The healing triad*

In one week, I have seen two clients reject their parents – cut ties angrily or somberly – and another who could not do it. Her mother has always maintained a friendly relationship with the relative who sexually abused her daughter. We know parents who are so completely blind to their child’s personhood that it seems to be either rank stupidity or psychopathy, when in fact it is that they are so deeply defended against their own childhood injury and death that they are unable to know beyond themselves.

One of the cord-cutters was inspired by a favorite of mine: Fairbairn’s “return to the bad object.” He understood, at the gut and soul level, that he’s continued to beg appreciation from a completely solipsistic father. His final phone call was on fire. The other client, a middle-aged woman, took my lesson in Gendlin’s Focusing process – reading body knowledge which is the truer self than one’s ideas – to heart, and realized on a cold spring day that she didn’t like her mother. The end.

A young woman with Borderline Personality cannot talk about her feelings to her parents or really to anyone she knows, because she can’t suppress the truth: all is lost, all is dark, all is the end. It would be better if they understood that she is less likely to die if she could cry to them. Instead, they hospitalize her every time.

She may, in fact, be less desperate than the client who can’t dismiss her mother. She is a doctor, and in a Type A and conflicted marriage. There’s money and solidity. But if she were to confront her blind and numb parent, even ever so gently, about the friendship with the abuser, and her parent were to react badly, she would have no one. I believe she would feel quite non-existent.

And just now we discovered a likely case of birth trauma that left a child-to-man so agitated, so bursting with free-floating, edgy survival energy, that he could not stop yelling, not stop working seventy to eighty hours a week, drinking, paralyzing his limbs from over-exercise several times a day. This was Janov’s “sympath” imprint: https://cigognenews.blogspot.com/search?q=sympath. For months I, thinking about his neglectful childhood, tried to help him reach abandonment depression, deep feeling. But what if his pain was so pre-verbal, pre-limbic that it was only terror energy? Wouldn’t that be a terrible place to be, pre-loneliness, pre-existence?

We speak of “change,” but that isn’t a one-dimensional product. It may be valid to think in terms of a triad: Healing is composed of the adult’s attitude (cognitive state), core injuries, and core health. Engage only one or two factors and change will be specious.

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* This post is a precursor to the more recent “Psychotherapy without the bushy tail,” which details the “healing triad.”

This is the "worried well"

I’ve seen some of the most powerful psychopathology in a 14-year-old boy, but to most people he would seem like a relatively normal teen. He acts silly much of the time in session but speaks from a cover: adult-sounding. That’s the persona he’s grown from living with a mother who’s a scientist, and rather cold. It must be hard to live both lives, which are intertwined. In my office, he flops on her with a dumb smile, clings to her like a baby while casting her aside. “I told you I’m handling it” – the schoolwork which he doesn’t do. After three months, ups and downs and a most recent decline in functioning, I suggested that the time for silliness might be over. He spent the rest of the hour in silence, but for a few disembodied adult-sounding words and silly arm gesticulations.

That silence was a sealed door over feelings, I am positive, of despair. For our purposes, it’s not critically important what factors led to that. No father. Raised, significantly, by babysitters. A mother who was all business. Inside him, now in high school, was the twilight-zone terror of being frozen in a bleeding, alone childhood when his life was no longer there. Silence, sleep, goofiness, some video games and a little defiance: These were the entirety of his existence at this point.

We think people just move on. No, they don’t. They can stay frozen, like a transparent upright crypt in the beautiful day of an entire existence. Absent parent’s embrace of love and empathy, life stops, really. (This will become unnoticeable at fifteen, because of your obliviousness and mine.)

Fantasy impromptu #8: Three existential guys

Part 1

Progress note: “This is an ‘existential’ client, confused about his nature, his feelings, his meaning, his goals. With such an abstruse problem, it is understandable that his way of expressing himself is vague, tentative, childlike, intellectualized.” In fact, I had two such existential clients at the same time, one late twenties, one early thirties, both “lost-boyish”-looking, both with solider wives than they, both still weak-kneed from their childhood.*

What would Yalom do?

When clients are floaty in their head from the “who am I?” or “what am I?” problem, do you keep them in their head, their thoughts, or point to the ground?

What will be the ground?

The body’s feeling through their history, all the way down to childhood, infancy, birth.

That makes sense, in a way. Imagine this ludicrous analogy: A nine-year-old’s beloved pet puppy has been struck by a car and killed. In extreme distress, he gets lost in his head: “Oh no! I want to cry. Should I? What if Waggles is in heaven and is happy now? What if this is God’s will? My dad is frowning – I’d better not cry. It’s embarrassing to cry! If I start, it won’t stop! No – I’m angry! What should I feel? What do I feel?” Obviously the answer is that he should be real and cry.

But what about our client who has lost his moorings, his oneness with his first feelings, decades ago? Now his body’s felt sense and his heady question mark are interchangeable and nothing lands anywhere.

Here is the problem that doesn’t want to be named in psychotherapy. Many, many, many people land nowhere.

Part 2

Today’s client was triggered by, of all things, the concept of “splitting off and projecting.” I had disclosed some elusive, early soul murder of humiliation that got projected into all people: Were I to say something even slightly negative or rejecting or hurtful to someone, he would die. His heart would be crushed, his knees would buckle, he would die in the bleakest despair. Listening, the client was struck by images and disembodied memories of awful humiliation. He began to shake. His face blanched, suffered. He screamed terribly several times, worrying me. The truth was coming up from his stomach to his chest, to his throat. I handed him the waste basket. He dry-heaved, maybe a little wet. It should have been everything – everything should have come up – but there are assuredly constraints in my ‘vibe’ and in the thin walls of the room.

When it was over, he no longer floated. “For the first time, I feel that I am here! I am in the room with you, not in my head.” He felt landed on earth for the first time, as I had when I fell through to this place twenty-five years ago.

Some people land somewhere.

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* While this is a subject for past and future blog posts, it is true that most clients are existentially impaired as their essential or underlying problem, not possessed of a discrete disorder such as depression or narcissistic personality. Who am I? is a common spoken or unspoken question.Therefore, I have dozens of “existential” clients, not three.