If all sessions could be as good as the first

I wish I had tape recorded this first session with a hopeless, self-hating, manipulative and drug-addicted twenty-year-old. She was so empty of self-worth, so poisoned by self-hate, she wanted to “run away” from herself. She watched herself demanding daily money from boys, for the privilege of dating her. There had already been a handful of psychiatric hospitalizations and rehabs. This was the rare diagnostic (intake) session where I skipped the childhood question: What situations, events, family atmosphere do you believe had an impact on you? (I rarely have to specify: negative impact.) This was because we started late – she was an end-of-day hospital referral – and because we were floating in an unusually benign and healthful mineral spring that was all the good we needed for the moment. I must admit that this was largely a fluke of good feeling I had Wednesday late afternoon, just before the office closed for Thanksgiving. There she was feeling denuded of meaning but garbage, and the atmosphere was friendly, even sweet. There wasn’t a miserable acknowledgment she made that wasn’t accepted, understood, OK in pretty much a dear way. A rare thing happened then, where she was anxiously sad that the session had to end. But before it did, I broached the subject of Borderline Personality Disorder and disorder in general, or in its cosmic nature. Borderlines and others are manipulative, because as my old professor said, ‘manipulation is the person’s effort to get her legitimate needs met in a way I don’t approve.’

And then I remembered a line that was made for this moment. “We are not defective. We are injured.” I’d like to think that if you say and explain this right, especially after proving that our strange character is a survivalist one, you will get a person with almost too much hope, but not too much that you can’t offer real assurance that it will be answered.

Sometimes the first session is so good that later ones can’t be that good, for a number of reasons. One is that so many clients are diving for hope and healing, and maybe love, into that room, into that therapist, and one can’t keep diving: You land somewhere. You land in defenses, in reality, in character.

In one of Lynn Grodzki’s books on starting a private therapy practice, the author notes that therapists should not give away essential goods at the beginning. The client will feel enlightened and won’t return for sessions. I believe that failing to do so is a sign that the therapist has no principle, no direction but the anarchic process of Rogerian being-there.

I hope very much that my client returns. I hope that she will dive for a long time.

I seem to have become meditation

Barring the occasional insight that strikes me in the client situation, I have no ideas. I’ve recently discovered this: My old ideas were just ego-clingers, or a desire to have a theme. But I’ve now seen that none of them can be valid. Look at some ideas that are nonsense: Life is nasty, brutish and short. Life is beautiful. People are good. I’m in love with love. Service to country is noble. Service to family is admirable. I am important. Liberty is right. Life is an adventure. Children are our hope. God exists and is moral. Each of these ideas can be found to have exceptions or to be unjustifiable.

I’ve also discovered that I can’t accept any identity feelings. I am not too much of any one: sad, content, happy, loving, wistful, angry, pathetic, anxious, afraid. They swirl in and out, like a liquid kaleidoscope.

And yet, there is a primary substrate of myself. It is a loneliness that started with birth and removal to an incubator and to a depressed mother, and that has always been the underlying axiom. Though needfully married, there is always a silent room between us. Sometimes the room is very thin. I have never in five decades sat in on an employee lunch or birthday party. I walk the dog at night, a car’s headlights approach from the distance, and I am angry. My two friends are states and many decades away. All my coworkers and neighbors are ships passing in the night. I’d say that is a feeling, but I’d be chary of calling it my identity.

So the upshot is that I am meditation incarnate. When I walk, or sometimes at the computer, there are no thoughts and no stories of mood, only the kaleidoscope, only silence. I have no ambition, which would be a sort of energy, but to do what I do.

An odd thing happens, though, sometimes. Thoughtless, and no spiritual goal in mind, I will press a couple of leaves on a bush, or touch one of the big rocks that are made into walls throughout my apartment complex. This gives me an odd feeling of reality, and the lightest possible feeling of affection, for lack of a better word. I don’t dare pollute that goodness with a thought. The phenomenon is the child that remains: He was once nothing but connection, or nothing but the need for it. Through neurosis and years, my eyes have become too distanced from things. But touch breaks through. If I had more ego or anxiety, I could turn that into a “truth,” a meaning. But there’s no reason to.

