Borderline States, Counselling, Dreams, Hope, Madness, Mindfullness, Narratives, Psychoanalysis, Psychotherapy, Reflective Practice, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

Advent

advent7All this was a long time ago, I remember,
And I would do it again, but set down
This set down
This: were we led all that way for
Birth or Death? There was a Birth, certainly
We had evidence and no doubt. I had seen birth and death,
But had thought they were different; this Birth was
Hard and bitter agony for us, like Death, our death.
We returned to our places, these Kingdoms,
But no longer at ease here, in the old dispensation,
With an alien people clutching their gods.
I should be glad of another death.

Extract from “Journey of the Magi”

T.S.Eliot

 

The extract above is from T.S.Eliot’s poem  “Journey of the Magi”. I first heard it when I was at college and it has stayed with me. He captures the struggle of the Magi to  make their journey. These are  not triumphant warriors coming home. These are  men  who are tired. For whom the journey is uncertain. “Were we led all that way for Birth or Death?” That is a question that arises so often in therapy. “What am I doing here? I thought counselling was supposed to make me feel better.  I feel like shit.”

The Magi responded to a sign which they saw as significant. They were unsure what it signified, but they understood it to be important. The same is often true of my patients. They see a sign. A difficult marriage or relationship. Tensions  at work.  Perhaps feelings of depression and anxiety. These are read as signs. Signs that need to be attended to and understood. We only know that the Magi came from the East following a star. Bethlehem was an unknown destination. The  parallels to clinical work are obvious. We start from a different place. Frequently the place of our beginnings. Our place of birth. Those earliest moments of conception, pregnancy and birth which seem so far from our current places. Yet each time I see a patient we end up back at their beginning. The men whose fathers leave months after  their birth. The men whose mothers abandon them. The women who feel overwhelmed by their father’s expectations  of them. This is where the journey has begun. This is what has shaped their life to date. The woman who has had  six children with six different men. And each of her children taken into “care”. The successful business man who always has a lover whom visits regularly.  Whose wife pretends not to know and not to mind. These journeys are more like death than birth.

The biblical account of the Wise Men is only found in Matthew’s gospel. He places this visit at the end of his genealogies “The book of the generation of Jesus Christ, the son of David, the son of Abraham…” (Matt. 1:1) Matthew is telling his readers their history. As counsellors we don’t share your histories but  nonetheless draw on them in our work. (Unlike Athena who emerged fully armed from the skull of Zeus we have learned our histories the hard way with journeys that seem to have made the Magi’s travels look easy!) We share our patient’s journeys in many ways.We, to, have slept badly at times and have wondered where our journey will take us. To birth or to death?

My aim is to write more about Journeyings. Meanwhile I shall end with some Advent music. Enjoy, as they say!

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Aylesbury, Counselling, Madness, Narratives, Psychoanalysis, Psychosis, Psychotherapy, Religion, Schizophrenia, Spirituality, The Inner World, The unconscious, Ways of Being

Black dog- a postscript.

What started out as a creative writing exercise morphed into a Psychoanalytic shaggy dog story. I wanted to take an unexplained event and offer one kind of interpretation. ( I think I made the assumption that there was never an actual black dog. I suppose that gives away my underlying rationalism. That’s one of the many reasons that I left Fundamentalist Christianity behind.)

So. My black dog. My attempts at offering a psychological reading left me thinking about other “supernatural” stories. How to think about divine visitations. Virgin births, for example. Or burning bushes. Or the finger of God writing on stone tablets.( I’ll use biblical stories because that’s the tradition I know best.)

The tension between a faith interpretation of events and a psychological one is not new. Consider the nuns who had themselves walled in until they died of starvation. They saw this as evidence of their devotion to Christ. We might see it differently. Or Madame Guyon who ate her own faeces as evidence of her self abnegation.

In psychiatry there is a similar schism. The psychiatric saints and mystics see their experiences as evidence of breakthrough. A uniting with a more spiritual self. Others see hearing voices etc as evidence of psychosis. A breakdown.

