Down and dirty #1: The weakest of men

A little comment (https://nyti.ms/3PWZyRL#permid=122256406) to a recent New York Times article on domestic violence and murder-suicide:

Men are often lonelier and needier than women are. Their plight – their dysfunction – starts in childhood when they are discouraged from expressing – giving to a caring other – their full spectrum of feelings. Because they're supposed to be real men. They become self-enclosed repositories of need for emotional bonds that they are not allowed to have. Men who stalk are desperate children of abandoning parents, but now are big and angry. The same for men who abuse and kill. The irony is that women who are victims are subjugated by the weakest of men: little boys who couldn't grow up.

This is a generalization that you can count on. One, it's hitched to a basic principle of human dysfunction: the ungrown "inner child" which is most of us. Two, boys are still tainted by the culture of macho, the strong, silent type, the less-feeling, the aggressive. This is not to say that girls do not grow up needy for love, and lonely. But there is a difference, the difference between reality- and delusion-based suppression. Girls will be deprived of what their introjected lesson tells them they should have: communion, bond, an emotional life. Their whole is injured, but vital. Boys are deprived of vitality as they are given to assume they should be left out in the cold. The soldierly calm, the soldierly lost. They can't conceive they are merely human.

Men are born, live and die under this delusion. What a fate.

Christmas Eve-Eve warning

I have already written with disgust about the empath.* I am displeased with people who think they're that. Such a conceit advertises different waves of blindness and fakeness. It's usually wounded people who don't know what they feel who believe they know other people's feelings. Even if sensations and emotions were as simple as categories rather than the near-infinite shades of chemistry they are, could a so-called empath pinpoint me somewhere on this?

To expand: A person who purports to "resonate" with another person's emotional state may be extremely repressed and therefore may not feel for the other person. What is empathy without care? In fact, it's "psycho/logical" that deeply buried people will be triggered by others' negative feelings, just as someone might weep at a Hallmark movie but have no feeling for their grieving neighbor or for nameless victims of authoritarian regimes. The inner child is being triggered but the adult is armored, cold and obtuse. We know that some of our most troubled parents of troubled children are "empaths."

At Christmas – though it's sunny and pleasant here in Henderson, NV and mortally cold elsewhere – we feel moments of childlike love and care for others, even strangers. It fades like the morning dew.** Jesus can do that to children, which (I constantly say) we are.

- - - - - - - - - - -

* https://pessimisticshrink.blogspot.com/2021/01/tps-whats-next-thing-youre-disgusted.html.

** https://www.youtube.com/watch?v=2LWgXIwLKXg.

Dry humor, or wet seriousness #7: I ponder as I wander

1998 or thereabouts, between 2 a.m. and 4 a.m. Emergency Services clinician at Netcare Access, Columbus, OH, to a walk-in homeless man who probably wants a sandwich and an Apple & Eve juice box: “You are feeling suicidal? Do you have a plan?”

No-Eject No-Reject Client: “I’m going to jump off a building.”

 

1998 or thereabouts, between 2 a.m. and 4 a.m. Emergency Services clinician at Netcare Access, Columbus, OH, to a walk-in homeless man who probably wants a sandwich and an Apple & Eve juice box: “You are feeling suicidal? Do you have a plan?”

 

No-Eject No-Reject Client: “I’m going to jump in front of a bus.”

 

1998 or thereabouts, between 2 a.m. and 4 a.m. Emergency Services clinician at Netcare Access, Columbus, OH, to a walk-in homeless man who probably wants a sandwich and an Apple & Eve juice box: “You are feeling suicidal? Do you have a plan?”

 

No-Eject No-Reject Client: “I’m going to jump in front of a building.”

 

Clinician: “That’s probably not going to kill you, but that story deserves a sandwich.”

 

🔩

 

I am in a rancid mood these days, but the above account is true. My shift was 12 midnight to 12 noon, Friday, Saturday and Sunday. With 24-hour crisis availability, nurses and psychologists* would drag their recalcitrant teens to our facility at 3 in the morning, such as the 14-year-old boy wearing high-heels and an evening gown (those were the days when that was OK but not yet de rigueur). When a Borderline threw her colostomy bag at Barbara D__ (the social worker who, admittedly, most deserved it). When a Somali man would make a bee line down the way, knocking all the computers off the long desk. When a Somali woman was seen eating the chair’s vinyl seat in the interview room.

