Counselling, Dreams, Hope, Narratives, Psychoanalysis, Psychotherapy, The Inner World, The unconscious, Ways of Being

Cinderella continues

I wanted to take my musings on the Cinderella a bit further and look at the story in terms  of Freud’s paper “Mourning and Melancholia”. (These days we talk about depression, not melancholia. It is the same thing.) I started by thinking that Cinderella was depressed. The story well describes the feelings attached to depression. A sense of impoverishment (sitting in dirty clothes in the ashes).  A feeling of being persecuted ( her step family hate her). Feelings that any task is impossible,( the tasks set her by her step family).  An idea that everyone else is much better off than oneself ( her step sisters can go to the Ball but she cannot).  Then I began to think a bit more deeply. Cinderella is Mourning .Her mother has died and her father has, effectively, abandoned her. But despite all this, she can still have Hope. She can dream that she could, somehow, go to the Ball. She can believe that she  is worthy.This self belief is more than justified when the Prince falls in love with her. It is also her self belief that allows to try on the glass slipper. These are not the actions of a woman who is depressed. The depressive would have decided that nothing was ever going to be good again. That the ashes in which she sat were all she deserved and all she could expect. She would not have gone to the ball and certainly would not have tried on the slipper. What was the point? She was ugly inside and outside.

This, of course, is one of the difficulties with depression. And the difference between Mourning and Melancholia. Freud puts it like this “In mourning it is the world that has become poor and empty. In melancholia it is the ego itself.” Cinderella’s mourning for her dead mother eventually allows her to begin to hope. (Or this is so in the Perrault version.) From a place of mourning she can begin to heal. Things are transformed. A pumpkin becomes a Carriage. Mice become Horses. A rat morphs into a Coachman and a lizard becomes a Footman. The things around her that are ordinary and commonplace become a source of pleasure and optimism. Not only for Cinderella but also for the Prince. And, by implication, for a new dynasty since Princes and Princesses always continue a Royal line and hopefully, rule well and wisely.

The picture at the top of this blog is Durer’s “Melancholia”. In it the central figure is surrounded by all the riches of the world but is unable to take any comfort from them. Durer obviously had a keen understanding of Depression! It is one  of the challenges of working with someone who is depressed. Along with the sadness, there is frequently a profound rage. (An extreme example of this rage being acted out is in suicide, which, amongst other things, is an attack on those around. Born out of a fury.)

Cinderella was sad. Understandably. But she had enough good things inside her to allow her to grow. To hold on to Hope. She could accept her sadness and mourn the things she had lost. But she did not need to destroy herself in the process.

Advertisements
Standard
Counselling, Mindfullness, Psychotherapy, The Inner World, The unconscious, Uncategorized, Ways of Being

10 Miles to go

A friend and I completed a 100 mile cycle ride yesterday. It was hard work! But enjoyable-if you like that sort of  thing! We managed to achieve Gold medal standard in our age group by finishing in seven hours. We had not set out with any expectations of  doing anything more than completing the ride before sunset! The medals were a huge boost to tired legs and sore backsides. We climbed a total of 3,000 feet in those seven hours. And alternately cursed, smiled, wept depending on where we were at any given point in the ride.

The hardest part came after 90 miles. There was a sign proclaiming “10 miles to go.” We whooped with excitement. A mere 10 miles. No problem! A few minutes later my friend turned to me and said “You know what that means, don’t you?” “Yes,” I said. “It means we’ve still got another 40 minutes riding to do.” For a short time our euphoria vanished in the face of how much work was still left. We carried on pedalling and, eventually passed over Marlow bridge and in to the finishing area, got our times and medals and gave each other a High Five, grinning like a pair of Cheshire cats.

As a mental health nurse I was always taught that the most dangerous point in the recovery of someone who is depressed, is not the acute phase. Mostly they are too depressed to act out in any way at all. The crisis comes when they are getting better. I’d always taken this as axiomatic. A useful piece of clinical data when managing somebody who is depressed. That remains true.  Until yesterday, however, I had never really experienced that maxim first hand. We’d ridden 90 miles. We’d got up at six in the morning, loaded the bikes, parked the car, signed in and set off on the ride. We griped, complained smiled etc. Then we  got to the “almost there” mark and nearly threw our bikes away and called a taxi .I’m pleased we didn’t. (And  “Thank You”to all my friends who sent “Bravo” messages.They are much appreciated.

