Pariah, friend

I have apparently offended two people whose help I’ve sought.  One is a former co-therapist, associate and “business friend”; the other is a one-time clinical supervisor of mine.  Though it’s just a guess, I believe that writings in The Pessimistic Shrink blog turned them away.  The supervisor refused to write a reference letter because of “differences in our therapy approach.”  The old associate didn’t reply to my request for advice.  Until relatively recently, both had maintained (or feigned) decent peer relationships.

Most therapists reading this would, I suspect, be surprised at the pettiness of a counselor supervisor who refused to help simply because of contrasting approaches.  I would like to assume her pettiness, too, but I know better.  What I know is that many of my writings – though always accurate to the best of my ability – are bathed in attitudes of superiority, defiance, remoteness, and bitter antagonism.  And that this is likely to reach people I’ve known.

See if, looking through a random selection of the fourteen months’ posts, you can detect a stain.  I will not help you with your search, partly because I believe the effects are very quiet, and if you fail to generally feel the soft acid of a righteous pariah, this will somewhat exonerate me.

There is so much behind this – literally, because it is childhood and most of my years weighing on top of it.  Losses and amputations of a psychic kind, somehow in consort with a truth-seeking mind, have made me an unfriendly helper, on paper.  Yet, you may, reading some articles, feel a serious benevolence that seems to belie this self-condemnation.  This is because my pain does not exist in the client hour.

When I write about my clients, I am still in an air of reminiscence about the relationship.  It is fulfilling, even warming, in certain ways.  But then I come home, and in the aloneness, all the feelings of the pariah return.

I see botches wearing parents’ clothing.  I see love that falls short, or is the wrong word, because one’s own needs were never met.  I see so many people who have escaped into feel-good thinking – an entire life of rationalizing.  When people rationalize and intellectualize, they are blind to everyone.  This blindness is the enemy – it starves.  In a way, everything I see that is not empathy is the enemy.

But then there is a client who wants to reach himself, and in that dangerous molten place there is vulnerability and some kind of connection.  The pariah is gone in those moments and the friend materializes.  And when my wife is home – not in another state as she is now – the ground becomes a peopled ground again, my mind becomes a relational mind, as they were supposed to be in childhood.

I see struggling children wearing parents’ clothes, love that’s the only thing that matters.  I see so many people lost in their heads when they need to come down to earth – a painful descent but possible with a therapist’s help.

The impossibility of anyone leaving

There is a “layer” of psychological existence beneath all the places most of us live and walk.  It’s our babyhood meaning and our infancy meaning.  It is similar to a child’s emotion: When voiced to a hearing and caring adult, an emotion passes on yet integrates into a benign stability; but when it’s unexpressed or unheard or shamed by an adult, it never leaves.  One deepest layer, personally known to me but vaguely, is the symbiotic dependency.  For some of us, because it was never succored at critical moments – never fully “heard” by the parent – it never leaves.

I remember the end of life, maybe around age three-and-a-half, before the family moved from Wilmington, Delaware to Baltimore, Maryland.  Mother left me at some sort of downtown daycare room for possibly several hours.  I remember there were strange kids, a thin mat for naptime, a woman whose friendliness was empty to me, and the hollow frightened depression of the alienness of it.  But what my psyche heart remembers most was mother’s leaving, and walking away.  This is because it was impossible.  I could not be left, because as a young unformed child I had no existence apart from her.  From that moment on, in a real way, I have remained standing there in the impossible, in disbelief, a toddler, in the end of life.

A client’s wife divorced him and has called the police several times because he does not obey the civil protection order against telephoning her and “driving by.”  He must call and look, whatever the consequences.  He has no life without her, and without being supported by his little child and stepchild.

A woman was granted Family Medical Leave because she could not function at work.  Each day she simply sat at her desk and stared tearfully at the framed photograph of her son.  She is one of the few adults I’ve diagnosed with Separation Anxiety Disorder, doubly true, because it must be her own infancy’s incompletion that paid forward into her children: a childlike mother seeking a mother in the baby.

