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

Containment 3

Two people suggested that the last two blogs about containment needed a third one to bring them together. This is an attempt doing that. Years ago we used to sing a lovely hymn, “Brother, let me be your servant” it ran thus

“Brother, let me be your servant

Let me be as Christ to you…

I will hold the Christ light for you

In the night-time of your fear.”

It was usually sung for someone who was finding life particularly difficult or painful. A kind of lullaby between the singers and the soothed. It offered a promise of containment. “We can’t take away your pain, but we will do our best not to leave you alone with it.” (A lovely thought albeit one that cannot be totally fulfilled. At some point we are all left alone in the night-time of our fear.) The most we can hope is that the night-time doesn’t last too long. And that somebody is there with us in the morning.

Effective containment is a balance. The child who is frightened of the monster under the bed can only share its parents’ bed for so long. At some point the child has to go back and look under the bed and face the monster. That way they learn to self care. Then, when the next child is scared the monster, they can comfort them.

I remember doing a role play in a workshop. I was playing a husband whose wife of 40 years had just been told that she had six months to live. The other participant was being a counsellor. They listened to me as I expressed my grief, my fury, my fear.  Nodded and made empathic noises. Then said “I understand how you feel.” At this point I nearly had to be forcibly restrained. How could this counsellor who was at least 30 years my junior begin to understand? How dare she have the temerity to say that to me? What did she know of grief, or loss, or suffering? Whether I was in role or out of it, I was furious. She looked ashen, having suffered an unexpected emotional mugging.  What she needed to have done was to demonstrate that she understood. And to show me what it was that she understood. So “You must be feeling very frightened right now” might have helped.  Or even “How are you both feeling at the moment?” I make a point of never telling my patients “I understand.” Because I probably don’t! I’ll ask how they feel. I’ll suggest how I think they’re feeling. I’ll ask “How does that make you feel?” But I won’t tell them I understand.

How does this relate to the previous pieces? My hope is that it highlights that good containment holds both the Light and the Darkness. The Love and the Hate.  When I was lecturing I worried about those students who were devoutly Evangelical. I interviewed one candidate, asking her for her responses to being threatened, verbally abused and generally intimated by a patient who might be severely psychotic. Her response “I’d let the love of Jesus flow into him” worried me. Here was someone who was unable to know her own hatred. This put her at risk. And her colleagues. We did not offer her a place.

I previously quoted Isaiah 45:7 “I form the light and create darkness: I make peace and create evil: I the Lord do all these things.” Containment allows these two to live together and be acknowledged equally. The psychoanalyst, Donald Winnicott wrote “What is a normal child like? Does he just eat and grow and smile sweetly? No, that is not what he is like. The normal chid, if he has confidence in mother and father, pulls out all the stops. In the course of time, he tries out his power to disrupt, to destroy, to frighten, to wear down, to waste, to wangle and to appropriate… At the start he absolutely needs to live in a circle of love and strength if he is not to be too fearful of his own thoughts and… imaginings…”  (Winnicott, Deprivation and Delinquency)

This is containment. This is care. This is nurture. The rest is just nonsense.

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Containment 2

I want to continue the idea of containment. I have a softer image .One which speaks of the willingness to allow the other freedom. One which assumes that the recipient wants to be held and is attuned to that holding. I was reflecting today how pleasant it is not to have left a hospital admission in an angry mood. I can look back at my Wycombe experience with a sense of appreciation. The unit- the  staff- contained me. From here I could become content. The words have the same root which has links to the idea of a tenancy or a tenant. Someone who doesn’t own the property but who occupies it by mutual agreement.  The mother doesn’t own the baby. Nor does the baby own the breast. They agree to a shared tenancy.

One of several strands that shaped my feelings about my hospital admissions was a disappointment at the tenancy conditions. I had read the contract in a particular way. It included words like care, nurture, interest, compassion. The other party seemed to have a different tenancy agreement. One that included records, busyness, form filling, box ticking. By the time we had met, it was too late. We both made assumptions about the agreement that would contain us for the near future.

This image is all about being silenced. About a very particular form of containment that is far from desirable from the viewpoint of the individual. It speaks to me of a fear of allowing the other to speak and be heard. It is the way of the bully in any situation where they might be challenged. Be that Brexit, sexual harassment, the  outlawing of opposition parties in politics. Or the voice of the  prisoner or the patient. Theologically and spiritually the idea is the same. The Old Testament prophet Isaiah says “I form the light, and create darkness: I make peace, and create evil: I the LORD do all these things” (Isaiah 45:17) The Creation story in Genesis has a similar idea. God doesn’t only create Light. He creates Darkness-with all its implications. He offers darkness a containment which allows it to live.

