Death and the Therapist

One of the hardest things I’ve had to do as a therapist is announce a colleague’s death.  For many years, I worked with Robin Cooper in a therapeutic community we’d both set up.  This community, one of the Philadelphia Association therapeutic communities, was based in an ordinary family house and was aimed at giving asylum and a home to those who had never felt at home in the world.  There were nine residents, with a variety of psychiatric histories.

Robin was a close friend and colleague, someone I’d known since I first came to London thirty years earlier.  We’d grown up together, having shared a flat, and worked together on the way.

I was home, having dinner before going off to a late house meeting when I received the call from the PA secretary.  Reporters had been calling the office to find out background about Robin after his death in a climbing accident.  Of course I knew Robin, an experienced climber, was off in the Alps, and I’d vaguely considered the possibility he would come to grief.  But Robin dead?  I couldn’t believe it.   I called my other colleague, Marie Laure, with whom I’d be running that evening’s meeting.  We were both in a state of shock.

And yet we knew that in half an hour we’d have to tell a house full of incredibly vulnerable people about this – it would be better that they heard it from us than in the morning papers – and we knew they too would be devastated, that the relative safety we were attempting to establish for them would be shattered.

On the drive to the community (which seemed much shorter than usual), Marie Laure and I shared our disbelief and prepared as best as we could for what was to come.

There were inevitably stragglers to the meeting, and we sent other residents to get them to come down to the big table where we met.  Then we made our announcement.

Everyone was in tears, including, of course, us.  One resident confessed that he’d read that a Scottish climber called Robin Cooper had died in the Alps, but that he hadn’t connected this with our Robin until the meeting started and we asked for people to fetch down the stragglers.

It’s a funny thing being a therapist.  You are meant to be on top of things, even when, as R.D. Laing once said to me in supervision, you are just barely managing to stay in your chair.  But often, being on top of things, in therapy and life, is a forlorn hope.  (I am indebted to the Sharpe series for my understanding of the original meaning of this phrase – those soldiers chosen to be the first through a breach in the enemy’s fortress – a suicide mission.)

You just have to ride the wave and keep your head above water, as best you can.  This is what Marie Laure and I did at this meeting.  The therapy that occurred was all of us, residents and therapists, being in it together, and the knowledge that sometimes, you just have to bear the unbearable.

As I recall it, the meeting turned into a wake.  We opened a bottle, and shared our memories of Robin, of things he’d said and done, of his characteristic ways of expressing himself (Robin did a great inadvertent imitation of Columbo – “So let me get this straight… you did this… and this…  and for this reason?”) and what was entirely loveable about him.  Doing this helped all of us cope with our feelings, and I doubt that anything else I could have done that night would have been more healing than being in a roomful of people who loved Robin, though from very different positions.

I recognize that in a strange way, this blog is a companion piece to my previous one, “Tough.”  This meeting was one in which we all had to face something that we couldn’t change, however much we wanted to, whatever we would have given to change it.  It was just “tough.”

Like Sharpe’s forlorn hope, we had to face death together, not ours certainly, but of a part of ourselves.  Those soldiers who survived being the forlorn hope were considered to be in a state of grace.  And I think that we all, therapists and clients alike, felt privileged to have shared in Robin’s life and death in the way we did.

It may have been tough, but not “just” tough.

The Dream Workbook

Today I’m pleased to announce the publication of my new ebook, The Dream Workbook.  And in line with hallowed blogger tradition, for one week only, I’m offering it at a special price to my readers.

To backtrack a bit, in 2007, Caroll and Brown published my first book,  The Dream Workbook.   It’s been out of print for some time,  and last year, the rights reverted back to me.  I decided to take the opportunity to revisit the text.  I was pleased with the way it had stood up, but there were some areas where, free from a commercially minded editor, I was able to express myself more clearly.

I’ve been rewriting The Dream Workbook for some time, and it’s now in a form I’m pleased with.  It’s meant as a handbook for those who want work with their dreams.  For novices, it starts with sections on learning how to remember and record dreams.  For those with more experience, it includes sections on having dreams to solve problems and creative impasses, techniques for understanding your dreams, and a section on what the major dream theorists — Freud, Jung, Hillman and Boss — can contribute to your understanding of your own dreams.  There are lots of practical exercises and vivid examples of dream work and the way it can enrich your life.