Mini-rant: These hibernated accusations of sexual abuse

The Pessimistic Shrink, hiding behind his wife’s name as a Slate.com commenter, wrote the following:

I don’t disbelieve any of these men or women (the latest accused, as of this minute, may be George Takei), but at the same time, my eyes are rolling. Every week in therapy, I see a couple dozen adults who remain emotionally crippled, in part because they have never held their abusers to account: parents, siblings, uncles, stepfathers, neighbors. Many adults would rather remain cowed, punctured “codependents” than own their anger at a physically or sexually abusive parent. Clearly the celebrities are relatively painless targets of delayed justice, despite the courage it may take to finally open one’s mouth about the abuse. To me, it’s real courage when the woman – ten, twenty or thirty years later – calls her father a pedophile, or condemns her mother for failing to protect her.

My argument’s best raison d’ȇtre is that it was probably these earlier abuses, in childhood and within the home, that created the teenager or adult susceptible, years later, to the wiles and pressures of an entitled bastard. It was these earlier abuses that created a quiet person who could not speak out for decades, who suffered the emotional problems that keep therapists working, that make such a troubled world. There is also the more exotic theory* (clinically evidenced though not by me) that the psychological origins of “stars” – those who need fame, power and the adulation of the masses to build a semblance of ego – is in homes where the child received approval** – for her looks and talents and ability to please – not unconditional love for her simple being.

Let these women and men continue to name their perpetrators, have courage, receive the stage and receive care. But maybe . . . maybe do not keep hidden the earlier, formative abuses and neglects that made you the person you are. To unearth these takes therapy, storm and stress, battle-like courage, not a microphone.

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* and ** – Arthur Janov, The Primal Scream and other books, and Alice Miller, The Drama of the Gifted Child and other books, have described the early dynamics and consequences of approval versus love.

A very dumb society: The latest shooter

One of the blindest and most contemptible features of present culture is our gaze at the adult lives and motivations of mass murdering shooters. Twelve hours ago, a twenty-six-year-old killed twenty-six people at a Texas church. Reports give us the news about his black outfit, his rifle, whether he got it legally, what he posted on Facebook and LinkedIn, how he walked through his spree, his dishonorable discharge from the Air Force, his domestic violence against wife and child. We may soon learn what jobs he had, a quick sketch of his personality at work, maybe the “human interest angle”: what some classmate or friend thought about him in high school.

Useless, stupid, useless.

What matters is who his parents are, how he was raised and treated during his elementary school years, if there are siblings and if they, too, have had problems. Was he a head-banging infant? Were there two parents in the home, were they immature, emotionally selfish, loveless, “working all the time,” jerks? Did they hit him? Was he bullied and did his parents have cruel or indifferent or weak ways to deal with it? Was he so cut off from them that it would never have occurred to him to tell them his troubles? Did an uncle sexually abuse him? It would be good to know what made him a misérable who dealt with pain by causing it in others. Do we want to know how these things happen? The parents would be interviewed, put through individual therapy. We’d know their incompetencies, because there is no doubt in the world that they dropped most of the balls they were thrown. Was the killer ever in therapy, and did it fail as it so often does? Therapists do have to be gullible for a few minutes, taking in information openly. But if they see a dysphoric young man who speaks anger, they have to work damned hard to find a buried scrap of heart and reach it. If the child is “callous and unemotional” or the teen is a pre-mature psychopath – these facts are observable and alarms need to be sounded. Of course, not everything can be done to prevent the youth from further corrupting. I’ve confronted the deeply injured, joined them in their misery. I’ve confronted young psychopaths. Sometimes maybe all we can do is call their bluff: “I see your game,” hoping to disenchant the defense of this personality.

Because of this Olympian-sized missing the boat, society often looks to me like a joke or bad theater: playing adult-land. We could see the child in us. Think of how strange that world would be! We’d be looking at parents and families and children’s lives, not “chemical imbalances.” We’d all know basic depth psychology and see people with standard x-ray vision. We’d see children as influenced – good or bad – every minute of their day. We’d morph schools into education and therapy. We’d absolutely kill the “stigma” of mental illness, which is emotional pain and what happens with it. I don’t know a single solidly sound person without this pain. Do you?

My strange cynicism

A certainty of mine: People are too complex to be able to validly endorse whatever they claim to believe in, or claim to feel. A twenty-six-year-old woman says she loves her mother. But her mother was always immature, whimpery and self-enclosed, never acted with primary consideration for the child. So the young woman actually hates her mother, feels like a dead rock in her mother’s eyes.

Bertrand Russell, philosopher and mathematician, said: “I believe that when I die I shall rot, and nothing of my ego will survive. I am not young and I love life. But I should scorn to shiver with terror at the thought of annihilation. Happiness is nonetheless true happiness because it must come to an end, nor do thought and love lose their value because they are not everlasting. Many a man has borne himself proudly on the scaffold; surely the same pride should teach us to think truly about man’s place in the world.”* I do not believe that Russell felt the meaning of these thoughts, but would be in a frisson of disconsolate and other emotions at the real consideration of his imminent death. And the man on the scaffold? A desperate dissociation of terror, anesthetized with some storybook noble or learned feeling: “pride.”