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Counselling, Dragons, Dreams, Hope, Madness, Narratives, Psychosis, Reflective Practice, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

Containment 1

I’ve just had a short stay in hospital for knee replacement surgery. It’s  a disconcertingly quick process, once you’re admitted. I was admitted on Thursday and discharged home by the Sunday. Out with the old and in with the new. Literally. This was my third hospital visit over several years and the first one that was planned. The previous two had been crisis admissions. I don’t do well as a  patient – particularly as one who has been a nurse for most of his professional life. My overall recollection of my two previous admissions was of a gap between “hard” medical skills and the “soft” nursing ones. Between  the “male” skills of surgery and the “female” roles of nursing. I remember one nurse observing of me (to me) that “we’re all ill in our own way.” She was right. I’m not good as a patient. I’m far too impatient and independently minded. I hate being stuck in bed. I fear a loss of autonomy. My defence against existential anxiety is to become difficult and demanding. It’s a way of reminding myself – and everyone else –  that I will deal with this situation in my own terms. And if those terms don’t accord with your terms, well, so be it. Which means I’m never going to be “that nice man in bed 12”.

This admission was a markedly better experience. In part because I’d had a lot of time to prepare myself. I had a list of coping strategies. Chief of which was “Be nice to the nurses”! I was and it paid off. I could relax and allow myself to be cared for. Which created a virtuous therapeutic circle. I was content and contained.

The image at the top of this blog gave me a lot to think about. I Googled “Containment” expecting to find images of holding. A mother feeding her baby. A parent and child walking hand in hand.  Holding and held.  Instead I found a number of images like the one I chose. I thought about using another gentler image but opted to stay with the violent image that Google gave me. I wondered why? Partly on the basis of my two previous admissions. Partly on my own experience of being in analysis and also of my clinical work as a nurse and a therapist.

Psychiatric nurses don’t get many boxes of chocolates from grateful patients. In 25 years I got one box! I was reminded of this when I left Papworth hospital. I dutifully brought a box of chocolates. “Oh. Chocolates. How nice.” was the distinctly lackluster response. “I’ll put them with the rest.” It was a fair response. I was expressing my hate not my love.

“Damn”, I thought, “nice Adult nurses always get nice chocolates from grateful patients.” In  Mental Health this was not the way of things. We didn’t get “nice” patients nor did we expect to be “nice”. We expected to keep our patients safe. If that meant restraining them and forcibly medicating them, well then that was what we did. We contained them.

My two previous admissions highlighted this difference. The nurses expected to be liked. Why wouldn’t they? They were there to make us better and we were supposed to be suitably appreciative. So why wasn’t I being appreciative? I was being well looked after. My medication arrived on time and when I needed it. I was constantly monitored by a machine that bleeped if I even sneezed. I had drains, catheters, fluids and drips. All conspiring to keep me alive. So why my ingratitude? Mostly because I wasn’t contained. Nobody was asking me how I felt about having nearly died. Nobody asked me why I wasn’t eating or drinking enough. I was simply put on a fluid balance chart.

So the picture above sums up my first two experiences, My rage, fear, hatred couldn’t be borne. So I felt gagged. And murderously angry. Which I evidently conveyed. Powerfully.

 

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Does God dream?

As a counsellor I’m always interested in my patients’ dreams. Freud called them the Royal Road to the Unconscious. I also have an interest in theology and spirituality. A conversation recently left me mentally combining the two and asking “Does God dream?”  Behind that there’s another question “Does God have an unconscious life?” 

In clinical practice I use unconscious material a lot. We think about my patients’ dreams. The Soto vocce asides they make. (In psychosis these are experienced as “voices”. They are a similar phenomenon. Communications that are only partially meant to be publicised.)

The unconscious seems to be akin to the Cloud. It is an undiscriminating storage space with limitless capacity, password protected and safe from external interference. ( I confess to understanding the unconscious far better than the Cloud!)   My other premise is that we are told that Man is made in the image of God. Logically, this should lead us to the thought that God has an unconscious life.

But what is stored in the unconscious? Predominantly those parts of ourselves we deem unacceptable. Those parts that Jung calls our Shadow. We hide our racist thoughts here; our sexual fantasies; our murderous and hateful feelings. And so on. How do we know we have these thoughts? Catch yourself the next time someone cuts you up when driving. Or has the temerity to queue jump. Or to say or do something that leaves you feeling patronised and not-seen.
So where does this leave God? Where does an omnipotent being hide his Shadow? Jung suggests He hides it in plain sight. He uses projection. Brexit seems to me to be a current example. All our social, political and economic woes are due to Brussels. And immigrants. And any “previous government.” Looking inside ourselves is anathema. Who knows what we might find?