There’s also an account of a unique dream dialogue.  As far as I’m aware, it’s the first account of two dreamers influencing one another’s dreams while dreaming, and also being “aware” of the effect they’re having.

That’s the “pitch.”

And without further ado:  The Dream Workbook,  the Ebook.

I hope you like the cover. (The artwork is by MeKenzie Martin.)

It’s now on pre-order at Amazon, and for one week only, I’ve reduced the price for all my loyal blog readers (and their friends, relatives, early Christmas present buyers, etc. etc.).  If you order now, you’ll receive it on the first day of publication, which is the 27th.  Here is the link to UK Amazon, but the Amazon branch of whatever country you’re in should have it.

There will be editions on Itunes, Barnes and Noble, etc, but I think they’re a bit slow getting up.  I’m also working on a Print on Demand edition (for those who want a paper copy), which should be available from Amazon in a couple of weeks.

Obviously, I’d love it if you bought it and reviewed it positively.  (And if, at this ridiculously attractive price, you gave it to everyone you know…)

As a taster, here’s the start of the book:

Introduction

This aim of this book is to show you through experience just how creative, wise, useful and entertaining dreams are. It’s full of practical exercises to help you understand and use your dreams to solve problems and gain insight. You will learn to value your dreams – not because Freud or someone else has said they’re beneficial – but because you have discovered it for yourself. Through all this, you may find why the original meanings of the word dream were “joy,” “shout of joy.”

At first glance, dreams can seem like a wild garden – unruly and chaotic. Our dreams contain beautiful flowers, useful plants and unexpected vistas – but all this is hidden from us. Fortunately dreams, unlike gardens, respond quickly to our attention and start to reward it. The first chapter, “Getting Started,” gives the information and tools needed to begin to reap this rich harvest.

Become an Authority on Your Own Dreams

The fact that dreams seem so chaotic and confused has fostered the growth of the “Dream Expert” and the dream dictionary. Dream of a tree and you are told your life will bear unexpected fruit. Nonsense. Dream images are specific to your life and experience. No one dreams of a generic tree: rather it’s the tree under which you buried your first dog or the tree which hid your first kiss from your parents. Here, you’ll learn simple techniques to help you discover why you dreamt of Tony Soprano, a war-torn old cat or a dangerously speeding car.

The theories of the dream “greats” – Freud, Jung, etc. – can help you get to grips with your dreams. “What You Can Learn From…” is full of practical exercises to enable you to apply their important insights.

Being a dream authority doesn’t mean you have to work solo: it’s a joy to share dreams with others, getting their feedback and having your understanding enriched by new and different perspectives. “Sharing Dreams” gives you advice on finding a dream partner or starting your own dream group. You’ll also learn about the extraordinary phenomena such sharing produces.

Peak creativity

Scientific research shows us dreams are a time of peak creativity. Our brains are as active as when we’re awake and the chemicals that enable us to make unusual connections are at their maximum. Einstein’s theory of relativity was inspired by a dream, as was Frankenstein, Paul McCartney’s “Yesterday,” several Nobel Prize winning discoveries and many world-changing inventions.

You too can use your natural dream creativity to solve problems in your daily life. Need help with a relationship that is stuck? Preparing a homework assignment or presentation? Can’t see your way forward at work? Need advice on getting around a neighbour from hell? All these everyday problems can be solved in your dreams. “Solution Dreams” shows you how, with step-by-step instructions.

Rose-Coloured Glasses

Whether we wear rose-coloured glasses or see the world through a glass darkly, we all experience the world differently. For some of us, our daily world is filled with positive possibilities, for others potential disaster.

However we see the world, we find justification for it in our experience. If we feel that people respect us, we find others treat us with dignity. If we fear attack, we interpret all kinds of ordinary behaviour as a threat. Because of this, it’s difficult for us to truly see the “lenses” which colour our every experience.

Our dreams can show us these glasses. Bill, for example, had been taught that everyone is always looking after number one. That’s how he behaved. He saw others doing the same. After he started working with his dreams, he began to wonder why everyone in his dreams was self-serving and selfish. Okay, that’s how the world is… But why didn’t he ever dream of anyone who was friendly, helpful or loving? Bill began to question the way he thought “things are.” He realized that what he was experiencing in his dreams was the way he constructed the world. Once he saw this, his dreams started to give him new experiences, to show him a new way of being.