It’s a certainty that this radical, embryonic broken link is at the base of many sophisticated dependencies – the glamorous and turbid romances we feel deeply about in movies and novels and poems.  It’s in suicides of loss and in stalking and in codependent controlling mothers.  It’s in individuals who seem to have a normal life but find that their ideas feel tin-made or cut in half: There’s something blocking their greater depth.  It’s in men like me who are fine and independent when our partner is there somewhere, but who turn instantly vacant when she is not.  How deceptive it is: Attached to the other, a man may even rage, reject and exterminate her, then evaporate when she is gone.

Part of my fallout of ruined symbiosis is an interesting feeling, so submerged I might remind myself of its presence once every decade or so: the feeling that no one can ever really say goodbye to me.  In the viscera, I do not believe that a person can leave me.  Any ending cannot happen.  How can anyone, whom I’ve met maybe only once, ever leave and become unconscious of me, where I must forget them?  How could a friend?  And there is, also impossibly, the sweet feeling that all minds, eyes and hearts, once met, must eternally be linked: We must all always know each other – always supported.  While that may seem only the mirror image of the impossibility of leaving, there is something else there that feels like universal love, a goodness that is a distance part of our Edenic template. But I am deceived. It is a flower, ripped at a critical moment of childhood: Mother left.

Idiosyncrasies, #1

Sometimes I’m a keenly observant person, sometimes less so.  One casualty of my blind eye is my transformation, unawares over recent past years, to psychotherapist guru.  This elevation, please understand, is all in my own mind, and the idea is not as hubristic as it sounds.  One part is acquiescence to ignorance: all that eludes me and that I will never know about human nature.  A bigger part is geological processes: sedimentary piling, weathering and metamorphosis.  The countless pebbles of people’s idiosyncrasies; the sharp and bloody principles of trauma, neglect and development, personality and projection, have accumulated and blurred and blended together over the years and reformed to be a quiet attitude of shy confidence and patience.

This has happened – and probably happens to many therapists – for a genial reason.  If one is interested in the psychological soul, in time the science and art of therapy melt down to just a peculiar way of looking at people.  We become, in other words, nice old eccentrics.

For me, it’s a perfect fit to have a profession that is more being than doing, where the core specialty is just to be a person.  For neurotic reasons based in childhood, or more likely, birth, I have always been revulsed by the concept of training: “Through training, he became a great doctor, philosopher, professor.”  “You can trust these men with your life, your wife, and with a knife – they’ve been well trained.”  “Rigorous training has done its job: He is a master of war and a wager of peace.”  I have always felt that a person cannot be trained – it sounds dehumanizing and mechanizing – but must only teach himself to be more of what he already is: someone interested in something.  This prejudice came, I know, out of my own identity impairment: an urgency to be a self when there wasn’t one.  To be more than that – through any sort of growth or sculpting process – was to become a replacement for that nonexistent ego.

This may be an odd way to perceive my calling, but I am certain that self study is the alpha and most of the omega of understanding the psyche, and that being a feeling and caring human – not trained – is the only way to apply it.  There are too many intellectual heads doing this work; clinicians who lean back when the client shows odd; technique island-hoppers who remake themselves with each workshop.  I think you just have to be, through time, more human, more geological. 

Intervention tidbit #4: The perfectionistic client

In the spirit of winding down, while The Pessimistic Shrink prepares for the odious national counselor clinical exam,* re-licensure and eventual relocation, it seems felicitous to present a micro-tidbit of an intervention, light of context and free of the drag of theory.  (If I were to dive into the many meanings of perfectionism, we’d be looking at anxiety and obsessiveness, absence of self and self-esteem, part-fuel for mania, facet of narcissism and psychosis, and probably more.)

The client, a STEM school teacher, had always been pulled by the need for perfection or excellence.  This had to be baby-shaken because she could feel that it was anxious, depressing and a substitute for whatever her real self was.  Before some theory was presented, I offered her the following opportunity, an opportunity for perfection.