 

Now, after years of doing one-hour once-a-week therapy with variably amenable clients, I can’t quite remember how I would help those folks attenuate – temporarily or even longer – their extreme crises. I was full of depth psychology information, which could then as now help someone see their plight from an understandable, valid and self-compassionate perspective. I was saturated with peak moment solicitous care and respect. But the magic that would make someone immediately stop feeling deathly – that may no longer be in me. But maybe it would kick in again.

 

Looking back to those hours, those years, I wonder if that work was in some ways more fulfilling than individual therapy. I have this sense that that one moment, where a person’s entire life has come to be condensed and twisted into a poisonous tiny ball, like the universe before the Big Bang, is the best time to give her a feeling of hope. It’s as if all of human life is distilled to a symbol: We always need a person to save us, and here he (or she) is. An hour during shift work becomes the perfect Mother, what we will always need, cradle to grave, in the human tragedy.

- - - - - - - - - - -

* That is, the professionals with the most troubled children.

Infinite regress minus one

If you want to help a client understand herself, be moved and changed simultaneously, you can use infinite regress minus one, which I made up yesterday. It's just a path to Gendlin's Focusing process which, as I said in "Rabbit hole,"* avails the person of "bodily nuanced feeling. One senses inner truths that the here-and-now head, with its brand-name labels for feelings and attitudes as platitudes, is not in touch with." Because "the feeling is the fact," digging down to buried feeling reveals and frees the true self.

The process is simple. State something you believe or feel, then ask yourself "why?" or "what does that mean?" Answer each question, then question that answer and do this over and over until you get past your explanatory thoughts and ideas to the feeling core. Here is an example:

Depressed client says: "I like being a nurse." Why? "Because I like helping people." Why do you like helping people? "I like to be valuable, to make a contribution." What does that mean to you, to be valuable? "It means to be of service." Why is that valuable to you? "It makes me feel good." What is the 'good' feeling? "It makes me feel important." 'Important' is not a feeling. There is no emotion of 'important.' What is the feeling? (At this point, the client is brought to what Gendlin calls a "felt sense" – an actual chemical-emotional sensation that she has possibly never questioned and has never read.) "I don't know. But it does make me feel good." Look. Sink into these felt senses: 'good,' 'important.'

(Long pause.) "The feeling is actually not good, but I think it is. This is strange." A longer pause, during which the client has gone inside the molecules, then: "I'm not actually a helping person. I've never been helped my whole life. I've built this needy shell into a giver. My patients love me for ten minutes, an hour, but they love the persona, the giver, not the real me." Why don't they love the real you? "Because it's not there."

If readers are getting the bizarre, absurd notion that this deep-sensing facility is the key to all human self-understanding, they would not be wrong. It's the paradox where great thoughts, Shakespearean thoughts, are false elements, screens, while the nuts-and-bolts material, our nuanced experiences inward, are the greatest wisdom.

Does that feel disenchanting?

Another example:

Client, with her husband, moved from New Jersey to Nevada and lives ten minutes from her parents' home. Why? "I like the neighborhood." Oh? "Convenience."** There are hundreds of thousands of nice houses and good neighborhoods all over the U.S. Why did you move near your parents? "They're getting old. I'd regret missing their golden years." What do you mean by 'regret'? "I'd feel guilty. You know my mom was abusive to me and my sister. But my stepdad was my ally." Don't you have to have done something wrong to feel 'guilty'? Did you do anything wrong? "No." Sink into the guilt sensation, the regret sensation. The client does, and an underground world of need, of feeling like a "little child," of "pull" to a self-enclosed and never-giving parent, of hope for love, opens up.

Regressive questions can draw forth the hues, tints, tones and shades of the psyche, the insides of the interior of a soul. But be careful: ". . . when you clearly felt-sense a door, it opens."*

- - - - - - - - - - -

* https://pessimisticshrink.blogspot.com/2015/01/rabbit-hole.html

** Actual responses!

The Death Bed in life

Script is read to the client, maybe early in a term of therapy, as he lies on the sofa, eyes closed:

Now, I want you to accept the following situation. You are lying on a bed in a hospital and you are dying. You are your present age. You are not in physical pain, but you are aware of the fact that in a few hours your life will end. Now, in your imagination, look up and see your mother standing at the side of the bed. Look at her face. There is so much unsaid between you. Feel the presence of all the unsaid between you – all the things you have never told her, all the thoughts and feelings you have never expressed. If ever you would be able to reach your mother, it is now. If ever she would hear you, it is now. Talk to her. Tell her.