A man loves his wife. But he simply lacks a capacity for empathy. This is understandable, as he never received a single atom of loving-care from his parents. He is empty of it. So what does he really feel?

People believe in God. Does having a good or self-bolstering gut-chest-feeling about something you’ve been taught equal belief? Does some kind of mental attachment to a weakly logical notion (the essences of the universe can never be comprehended, so the Incomprehensible must have caused them) equal belief? Does saying “I believe” make belief real? It seems so (try it!), but how could that really be? People’s beliefs weather, they have doubts, their wine turns to water.

Does a white supremacist hate black people, Jews, Hispanics? Hatred, like “cause(,) is not what it used to be,” as Lord Russell noted.** We know that hate starts, in the person’s life, with hurt, with the failure to receive what should have been given by parents. Loss congeals over a pained heart and becomes fire over ice over fire. This, then, wants an idea, because thinking distances us from pain. “Immigrants are not real Americans.” This is not a belief. It’s a desperation.

I deconstruct people in this way because I have to: It’s both how I see the world and a feature of my therapy.  But another part is the blindness that is our molecular, organic structure: We just live and we just feel. We don’t “know,” we don’t “believe.” I’d like us to feel better and maybe to wonder what everything, what anything, is.

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* Bertrand Russell quotation – https://www.goodreads.com/quotes/28449-i-believe-that-when-i-die-i-shall-rot-and.

** Russell, lecture “Why I Am Not a Christian” –  https://users.drew.edu/jlenz/whynot.html  – subheading The First Cause Argument.

Warning: Acceptance and Commitment Therapy

This morning, I took a three-credit Continuing Education seminar on Acceptance and Commitment Therapy (ACT), and it has ruined my mind for the remainder of the day. It is a therapy of dissociation from the body – how one actually feels – and from the impact of one’s injurious history. It is a therapy of dissociating from our dissociation – “looking at thoughts, rather than from thoughts,”* when thinking itself is likely to be a defense and escape from deeper truth – and living in some disembodied “value” that we must doggedly commit ourselves to. As a theory that fanatically endorses only the cognitive realm and only superficial “I want” intentionality, it must use abstruse terms of smoke: “ACT brings direct contingencies and indirect verbal processes to bear on the experiential establishment of greater psychological flexibility primarily through acceptance, defusion, establishment of a transcendent sense of self, contact with the present moment, values, and building larger and larger patterns of committed action linked to those values.” It numbs one’s mind with cotton like: “Self-as-Context: The sense-of-self that is a consistent perspective from which to observe and accept all changing experiences”; the “ACT question: (1) Given a distinction between you and the stuff you are struggling with and trying to change, (2) are you willing to have that stuff, fully and without defense (3) as that stuff is, and not as what your language says it is, (4) and DO what takes you in the direction (5) of what is vital and meaningful (6) at this time, and in this situation? If the answer is ‘yes,’ that is what builds . . . Psychological Flexibility.” In ACT, you are “distinct” from your struggles, your thoughts, your emotions. This approach’s proponents may not realize you must also be distinct from your values. But then what would be left to you?

It disturbs my reliance on human rationality that PhDs and counselors, researchers and promoters of “empirically based principles” can jump over all historical psychological knowledge, can be so lost in this man-made dimension to believe this garbage. The therapist will see you the way an ideological partisan sees a naïve and wanting soul: empty of substance but for how he can mold you into his ideas – “psychological flexibility,” “commitment,” “behavior change strategies” – which he will frame as your idea. Your pain and confusion will be shoved aside by “mindfulness,” then replaced by a “value” and its henchmen “goals” and the brute-force signed contract to push yourself toward them; depression and suicide, anxiety and identity emptiness be damned.

It’s frightening and lonely, for me, to think that clients are taken away from their true needs for help, are given this absence of care for their real self. Be aware that you will be walking into a scam that is worse than some product bait-and-switch: an existential scam.

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* This and the other quotes are from the seminar’s PowerPoint material.

Personal tenets, for any readers I've failed to trouble up to this point

*  I want my clients to become happier than they are, and happier than I am able to be. This goal – especially the second part – is not a virtue of mine. It’s actually my neurosis, coming from childhood when, early on, I ceased wanting anything for myself but derived some very transient but poignant (“vicarious”) pleasure from facilitating someone else’s happiness. That is not, however, the motivation that launched me into this field.