This way of understanding dreams has enormous power – we can literally see our world-construction “software” in action, those “lenses” that make people and the world appear to us in the way they do.

The Value of Dreams

Most of us in the West start from the perspective that every experience must be made to “work” for us, must prove its “cash value”. We feel that our time is precious and that anything we do must produce some tangible gain. One of the most damning criticisms of dreams is that they’re meaningless garbage produced by the brain at night.

Recent scientific discoveries do not support this criticism. Nor does my experience or that of countless others. But more to the point, if you do the exercises in this book you will find that your dreams earn their keep, many times over.

Dreams have also helped me and others bring into question the work ethic that makes us feel we must profit from every moment of our lives. Many dreams are poetic and personal works of art. Once we start remembering our dreams, it is impossible not to appreciate the images, narratives, characters and the incredible cinema they create for us night after night.

Dreams also bring us into contact with something larger than ourselves: God, Spirit, Being, our higher Selves, the Unconscious whatever you choose to call it. We are so much more than our limited perception of ourselves. At night, we can have an experience of a different realm of being.

How to Use this Workbook

My emphasis is on the practical: on giving you hands-on, or dreams-on, experience. Every chapter contains exercises you can do to deepen your understanding.

To get the most out of this book, I suggest you take an experimental approach. Try the exercises and see what happens. Learn from your experience as well as mine.

Each chapter is also complete in itself. For beginners, it’s probably best to start at the beginning and work your way through the book. If you are more experienced, you can skip from topic to topic, following your desire. If you are interested in finding out how to control your dreams, go to “Lucid Dreaming;” if you’re keen to develop your sixth sense check out “Dreaming through Time and Space.”

There is one proviso – you’ll get the most out of this book if you’re actively remembering and recording dreams as you read it. So, if you’re not already keeping a dream diary, begin with the Getting Started chapter.

Dreams are Idioplastic

Dreams are incredibly responsive to what you want from them. They’re idioplastic – shaped by your ideas and desires. So whether you want to have lucid dreams, Solution Dreams, psychic dreams, Freudian dreams, Jungian dreams or all of these in succession, they will do their best to help. Go on, give them a chance. You won’t regret it.

End of Introduction

Remember the special offer price lasts for only one week, until the 28th of October.

at http://www.amazon.co.uk/Dream-Workbook-Practical-Understanding-Dreams-ebook/dp/B00OMPR5ZM/ref=sr_1_1_twi_2?ie=UTF8&qid=1413715347&sr=8-1&keywords=the+dream+workbook

Or your local branch of Amazon.

How does Therapy Help — The New

In my last blog, I considered psychoanalytic theorizing and its core understanding of repetition.  Today I’d like to consider the uniqueness of the therapeutic situation itself and the ways that it is different from whatever we presume happened between mother and infant, toddler and parents, etc.

For it may not be, as we largely assume, that parents have not had the ability to contain/digest/understand/empathize with what our client has brought to us to deal with.  Perhaps, they haven’t been given a chance.

For there is a profound difference between infanthood/childhood/teenagerdom and what happens in a therapeutic situation:  the client has chosen to be there, however ambivalently and reluctantly.

Even if our clients arrive expecting magical understanding or advice, they must, after some time, recognize that what we offer is more modest – the chance to think about and re-explore their lives and history, a chance to reinterpret events.  If they persist beyond this initial stage of disillusionment, they are choosing to go on a journey of understanding with us.

When the client continues to come, they are saying, however ambivalently, “bring it on.” And this may well be something that they have never been in a position to say, or think, or do, before.  It makes for an entirely new situation.

I don’t believe we have adequately thought through what this means and how it makes therapy essentially different from that of a child/infant with his/her parents.

A client who persists with therapy says “I choose you to be the person with whom:

• I will attempt to feel and think things I have always avoided,
• go to places no right-minded person will go,
• share experiences that drive me  (and will probably drive you) crazy,
• and if you prove understanding and trustworthy enough, to whom I will say things I have never said before.

It’s very likely our client has never said/done this before.  It is new, and will have profound consequences in enabling our client to find resources within themselves which they had never previously had cause to discover.

