December 2013 was a poor month for me, and January 2014 was worse. I’m an independent contractor therapist working at a boutique offshoot of a community mental health center. My position, on a cup-half-empty day, could be likened to a cold-call salesman hawking enema bags.
“Knock,
knock.”
“Yes?”
“You
know you want to feel better, more ‘regular’.”
“By
far, that is true.”
“Then
please – shove this up your ass. For the
next three to six months, maybe a year.”
The vagaries
of client attendance are well known to all clinicians, but there may be a
little extra looseness for those in my position. Per-unit income, no salary, no benefits. No broad opportunity to be one’s own marketer. New intakes are disbursed somewhat
haphazardly, somewhat tendentiously, among all the workers; inflation – more hires
– means fewer for each. Bad economy, people
lose insurance. I believe, additionally,
that I may be a demographic magnet for special suffering. As the male oldster here, I see more
middle-aged folk, and more men of all ages.
They have mental health problems, which sometimes include lack of sense
of responsibility to make and keep appointments. And with the younger men, their issues (1) should
be solved quickly; (2) are their wives’ and children’s fault.
Another
factor is an argument that I’ve invented and therefore pay serious heed
to. “Aren’t” – you say – “the counselors
who see young kids in the same boat or worse boat? Aren’t youngsters rabidly against self-knowledge
and improvement and sharing their feelings, and resistant to coming in?” While that is generically true, I believe a
greater force at play is the parents’
need to have their child be the patient, the one with the problem. This is consonant with Breggin’s observations
about NAMI:
“In
turn, the parents too often tend to reject responsibility for their children’s
emotional anguish. This phenomenon may
well explain the positions taken by the National Alliance for the Mentally Ill
(NAMI), a national organization of 100,000 parents of disturbed offspring,
whose informal rallying cry can be characterized as “We are not to blame.”*
This being
so, the parent is passionately, nobly and consistently motivated to bring her
child to therapy.
Yet beyond
all these pernicious and self-pitying parameters, I believe that I carry an
extra, unique burden. It is one that can
make me feel like the gentle wanderer in Peter, Paul & Mary’s song, Long Chain On – http://www.youtube.com/watch?v=xhM0hAzrl8A. This crown-of-thorns is my particular way of
seeing psychology and doing therapy; that is, my primal-related, regressive,
feeling-centered approach.
As Paul Vereshack
says, “the brain hates pain.” And as Ralph
Klein, M.D. notes in Psychotherapy of the
Disorders of the Self (though he is speaking of borderline personality),
the “patient does not come into treatment in order to ‘get better.’ Rather, he or she enters treatment primarily
to ‘feel better’” (p. 217). My underlying
approach asks the client to question almost everything about himself short of
the deepest birth trauma.** To question
the defensive behaviors, the defensive beliefs, the defensive personality. And to feel the results. And to stay
with and work through the
feelings. Though I encourage clients to
“get therapeutic momentum” by attending weekly for a while, looking inward
causes them to stop the momentum of their running life: the self-evasions, the
delusional happy beliefs. They sit in a
quieted pool, and if things go well, they sink.
People are
dysfunctional because of injury, the injury is usually child-deep, and deep
means a kind of surgery is needed. The
difference is that this surgery occurs week after week, and the patient must
remain awake for it – more awake than she has ever been since childhood.
So I do feel
like the song’s wanderer –
I
got my hammer and chisel,
Offered
to set him free.
He
looked at me and said softly,
“I
guess we had best let it be.”
– who could
relinquish the chains of a methodology that carries people to places they both
want to and don’t want to go, but can’t really relinquish them. We therapists are embedded in our
psychohistory exactly as profoundly as a poet is equal to his verse. Both professions have frameworks and rules
and “ethics” (can you call a poem a sonnet if it has seven lines, a loose rhyme
scheme, no pattern of stressed and unstressed syllables?), but are transmuted
by the idiosyncratic content of the practitioner. Most psychotherapists want to minimize the
dark parts of their soul, appreciate the intoxication of positive and rational
(yet sometimes irrationally hopeful) thinking, and they want their clients to join them. I have a history that formed a severe allergy
to delusion, deception and distraction, to ignoring the elephant and the
trichotillomanic child in the room. I,
also positive and hopeful, want my clients to join me in the intoxication of
deep reality and clear sight, in the strength accruing to accurate judgment. Or, if not to join me, then at least to see
there is a difference. I really can’t go
anywhere else in my helping: That would return me to the child still alone in
his room, watching the powerful people blindly walk by, and pulling out hair.
All in all, it’s
actually a pretty light chain.
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* Peter R.
Breggin, M.D., Toxic Psychiatry, St.
Martin’s Press, 1991, p. 34.
** That is left to “orthodox” primal therapy.
** That is left to “orthodox” primal therapy.
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