Your favorite television show is “Bones.”  Imagine that you want to be the perfect watcher of this show.  You deeply desire to exceed excellence and reach perfection in your prosecution of this task, present episode and every episode.  You make your attention rapt; your discernment of all is steely-eyed and rocket-fueled.  You take copious notes, intuitive and microscopic, on the plot, subplots, actors’ expressions and body language and hair and dress, thoughts said and unsaid.  You watch, perceive, imagine and instantaneously build, test, and discard theories of meaning – episode-specific, cultural and pop-cultural, aesthetic, philosophical and personal meaning.  You master the story, then write an exegesis which you hone through further thought, consultations and readings.  Finally you re-watch the show through your refined eye, rigorously challenging all your tentative wisdom.

The client, of course, realized there would be no enjoyment if she watched her show as a perfectionist.  To enjoy, she needs to be a person, to do by feeling not by ego, or false ego.  Could this apply to other areas of life, where you smell the roses unself-consciously and become them, become the world . . . and thereby become you?

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* The NCMHCE tests a psychotherapist’s gifts primarily by forcing him to determine what client factors are not relevant (according to the test creators) to a consensus psychiatric diagnostic label.  My view is that the long-experienced clinician should see every client factor as relevant to an actual diagnosis and therapy: if he listens to weather reports; is unemployed and owns a smartphone; grows a beard, shaves it off then grows it again; attends therapy twice, skips three weeks then returns with no explanation; has two cats or five; wears one of those rubbery nondescript wristbands; uses words like "nondescript"; has a child who is a straight-A student; likes The Big Bang Theory; has a hangdog face or childish inflection or saucy lilt, low neckline, jeans with holes in them, ad infinitum.  The test, in other words, is the apotheosis of concrete thinking (a milestone on the way to maturity, according to Piaget).

Dark matter

I don’t know if I can take any credit for the particular kind of nihilism that possesses an eighteen-year-old client, or for his ability to know it and express it.  I’ve been seeing him for close to three years, so I have to wonder.

This young man says, deeply and seriously, that he doesn’t want to do anything.  He means it exactly, as ultimate, as it sounds.  This is not merely a matter of lacking ambition.  It is feeling a blank inertness inside that says – Sit down forever, as the mind drips or drifts passively or is empty.  Maybe feel impelled to walk to the fridge, look out a window, sit down again.  The future does not exist in his mind except as the vaguest body anxiety.

There must be a continuum of Nothing.  He is near the beginning of it, greater voids being depressive catatonia or deep-trance depersonalization.  Another client, a fifty-year-old childish woman, is on the continuum.  Whatever her job, she never wants to go to work, makes excuses for herself (“my tummy hurts”) as a child would.  The only thing she wants to do is bake: a life of comfort food.

I have no more research about this Nothing, except that I think it is part of my own nature.  So I can liken it to a large rock with eyes.  Not a tree with eyes, which one would expect to feel deeply and beautifully and to “reach out” in some way.  But a rock that doesn’t move or want to.

Getting back to my young man, one would expect a person his age to have some desire, push, or activating dread.  Look at the possibilities: college, job, career, vagabond, travel, adventure, creativity, fame, power, marriage, comfort, revenge.  Instead, it’s zero, and I find it uncanny that he knows and pretty much endorses that he is an empty old man at eighteen.

A question is – Is this common?  We talk about lack of motivation, but haven’t defined or dissected it.  We talk about depression, but no one really knows what it is.  In college, narcissism fooled me into thinking I wanted to write philosophical books, but in fact I had never had one second’s thought or heartbeat about the future during my four years.

I see a different young man, seventeen, who has lived an insular, depressing childhood.  His development has remained thin – little feeling, little information, juvenile vocabulary, little introspective ability or care – yet he claims to want to be a psychologist.  I don’t believe it and, helpful like a cattle prod, referenced Alice Miller’s “how we became psychotherapists” and Claudia Black’s “placater” persona – the empty helper.

I believe this quiet-of-the-universe is very common, like the “dark matter” that astrophysicists can’t see.  It comes out of a childhood that has stopped cold then lies within the adult who looks at the world and can only see and grab the surface molecules.  His real reality is the frozen child inside.  If we could regress, this little boy or girl would move, in flame.