Though this new situation may inevitably involve repetition (for our behaviour/thought and feelings are not starting from scratch), it is profoundly different from what occurs with our parents, who are there, as a given, from the beginning.  If we’re lucky, they’re loving and thoughtful and mean well.  If we’re even luckier, they have some sense of what they have taken on in this most impossible of jobs, and are, in most ways, adequate to it

But I believe what parents sign up for is fundamentally different from that which analysts offer.  And so retrospectively understanding parents as inadequate analysts is a profound mistake.

If this isn’t obvious, there are a number of things that should make it more so:

• It’s simply out of order for parents to “interpret” their children. I speak from experience here:  my daughter bristles (rightly, I’m afraid) whenever I’m tempted to do so.  She simply has not given me permission to do so, in the way a client gives a therapist.   Interpreting, in the words of Jay Haley, is a “power tactic,” and not one parents should use. I have permission to be her parent, but not her therapist. Thus the fundamental activity of therapists is denied to parents.
• Of course, much of the “containing” that analysts feel parents haven’t done would be pre-verbal, from the earliest days, months and years of an infant’s life. But even here, I’m not sure we’ve adequately thought the difference between containing/digesting feelings which are formed before significant contact with language (what early mothers have to do) with containing “early” feelings of adults who are swimming in the sea of language, which is what therapists, at their best, do.
• If being a good parent was simply a question of being an adequate analyst, you wouldn’t find many children of therapists who are messed up. Unfortunately, it is quite easy to do so.

Of course, I am not saying that there aren’t many ways bad or inadequate parents or even good parents in bad moments can’t mess up a child in ways they will still be struggling with years later.  In many of these cases, there will be a clear line of causation which it is possible to make:  for example, if a parent physically/verbally/sexually abuses a child, the scars which the adult bears years later can be traced back to the abuse, and what it meant to the child.

But a great deal of what analysts do, or take themselves to be doing, is dealing with  feelings/thoughts/perceptions/fears that are pre-verbal.   For example, Klein and Bion talk about the primitive fear of dying, which is attributed to the earliest months of a person’s life.   Such feelings may indeed need to be contained/digested/processed in a good analysis.

But here we are in quite different territory as far as causation goes.  We have no way of knowing whether this client’s early mother couldn’t deal with/contain/digest, his early hatred/fear of dying, etc.  This is true even if there is evidence the mother was depressed, preoccupied, grieving – absent in some major way.

All we really know is that there is work to be done, and if we, and the client are fortunate, we will be able to do it together, in a way that has never proved possible before.  But my suspicion is that a big part of why we are able to do that work is because the client has walked into our room under their own steam, sat in our chair (or laid on our couch) day after day, and has continued to do that until what they want/need has been accomplished.

For our clients, in our consulting room, everything they do/say/feel is understood as part of the work they have come to do.  This is an ennobling understanding. What has previously been understood as pathology is seen as attempted communication, as co-operation.  Even when clients seem to be working against us (resisting in its many forms), it is our belief as therapists that this is essentially working with us, presenting us with what we need to grapple with to help them.

All this makes for a unique situation, a proper “job” that clients can find themselves able to do however much previous “jobs” have been beyond them.  Being able to work with someone, in such a difficult situation with such difficult “material,” again, may be new for a client.  The sense of achievement they get from this and the support they get from being party to discovering the “truth” about themselves, may, and I believe is, much more important in their “cure” than the explanations in terms of repetition which we provide for them.

Repetition and Psychoanalytic Theorizing

A lot of psychoanalytic theorizing follows this basic path:  you try to understand (made a model for) what happens in the consulting room, say when a client who has been consumed by self-hatred gradually comes to hate themselves less, and then, you project backwards (often to early childhood) the absence of what you believe has happened between you and your client.

For example, some time ago I wrote about a “nightmare client” and of the moment in which, on reflection, her therapy changed.    However much a one-off this experience was, it’s inevitable I’ll find myself turning it over in my mind, trying to figure out what it was about this moment that made a difference.  And why it made a difference.  In other words, trying to understand what was lacking in my client’s history that was remedied by what happened between us.

But my success in doing the latter (trying to understand what was lacking in my client’s history), would very much depend on the “correctness” of my understanding of the moment where everything changed.  And there’s the rub.

