I placed symbols of the four directions. 30th August 2021
- A stone in the North.
- A feather in the East.
- A candle in the South and
- The sound of the sea (I played a recording) in the West.
Perhaps I should have dropped this fly-by intuition thing I was doing, perhaps I should have availed myself of his psychotherapeutic knowledge. But, he was my beloved. I had just an hour. And the terror of the Kohuts was upon me - that our laughing together, our getting on, was his deliberate construct - twin ship or some other reparative relationship maneuver.
Not real.
No actual connection.
Manipulation.
Only his illusion and my delusion.
And in this room, well our laughter, it felt real. But that question he asks himself, the 'who am I to the client' question and how he seeks to be 'who they need me to be'.
But I don't need him to be anyone except who he is!
My North star is vanishing. Working out the directions in his room is my grounding ritual, I am able to say: I don't know which way is up or down, and I feel as if my blood has turned to water and my legs wont work, but now I know where the sun is! Focus on that. My experience of chronic stress had taught me the importance of this. When everything is fragile and nothing makes sense, then holding on to where the sun is - is something in a world - because at a certain point all that is solid, melts into air. The stability, solidity of North, of the Earth is gone! And I'm telling him about how extreme stress meant that my sense of time was broken, and how it is the hippocampus that deals with time - and how the hippocampus is damaged by adrenaline and cortisol....and how, just a year ago I felt the edges of my sanity starting to break.
He doesn't think that knowing neurobiology is important. I disagree. It was my golden thread. It allowed me to find my way back to the world. It gave me sound and solid reasons why I would be destroyed by self attack and self abandonment. So I held tight to my relationship with direction, space and time - because this is how I hold tight to my place in this world.
I tell him I had felt - and still do to some extent - as if I'd been shot through the head. And I don't hear him say, 'You suffered such a profound loss of normality, your family fractured and gone. How on earth did you get through that?' But I answer that question anyway; I tell him that I was privileged to get a ring side view, to observe in myself the process that culminates in sectioning. I tell him that because of this, I'm not concerned with the cause of people's vulnerabilities - the attachment issues or any 'basic fault' - I am very concerned with what people are doing that is helping them now. My question is never 'what do I think they need from me' it is always a question to them, 'what's helping you?'
The strategy of therapists to use a concept of attachment and wounds from the past may create a handle for some parts of the experience, but being asked to observe the wound, to concretized suffering just made it worse for me. It avoided now, it avoided my answers and strengths - But I've said this before and I will say it again!
He says - "There is a whole question there of a sense of self isn't there"
What?
No!
I don't understand?
I've just described the effect of terror, loss and grief!
He continues - "I'm getting at any potential client who might be sitting in front of you who might not have a sense of self and might not know who they are. There are many clients I've come across who describe sensations and feelings and events and experiences, but they have no sense of self to carry them in, and therefore having a framework for self understanding is critical for somebody like that. Because that's their chief trauma if you like, that I'm going through the world not knowing who I am, and not having a place to put anything. Particularly if somebody has disorganised attachment - because people with disorganised attachment, their chief emotion is fear - and if the background feeling is fear than they are constantly hypervigilant and there is no space for any sense of self"
The sound of the sea had stopped. And I was feeling my own hypervigilance, the feeling that at any moment he'd see into my heart and tell me to go, and I know that right now I'm not strong enough for this, not at all, and I'd just break.
But there is a serious issue here. I'd break now not because of my childhood issues, I'd break because I'm recovering; it takes time for the body to release the panic, when one has been too close to death.
I find the concept that someone without any serious attachment issues, or a 'basic fault', could cope with what I have been through, as childish...actually.
But hey, I get it.
Only people who have lived through it can know.
When I was at the inquest for my son's friend, I could not imagine why the family hadn't got help. Surely it was obvious how dangerous the situation was? So I remember how profound my ignorance of their situation turned out to be, I'm fortunate, life intervened and ripped up my idiot notions. It is a judgement, pure and simple - a process of subtle blame born from a desire to believe that the world is less random, and more fair than it truly is.
So I guess he doesn't know this. He believes in a more orderly world than I do! Well perhaps no one knows how fragile ordinary can be unless they have lived through it's shattering. Certainly that inquest and what happened to me afterwards taught me to never make judgments again! But no, I'm not going to play along in this conversation today.
Where I've been, and where others are, is too serious.
This self, no self thing is angels on a pin.
I said - "I'm not sure where we go next - anywhere - more time travel. The 'unconstructed space' what do we do with this space? I could ask you, what are your best hopes...
He is taken aback:
He - "What turning the tables and making me the..."
Me - It's not turning the tables, it's a fair question....I'm in a funny position. I could feel uncomfortable about not 'doing' therapy but I don't think I've got therapy to do. But you are a therapist, so if you want to do therapy I will attempt to do therapy. I don't see myself as a client..."
He - "Well this space is for what ever you want it to be"
I reply honestly - "But I don't know what I want it to be, except through asking you what your best hopes might be.."
He - "Well not for anything you might want it to be, but within the bounds of...I was thinking actually before you came , I was thinking in my experience going back to training what are the biggest holes in training. The things you ought to cover and don't. And I know what my thoughts are on that, so if we are going to go down that road, and thinking well we ought to cover X and they haven't.."
