Little boy, what are you doing here?

 

My progress note read: “26-year-old client continues to ‘wear’ his fawn-in-the-headlights affect, which has not been understood, possibly, until this session.” Bottom of the note: “We determined that client has a pathological need to see his parents as ‘all good.’ He has effectively ‘EMDR’d’ (retained cognition, lost feeling of) their stunning neglect at critical points in childhood, and now cleaves to them as his primary structure.” Clinical summary suspected that he has never left childhood and ego-syntonically needs his parents as a four-year-old would. Brutal summary is that he is more psychically attached to his Mommy and Daddy than to his fiancée, and that this will cause ruin before too long. I would be surprised if he returns, unless he enjoys these long, doe-eyed peeping-out-of-the-womb silences.

A different client, 63 years old, is diagnosed with Avoidant Personality. He “knows” that every­one bullies and rejects him. I introduced him to Vereshack’s winsome concept of the “time pebble”: “These are the childhood phrases and feelings which . . . lie scattered on the beach of adult conversation.” I suggested that “his sense of being ‘bullied’ is a childhood feeling that has remained in place from early experiences, possibly going back to an epiphany of mortification in second grade.” I offered encouragement: “If you are able to see the childhood roots of your present ‘avoidant’ character, you may then be able to effect safeguards and insights to enable you to improve.” I added that he should NOT look at himself with contempt, telling himself to “grow up,” but that he should have compassion for his holistic self, which is composed of past and present processes.*

Imagine saying that to a seven-year-old – which is essentially what I was doing. With thirty minutes remaining to the session, he got up and left the room.

In so many cases, therapy hopes that the adult client will be primarily invested in his adult persona. We may not realize, deeply, how often this is frustrated. The Borderline we teach solid-gold parenting principles to, which are forgotten or failed by next session. The countless men and women who should tell their parents to shut up and keep their distance, but who continue to be guilted. The alcoholics who drink more after a good session. My clients who still sit on mother’s knee or alone in their childhood bedroom, who I can’t make grow up. Sometimes I purposely – for study’s sake – scare myself by suspecting that most of our clients are only two parts: their injured child psyche at the beginning and the unintentionally insincere words of their presenting problem at the end. Nothing but acting and dreaming in between.

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* Clinical theatre critics may fault me for failing to go full empathic, for not supporting his self-sense: “It must be terrible to feel that everyone is bullying you, everyone is rejecting you.” Empathy is a great healing agent. But when it’s offered to the client whose personality disorder has frozen him at infancy, we would only be encouraging the infantile.