First of all, unlike in the movies, (Ordinary People being a prime offender) there is rarely one blinding moment of insight, in which everything becomes clear (for both client and therapist). Further, in such movies, there is only one possible interpretation of this moment.

Secondly, the only instrument I have for understanding what happened is my own being – my thoughts/feelings/perceptions and ability to resonate (consciously and unconsciously) with the moment and my client.  Even if she should give an account of what happened for her, this too would be limited by her capacity to conceptualize what may essentially be an experience beyond her understanding/experience.

Third, it’s inevitable that my understanding will be shaped by the thinking of those who were involved in my education as a therapist – my analyst, my supervisors, teachers, and of course, what I’ve understood of the writings of the founders of my field – for me, Freud, Klein, Bion, Lacan on the psychoanalytic side, and Heidegger, Farber, Merleau-Ponty on the phenomenological.

So, when I try to understand correctly any moment of change, I am doing so through the lenses of my own perceptions and (my reaction to/comprehension of) the theories with which I have been graced/saddled with.

The “truth” of any psychoanalytic explanation that I arrive at, in other words is highly shaped/constrained by my personal openness to my thoughts/feelings/fantasies and by the theories/understandings that have become part of me.

For example, I’ve written in an earlier blog about a moment when a “nightmare client” walked out of a session to sit on the stairs outside my office.  I followed, sat down next to her, and then, consumed by despair at my inability to help/reach her, found tears running down my face.

Psychoanalytically speaking, I would say that this moment was one in which I allowed myself to fully experience/suffer my client’s utter despair at ever reaching me (or originally, I assume, her psychotic mother).   And that when she felt this, and my capacity to “contain” this moment, in a way that neither her mother nor her adopted parents had been able to do, something in her changed.

Her “undigested” maddening experience became one which had been altered by my taking it “in,” with compassion and love. (Those familiar with Bion can easily view this in terms of β elements and α elements.

This, I hasten to add, is only one possible interpretation of this moment, but it shows how the notion of repetition functions in psychoanalytic theorizing – that I, unlike her earlier parental figures, was able to contain (deal with emotionally) something which she had repeatedly tried to get someone to understand/feel/contain.  (I am very aware in writing this blog for the general public that this may not be convincing, or even much of an “explanation,” to someone not trained in my traditions.)

Another way repetition functions in psychoanalytic theorizing is in the notion of transference, basically, that clients “transfer” their past onto the therapist and thereby repeat it with them.

As it happens, my nightmare client spoke very little of her adopted family, and even less of her mother, who she only managed to trace and meet 2/3 of the way through therapy. In this case, psychoanalytic theorizing involves even more supposition, because I am trying to reconstruct her past by construing what is happening with me (or properly, what I understand of what is happening with me) as a repetition of it.

For example, early in the therapy, I frequently found myself reasoning with my client – explaining to her in reasonable terms why she shouldn’t be acting as she did.  (Often, as she was hanging out of my second floor window threatening to jump.)  Even as I did this, I recognized it was a rather stupid thing to do.  After a while, I began to think of this as something that my client’s adopted parents did with her, when she behaved passionately or angrily.  I made an interpretation based on this – “I seem to find myself trying to reason with you, even though I know it’s pointless.  I wonder if this isn’t something your father did, which drove you crazy in the same way as my being reasonable does.”  My client looked at me with soft eyes and nodded.   After this, I didn’t feel so compelled to be reasonable.

In other words, here the repetition of the past was played out in my behaviour.

The notion of repetition, in its many forms, dominates psychoanalytic interpretation, necessarily so, as psychoanalysis is based on trying to understand the present in terms of the past. But for all its power (and I don’t doubt that it’s real), such explanation involves repeatedly attributing to absent parents behaviour/thoughts/feelings/qualities for which we have very little external evidence.

I increasingly feel that this attribution is necessitated much more by our way of theorizing than by the “facts.”

Even if a client has spoken a great deal of their family (and clients vary enormously in this), I am very aware everything I hear is coming through a particular lens, and often is spoken to a particular end, to have me think/feel something.  More pointedly, most psychoanalytic theorizing focuses on the first year(s) of life, about which most clients “remember” almost nothing.

This time frame becomes the “blank screen” onto which analysts project their theories of repetition.