So, black dogs, hauntings, angels and miracles. Divine intervention or psychological mechanisms? Or both, perhaps?black-dog

 

 

 

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Aylesbury, Counselling, Madness, Narratives, Psychoanalysis, Psychotherapy, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

The Black Dog goes Home

black-dog

I feel as though I should preface this piece with a “New readers start here” summary. I shan’t. This dog has had its’ day and it’s time for it to go back into its’ kennel. We are  left with my patient’s friend whom I suggested was suffering from conversion hysteria. I suspect that in some way he identified himself with the dog. My patient had already said that his friend could be violent at times .”He would never back down from a fight. It didn’t matter if he knew he was going to get a beating, he couldn’t back down. As if he was hard-wired for aggression and violence.”  I asked about  his friends attitude to women.

“He was an odd mixture. He both loved and hated women. He’d been in arrested several times for domestic violence but none of the women would ever press charges. He go home  and for a bit it was all flowers and chocolates.Then something would happen and the violence would erupt. We often saw his girlfriends walking about wearing dark glasses. After a bit we stopped asking  ‘why?'”

With this in mind I contacted the friend’s psychiatrist and wondered if abreaction might be worth a try.

Here is a very brief definition of abreaction:

“Abreaction is a concept introduced by Sigmund Freud in 1893 to denote the fact that pent-up emotions associated with a trauma can be discharged by talking about it. The release of affect occurred by bringing “a particular moment or problem into focus”… and as such formed the cornerstone of Freud’s early cathartic method of treating hysterical conversion symptoms.”

In simple terms, if one can help the patient talk about an event, it brings it into consciousness where it can be thought about and discussed, in the hope of resolving the conflict.

We used this with the friend. We asked him about the black dog. At first he just laid there and shook his head. Which was a kind of progress! Then he said “That black dog was my life. It was me. I loved it. I hated it. I needed it and I loathed it I always knew that one day one of us would kill the other.It had to be that way. I always hoped it would kill me. But that’s not the way it was meant to be,” With this he relapsed back into his “coma”. And has never since moved or spoken. My patient came for  about a year longer then left, happy in himself and settled his marriage.

 

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Aylesbury, Counselling, Madness, Narratives, Psychoanalysis, Psychosis, Psychotherapy, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

Black dog

black-dog

I wanted to finish off this story with a brief exploration of the other person in this story. Namely the friend. This is really a clinical note to myself rather than an explanation given to my patient. I include it in case it is of interest or value to anyone else. The explanation that seems best suited to this event is conversion hysteria. Defined as

“The diagnostic criteria for functional neurological symptom disorder, as set out in DSM-V, are:

The patient has ≥1 symptoms of altered voluntary motor or sensory function.
Clinical findings provide evidence of incompatibility between the symptom and recognised neurological or medical conditions.
The symptom or deficit is not better explained by another medical or mental disorder.
The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation.”

In layman’s terms there is a mismatch between the event and the symptoms. Why should killing the black dog be so problematic for my patient’s friend? One would have expected a feeling of relief .A problem had been solved. There might have been some feelings of loss. A rare and strange creature is no longer present. A challenge has been met and won. But to end up completely paralysed? This makes no sense. During the World Wars it was nor  uncommon for some soldiers to be sent home because they had become blind .Or because they had lost the use of their shooting arm. Other expressions of this disorder are:

“In practice, the term is limited to findings on neurological examination that imitate neurological disease, but do not conform to anatomical or physiological patterns. It includes paralysis, somatic and special sensory disturbances, involuntary movements, pseudo seizures, speech, gait, and memory disorders…”

The body acts on behalf of the mind to provide a way out of an impossible solution. If a soldier can no longer tolerate the fighting, what is  he to do? He can’t simply go home. He can’t desert. Nor can he stay where he is. One answer is for him to develop a physical condition that allows him a way out. Albeit a physical problem with no organic cause. That way he can leave the fighting and stay alive at the same time.

To return to my patient’s friend. We know from my patient that he and his friend desired the young woman at the end of the lane. For my patient he decided that he had too much to lose by visiting her. His black dog was, ultimately, helpful. It made him evaluate his  behaviour in a new way. It seems that his friend reacted differently Which suggests that the black dog had a different meaning for him.

