Borderline States, Counselling, Madness, Psychosis, Psychotherapy, Reflective Practice, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

Humpty Dumpty

humpty-dumptyFor a variety of reasons I’ve been thinking about Humpty Dumpty this week. He makes an interesting case study. What strikes me most is his sense of omnipotence. He knows he is an egg. He must know that eggs and walls do not go well together-no matter how one defines  “egg” and “wall” and “risk”. There is a refusal to accept his vulnerability-which, we assume, is why he is found sitting on top of a wall. Because his fantasy is that he is unbreakable. This belief almost has the power of a psychotic delusion which is usually defensive. I have lost count of the number of patients who believe themselves to be Jesus and to have special powers. (As one begins to unpick this idea it becomes apparent that the underlying belief is just the opposite. That they are of no worth to anyone. So in response to this depressing thought, they evolve the fantasy of being messaianically important.And who is to blame them?)

If we were looking at Humpty Dumpty clinically we might diagnose an underlying depression. Or at the least feelings of low self worth. It is an interesting phenomena that I have seen many women who have ben abused as children repeat that pattern in adulthood. They manage to seek out men who will continue that abuse-albeit not physically. This serves to confirm an unconscious belief in their own worthlessness. Is this part of Humpty’s grandiosity? That he fundamentally lacks any sense of self worth? The famous exchange between him and Alice in “Through the looking Glass” gives a sense of his thinking.

” ‘When I use a word” Humpty Dumpty  said in a rather scornful tone ‘it means just what I choose it to mean- neither more nor less.’ ” How much more grandiose can one get? To believe that the only meaning of a word is what I choose to give it at any moment. Centuries of meaning are thrown away and Humpty rules supreme. (How dreadfully humiliating to have to abide by someone else’s definition of something. Like “egg” and “vulnerable”!)

Given this omnipotence is was only going to be a matter of time before Humpty had a  great fall. There could be no other outcome that allowed him to keep his integrity. He could hardly go back to the hen-coop and regale his fellow eggs with his adventures. Nor was he going to become a successful egg in the human world.Sadly he felt that he belonged nowhere- which opens up the possibly of a differential diagnosis of Borderline Personality Disorder. The tragedy of his great fall is akin to a successful suicide.  It is a pyrrhic victory. Suicide proves my omnipotence. “None of you could help me. In the end the only person I could count on was me.”

As a final thought here is Geisha performing her interpretation of Humpty Dumpty. Enjoy, as they say!

Borderline States, Counselling, Madness, Psychoanalysis, Psychosis, Psychotherapy, Reflective Practice, Religion, The Inner World, The unconscious


Every day brings news of a new violation. Yahoo answers tell me that , worldwide, one person is murdered every minute. (And we talk of animals being dangerous killers!) Today I was thinking particularly of the Paris killings and of the death of Becky Watts. I wonder if one common link between these two murders is Envy. We know that Nathan Matthews has spoken of his envy of Becky. It also seems probable that, at least in part, envy plays a role in the latest Paris killing (linked once more to Syria.) In each case there seems to be an undying belief that someone else is getting what is “rightfully” mine. Be that political recognition, wealth and prestige or simply more love. The etymology of envy is, simply, “feeling ill will at another’s fortune”. Melanie Klein, an early and highly influential psychoanalyst who came after Freud,  suggests that an envious attack is  launched on something good (see my piece last week about internal objects.). The attack is made simply because the object is good. That becomes a source of envy. This is compounded by a feeling of being left out. That everyone else gets / has all the good things except me. (A familiar feeling in families, friendships, marriages, organisation and nations to name a few.) Most of the time, most of us can manage our envy. Either by reminding ourselves of  the good things we have-both within and without. Or by doing something about the root of our envy. Many a thing has been accomplished by a person thinking “Well, he or she can do that. Sod it, so can I! (If envy leads on to reparation, then it can be a healthy spur .When it is allied to the death instinct, it can morph into murderous rage and hatred. Just watch a set of children playing. Or a couple of dogs with a bone.)