The “correctness” of these theories about early development becomes an issue of huge contention for analysts. I would argue that this is the wrong focus, as the “evidence” for these theories is not in early childhood but rather in the consulting room.

It is how we conceive of what goes on in the consulting room that is really important. And I increasingly feel that conceiving of this primarily in terms of repetition, underestimates the importance of the new. I will talk about this in my next blog.

Tough

I’ve noticed lately I’ve started using an expression that isn’t usually in a therapist’s vocabulary – “tough.” As in, “You don’t like that? Tough.”

I don’t use it about my behaviour – anything I do or say I am accountable for, and can be commented on, criticized or complained about.   So I wouldn’t say “tough” if a patient complained about my holidays or an interpretation. That would be cruel and an abuse of my position of power.

But when it comes to things people don’t like about life, other people, their parents, or their partners, I’m much more willing to say this. What I have in the back of my mind is Reinhold Niebuhr’s serenity prayer:

God grant me the serenity to accept the things I cannot change.

The courage to change the things I can.

And wisdom to know the difference.

When I say “tough,” I’m saying “this is something you can’t change. You have to find a way to accept it.”

Our ability to change our thoughts, feelings and the world around us is largely based on our capacity to see things differently. This is the tiny lever with which we can change our world, and that of others.  Everything we know, or think we know, comes from a particular point of view. When that changes, so does our world.

Your pov is infinitely malleable. But reality isn’t. Some things you can’t change. You can’t change your mother’s postnatal depression, that depression that made her dead to your cries, smiles, need for her love, attention, and understanding. (Or your father’s alcoholism, or his preoccupation with work, sports, finances, his navel, etc.)

Some people spend their whole lives trying to do this, in their mothers, fathers, and her/his many subsequent substitutes.   You can be lively, pleasing, attentive, interested in football etc. It simply won’t work. You will always run aground on your mother/father’s deadness, which you will encounter again and again even as you try to escape.

You have to accept the original reality was just “tough.” Or, as my childhood friend Richie would say, “tough titties.” (I have to admit never understanding this as a child, and I am the first to acknowledge that my current, psychoanalytic understanding, was probably not what Richie had in mind…)

This doesn’t mean you are helpless, that you have to throw up your hands in despair. Your potential potency is not in changing her or him (whoever the particular her or him it might be at the moment). It is in altering how you understand her/his deadness to you.

You can appreciate now (in a way that was clearly impossible then) that it wasn’t personal. It wasn’t that she didn’t love you. It’s just that she couldn’t love. Or that she/he was so narcissistic that they could only love what they took to be a likeness of them. Etc. Etc.

This was a disaster for you then, and you have spent many years reeling from that awful truth. Which felt much more awful because of course you did think it was personal. You took it as a judgement on yourself. It is only, now, on reflection, that you can see how you were mistaken. And you can let yourself, and Her/Him, off the hook.

There is always a pleasure in saying “tough.” It puts you in the position of the One Who Knows, the One Who Can Face Reality. And there is a transgressive pleasure too – therapists are not supposed to say this!

So it has to be used sparingly. And in full awareness that you are not the one being called to face this particular painful reality.

But when used in this way, “tough” has its place. In our practice, and in our lives. It’s even become part of my interior dialogue, where a full stop is called for.

“Tough love” is a cliché, often used to justify cruelty and mistreatment. But that doesn’t mean the words “tough” and “love” can’t go together. I hope that’s the way they are used in my practice, and in my self-talk.

Deep Haven

I thought my readers would enjoy this thoughtful post about what therapists call, in their rather unevocative technical language, the “nonhuman environment.”

what a shrink thinks

 “There is perhaps one attitude toward that environment which can be said to be characteristic of the emotionally mature human being… however widely and richly his feelings in this regard may fluctuate, over however wide a range, in the varying circumstances of his everyday life. One can think of this basic attitude as a firm island upon which man grounds himself while directing his gaze into the encircling sea of meanings, more or less difficult of discernment, and some no doubt inscrutable, which reside in this area of human existence.

This basic emotional orientation can be expressed in one word: relatedness.”

~ The Nonhuman Environment, Harold F. Searles, MD 1960

 

I am simultaneously being pressed by internal forces and consciously resisting writing this. Perhaps that is always the case – but this one feels both like it needs to be written, and that maybe this is not the place.

View original post 2,491 more words