Pathetic

I can’t be the only therapist to look at a client and see pathetic, despite our natural and learned compassion.  Not in the way of Gary Larson’s The Far Side psychiatrist with his session note: “Just plain nuts!”

Rather, observing someone enclosed in her tear-laden mantle of wrong suffering, and knowing the mantle won’t ever come off.  It has replaced mind, spirit and backbone.

These are the men and women whose identity was “kick me” from childhood on.  Every adult in their life was raping, drugged, id-based masturbatory and malignant – just plain fucked.  Sticking a twenty-five-year-old Child Protective Services caseworker into this torture-scape is to Windex the prison cell window: It can add an antiseptic clarity – or film – to the experience, but not anything else.  Women who come from this background carry their neediness into the world and call it love.  But actual love they do not feel: The middle-aged woman who condemns her own daughter but “bonds” with her granddaughter or someone else’s child.  She, clenching the child like a life preserver, is ultimately excommunicated and never knows why.

They will have fibroid tumors, fibromyalgia and endometriosis, irritable bowel syndrome, bleeding ulcers, lupus, arthritis at age thirty-five, knee replacement at forty, chronic fatigue, ovarian cysts, a side show of other somato-emotional exotica.  They will be misdiagnosed; they will fire their doctor, get a new one, finally cut out the offending organ that was sickened by rape or rage.  They will look ten years older than they are, worn and sick.

The client is pathetic and very hard to love because she has never become an adult in any way, and that is unbecoming.  Worse than being unable to stand on her own two feet, she does not want to or even understand the idea.  Therefore she would not even want to fake it, which in her case would be noble.  She is dedicated, moth to flame, to her aged mother, still drinks and bites the cold witch’s tit.  She sees herself as giving – the shirt off her back and car rides and babysitting and martyr’s toil to bosses, but nobody appreciates or notices her: They can’t see what’s under their feet.

I would very much like to help this client, but defeat is everywhere.  She can neither grow strong nor regress to her deepest wounds.  She can only whine and be angry about everything and never see the child under the ice: herself.

 

Future post #1: Your mother didn't have it to give

This is an article that I will not write until I am hopefully much older, and a few months distant from my deathbed.  That’s because this is the bleakest information that I will ever have to offer, and I will not have the guts for it ’til then.  The full title could be, “Your mother didn’t have it to give, or you couldn’t have received it anyway.”  My idea contradicts Vereshack’s* insightful postulate –

“We are the living disguise of a primitive and powerful childhood self.”

– with the assertion that we did not actually reach childhood, a place that implies a consciousness capable of moving and looking in the world, though maybe in fear or rage.  I believe that we remained in frozen fear and hurt that could never become verbal.  It needed the perfect mother (not the “good enough”** one) to pull it from hell; but that would be nearly impossible because she would have to know that is exactly what she was doing.  Otherwise we would be alone – the beginning of our aloneness.

The next idea would be that all of our words, thoughts, acts, feelings, beliefs, cradle-to-grave symphonies are slow-running escapes from that monster in our dreams.  As Janov*** said, we wake from sleep not into consciousness but into unconsciousness: Our back turned, we don’t see the monster as we go about our day.  But it, a blanket of fire, is always swaddling us.

So the day will come when I write this article.  In the meantime we drink wine or beer or Rachmaninoff to feel good; we work or play.  But if we are acute, we feel what we can’t see or feel: There is some disconnect between us and all the things of the world that should be orgasms to our eyes, our skin.  And we may know that we are still at our beginning.

’Til then.

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* Vereshack’s on-line psychotherapy book, often quoted in this blog.  From Chapter 2 -- http://www.paulvereshack.com/helpme/chapt2.html.