In clinical work, envy can be a spoiler. The patient becomes so envious of the therapist that they find any contribution intolerable. Rather being able to take in something nourishing, they are so incensed that their envy leads them to try to destroy the therapist and any good thing they might say or do. This might be one way of thinking about ISIS and similar groups. Their envy leads them to destroy the envied object rather trying to take some nourishment from it. One of the many tragic aspects of the killing of Becky Watts is that her step brother’s envy was not understood early enough. (Which is not to blame anyone or anything.) If he had been able to talk about his murderous envy in a safe place, it is just possible that this enormous tragedy might have been avoided.

Much the same might be said of ISIS and their kin. If we had understood their envy of us, we might have been able to prevent many deaths. And those yet to come. (Perhaps it’s time for the Prime minister to appoint a resident psychoanalyst to his team. Or a sub team of therapists working as  a parallel group to the cabinet, using their understanding of parallel processes to inform the work of the politicians.)

Borderline States, Counselling, Madness, Psychoanalysis, Psychosis, Psychotherapy, Reflective Practice, Religion, Schizophrenia, Spirituality, The Inner World, The unconscious, Ways of Being

Depression 1

This week I want to finish off the trilogy of Anxiety, Anger and Depression. (They are all part of the same family tree of emotions coming of the central trunk of fear of being annihilated.) Firstly, however, it will be helpful to define some terms.  The image on the left is of a mother breast feeding her baby. In psychoanalytic language the breast is known as an object and forms a central tenet in analytic thinking and writing. This gives rise to what is known as objects relations theory. The idea being that the mother’s breast stands for the whole process of nurturing, being fed, being cared about. The baby’s experience of the breast will include the smell of its mother, an awareness of her feelings, a sense of being the centre of the universe- albeit briefly! All these feelings are encapsulated in the word “object”. The theory goes on to suggest that this external breast- object- morphs into an inner representation. Thus the experience of being nurtured in real life is taken in by the infant as an inner experience. So the infant of an anxious mother will acquire a sense that the world is not a safe place. That he or she is also unsafe- that at any moment a disaster will occur which will overwhelm them. A child of a depressed mother may well acquire a sense of low self worth due, in part, to a mother who was too preoccupied with her own concerns to care about her baby.As the baby grows up it will find that it makes choices that seem to confirm their view of themselves.This can be expressed in all manner of ways .At the extreme end is suicidal depression running through to  paranoia and Manic depression. These are linked to the inner world and the individual’s relationships with its internalised objects.

Some examples:

Mike who finds it very difficult to hear anyone who does not agree with his view of things. (The fear being that everyone is intent on stopping him pursuing his dream career.)

Jane who cannot allow herself to be angry for fear that everyone will reject her if she shows he true feelings about something or someone.

Marie who is a compulsive carer who has to rescue anything or anyone in distress. Less from compassion and more from a complex mix of fear of her own anger and a terror of being unloveable.

In all these cases their actions and activity comes out of a difficult inner world. Their relationship with their inner objects is conflicted.  This makes the activity of living a  difficult one.

In part 2 of this blog I will focus on depression and one way of thinking about it.

brewast feeding mother

Counselling, Mindfullness, Psychoanalysis, Psychosis, Psychotherapy, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

Anger and anxiety

I’ve needed to do quite a lot of thinking recently about anxiety and anger, which I had always seen as discreet phenomena. My patients tell me otherwise so it seems wise to do some reading and thinking. This blog is a summary of my thoughts so far. Anxiety, angst, anguish and anger all have a common root, the Latin angere meaning to choke, dread, panic, anguish. These certainly seem to describe the feelings we associate with both anger and anxiety.

This is fine as a piece of semantics. I always like finding the root meaning of a word. It sheds light on what gave rise to the word but does it do anything more? In this case I think it does. Angere conveys the sense of destruction. Choking, panic, dread make me think of drowning or any experience that threatens to destroy me and end my life. (People who talk about having a panic attack will say they thought they were going to die.)