Whilst being ill is horrible, one knows where one is in a strange way. Hair falling out? Blame the chemo. Depressed. Blame the divorce. Dropping things? Blame the arthritis. One gains much justified support and sympathy an acute phase. The problems begin with recovery. One’s life is no longer in immediate danger. The expectation is that one can resume normal duties-albeit in a graded way. It is this stage that is the most demanding. Having come so far, that final 10 miles seems so near yet so far. Small wonder that this is the danger phase in so many illnesses. As it was on our ride. Hope had been kindled followed by the almost overwhelming realisation of how much effort was still required of us.

Once more I’ve had practice teach me the real meaning of theory. But on reflection, I’m still pleased they told us we only had another 10 miles left. If only because it made the 5 mile marker all the sweeter.

 

10 miles to go

Standard
Counselling, Reflective Practice, The Inner World, Ways of Being

Thoughts from a Sportive

_knebworth_house_

On Sunday two friends and I did the Herts 100 sportive. We cycled 100 miles in a total of eight hours. Seven hours cycling time, eight hours elapsed time as my friend carefully pointed out. (Seven hours riding had been our target time.) This blog offers some reflections on that experience.

The first thing is the difference between 100 miles on paper and 100 miles on the road. Sitting down on a sunny afternoon with the application form reading 100 miles through the Herts countryside, one thinks “That’s fine. It’s only a long training ride plus a bit more. I can do that.”  What this mind-set misses out is that we got up at 5:30 a.m.in order to be at Knebworth house for an 8:00 a.m. departure. Plus I had booked tickets for the ballet on the Saturday night and had spent Friday and Saturday at a conference in London. This meant that all my careful plans for a quiet preparation were impossible. I had hoped to have Saturday at home. Servicing the bike. Eating a large pasta meal and getting an early night. In the end I rushed back from the conference. Dashed off to the ballet. Parked the car and found the nearest quick service restaurant to eat before the performance.Shovelled  down some rice and sat down to the performance. (The ballet was Matthew Bourne’s amazing product of Swan Lake.I was in tears at several places.)

So, preparation is all, it is said. (I felt more like Alf Tupper than Lance Armstrong.) But we made it to the start. Found each other and set off, slightly later than planned.The first 30 miles were reasonably comfortable although the pace was faster than I would have liked. I also rediscovered what a selfish sport riding can be. I stopped to see if I could help another rider who had a mechanical problem. I called to my friends but they were already gone. So I got back and carried on riding, hoping to catch them. (I did but it meant riding much harder and faster than I wanted.)

At this point I want to become slightly allegorical- as I shall be at various points through this blog.I was annoyed at my friends for ignoring me and a fellow rider. In his place I would have hoped for some support. As clinicians there is always a danger that we become so target driven that we forget the reason we are here. Our own needs take precedence over those around us who might need a helping hand. Does it really matter if I do this ride in seven hours or seven and a quarter? (Ask my wife about the joys of riding together!) In the realm of Mental Health we seem to be working to a minimum standard. How few sessions will this person need to get back on their feet? Can we give them a CD and call it Self Help? We seem to have created a system where the patient has to fit the service rather than the other way round.

Back to the ride. Signage is important. Mostly the organisers had good signage. Arrows showed clearly left turns, right turns etc. Often there was a marshal as well. But there were several long stretches with no signs for about five miles. I followed what I hoped was a directional arrow, assuming that I would see some signs confirming my route. Eventually there was one pointing to the next turn. But I had already cycled 50 miles and was feeling tired. The thought of having to cycle an additional five miles brought me near to tears.

This is my second allegorical point. Signage matters. I had no way of knowing with certainty that I was on the right road. It is very easy to misread a sign after 50 miles. No doubt the organisers thought it was obvious. On the road it felt very different. As clinicians we know the road. !0-12 sessions of therapy. A support group. A visit from a nurse. It sounds fine.But that still elves an awful lot of unsigned time. “Who do I contact at three in the morning if there’s a crisis?”  “What happens when DSS mess up my benefits?” “Who can I talk to about my husband / wife /child?” As a health professional I work in a select area. It might be a Day hospital. An Admission ward. In the Community. I know the rules for my patch. I don’t usually cross over to another area. I assume that others will do this. But our patients may nor know this. They want clear signage. “This is the right way.You’re doing fine. This is normal at this stage.” Do not assume that because somebody somewhere knows the route, it will be obvious to me!