'Not for anything you might want it to be' ?
Each syllable a dagger into my heart.
So he knows?
Of course he knows!
Then why has he not said anything!
There is no room for this kind of thinking, it will drag me into anger or despair. I need to stay on firm ground. OK - so I know that I don't want more pedagogy, so I try to explain that in talking about anything I hear how he does therapy - as that is so often a part of what we talk about. I tell him that I hear the heart-essence, his attitude, his tone of voice. I ramble on about theory too, and that what I've got from him is really useful. Some part of me is pleading silently; please cross the river, please let go so we can start again as equals, as people.
I disconnect from that part, I hold the calm part of me steady...
And he says - "Just press the pause button there for a second! I'm intrigued by what you have said, because I'm wondering now - of course implicitly revealing something or telling something without doing it explicitly happens all the time of course. But I get the sense from what you have just said that you have got things from me that I haven't directly said - and I wonder what those things are...?"
I respond - "Yes, of course! Your attitude and your responses, a learning through doing or rather I learn your attitude by experiencing it. Learning isn't only following instruction. I learn through observing and feeling...But regarding college - I don't know what we don't know - I've learnt a lot from my other Diploma course!"
And then he says - "They rarely tell you for instance, how to deal with a client who suddenly says that he is suicidal"I tell him truthfully that actually they have done their best to teach us to feel confident in such a situation.
He tells me 'we should ask about suicide, and ask in the first session'.
He had asked me in our first session and, I lied. I didn't feel safe enough to be honest. Recently I've been asking the suicide question of our clients because it is 'our policy' and done as part of an assessment, but I don't know how useful it is. The people I've spoken to for whom suicide is a possibility have just told me their situation as we spoke. And even before it is said directly, I hear it in the tone of their voice and see in their body language, I feel the future has vanished, a closing down, a shutting off, preparing to go - no future beyond the wall of fear, fury, and rage. I say what I see. I need to have the suicide conversation, and I explain that this is about my fear, but I hope it will be useful for them. I don't leave the unsayable unsaid...
And as he speaks I remember the moments clearly; when he asked me about my suicidal feelings it felt like what it was, an assessment question - it didn't even feel like it had come from him!
I say - "It is quite difficult in the first session to be asked that. I found it quite difficult"
Again I experience a nothing, his reply is: "hmm"
I echo it: "hmm"
He says - "Because very often - I know this from others - someone who is genuinely suicidal can be very, very good at hiding it and therefore it's something we need to get into the open"
And right now, what is happening here, why hasn't he heard me? I had just said that I'd found it difficult in my initial assessment dialogue with him to be truthful about self harm and suicide. Then he had replied with 'some people are good at hiding it'. So has he heard? Is he talking about me in this moment?
So he knew - at the time?
He didn't 'get it into the open'....so what is he talking about!
I ask a really oblique question to find out.
I say - "I would be going by instinct, by feel - that I'm listening for the 'ring of truth' as they answer the assessment questions. Would you say that that is how it is for you, it didn't feel right (their tone of voice, body language)?"
He replies - "I don't recall that that has ever happened (so that answers my question - unless he is extremely skilled in sidestepping truth?) I've never had clients who've been dishonest about that, but if I did sense - oh this person isn't really telling me - in the first session, I wouldn't push it. I would come back to it. It could be a case of they need to get their feet under the table, they need to feel safe before they can tell me. But I've never been in that position. I've always had honesty. There is one thing that some supervisors suggest which I only did once, under duress and it was a disaster, and I would highly recommend that you never go down this road. The 'no suicide contract' ...I've heard people describe it as a physical thing which you both sign, and I've heard clients describe it as you both shake hands on it - and - I only did it once, but it turned out to be a valuable lesson actually because it is irrelevant. If we really believe in autonomy, then a part of autonomy is that if they want to take their own life then no contract is going to make any difference...But the thing I discovered about this particular client, and there have been other clients since was the great paradox for this person is, that having suicidal thoughts is what kept them alive. The function of suicidal thoughts like that is as an escape hatch that enables them to live - and so not only is a no suicide contract useless, it is potentially taking away their escape hatch! Partly it is this real tension that is always present in a therapy session, I think in the background between all this theory and this knowledge and all this experience of other clients, all of whom are completely unique which I need to understand, which is primary - theory might be useful - but you are primary...but again, sometimes I mean I've had self harming clients and I've said 'what's it all about for you'? And they can't tell me they go blank. Partly it's because they've never talked about it, never expressed it. Partly there is the flavour of shame about it so they become mute, so in circumstances like that I would say 'well in my experience a person usually self harms for one of three reasons - does any of that sound like you?' And when they say 'yes, sounds like the second one, maybe the third one' you can see the response - ' Oh my god somebody (the therapist) gets it'. Again what you are doing you're just deepening the therapeutic alliance by having a conversation like that. The big picture is, there should be no, no-go areas in what you can talk about..."
'There should be no, no go areas'! At at the end of 2021 I tried so hard to cross the divide, to talk about 'us' as two people in the same room. It was impossible for me to disconnect from him without getting the full picture. So now, 2023 my feelings remain exactly as they were.
And as this conversation about suicide went further, the ground became as loose and as wobbly as jelly, and I wanted to be held - I needed it so much...
I left his room understanding how devastating a non-response can be.
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