A psychoanalytic understanding of anxiety is given by Charles Rycroft as being to ensure that primary anxiety is never experienced. And this in turn is described as “the emotion which accompanies the dissolution of the ego.” Or psychic death. Who would not want to avoid that? (Think of how we feel when we’ve had a near miss in a car or as a pedestrian.Relief is quickly replaced with fury. Both are a reaction to near death.) In clinical terms anger and anxiety are both responses to threat – the well-known Fight or Flight reaction which is much more difficult when the threat arises from within us rather than from an external threat. Which is why those who are permanently anxious or angry can be so hard to be with for any length of time, because they project their fears into those around them. We become the enemy. So, the wife who is experienced as always critical may stand for her husband’s critical super ego (that voice in our heads that is forever running us down, telling us how stupid we are etc.) The wife who is always angry at her  family may very well be following the same path. Putting her own insecurities into others so they become someones else’s problem-not  hers. What is being projected is the internal battle raging in that individual’s psyche. Their own fear of being overwhelmed by their feelings are transformed into feelings of being attacked by outside forces. Hence racism, sexism, homophobia and the like.

The more difficult part is what to do about these thoughts and feelings. Cognitive Behavioural therapy is increasingly popular. This teaches us how to manage our thoughts and feelings. So, in the face of anxiety we might teach simple relaxation techniques. Anger might well be “managed” in a similar way. Google “Anger Management” and there will be pages of techniques, courses, exercises and the like. My own approach is to try to understand the links between anger and anxiety. To help my patient see who or what  is the source of their distress.Frequently something was missing in their experience of growing up. Parents who were preoccupied with their own concerns. Parents who, somehow, failed to pick up the messages their child was giving them about their needs. (Which is not to blame parents or criticise their parenting skills. Simply to observe that there can be a mismatch between what a child might need and what a parent is able to give.)

Medication has its place. Prozac is so popular because it works! We get relief from the misery of depression, anxiety and anger. Which in turn can give us the necessary energy to do the talking therapy that will allow us to change and grow.The actress Amanda Seyfried put it succinctly “Anxiety, it just stops your life.” (Replace “anxiety” with anger, depression, or something similar. It still works.)

Anxiety and anger

Counselling, Psychoanalysis, Psychotherapy, Reflective Practice, Spirituality, The Inner World, The unconscious, Ways of Being

Man or Machine?

I was speaking recently with one of my patients. They were describing their relationship with their parents in sad tones. “What about this relationship here?” I asked. “What do you mean?” they responded.

“Well, there’s a relationship here between you and me” I ventured.

“No there’s not. This isn’t a relationship. Relationships are about love and care and things. You’re my counsellor. There isn’t a relationship.”

I was tempted to launch into a lecture about the Presenting Past and its relationship to Transference and Projective Identification- but thought this probably wouldn’t help the work. So I asked instead how they did see the “relationship” between us. My patient wasn’t sure. I suggested that they saw me as a psychological “Speak your weight machine.” They put in a question or a problem and out comes an answer, with no sense that I might be touched by their question. Or curious. Or puzzled.Their is no therapeutic work without a relationship between the therapist and the patient. The nature of that relationship is always deeply informative and at the core of how I work.

The truth is that all my patients are in a relationship with me. They have found out my details, looked at my website, possibly read my blogs and , finally, met me. By which time they already have a fantasy about me and how we will work together. The relationship starts a long time before they come to me. This relationship will mirror all other relationships. Sometimes my patients ask about my health. I usually reply that I’m fine. Others come in and want to check out that I still like them. Then they can allow themselves to begin. Some come in a sit down quietly in their chair whilst others come in, lean forward and launch into a tirade against their family, their boss, their work, their life. One of my many tasks is to try and understand what’s happening today and what it might represent for both my patient and myself.

The roots of the word  “relationship” have the sense of a bringing back, restoring, association. All things that can be done alone but which make more sense when done with another person. (Which is why I dislike the idea of computerised “counselling”. It is at best a misnomer, at worst dangerous.This truly is “speak your weight” therapy. Input your problem now and the program will search its files for an answer that seems closest to your question. Please speak Now.I can imagine nothing further from the spirit of Freud, Jung and company. One does not have a relationship with a computer program.)

So, I shall continue to practice  therapy which makes the assumption that when two people meet, something dynamic happens. It’s called a Relationship.
Santa on 'I speak your weight' machine. Machine says 'Ho,ho,ho.'