There are some more ride musings to come. But Ib have written 800 hundred words. That’s enough.

Standard
Counselling, Reflective Practice, Religion, Spirituality, The Inner World, Ways of Being

He is risen?

RisenChristI am writing this piece on Easter Sunday. The day when Christ rose from the dead, according to Christian tradition. The implications of this vary widely, depending on one’s emotional and theological make up. For some it means that our sind have been forgiven. That Eternal life is now available to us if we accept the gift that Christ’s death make available to us. We give our hearts to him and he makes sharers in his Risen life. (Not accepting this gift means that we spend all this life and the next separated from God-and all that might follow from that state.) Another version is that Christ’s death shows us that God is not sitting in Heaven remote and untouched by humanity’s struggles. The death of Christ shows us that God knows about suffering and walks the road with us. These are two of the many shades of meaning attached to the Easter story. Which version one chooses is, I think, shaped as much by personality as by reason.

I have no idea what happened on the original Easter Sunday. Nor do I know what implications follow from that. I spent too many years following the traditional evangelical line that I was a sinner who was bound for hell unless I accepted Christ as my personal saviour. I worked very hard at believing that doctrine. I was successful at it.I’ve preached on street corners; witnessed; given out tracts; cast out demons; spoken in tongues,prayed and prophesied. And kept quiet about those “But…” questions. Then I went into therapy and had a chance to ask all those questions. And find my own answers. Which meant that I left all those evangelical certainties and have never come back to them. So, I too have my own empty tomb and am left wondering what happened to the body I buried there.

In 1892 Martin Kahler coined the phrase “The Jesus of history and the Christ of Faith”. As with any phrase, Kahler’s original meaning has been changed over the years. I want to add my own interpretation here. I offer a psychological interpretation.  To think about our own “historical Jesus”. The parts of us that are not divine. The ordinary everyday us who was born, lives, goes about mundane daily life. We can date when we were born.Where and to whom. We know about our growing up, going to university, marrying, having children etc. All the usual activities of daily living. We have good days and bad days. Times when we are sad. Times when we are happy. Ordinary everyday lives. The Christ of Faith belongs to those parts of us that dream dreams. See visions. Choose to Hope. When I worked in a Therapeutic Community we always had a good-bye tea when someone left after their year. We made much of it because it was a new beginning as well as an ending. Good Friday and Easter Day. In standard psychiatric units this ending is not marked. A decision is made and the patient is discharged. There is no ceremony to mark the event.There is no discovery of something different or new. Nor any chance to mourn what has been left behind.

If our ordinary lives might represent the Jesus of history, where does the Christ of faith fit? For me, the Christ event is found in moments of change. The moment in therapy when one feels understood. Or when as a therapist something makes sense about a patient. From this understanding, new work can start. A Christ event occurs.A different future can begin. Equally Christ events occur when all we see is Good Friday with its suffering. “My God, why have you forsaken me?” It is an act of faith to believe that there is an end to pain. To dare to hope that a resurrection is possible. Holding this hope is also the task of the therapist. I remember working for a long time with one patient whose childhood had been grim but who refused to mourn what he had lost. “I’m not going to be a fucking victim” was his catch phrase. He defended against this by presenting an air of contempt for everyone. The Christ event occurred when he allowed himself to acknowledge the hurt and vulnerable aspects of himself. This cost him many tears. From this point new life was possible. But I had to keep the hope. To believe that change was possible, even though it frequently seemed a forlorn hope.

These are my Easter thoughts. They are a long way from my early fundamentalism. But the pleasure of my current thinking is that it fits. It belongs to me. I can live with a Jesus of history and a Christ of Faith. I have to since I know too well the cost of trying to be someone else. Words from Eliot’s poem “The Journey of the Magi” come to mind.

All this was a long time ago, I remember,
And I would do it again, but set down
This set down
This: were we lead all that way for
Birth or Death? There was a Birth, certainly,
We had evidence and no doubt. I have 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.

I will leave to the last words to the choir of King’s college, Cambridge singing one of my favourite Easter hymns.