** Winnicott’s idea of the good enough mother.

*** Arthur Janov, PhD.  This idea is found in either The Primal Scream or The New Primal Scream – or both. 

The lenses fell out of your glasses (Addendum: January 1, 2023)

I am having a hard time getting licensed in my destination state.  Counselors, apparently, eat their own rather than save their turf wars for social workers.  While Colorado accepted me from Ohio, in 2001, “as is” – I had only to take a jurisprudence (counseling ethics) exam – for the State of Nevada, an accredited graduate program, twenty years' intimate client work with no malpractice suits and a constant stream of women clients who gussy up to see me* aren't enough to give me standing.  I am considered by the punctilious panel known as the Board to be under-equipped.

Equipped, though, I am: with aggravation.

It may come down to education: a couple basic courses that were not required when I was a student.

This brings up the question: How is one assessed to be a good therapist?  The National Counselor Clinical Exam (NCMHCE) is as acute a determiner of quality as would be a panel of etymologists judging a novel by the cumulative Scrabble® point-value of its words.  (See footnote to blog post http://pessimisticshrink.blogspot.com/2014/11/intervention-tidbit-4-perfectionistic.html).  Psychoanalyst candidates (the Freudian school) must go through years of their own on-the-couch analysis to earn their prestigious profession.  But Jeffrey Moussaieff Masson’s exposé of the money-making cynicism, sleaze and hidebound dogmatism of that process seriously dethrones it as a filter for quality.**

Psychology aficionados and students hear about the “great” names, the hall-of-famers of theory and therapy – Freud, Ferenczi, B. F. Skinner, Albert Ellis, Carl Rogers, Fritz Perls.  But I think we must pause long and wonder what built their statues.  Watch these last three in the classic Gloria sessions.***  Gaucheness and buffoonery aside – that severed babbling head of Ellis wants to pinch your bowels and chase you, like a Ringwraith,**** into your dreams at night – I believe we see little but death in the water, tedious conversations that are not moving, life changing.

No one, really, can crown a passable, good or great therapist, but for the individual client.  And even that verdict loses its terra firma when the definition of “good” must contain self-medi­ca­tion, self-soothing.  If we condone her happy thinking –

By end of session client had reached the enlightening but troubling insights that she ‘lives in her head’ – her preferred thoughts of forgiveness and acceptance – and is out of touch with her deeper, felt-sense knowledge of herself; and that she may prefer to stay in the self-delusional place. 

– we are leaving her to her pre-therapy state.  Yet she may feel we have helped her, feel relieved.  I interpret and connect the dots across a woman’s childhood to show her how justified, how right she is to dislike her small children.***** Now she feels seen, cared about, vindicated.  But I suspect she’ll only back so far into her cold and abandoned past, and intrapsychically will work some soothing détente between her “child” and her children.  She’ll remain partly in the adult clouds.

Nevertheless, good work exists, though "the good's" internal definition is always moving and changing inside us.  I can guarantee the State of Nevada that I have a fairly good handle on it.  But I’m afraid they want me to learn more about alcohol, and maybe the Somalis.

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* Hey Man, the front desk ladies have informed me of this, as the women have said it to them.

** Jeffrey Moussaieff Masson, Final Analysis – The Making and Unmaking of a Psychoanalyst, Harper Perennial, 1991.

*** -- https://www.youtube.com/watch?v=odnoF8V3g6g, https://www.youtube.com/watch?v=ee1bU4XuUyg, https://www.youtube.com/watch?v=8y5tuJ3Sojc.

**** http://en.wikipedia.org/wiki/Nazg%C3%BBl – Tolkien.

***** Addendum, Jan. 1, 2023 as I noticed that more than a hundred anonymous (those who do not leave comments) readers caught this old post. I should have expanded on the situation of the mother disliking her children. A very interesting explanation of the paradoxical phenomenon of accepting the worst about oneself is given in P. Vereshack's online book at https://www.paulvereshack.com/helpme/chapt20.html#9. A harrowing scenario ends with the author's comment: "Only when the patient experiences the full power of her rage against her children, does her pain rise to an intensity which will fracture her defences against remembering that her mother used to threaten her life regularly."