The Death Bed Situation, conceived by psychologist Nathaniel Branden and introduced in his book, The Disowned Self, can evoke the most abyssal, most unearthing, most moment-of-truth feelings in a person's life. When I read it for the first time, I was instantly overcome in the way that I suspect a person is when at the moment of death, their entire life appears before their eyes. Childhood need as deep as time, ages of invisibility, and lifelong loss surged to pour out of me at once, an unstoppable nuclear bomb. But something did stop them: my repression, which I have come to see as one of the most powerful forces in the universe. The infinite juggernaut stopped, and disappeared. Though not the first or only means, this triggering exercise proved diagnostic of my nature in different ways. The first was: It was supposed to open me up to healing, but it couldn't: The repression was too strong. Another: The ephemeral feeling showed me how much fatal hurt was suppressed, a "quantity" that appears impossible at the thought of it.

I have used the Death Bed Situation sparsely, not with most clients, always with the hope that it will evoke a representative epiphany of their life. As it goes, it is mostly diagnostic.

Many clients are tearful, but I've rarely if ever witnessed the anguish that I know is "always there, whirring continuously just beneath the membrane of life."* One can see this deficit in Empty Chair process, too. If the person were really in communion with their father or mother, they would collapse to the floor, or possibly throw the chair through the wall. Death Bed is even more powerful. This is the one moment to be what you never could be, to name your need even before your identity formed.

Some clients prove, by their words, tone and affect, that they cannot really do therapy. These are the individuals who, in that very moment when they could be a person who matters, apologize to their mother for not having been a good enough daughter. Or they praise their terribly deficient parent for "doing the best you could." This is repression and self-sacrifice, alpha and omega, of their entire life, a badge of honor of no dignity, no value.

A woman who had already shown her complete immersion in what Virginia Axline (Play Therapy) called the "emotionalized attitude," a style of tainted consciousness, could feel nothing as she saw her mother standing at the side of the bed. After a long moment of silence: "When I picture the scenario . . ." Detached from self, the world, life.

It's understandable. People come to therapy as a system of defenses and flaws that predominately work. They are Freud's optimal state: "I do not doubt that it would be easier for fate to take away your suffering than it would be for me. But you will see for yourself that much has been gained if we succeed in turning your hysterical misery into common unhappiness." No one wants to be more undone than they already are; so undermined that they lose their ability to talk and reason and rationalize.

Arthur Janov: "Most of psychotherapy is talk therapy or insight therapy, or therapy with words. And Primal Therapy has found that it's not words necessarily that we need to go to. In other words, we need to talk to a brain that doesn't talk, that feels."**

- - - - - - - - - - -

* Irvin D. Yalom, Love's Executioner and other tales of psychotherapy, Basic Books, 1989. Prologue, p. xi.

** From a short video available at YouTube: https://www.youtube.com/watch?v=_bcOO3JICgY

Progress report

Life has lately gotten more interesting than ever, as I've been fucked over by Anthem Blue Cross / Blue Shield. As described in an earlier post, Anthem has decided to hold onto more dollars by requiring the kinds of nonsense dream descriptions of "measurable" progress that have heretofore distinguished Medicaid as the arse end of therapy quality assurance. Imagine working with a person whose identity is empty and false owing to childhood catastrophe, who therefore has depression, absence of self-esteem, the anxiety of no existential safety net, suicidal resignation, and having to fabricate minutiae of "progress" at each and every session over the course of several months to a year or more, or different reasons for the lack of it.

My most recent paycheck was less than one-half of the typical amount. It doesn't matter to Anthem that I may be homeless if this happens two more times. The remedy would be to dumb down the essence and nuance of therapy – and for that matter, of the client – and create long- and short-term measurable objectives and goals that turn the client into a sixth-grade math word problem. What is so awfully undermining is that I don't know that I can do it, despite real effort. I don't know how to have a terrible imagination and to write the meaningless stupid. And I will admit: I can't stomach asking clients to digitize their distress.

In the meantime, I continue to see thirty-five to forty clients per week, always giving my all, even if half of them turn out to be pro bono. I am very lucky that the presence of a client on the couch is one part of the two parts of my sense of motivation, what wakes my heart from its long dysthymic nap. The other part is the existence of my wife. As new pay periods come and go, I will keep my readers abreast of developments, which I fear may be inevitable atrophy.

📉                  📉                  📉

Addendum two weeks on: Next check, again less than one-half the earned amount. Anthem sends me clients, I do my job, write peer review-quality progress notes, and am refused payment. I am told that the owner of the group practice is working with lawyers, calling officials, confronting jackasses who wield power. Next Addendum may be more interesting.