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

Emotional etymology

I realise how often I will look up a word’s etymology when writing a blog. It seems a way in which I can ground my thoughts and my writing. A literary “ground of my Being”. It gives me a sense of starting from somewhere honest, which is the original sense of the word “etymology”. It has to do with true meanings. But words don’t remain static. Thankfully. They “slip, slide, won’t stay still” to quote Eliot. ( A friend wrote a brave and fascinating piece on the word “cunt” I’m not sure I would have been as brave!) My thoughts then wondered off to my clinical work and the idea of clinical etymology i.e. what are the origins of this symptom, idea, fantasy etc.  (Freud’s essay on The Rat Man is a classic example of the beginning of a symptom and the ways in which these symptoms changed over time. It is also an exploration of the creative uses to which we put our symptoms. It is also quite opaque at times with Freud making extraordinary jumps of understanding and interpretation. But why should this be a surprise? If language is full of hidden histories, how much more so our unconscious lives?)

To take this idea a little further, we can follow Lacan in suggesting that the unconscious  is  structured as a language. Which might give us access to wondering about what part of speech any given symptom m might equate to. Thus a symptom may serve several functions. It might work as a noun, having a naming function which also serves as a limiter i.e. it is this thing, not that thing. It is depression, not anger. A symptom may also  be a verb. a doing word i.e. I”do” psychosis. It is an active process that needs a subject and an object to fully make sense. (Which is why whenever we take a clinical history, we try to put a symptom into a context. When did this symptom first begin? How do you use it? There is really no such thing as an isolated symptom .Somewhere in the unconscious we will find the rest of its family.

And like any good piece of writing, I’m now struggling to find a satisfying way of ending my blog. I think M.Scott Peck sums it up beautifully when he writes, in The Road Less Travelled “The fact of the matter is that our unconscious is wiser than we are about everything.”

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Counselling, Hope, Psychoanalysis, Religion, The Inner World, The unconscious, Ways of Being

Aleppo

aleppoI have nothing new to say about the battle for Aleppo. Many better writers than me have written reams about it. Psychoanalysis knows all about war, murder, envy and hatred. Both within and without. It also knows about love, care, compassion and kindness. Within and without. Aleppo has seen both of these worlds-the internal and the external. I want to use Aleppo as a metaphor for the inner journey.(I know something of this battle zone. I know nothing of a physical war zone. Thankfully)

I was watching the news last night. A Syrian man was interviewed walking among the ruins of the city. He was surrounded by rubble which he was looking at despairingly.(I was reminded of Hercules and the Augean stables.) He commented that if only the rubble could be cleared, others would return to the city. This seemed a powerful image for  the work of therapy. We all have our own rubble. Sometimes it’s a relatively small pile-or seemingly small. I don’t think any rubble is truly small, representing, as it does, the ruins of some kind of demolition. That pile was once something else. A building. A planned project. Something left behind by a previous owner.

The Syrian man was faced with a painful task. He had no clear idea who or what he might he find underneath the rubble. His family. His home. His life. In some ways it might have been easier to go somewhere else and leave the past buried where it was. Except that he has a right to see what might be buried there. To see what he can salvage that might help him begin again.

His comment about others coming back if the rubble is cleared struck me. I’ve seen so many people  over the years who have lost their friends and family because they can’t get through the rubble. That’s why I think counselling can be so helpful. It provides a space for someone to begin the rubble clearing process. We can’t move al the rubble as counsellors. But we can help the individual find the courage to begin some of the work. Week on week we can think about what might be involved. Where to begin. When to stop. We can offer a space to talk about what has been found in the rubble. What to do with that memory? How to find a way to  the past without being irrevocably dominated by it. It’s slow and often painful work for both the therapist and the patient. Frustration is present. Along with fear and loss. (Also joy and hope.) As a therapist one has to hold all these feelings until the patient can carry them home. Or leave them behind. Move the rubble and others can come along and help.

Freud characterised this struggle as the conflict between id, ego and super ego. Rubble clearance is another way of thinking about this.

 

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

Revolutionary thoughts

7-_the_beatles_illustrated_lyrics_revolution_1968_by_alan_aldridge__iconic_images_alan_aldridgeI went to look at the “Revolution” exhibition at the V&A museum yesterday. “A rousing and pertinent excavation of the revolutionary spirit of the 1960’s”
I did think that the 60’s revolution seemed to meet fewer barriers than my journey to get to see it. First book my ticket on-line. This took at least three attempts since each time I typed in my card details they mysteriously morphed into something completely different on the screen. Eventually my computer and I agreed on a number. Stage one complete. Than go to the station, guessing at the time of the next London train. I guessed fairly well giving myself enough time for a cup of coffee. On to Marylebone where I spent another five minutes checking and double checking my route. Then 20 minutes on the tube, anxiously counting off each stop in case I was West not East or vice versa. (Which is quite ban apt metaphor for the whole 60’s scene.)