Jung suggests that God put all His shadow into Satan, also a son of his. But one who for a number of reasons was not his father’s favourite.  A dynamic not unknown in ordinary non divine families! So any thought or idea that Yahweh couldn’t tolerate was given to Satan to own. (The NetFlix series “Lucifer” plays with this idea very perceptively and amusingly. A kind of “theology lite”!)
If God went into Psychoanalysis we could explore his unconscious life. Which might make many things clear – not least Him!

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Analogue Brain

I was sitting having coffee with a friend who I know is ” good with I.T.” He understands these things. I was struggling to set up another Twitter account. I’d followed all the rules. Pressed all the right buttons. Uttered all the appropriate digital incantations. To no avail. “Here. You have a look. You do this stuff.” He looked at the runes. Waved his digital wand and told me what steps to take. It made no difference. I couldn’t understand a word. He sighed and pronounced judgement ” Your problem is that you have an analogue mind in a digital world.” He’s absolutely right. My brain doesn’t seem to do digital.

I’ve just visited the Tesla museum in Belgrade. We were given a tour with various clever demonstrations. My wife and friends assumed I’d be bored. I wasn’t. I wasn’t engaged enough to be bored. I simply had no framework into which I could put what I was hearing. ( I say this with no sense of ludditism. I should be better informed.) I’m not. Put me in front of a Dali painting and I’ll find a way in. Jackson Pollock’s work is the same. I know how to think about what I’m seeing.

Psychoanalysis is the same. I can work with dreams. I can make sense of my patient’s material however it is communicated. Even if  I feel completely lost in a session, I can think about that state of mind and wonder about it. 

As a teenager I remember my father coming back from a school open day and reporting my headmaster’s indictment of me. He says your head is full of nothing. This was not true. My head was not full of maths, physics and chemistry. It was full of Romeo and Juliet. Of dreams and hopes that could not be contained in a dry formula.

Fifty years on and very little has changed. If    I’m sitting with a patient I’m not good at concise formulations. I can’t build a plan of action based on an initial assessment. I meet my patient as they are on that day in that moment. I’ll wave my hands and say things like ” You know it occurs to me that…” Or ” I think you want me to understand that…”  I worked in a CBT team for a few months. It was not a success. I focussed on all the wrong things. I was supposed to divide my patient into neat proportions and ratios. Anxiety = 60% Depression = 40% Therefore create a plan of action for the depression. I left after a year.

My point is to make a plea for those of us who are digitally challenged. We aren’t being difficult when we can’t make this app. work. We know that a good digital filing system with appropriate passwords is a thing of beauty. It’s just that finding the meaning in Dali seems so much more useful. Or being able to create a well framed interpretation of a patient’s words. Here only analogue will do…

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Counselling, Dreams, Hope, Narratives, Reflective Practice, Religion, Spirituality, The Inner World, The unconscious, Ways of Being

Cathedrals

 

I came across this comment by the Anglican mystic Evelyn Underhill. She is writing about beauty:

“So, too, all who are sensitive to beauty know the almost agonising sense of revelation its sudden impact brings – the abrupt disclosure of the  mountain summit, the wild cherry tree in blossom, the crowning moment of a great concerto, witnessing to another beauty beyond sense… when we take it seriously, it suggests that we are essentially spiritual as well as natural creatures.” (The Spiritual Life)

I find myself uncomfortable with this idea. I acknowledge the sense of the numinous that we meet at times and places. I remember being moved to tears the first time I saw Rodin’s sculpture of the Prodigal Son. But what moved me was its humanity. Nothing to do with the Divine. I can listen to a great concerto, see a moving play, look at a landscape and be  moved. And be challenged to think about my life, its purpose and meaning. But I do not necessarily intuit the Divine in this.

Speaking of religion, Freud noted that:

“The psychoanalysis of individual human beings, however, teaches us with quite special insistence that the God of each of them is formed in the likeness of his father, that his personal relation to God depends on his relation to his father in the flesh and oscillates and changes along with that relation, and that at bottom God is nothing other than an exalted father.”

I find Underhill’s view one that demeans humanity and our creativity. I dislike the gothic cathedrals that, in my experience, seek to dominate man and propagate a view that reduces us to nothingness in the face of the grandeur of the Divine. I have no wish to be involved with a God who subjugates humanity. Following Freud, one has to wonder at the forces and influences that shaped the  inner world of the architects of the buildings. Robert Louis Stevenson wrote  “I never weary of great churches. It is my favourite kind of mountain scenery. Mankind was never so happily inspired as when it made a cathedral.”    For the most part I disagree.  There are cathedrals that inspire. Liverpool’s Catholic cathedral is one. Its light, its space and potential offer me a feeling of celebration and creativity. I always  want to dance when I’m there. Gaudi’s cathedral in Barcelona has a similar impact.

