Your final diagnostic evaluation

In your last days before you turn to the grave, will your spirit have love and good memories or will it be bitter and crash-and-burn? I’m conceiving this as the final and maybe truest diagnostic assessment of the psyche, which formed in the primary crucible of birth, infancy and early childhood. All later development will be adaptation and not our true self. So many layers of experience, like the earth’s layers. But in the end, at our death, it’s the core that will either be white hot and ruinous or it will be the hearth that fades to cold.

I suspect that I may be the bitter ending, notwithstanding the good things in my life. I think the best I’ll be able to hope for is ambivalence: warm, cold, pastels, dark, post-regret. It won’t make a difference if I predecease my wife or not. The core is the core.

I see clients who you’d think had a basic benignity but who repeatedly sabotage themselves. Others, such as a fifteen-year-old very depressed boy, talked and felt away much of his thick dark layer to reveal a bright sun. There is every reason to believe that it’s the core that determines long-term success or failure in therapy. It’s the core underlying all our feelings and beliefs about ourselves that determines our final phase, that death bed.

Can therapy change it, our primal identity? Maybe the best it can do is sink a few pastels into the breach. Therapy can’t give you the good birth, the good mother, the parents who loved each other. But it can visit that core. And if it goes there, it should add warm light.