And, as I say to my patients, that is the end of this session. You might want to continue with this material in our next meeting…

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Aylesbury, Counselling, Madness, Narratives, Psychoanalysis, Psychosis, Psychotherapy, Reflective Practice, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

The Black Dog

black-dog

This is the last part of the story of the Black Dog of Aylesbury as told me by one of my patients.. It’s a frightening story and easy to dismiss as the product of too much alcohol or other dubious substance. But my patient made it very clear that he was absolutely sober.  I believe him. So, what to make of this story? Jung would view the Black dog as an archetypal figure raising from a shared unconscious. Not being a Jungian, I chose to interpret this story as a kind of waking dream. Dreams being  seen as the Royal Road to the unconscious by Freud. In the earlier blogs  I’ve spoken about one view of what this event might have meant for my patient. I now want to look at how we might understand what happened to his friend. (Although like all therapy sessions, this might take longer than initially planned.)

In the story my patient and his friend both go out to challenge the dog. The friend beats it up and it vanishes. But the consequence of this is that he goes in to a kind of coma and is hospitalised. At the time I was seeing my patient his friend had been like this for several months.

“What do you think happened, Terry?” my patient asked.

This was not a question I knew how to answer in simple terms. In fact the whole saga stretched me to my emotional and intellectual limits. I found, and still find, the whole event disturbing. Here is a summary of what i suggested to my patient.

What did he know about trench blindness, for example? Or of soldiers who developed paralysis in their hands when it came to shooting a rifle. He said he’d vaguely heard of this idea.

“Weren’t they seen as skivers or cowards and either shot or court marshalled? Or both?” he asked.

“Yes, that was often what happened. Psychological thinking wasn’t very sophisticated in the forces in those days.”

“So”, asked my patient, “what does this have to do with the dog? It was real. We both saw the damned thing.”

I took a deep breath and started.

“I think something like this happened. Both of you wanted to visit this woman at the end of the lane. Both of you wanted to have sex with her. Both of you were stopped by this dog. This dog represented the bit of you that felt guilty about this. You wanted this woman but also knew that you had a family at home whom you loved. The dog ‘worked’. It kept you faithful-which you wanted it to.”

I paused.

“I sort of get that.” said my patient. “You’re saying I invented this dog to stop me from doing something dangerous like having sex with this woman.”

“That’s close enough .I’m not sure I’d use the word ‘invented’ but that’s pretty much what I’m suggesting.”

I went on to suggest that the dog had served its purpose. (We rarely ‘state’ or ‘tell’ as therapists. We ‘suggest’. We ‘muse’.  There are all sorts of reasons for this…) It had given him a  chance to think about what he was doing. To decide that he wanted to keep his marriage, home, family etc. In a sense the dog was no longer needed by him.

“OK. I see that and it’s true. Mostly.I did want to keep my marriage more than I wanted to have sex with this woman. But, it would have  been fun finding out …”

“Agreed. It might have been. We don’t know what else you might have found out.

We left this thought hanging and returned to his friend. And since that is the end of our time for today, the story of the friend will have to wait for another session.

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Aylesbury, Counselling, Madness, Narratives, Psychoanalysis, Psychosis, Psychotherapy, Religion, Schizophrenia, Spirituality, The Inner World, The unconscious, Ways of Being

The Black Dog Understood

black-dogI hoped it might be interesting to write about my own responses to this story and my patient’s thoughts.

My first association was that this black dog stood guard over a long, dark entrance at the end of which stood something both desired and forbidden. The  idea of the vagina dentata the vagina with teeth or the vagina that bites. My patient desired the prize but was also forbidden by his own moral standards. He was a married man with two children. This precluded him from having an illicit liaison. Thus speaks the super ego, the inner policeman. But this was in conflict with his more basic instincts (the id) that says, simply. “I want it.”  What was he to do? He couldn’t say “Yes” and  didn’t want to say “No.” So he comes up with an ingenious answer. He sets up an impassable barrier in the form of a ferocious Black dog. (A lovely representation of his super ego.) This works very well up to a point. So long as the dog is in place, he is safe. But if the dog goes, then what will stop him from pursuing his desire for this woman? He needs the dog alive which may account for why he never tries to kill it. The problems begin when his friend apparently succeeds where he cannot.But more of his friend later.