My point here is not to criticise gothic cathedrals per se. Coleridge saw them as “infinity made imaginable”. Perhaps he was right. For me, I prefer the image of an exalted father to be one of a father who can sing and dance with his children and teach them to celebrate life. I do not want to exalt a father who is remote, distant and intimidating.

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Counselling, Dreams, Hope, Mindfullness, Narratives, Psychoanalysis, Psychotherapy, Reflective Practice, Religion, The Inner World, Ways of Being

Winnie the Pooh

This is a piece about Winnie the Pooh who lived in the 100 Acre Wood where he had lots of friends.: Christopher Robin, Owl, Tigger, Piglet, Eeyore. Kanga and Rabbit. (Have I forgotten anybody?) When they got in a muddle he helped them out and when he got in a muddle, they helped him out. And he needed his friends just as much as they needed him. Which is how all good friendships work.

I want to spend some time getting to know this group of friends and see what we can make of them. Starting with where they live would be a good idea. The psychoanalyst Donald Winnicott observed that “home is where we start from.” So, home for this group is the 100 acre wood. Woods are important places. They represent stability and protection. We all love walking through woods.

But there is also a darker side to woods. Things are killed in woods. Owls, foxes and badgers kill other creatures in order to survive. Along with “All things bright and beautiful” nature is also “red in tooth and claw.” The 100 acre wood will have been no different. And whilst nobody physically dies in Winnie the Pooh, the emotions are there. A depressive Eeyore has to live with the manic Tigger. The young and feckless Roo has to live alongside the elder statesman Owl. As with any family, conflict was unavoidable, and necessary. Much as Tigger would have exasperated Eeyore, the former’s optimism would have offered Eeyore the possibility of Hope. Reciprocally we might think that Tigger could learn that quietness need not always be feared. So the home of 100 Acre Wood was a containing place that could hold both light and shadow. Which is probably as good a definition of “home” as we will come across.

Having looked at the context for the story, it might be interesting to look at some of the characters. My own favourite is the lugubrious Eeyore. He isn’t going to be fooled into thinking that everything is automatically and necessarily going to work out well. This way he can’t be hurt when people let him down. In one of the stories, his house is blown away. He always knew this would happen. Didn’t it always? Yet despite himself, his friends always help him out. Most infuriating. It is as if someone had offered Diogenes a proper home.

Then comes Tigger, ostensibly Eeyore’s polar opposite. Tigger always seems to land on his feet- all four at once. And just as often treads on someone else’s feet in the process. At first sight, he has nothing in common with Eeyore. On a close look, however, he uses bouncing in the same way that Eeyore uses melancholia. Tigger just uses a manic defence to keep at bay his existential anxieties. They are much more alike than either of them might want to admit!

At this point it is worth considering the 100 Acre Wood so that it tells us something about ourselves. “To make conscious the unconscious” as Freud put it. We all have our Tigger moments and our Eeyore moments. We also have our Piglet moments and so on. Depending on many factors we will all have a dominant personality trait. We may be more prone to an Eeyorish depression; a Tiggerish mania or a Rooish dependency. The process of emotional growth is the work of integrating these parts of ourselves in the same way that families have to accommodate children with their differences but who are still part of one family – hard though that is to comprehend at times!

To finish I want to suggest that all these characters reflect Christopher Robin’s inner world. And these in turn all reflect A. A. Milne’s inner world, and ours. In psychoanalytic language they are internal objects and part objects. Or “bits of ourselves” to put it more colloquially. So, when we read Winnie the Pooh we are reading both backwards and forwards. We are reading “forwards” in that we can look at the inner worlds of the characters in the stories. how they relate to each other, their world, themselves. Then we can look “backwards” to Christopher Robin and his world. Then we can look at the world of A. A. Milne and his hopes and dreams. Which begins to make a complex picture seemingly a long way from the simplicity of the 100 Acre Wood. Yet as counsellors and therapists we do this work all the time. Our patients bring themselves to therapy. But they also bring their partners, children, work, friends etc., as well as their relationship with us and all that represents. It is a sort of 3D chess game. It is this dynamic that makes the work so rich and rewarding. Mostly! (Occasionally also deeply frustrating and confusing.)

Let me leave the last word to Winnie the Pooh who would have made a very good therapist. He observed “I am not lost for I know where I am. But, however, where I am may be lost”.

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