The antithesis client

This is Nathaniel Branden’s “Death Bed Situation” from his book, The Disowned Self. I use this drastic evocative scenario a dozen or so times a year with clients who need to break through their adult persona:

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.

Let’s say that we want to know if a client has any chance of being a person, of having self-esteem, of actually caring for himself or herself, of having a fundamental sense of self-value. We want to know this because only this person can be helped in therapy at a real and enduring level, not in a superficial, “cognitive” and ephemeral way.

Let’s say we want to know if we are even aware that there are individuals who come to therapy, an ostensibly self-caring act, yet have no “self” that can accept help. We may not be aware that such people, and such a problem, exist.

The Death Bed Situation will be a good diagnostic tool of identity and nothingness.

Clients with at minimum the rudiment of Being will say to their mother (or father) in their final moment of truth:

“You were never there for me. You may have believed you did your best, but you only did your feeling, your own pain, your own needs, your own purpose. I needed your love. I needed you to see me – me – with nothing else on your mind, with your eyes clear and with eternal patience for a child. I have been a ghost in my own clothes, wandering the world without that touch of love that would have given me life. You failed me, Mom.”

That is someone who can grieve and move on.

The clients who cannot be helped will say:

“Mom, I’m sorry I disappointed you. I’m sorry I wasn’t good enough. I failed you.”

These are antithetical people, who never became anything other than their parents. They never individuated. Their parents continue to be all powerful, always more powerful than them. They would rather die than try to matter – to their parent, to themselves. As a client said, “I wouldn’t want to say anything on my death bed that would make her regret knowing me.” This is clinging to starvation because it's their only identity. There was never the connection of love, the psychological birth of the human infant.* They have never been given to understand that they should be loved, not required to be something to satisfy their parents.

They are not able to feel and exorcise their own pain because that would make them sense the person they never were.

Therapy that works at depth will lose clients who remain in their parent’s cupped hand. That would, I thought, be the case. But I’ve seen a strange consistent phenomenon: Clients who need to remain killed children are pulled to the idea or the wistful or dear or quixotic feeling of being a self, maybe of being born for the first time. They stay longer than many others do.

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* Margaret S. Mahler's book by that name.