st thou then;
One short sleep past, we wake eternally,
And death shall be no more; death, thou shalt die.
~ John Donne, from The Holy Sonnets, Death Be Not Proud
Whatever I believe or you believe or don’t believe I have no question that life doesn’t disappear. We leave trails, waves, wakes, after-shocks, hang-overs behind us.
Our lives keep living, unfolding long after we are dead.
And we are all unquestionably of eternal consequence.
No man is an island, entire of itself; every man is a piece of the continent, a part of the main. If a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friend’s or of thine own were: any man’s death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bell tolls; it tolls for thee.
~ John Donne, Meditation #17 From Devotions upon Emergent Occasions