The other association that came up for me was Freud’s notion of The Uncanny. Particularly his commentary on the idea of heimlich or homeliness. The central idea is that homeliness stands for warmth, security, safety, etc. But the shadow of this is that it suggests something hidden and private. So a faithful black dog may be a family pet protecting its owner. But  the shadow can turn this feature into something dangerous and unknown. A ghost or demon or some other paranormal being. So my patient sees the heimlich of his own two dogs. The Black dog is only an extension of his own dogs. The ghost dog, like his own, his there to protect and keep out intruders. (And here we are again back with that vagina dentata. Something that protects and defends its owner.)

So, these are my own brief thoughts and associations on this account of a haunting.There are a few more notes to come but that’s enough for one reading.

What do others make of this story? And of the supernatural in general?

 

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Aylesbury, Counselling, Narratives, Psychosis, Psychotherapy, Religion, Spirituality, The Inner World, The unconscious, Uncategorized, Ways of Being

Black dog

black-dog

This is the second part of my work with a patient and his story of the Black Dog of Aylesbury (www.mysteriousbritain.co.uk/england/…/aylesbury-black-dog.html )

In the previous session he had told the story of a mysterious black dog and how his friend had attacked it with disastrous consequences. Here are some more notes from another session.

He is describing the place where the dog is on guard.

P.”It was stood at the far end of a field. There was a lane on the other side. Just one cottage was down there. A bit lonely, I’d have thought…”

A long pause.

T. “Where have you gone?”

P.”Oh! Nowhere. Just wool gathering. ‘A head  full of nonsense’ my mother always used to say. ‘You’ll get into trouble one day if you don’t mind those thoughts of  yours.'”

T.”I wonder if you feel you’re in trouble now?”

P. “Trouble? No. Not me. I’m a good boy these days. A wife and two children to think about.”

T.”And what do you think about them? This family of yours.”

P.”They’re great. The best thing that ever happened to me.”

At this point my patient has  a coughing fit that lasts for several minutes.  I ask if he would like glass of water.

P. “Yes. Please. Thank you.”

I get him his water which he sips slowly.

P.”Thank you. I don’t know where that came from.” Pause.

T.”Well it seems to be triggered by talking about your family. As if something got stuck in your throat and threatened to choke you.  That quite a powerful reaction…”

P. laughs uncomfortably but says nothing. He sighs deeply.

P.”I reckon that dog was a blessing in disguise…”

T. “Mmm. A blessing in disguise?”

P. Sighs. “I know who lives at the end of that lane. A young woman. Pretty. Always looks as though she wants a good time. I’ve met her in the pub a few times. Chatted with her. Brought her a drink.She told me where she  lives. Asked if I knew it. I said I did. That I sometimes walked the dogs that way. She  made it very clear that I’d always be welcomed to call round.  She lived by herself, she said, and often got lonely. Then she’d smile, finish her drink and leave. I think every man in the pub fancied her. Hard not to. After that I’d use the dogs as an excuse to go down that way. At least once a week. I never let myself know why I was going that way. But I knew…”

T.”So you wanted to have sex with her?”

P.”That makes me sound awful, doesn’t it? Here I am. Married with two children and still I want to go after some girl.”

T.”You said the dog was a blessing in disguise. What did you mean?”

P. “As long as that dog was there I couldn’t go down the lane, could I? No matter what I wanted, that dog stopped it. I hated that animal. If I could have shot it I would. But somewhere  I was relieved. It meant I couldn’t cheat on Anna and the kids.” Pause. “Listen to me. I sound a complete lech. Longing for  a quick shag with a young woman. But it’s true .I really wanted her. But I also know I love my family.”

T. “I wonder, then, how you felt when your friend did destroy the dog?”

P. “I’m not sure. Terrified, mostly..”

T. “Terrified…”

P. “Yea. Terrified. One  minute there’s this bloody great dog in front  of us. Them it’s gone and my mate is lying on the ground. Not moving. I thought he was dead. Had a heart attack or something. I rang 999 and waited for an ambulance. They came and took us both to hospital. They said I was only suffering from shock but that my friend was very ill and they had admitted him. I rang  Anna and she came and picked me up. Her mum looked after the kids until we got home.”

T.”It sounds terrifying but that is the end of our session. I’ll see you next week

 

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