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

Spiderman meets Allah

 

I recently watched the latest Spiderman film Homecoming. I was slightly disappointed by it. I enjoyed the Toby McGuire versions. I think because he portrayed more of the conflict he felt about being Spiderman. It seems to me that Tom Holland plays it as a teenager having huge fun as Spiderman but not really having to work overmuch about the implications of this role. But i’m a counsellor versed in psychoanalytic theory, so I may be expecting too much from the film! Although having so said, “Homecoming” does give a good portrayal of Peter Parker’s oedipal conflict .Tony Stark is an excellent father figure whom the young Spiderman has to deal with.

The piece of dialogue that struck me forcibly is this one. Peter wants his Spiderman suit back from Tony Stark who has confiscated it. (Castration anxiety anyone?)

Spiderman “I’m nothing without that suit.”

Tony Stark “If you’re nothing without the suit, you shouldn’t have it.”

(There is a lovely irony here since Tony Stark invented IronMan as his superhero alter ego. He needs his Ironman suit as much as Peter Parker but is unable or unwilling to recognise this need.)

I watched Homecoming around the time of the terrorist attack in Barcelona. The question of “suits” came to mind. As Spiderman Peter Parker can achieve all sorts of things that he cannot do as an ordinary adolescent. He needs to become Spiderman. (There are important questions here about potency and identity.) Like so many other people I wondered how a person can ram a truck into a group of people enjoying an evening out. (And at the risk of death by parenthesis, there are issues of envy here. How dare you be enjoying yourself when I’m not!) Could plain Mouassa Oukabir have driven his car into a group of people, aiming to kill as many as possible. Perhaps not. But as a disciple of a particular Iman, Abdelbaki Es Satty, Oukabir had a suit to wear. Like Peter Parker, it gave him an identity as a perverse “Superhero.” Presumably his version of Islam gave Es Satty a similar kind of suit.

In the closing scenes of Homecoming Peter is offered a brand new Spiderman suit, which he refuses, much to Tony Stark’s bemusement. “That was a test, right?”asks Peter. “Of course”replies Stark. So Peter Parker goes back to  being your average, friendly neighbourhood Spiderman. It seems he has found a way to resolve some of the issues he has with Tony Stark. And, more importantly, with himself. One wishes that “radical Islam” and all its kind could make a similar resolution.

 

 

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

Certainty

There was  a discussion recently on Facebook about a newly found translation of the KJV bible. The academic involved claimed that this new manuscript showed how much of the text had been edited to support particular political doctrines and ideas. The discussion that followed was, inevitably, about the  nature of biblical authority. Is it a case of “God said it. I believe it. That settles it”? Or a case of  “The words of God in the words of man”? The discussion lasted a few days  before moving on to something else. Probably a discussion about giant pandas or the Amazon rain forest.  At the same time a Quaker friend wrote a piece about certainty and religious faith.  She had disagreed with somebody who had wanted it to be the case that faith banished doubt. My friend’s point was that this was not the purpose of faith. Its task is to provide a framework to think about life and its vicissitudes, not to provide an answer to every conundrum. It is a familiar and important argument.

In his paper “Mourning and Melancholia” Freud commented that in mourning what was important was not whom someone had lost, but what. This thought has stayed with me. I spent my 20’s and 30’s  defining myself as Christian, albeit in varying ways – but mostly Evangelical. (That wish for certainty was pervasive.) Then I began psychotherapy and allowed myself to look behind some of my locked doors. What did I think about Jesus, the Church, Evangelicalism, things Charismatic etc? I discovered that I thought all sorts of things that I hadn’t allowed myself to think! Now in my 60’s I am happily agnostic as far as religious faith is concerned. I’m probably agnostic about many things. It’s a position I feel very comfortable with. It’s particularly helpful as a counsellor where I spend much of my time simply holding someone in my mind. I choose to suspend judgement about almost everything. One of my patients commented,”This feels so weird. It’s the only place where I don’t have to defend what I say or think. You’re just interested in the fact that I do think such and such.” My experience of therapy from both sides of the couch is that this is the only stance one can take. The only certainty is that there is no certainty, which makes this work so rich and rewarding. On a good day. On a bad day a small part of me longs to be back in my warm fundamentalist womb being effortlessly nourished by a divine umbilical cord. But we are not meant to spend our lives in any kind of womb. We are meant to be outside exploring and discovering. Endlessly asking “Why”

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Counselling, Hope, Narratives, Reflective Practice, The Inner World, Ways of Being

Cinderella sees a counsellor

This is  for Andy who wasn’t sure about Freud and Cinderella. And for Clare who pointed out that, sometimes, less sweat makes for better writing.