*  By the accidental way my brain works (in the same way I was aware of my atheism, within a lightly Jewish family, at age eight), and by chancing upon a good psychology book, I realized that the adult stage and character, as most people live them, are much less valid a reality than the child within us, the child we came from. I suspect that most people believe their adult is their replacement baseline, post-youth. Not true: It is merely the small boat riding in a deep ocean, dependent on that ocean, victim to it, give its meaning by that ocean. (The metaphor fails slightly, because you can take a boat out of the water. But what kind of boat would it be?)

*  If I had to name the essence of psychological dysfunction, I’d say it is the lethal contradiction between the injured, never-helped child’s needs, and the necessity to leave those needs behind. I use the term “lethal” without exaggeration. We might lose an arm or a leg, our health, and still have our spirit. But we can’t be a spirit with bright potential if we were not loved. I’ve seen individuals with youth, health, loving partners, the world before them, but they are in some strange, oceanic pain that says “Why am I here?”

*  I know that nearly everyone must have a delusion of happiness or contentment or serenity or “acceptance” or success – whatever their particular positive is – that rides over this darkened potential. It is for them, not the therapist, to come to question the delusion. However, I will show a woman her fake laughter, so surface yet profound a defense, because it can prevent all therapy and healing.

*  It is the same with “love” – also too often a delusion. Let’s put it this way: When you were a child, if no one ever took your hurt away – which is the job of your caregiver – then you will still be living with that hurt, within that hurt. Whatever the reason your caregiver didn’t reach it and heal you: that they didn’t or couldn’t is the absence of love, regardless of their intention or goodness, regardless of your belief or your forgiveness. We reveal at high risk this delusion of love. But in good therapy, people come to see it.

*  I would like my clients to grow, before too long, a deep relationship with me, though I know it often doesn’t happen. The great problem is that they can’t reach out to me, or let me reach them, because long ago they had to withdraw into themselves to prevent more suffering. And now that it’s time beyond healing the child – so they feel – it’s even more despondent to crack themselves open to their child’s heart. By “deep relationship,” I mean for a moment they feel I am important to them. A moment when they come out of their shell and don’t feel alone with their pain. I have to be the momentary parent. If not, they have never joined the world, are just in-dwelling with their tears or grief. That cannot heal. There is a bond, or there is absence of love and continuing sickness. No other possibilities exist in therapy.

Sabotage

Jimmy Carter,* in a recent article, referred to his father as “daddy.” I wonder – Do adult Southerners call their mothers “mommy”?

I’ve written throughout this blog, and have conceived in my sessions, psychodynamic metaphors such as “some people have a heavy emptiness inside them, an anchor holding them back.” “A splinter in the soul” that does damage despite the soul’s lofty plane. We are a “molecular mess.” Old-timers may remember the Dr. Joyce Brothers-type conception, “fear of success.” Janov wrote of “housewives”** who’d always leave a room or two in disarray, as a clean house, a completed task, would give them the feeling, ‘Is this all there is?’ In a way, many of us are like the father of the little girl, Twilight Zone episode 91,*** who falls through her bedroom wall into another dimension. Leaping in to save her, he is lost, floating, but then is lurched back to ground: A friend had been gripping his leg the whole time, but he had no awareness of it. Our past, the most exotic dimension, has us in its grasp, and we are not aware of it.

The explanations one woman gives for losing guardianship of her son to her terrible father! It’s as if her true north were quicksand. Another woman smiles wanly, tells me her mother has won custody of the grandson on spurious charges of bad parenting.**** And watch out: When she gives birth in a few months, her mother may come with CPS and snatch this child, too. Helpless to stop it! I see a woman whose theme song has been self-ruination: Friendships curdle, gifts are rescinded; her mind colludes with her body not to be able to work; plausible plans to escape the city are spoiled; people who’d given her a room change the terms and kick her out; her son won’t talk to her, but a couple months ago they were getting along.

The many people who lose or quit one job after another. Something internal stops moving, and they wander off.

My wife and I, professional people with a strong relationship and a nice set-up, are so bad with money that we could potentially get in trouble from ten different directions.

In a bad mood, I’d want to give all these people (except myself) a tee-shirt that reads: “The dog ate my homework.” Your life is excuses. Grow up, find a backbone! Grow some fucking anger! Take off your stupid diaper! But I know about self-sabotage. Its seeds, of course, are in our childhood. But it’s complicated: soul and splinter. Depression versus the desire to love life. A twenty-three-year-old cries and whines in that gut-twisting sing-song of a child. I’m all alone. So boring at home, nothing to do! Sister criticized him as selfish when he asked for help. We haven’t yet found the awful splinter that poisoned all four siblings (the parents have a lovely résumé), but we know he cannot grow up.