Being 18

I’ve long had the sense of a problem that may not actually exist.  Yet I believe it strongly.  I believe that many terminal teenagers – eighteen year olds – are in a terribly difficult place.  The ones I see in my office are not ready to move on, they cannot deal with the face of adulthood.  They are at an impasse, the end of the road where they stand, but that keeps going on.  I know eighteen year olds who hit that birthday, that high mark, then leak and stumble into empty but intimidating days.

I don’t personally know what it takes to move naturally, happily or peaceably into adulthood.  I didn’t do it, and my young men* are brakes, potholes, empty tanks not vehicles riding into that future.  I submit that real maturity is a very rare thing and that most people yank themselves panicking or sleepwalking or angrily over the divide.

Troubled children of troubled parents grow up too slow or too fast – bleeding wounds or smooth scar tissue – which means that they don’t grow right.  Wishing that the ascendancy to adulthood were true, assuming and thinking it is so, equating the necessity of it with the fact of it, adolescents’ naming ambitions and speaking wisely or hopefully or cynically with sophisticated words – doesn’t make it so.  These are still children, needing to be held, needing to be heard, and the wind pulls them but they do not fly out of the nest.

A recent Yahoo! news article** covered the “spate” of suicides at Tulane University.  A “28-page compendium of students’ firsthand accounts” “depicted a campus in a full-blown mental health crisis.  Students struggling with anxiety, crippling depression and other serious mental illnesses said they weren’t receiving the help they needed from the overloaded campus counseling center. . . .”  “Students wrote about falling into a hole of despair, wanting to die, and feeling as if no one at Tulane wanted to help.”  Society’s Sociology 101 bromides fall in line: “growing pressure to get into a good college”; “over-involved” helicopter parents who leave their children enmeshed and helpless; proliferation of psychiatric drugs – lifesavers and prosthetic spirits that enable more youngsters to get to college.  But underlying all of these factors is the developmental material that these families create: Emotionally injured children stop assimilating experience.  The binds of defenses keep them from breathing-in the world.  They contort in quicksand while the world grows around them.

Steven Levenkron makes the premise that “underparenting” is the source of many children’s obsessive-compulsive disorder.  Lacking the healthy dependency on a "nurturant-authoritative" parent, the child both projects his anxiety upon an unsafe world and soothes it by ritualizing his safety-making.  In 1991, the author wrote that

“Underparenting is on the rise in this nation, and so is OCD.  During the past ten years, the number of reported cases has increased alarmingly, and this rate of increase is almost certain to accelerate in the decade ahead.  We live in an age when millions of parents are so obsessed with making money that they do not have enough time or energy for proper child care, an age when the drive for a fashionable image defined by expensive cars and opulent homes, designer clothes, and flawless faces and figures has driven couples into modes of thinking and ways of living that are separating parents from their children much too early.  This style of living prevents them from ever being close enough; often mothers feel that caring for their children is the lowest part of their day in terms of self-esteem.  . . . .

“All this is disastrous for the nurturing quality in our nation.

“. . . . This means more and more young people struggling with emotional isolation, unable to depend upon anyone or anything but their extraordinary rituals. . . .”***

Sometimes, in inspiration or desperation, I’ll find myself offering one of these youngsters in psycho-existential stasis a lite hallucinogen.  I will say that this traversing is the frightening part.  Get over the rim, soft-land in the adult country, and things will feel better.  Though I've said this in a therapy that may have some magical qualities of re-parenting, I honestly don’t think I know how to get more accurate or eloquent than that.  I believe this is a problem.

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* I see many more older teen males than females.

** http://news.yahoo.com/tulane-s-mental-health-meltdown-144028239.html;_ylt=A0LEVj5KDR9VwZ8AegUnnIlQ;_ylu=X3oDMTEzMW0yNTZkBHNlYwNzcgRwb3MDMQRjb2xvA2JmMQR2dGlkA1lIUzAwMV8x.

*** Steven Levenkron, Obsessive-Compulsive Disorders, Treating and Understanding Crippling Habits, 1991, Warner Books, p. 3.