Eventually I got to the V&A where there was a statutory bag search. This completed I could go to the exhibition via the sculpture hall. Rodin and a host of other sculptors were on show. What fascinated me was how much they gave a sense of perspective and history. Rodin’s work (which always moves me) did not come out of nowhere. It stands in the context of thinking about how people are. What do our bodies say about us and the way in which society views us. This set the scene for me for the Revolution exhibition which was about change, development, values and perceptions. As well as great music, wonderful fashion and nostalgia! But most fascinating was seeing students in their 20’s making copious notes about the exhibits. What was so interesting about seeing Mary Quant’s dresses? Or reading about the posters about Vietnam war protests. This was my youth.That’s all. I was lucky enough to have been a teenager in the 60’s. My wife grew up in a later decade with different values which shaped her. But neither of us see our era as historically important to anyone except ourselves.

When I interview a new patient I always take a history going back to grandparents if they are remembered. Patterns emerge and when I comment on them my patients often looked surprised. “I hadn’t thought of it like that” is a frequent response. It’s also often the small details that can tell a lot. So one patient remarked almost in passing, that they had asthma as a child. I commented on this and wondered it might be a clue about their early experience of family life. They looked at me as if I had asked if they had been to Mars. But in the context of their history, this was a hint about some feelings of being unable to breathe sometimes. As George Santayana observed
“Those who do not remember the past are condemned to repeat it.” So with this patient there were times when they felt being at home to be a suffocating experience. A pattern that repeated itself in their adult life.

So in taking a history I’m not merely asking out of curiosity. I’m asking to help me find a bridge between their past and their present. In the same way that “Revolution” was reached by history so much of my patients material is hinted at-indeed formed by-their early experience. So, I enjoyed the exhibition and found it odd to be an observer of my own history.But that is a good image for the work of counselling. It gives us a space to step outside ourselves and think about our history. As Eliot put it, “In my end is my beginning.” or that both time past and time present are, perhaps present in time future.”

Finally,a note on the link below. It is mainly an excuse to promote one of my favourite songs from my youth. But it also has something to say about revolutions which are as much an internal process as an external one.

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

Nothing

One of my patients recently said that one of the things that I did in our work was that I bought into the front of her vision those things that were just on the periphery of her sight. As a child I used to lie on my bed and try and see what was at the edges of my vision. I strained to see what I knew was there but couldn’t see. Perhaps that’s why I became a counsellor. I spend a lot of my time looking at things that aren’t there. As Freud put it, the purpose of psychoanalysis is to make conscious the unconscious.

Simon Feuerman, an American psychoanalyst, recently wrote about God. Or, specifically, a patient’s thoughts about God:

“I went to the cemetery to visit my mother’s grave,” a patient told me. “I put the stones there, I knew I had to pray, but believing in nothing, I put my head down and prayed to ‘nothing’. But who, exactly, is this ‘nothing’? I ‘know’ there’s nothing out there, but I pray because there is something in that ‘nothing.’”

I like that. “There’s something in that nothing.”

Many of the creation stories have this idea. That Something is created out of Nothing. It’s an intriguing conundrum which belongs outside this blog -thankfully. Yet it is not unusual for a patient to come and tell me they have nothing to say today. Fifty minutes later we find that this Nothing contains all manner of ‘stuff’, that is very much Something! It is one of the pleasures of working as I work that I, too, can come to a session with Nothing. The analyst Adam Phillips commented that he approaches his work in a state of boredom, waiting for his patient to enliven him.  I know what he means. A patient came to see me asking for advice about a problem. I explained that I didn’t ‘do’ advice because I saw no point to it. They looked puzzled and irritated.  “You don’t give advice?”

“No… but what I can do is listen with you and think with you, to try and understand what might be going on, both here in this room and at home.”

“So you have no advice for me about what I should do?”

“That’s right. But as I have said, I can listen and comment on what I hear.”

My patient left feeling cross and irritated – which was not my intention. But unless they were able to risk Nothingness, I couldn’t help them.  There are, in fact, many days when I half wish I had trained  in CBT. Then I would have a manual to refer to:

“Anxiety states pp 12-45, Depression pp 1-56, Anger management pp 45-70”

And so on. A set technique for any given problem. Learn the manual and, hey presto, you are a therapist! Apologies to my CBT colleagues for a shameless caricature of your work but sadly I can’t work like that. I like Nothing. It’s so interesting.

nothing

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