 

 

Standard
Counselling, Mindfullness, Psychoanalysis, Psychotherapy, Reflective Practice, Schizophrenia

Hope

ImageChristmas is an odd time if one writes a blog. One option is to studiously avoid any reference to it. Another is to debunk it a la Scrooge. Or one takes some kind of spiritual view of the festival. I’m hoping to try and write something of my own thoughts about it – and link it to some wider ideas. In 1919 W.B.Yeats wrote a poem called The Second Coming which has the lines “And what rough beast, its hour come round at last, Slouches towards Bethlehem to be born?” The link is to a reading of the poem

http://youtu.be/OEunVObSnVM.

I’ve always liked the image of a beast slouching towards Bethlehem, waiting to be born. This is no triumphal entry,  no birth announced with trumpets and fanfares. This creature waiting to be born, travels holding its breath. As if by no means certain of reaching Bethlehem – or anywhere else for that matter. But it carries on, hoping to get there in time. (I always think this creature would be much happier out in the fields with the sheep than accompanying the Great and the Good. And even in the fields I always suspect it would stay on the edges, near shelter. Not certain what welcome would meet it if it made itself known.) For me this creature is Hope. The birth of any baby is a hopeful time – albeit mixed with anxiety. Babies represent many things but at best they stand for hope. A desire to make things as well as possible for it. To look after it, care for to nurture it. From my work as a psychiatric nurse I have been involved in a few cases where a woman has had four, five or six babies taken into Care (an odd euphemism!) because she is not considered able to look after them herself. Each new pregnancy represented another chance for these mothers. Their hope was that this time things would be different. This time they could look after a baby.  The authorities decided otherwise and each child was taken away – leaving another generation of damaged individuals. The Christmas story is about a baby who wasn’t taken away and who represented a new beginning for both his parents and, we are told, all humanity. Hope was born in Bethlehem albeit, as T.S.Eliot has it “more like a death a birth”. Hope is like the Eliot line. It costs to hope. In my teaching the phrase that many of my students use is “I will offer reassurance.” When I ask them whom and what they will reassure they reply “The patient”. I then ask what reassurance will they give?  Things go quiet at this point. I tell them “Reassurance never reassures”. We “offer reassurance” to make ourselves feel better. We cannot make guarantees about outcomes. The best we can do is to hope. I hope I will not be involved in a car crash coming home. I hope my children will grow into healthy adults. I hope that I will pass my exam. But this is not certain. An exercise I do with my students is to give them Brian Patten’s “Prosepoem towards a definition of itself.” I ask them to replace “Poetry” with “God” and then “Nursing”. The responses are aways fascinating. It also works well with “Hope” – Prosepoem towards a Definition of Itself by Brian Patten

In all clinical work, Hope is essential.  (I have four psychoanalytic dictionaries. None of them have an entry for “Hope”.) Hope is not false assurance that everything will work out well. Hope is this can be survived. Together we can find a way through this. I tweeted recently that ” … some of the work of therapy is to decipher what can sound like babble and reframe it as a shared language.” A shared language gives us the possibility of a shared understanding. From this hope can be conceived. And born. And helped to grow. But Hope will never wear King’s robes. Or expensive vestments. It will be hiding in corners. Sitting on the sidelines. But always slouching towards Bethlehem, waiting to be born.

Standard
Counselling, Psychotherapy, Reflective Practice, The Inner World

What have feelings got to with anything?

ImageSome years ago we were having dinner with some friends. Jane was talking about an incident at the school where she taught. I listened and asked “How do you feel about that?” Before she could answer her husband commented ” What a self referential question ‘ What do you feel about that?'” That stopped her in her tracks and the conversation moved elsewhere. It took me a long time to think about his question- and to find an answer. My answer is “Why should a feelings question not be self referential?” We were not discussing whether acid burns or whether the moon is round, which are questions of fact. I was asking about her inner world. The men whom I have seen for Anger Management are very remote from any inner world. They have little idea of the effect of their behaviour on others. Little idea of the effect of their behaviour on themselves. Mostly because they are emotionally inarticulate. They have no vocabulary of feelings. (Which is not the same as having no feelings.) When this inability to articulate one’s feelings is linked to a sense of entitlement, there is a recipe for misery.