Counselling, Mindfullness, Psychosis, Psychotherapy, Reflective Practice, Religion, Spirituality, The Inner World, The unconscious, Ways of Being


We went for a walk yesterday along the Thames path. l thoroughly enjoyed myself-to my surprise. It was hard work but good to have time to talk-albeit about nothing very profound. My wife has already done most of the seriously pretty bits of the walk and I’ve always said “No” to going with her. My choice would  have been a 50 mile cycle ride. This year, however, is not going to be the year of 50 mile rides. (I haven’t done a 20 miler yet.) So I said “Yes” this time when she asked me. And it was lovely.

I was thinking about these two parts of me. The part that has always in the past been able to do long, fast cycle rides with confidence-if not ease. I knew what my body was capable of and expected it to get on with it. Which it did. Then came  February and major heart surgery with all the attendant baggage that brings. Suddenly my body was not under my control. Every day seemed to bring a new set of worrying aches, pains, creaks and moans. The earth beneath my feet was definitely not as solid as I had once assumed. Now in September I have just celebrated my birthday- one I so nearly didn’t see. Doing a longish walk seemed like a good way to celebrate being alive.

I was thinking about vulnerability. About loss. And Recovery. About Hope. About acceptance. In my career as a nurse and as  a counsellor I’ve seen so many people in distress. And so many people who are at war with their wounded parts. The war is conducted with sex or drugs or alcohol. With depression or anxiety or psychosis. Sometimes in combination-which makes life very difficult.(Steiner talks about psychic retreats in the sense of people retreating behind anger or misery etc as one way of avoiding psychic pain. Sadly it doesn’t work. One simply remains trapped and mostly unreachable.)

One of the psychoanalyst Melanie Klein’s great understandings was that we are healthy when we know both our love and our hate. We cease pretending to be nice.kind, good al the time and allow ourselves to kIMG_1338now the shadow of these feelings. Our hate, envy, rage etc .When both these aspects of ourselves are acknowledged, says Klein,we are healthy emotionally. It seems to me that this integration covers other parts of our selves. Knowing that our limitations are as much a part of ourselves as our achievements. That the times when we are depressed also go to make us who we are as well as our times of triumph. That doing an eight mile walk is as much part of me as doing a hundred mile bike ride.

Welcome to walking as well as riding.





Counselling, Mindfullness, Psychoanalysis, Psychotherapy, Reflective Practice, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

Naming Ceremony

There is a piece in Lord of the Rings about a conversation between one of the Ents (who guard and protect the forests) and two of the Hobbits, Merry and Pippin. It is a conversation about names. Treebeard, the Ent, won’t tell the Hobbits his name. He tells them “For one thing it would take a long while: my name is growing all the time, and I’ve lived a very long, long time; so my name is like a story. Real names tell you the story of the things they belong to in my language…” This seems to me to be akin to the idea that we all have two names. A “given”, public one and a hidden “real” name which we should treasure and not give away lightly. Padraig O Tuama  in his book  “In the Shelter” comments that “To be named is to be summoned into being, and to name is to participate in this project of living.”

Hearing names and learning their meaning is part of my work as  a counsellor. Often my patients will come and say “I’m not really sure why I’m here but…” Between us we try to fill in the missing words. We discover, in this process of naming, that some things are easier to name than others. It is not too difficult to name Love or Joy or Care. Words  like Hate, Envy, Despair take more effort because they are hidden. We are uncomfortable with the idea that we can Hate someone or something. We want to use softer words and phrases. “I don’t like that person”. Or “I find that difficult.” These are ways of hiding ourselves from ourselves- with sometimes disastrous consequences. The writer of one of the Psalms says”You desire truth in the inward parts.” (Psalm 51:6) This seems to accord with Freud’s maxim that one aspect of psychoanalysis was “to make conscious the unconscious”. Both writers seem to be calling for an inner integrity that allows us to correctly name the various parts of ourselves.

One of the advantages of naming something is that it then has an identity. It can be scary to know something’s identity but, it seems to me, it is even more frightening not to know something’s identity. A patient spoke of her nightmares as a child. Her dreams were full of unnamed things that were set on hurting her. These things were never named and the nameless dread has transferred itself to her adult life. Some of our work together will be to name the things and to try to understand where they come from. And by naming them to give her back some control. Naming things seems to me to be something empowering and life affirming-even if the name is Cancer or similar. If I know something’s name I can manage it.

So to use a phrase Padraig O Ent Tuama might use “Hello to naming the unnamed.”