Saturday, November 15, 2014

The disappointed person

I have a client who seems on the verge of killing herself.  So in obvious ways, it is terrible to be her, and terrible to be me.  To the best of my memory, I’ve never made this prediction about anyone before, even though half my clinical years were in crisis intervention, assessing and treating disasters in cramped Emergency Services offices and hospital ERs, writing M-1’s or pink slips (involuntary commitment) to in- and out-of-county psych units.

Seeing this client gutted and miserable, month after month, damages my professional narcissism which long believed I could turn dark to light, or at least to grey.  Why does the skill-luck-magic not work now?  And isn’t the bitterest irony that she has continued to drag herself to therapy – real hope, by appearance – all to eventually dilapidate to a hospitalization?

Once she’s out of “official” danger, I will work harder based on a complex of emotions: relief, anger (at two people), care, and more complex ones I foresee having to do with the beauty and necessity of life, and the contradictorily sanguine and embarrassing feeling of having a second chance to help.

The young woman grew up starved of love and too assailed to form any ego defenses: mother’s early death, father’s depression and immaturity that moaned “giving up” every day of her life.  Then one day a mirage appeared, a young man who was everything: father and mother and lover and meaning, past present and future.  I knew he was an Antisocial Personality, alluring and luring her on.  But it gave her back her life.

Then he barked ‘it’s over,’ and she became herself: nothing but pain and emptiness, nothing to stand on.

I believe, without seeing it directly, that “pain and emptiness” is the radical core of many people.  Possibly it’s the deeper, real reason that the legions of suicides each with his or her unique circumstances kill themselves.  Look under the loss, the loneliness, the eviscerating illness to see the source of depression and the real reaper: pain and emptiness in the core.

It might be helpful to consider Raskolnikov’s thought, from Crime and Punishment:

“Where is it?” thought Raskolnikov.  “Where is it I’ve read that someone condemned to death says or thinks, an hour before his death, that if he had to live on some high rock, on such a narrow ledge that he’d only room to stand, and the ocean, everlasting darkness, everlasting solitude, everlasting tempest around him, if he had to remain standing on a square yard of space all his life, a thousand years, eternity, it were better to live so than to die at once!  Only to live, to live and live!  Life, whatever it may be!*
I can, reading this, feel fired by this eternal value.  But I think it’s tied to awareness of finality, as it was for Dostoevsky who, once facing a firing squad, was arbitrarily saved with seconds to spare.  But is the feeling of love of life still real?  Could it actually still exist in the person who had nothing from childhood on?  I believe it exists, but the disappointed person has to look for it.  It may be the smallest thing, the first thing, therefore irreducible, therefore indestructible.

Therapy, now without narcissism, will try to help her find it.

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* Dostoevsky, Crime and Punishment, Part II, Chapter 6; see Project Gutenberg copy at:

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Update --
February 2, 2016 -- I wanted to mention that these many months later, my (erstwhile) client is doing well, has not been suicidal, and after my departure from Ohio has continued to engage in therapy.

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Comments are welcome, but I'd suggest you first read "Feeling-centered therapy" and "Ocean and boat" for a basic introduction to my kind of theory and therapy.