Self harming is well recognised as being both a way to feel and a way to not feel at the same time. The angry men whom I have met use their anger in much the same way. To both feel and not feel. They can feel angry. What they cannot  bear to feel is loss, sadness, fear, anxiety, vulnerability. At least some of the reasons for this are defensive. If I make  myself vulnerable, will anyone know? Or care? At its most pernicious, Anger represents an attack on Hope.For patients B and C they had lost Hope. Almost as if it was a parent from whom they had become separated in a supermarket. But a parent who was never able to be found again. THese men had developed autistic thinking as an art form. As a veey effective way of not thinkijng. Rycroft in his Critical dictionary of Psychoanalysis (Penguin 1968) defines Autistic thinking as “… thought which is determined solely by the subject’s wishes and phantasies without reference to the environment or realistic considerations of space and time.” In this style of thinking, the ego is King. I need make little or no reference to the outside world except when it suits me. I will use whatever means I can to keep dependency at bay. And Anger is one very effective way of keeping everyone at bay.

My work as as a counsellor is to provide a safe place where it might be possible to Hope. Or at least think about the implications of Hope. And if-when – hope becomes possible then other feelings can come out the closet in which they have been locked. Laughter, joy, fun, pleasure. But also loss, pain, loneliness, fear. But these last ones need not be so feared. Because with Hope comes the ability to allow the full range of feelings. The Apostle Paul wrote “… hope does not disappoint because the love of god has been poured out into hearts through the Holy Spirit.” (Rom 5:5) The KJV puts it better, I think , in its translation “Hope makes not ashamed…” To Hope is to Risk. I might be let down again. I might fail. But Hope also enlivens. And that is no cause for shame.

Image

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

Empty Easter Eggs 1

I went to church on Easter Sunday. I think the preacher had been told to make his sermon child friendly. His visual aids were several different Easter Eggs. He tried to make some sort of spiritual point about each of them. (I shall now view Cadbury’s Creme Eggs in a different light!) His main point was to take a Kinder Surprise egg and an ordinary one. He tried to show that an ordinary egg was not a good illustration of spirituality because it was empty. The Kinder egg, however, was a better one because it always contained a surprise. This he suggested was a picture of Christianity. It always holds a surprise inside itself. (I’m not too sure about this picture of religion but…)

Despite myself I was struck by his two images. I was, however, more struck by the “empty” egg and its possibilities. (At this point I am going to get “religious”-or perhaps”spiritual” is a better word.)

I found myself conflating two ideas from this sermon. Or perhaps three. One was the idea of emptiness. Specifically the emptiness of an Easter egg. This reminded me of the empty tomb of the Easter story, which we are told signifies Jesus’ resurrection from the dead and his eventual ascension to heaven. (All of which find echoes in psychological language.) I then played with what might have been painted on the walls of the tomb. (Hence the picture of cave paintings.) Finally I had an idea of these images “rising” with Christ into some new life, having been redeemed. (Again I think all these words have a resonance beyond their specifically Christian context.) Hopefully I will make my point in the rest of this piece-and probably in another one as well.

The Christian meaning given to the Easter event is that Christ’s death and  resurrection are a means- the means?- by which our sins are forgiven and we are able to be at one with God and ourselves. Implicit also in the narrative and subsequent commentaries is the idea that we can choose whether or not to accept this offer. If we do, the story goes, our lives will be richer. We will be made whole. If we choose not accept the offer, then we risk losing out on many levels. (And depending on how cruel one’s God is, this loss extends through all our temporal life and into eternity where we will have plenty of time to regret our choices. Or to delight that we made the “right” choice.)

At this point I want to suggest some obvious emotional parallels here. Many individuals and communities know what it is to have suffered at other’s hands-and feet. And guns. And machetes. And assorted other methods of abuse, both physical and psychological.  The image of a man  hung, naked and helpless on a cross is one graphic way to encapsulate suffering.

In psychological terms Easter seems to suggest that we have choices. That, with help, suffering can become a spur to wholeness. That trauma, whilst not to be forgotten, can be used creatively. Most of my patients come to me because they want to find a way to make sense of their past. And to try to find a more healthful future for themselves. Their past hurts and abuses are not forgotten. Nor ignored. They bring these pasts into every session one way and another. And part of the work is to try to redeem these pasts. to detoxify them. which seems to me to be one way to understand the Easter story. It is a detoxification narrative.cave painting

Standard