Leonora De Havilland looked at her appointment diary. At 10:00 this morning she was due to assess Cindy. That was all the name she had. And that she wanted reduced fee work. Preferably free work since she was on a very limited budget. That was the sum total of the information she had given Leonora’s secretary. As a counsellor who was very much in demand Leonora could afford to offer some low-cost work. That and the fact that she charged a hundred pounds a session to her Harley Street patients. She could afford to be generous – sometimes!

Her phone rang “Your ten 0′ clock patient has arrived” said her secretary.  Leonora got up, collected her patient and invited her to come in and sit down.  “Hello. I’m Leonora.” A pause.  A longer pause. The pause carried on.

Mmmm thought Leonora. A therapy virgin. Doesn’t know the rules. Free association and all that. Better say something or we’ll be all day.

“What brings you to therapy, Cindy? How do you think I can help you? ”

Cindy sat there looking down at the floor. Leonora waited. The girl was clean and tidy albeit wearing an old dress and shoes. Her hair was tied back in a pony tail and she wore no make up. Her hands, which she was busy wringing, were obviously used to hard work.

” Mum died when I was small.  It was just me and dad for ages. That was nice. Then he met this woman. June. They got married last year. We moved in with them. She’s got two daughters from a previous marriage. They hate me. So does their mum. They bully me all the time. I can’t stand it much longer. I’d be better off dead…” She left the sentence unfinished.

Poor kid, thought Leonora. I know that feeling. (Fortunately she had worked through her “issues” in her own extensive therapy. God, five times a week for twenty years. How did she find the time, money or energy?)

“Can you tell me a bit more, Cindy?” (When in doubt, ask an open question.)

“There’s not much more to tell. Dad always takes June’s side in everything. I used to try to tell him stuff, but then I gave up. He would tell me that I was being selfish. That he was lonely too. That June had had a hard life. That I should be grateful to her for looking after me as well as Mary and Clare.” She stopped again.

(Leonora sighed inwardly. This was going to be a long 50 minutes. And for free. She would have to review her pro bono work. Charity was all well and good but she did expect her patients to do their share of the work.)

 

“It sounds as though you don’t like June very much. You feel she’s stolen your father from you… you might be very angry him for doing that…” Leonora sat back in her comfortable chair, steepled her hands and waited. She looked the clock on the wall.  Only 10 minutes. It felt like an hour.

“I couldn’t hate dad. He’s all I’ve got. And he’s entitled to a bit of happiness. It’s June and Mary and Clare I really hate. They make me do all the chores. ‘Cindy have you finished the washing up? Cindy why haven’t you laid the fire? Cindy come here. There’s dust on top of this picture. No dinner for you, my girl. I haven’t got time for you and your slovenly ways. And I’ve got my sister coming to stay and she’s in your room. So you’re sleeping downstairs for the week.’ And I go out of my way to be kind to them. Mother would have been, so I try to be the same. But it’s so hard at a times…”

“Mmm” pondered Leonora. “Oedipal material? Wants daddy all to herself with mummy dead. Gets what she wants and feels guilty. Thinks she’s responsible for mum. But delighted to have daddy back again. Then loses him again and is left with murderous rage. Could work.”  But after a moment or two’s reflection she decided against this interpretation. Too complicated for this girl. She’d save that idea for her Harley Street patients. They lapped it up. The more arcane and obscure she made their problems sound, the more they came back. Instead she settled for a neutral but empathetic response.

” You must feel very lonely at times.”

“Oh yes.I go to mother’s grave every day and cry. I tell her all about father and June and Mary and Clare. I’m sure she hears me. I mean, that’s what mothers do, isn’t it? Listen to their children.”

“Shit” thought Leonora. “Where did that come from?” For a brief moment she was back in her childhood home with a new step dad who liked her far too much. Then her own two daughters whom she never saw. So much lost. That’s why she’d come into this work, her therapist had pointed out .To try and make herself better by helping other people. Possibly.

“Well, yes. That’s one of the things a parent tries to do.”  She looked at the clock. 10:50. Five minutes left.

“I think there’s a lot to talk about, Cindy. Much more than we have time for in this session. Do you want to come back?”

Damn. Where had that come from. She’d had no intention of taking on this girl.

“Yes please. If that’s alright. And thank you.”

“Good. I’ll see you this time next week. Goodbye.

 

 

 

 

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