Even when we seem to hit all the milestones, we may look and see there is no path. The engine is revved in neutral but the road is a decline and we move. We feel good then bad within two seconds, hopeful then inert within two seconds; expansive, then old hates emerge. Probably no one knows what real maturity means. How much, what kind of youthful psychology can we manifest that’s actually adult, not regressive? How much is nothing but regressive? People gamble much of the day, play video poker all night. It’s neurotic. (But when James Bond sits at the baccarat table, it’s very sophisticated.) Grown men play macho, women talk serious but look frilly, men make money of prime importance, women don’t report sexual harassment, people in therapy reveal they are ninety percent child. The past is so embedded in the present that we see only one thing: nothing, our blindness.

I’m wondering, as I write, if any immanent past must be a saboteur. Mine is: Future seeking, forward seeking has and will always be prevented by my particular problems. The ruining woman has to show an invisible father that she is homeless forever and in pain. The job quitters need – absolutely need – to be taken care of. But what of people who seem healthy and moving, happy, serene, accomplished? Has their past held them back? I think the answer is like quantum mechanics, where there’s a very different truth at the deepest level. If we look inside, we will feel where we have never moved on. We will find emotions that have never “matured”: still the child’s that are still attached to child’s things, though they’ve shape-shifted: A craving to be seen has become a need to impress; day camp has become a resort in Vail; a need for touch has become an extramarital affair. We will find our anchors.

Are there any conclusions we can settle on? The past in the present, the brake pedal always pressed, some. Even “failure” can be a kind of success as it tells the truth, where success often doesn’t.

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* https://www.nytimes.com/2017/10/21/opinion/sunday/jimmy-carter-lusts-trump-posting.html. Maureen Dowd editorial – “Jimmy Carter Lusts for a Trump Posting”.

** The Primal Scream, 1970. Arthur Janov died on October 1, 2017 at the age of 93.

*** “Little Girl Lost,” 1962. https://en.wikipedia.org/wiki/Little_Girl_Lost_(The_Twilight_Zone).

**** See “Warning to grandmothers” – https://pessimisticshrink.blogspot.com/2015/05/a-warning-to-grandmothers.html.

Other therapy

One pleasant challenge in psychotherapy world is to find useful ways to work with those clients who can’t do a damned thing. I assume this happens infrequently in private practice, but it’s not uncommon in community-funded mental health centers. And I don’t think it’s rare among clients who choose an agency name out of the book (“New Directions,” “Horizons for Youth & Families”) rather than a specific practitioner’s name. To be unable – which often means unwilling – to work does not mean sitting there looking defiant or numb. (Those would be the court-ordered men.) It means individuals whose personality disorder prevents any contact with their actual state; those whose “attention deficit hyperactivity disorder” impairs them from sitting still on a feeling – or wanting to; those who are deeply uninterested in having self-insight but think therapy happens, just happens. And it can mean clients for whom I can find no entry.

I work with these people who’d best stay home or read a booklet of positive affirmations. They, after all, come for something: an obscure hopeful difference. I am good at obscure hopeful differences.

One thirty-something-stuck-at-twenty Borderline waxes euthymic (fake happy), producing constant homilies of love and improvement. She has a perverse former (boyfriend is thirty years her senior) and a mirage latter. During a well-earned break, I’ll find myself making droll faces, piquant raised eyebrows, asking “why is the sky blue” questions, spontaneously playing some youtube classical music. It’s good, or at least not bad, to discombobulate a balmy Borderline. Have no fear or criticism: She believes I’m as authentic as she thinks she is. Later I may reference her childhood kidnapping and rapes and mother’s breakdowns and father’s effeteness, and make sure she understands that her very bad moods in the midst of very good moments come from this past. Else she would also feel lost.

An ADHD client with cancer is not able to hear anything I say other than questions about her health and treatment and her family. Odd as it may sound, I make money just by listening and offering the kind of eye contact that shows “I see you.” In the past with her, I tried psychosomatic theory, how to use it, suggested feeling her father’s “meanness” and brutal authority, and crying now. These were rejected by being unheard. I now support her frightened positivity with reasons for positivity, which I believe exist in our inner baby.

Mary the undiagnosable. In The Fountainhead, Rand’s character Gail Wynand introduces his newspaper’s staff to a man whose face is so nondescript, one can’t remember it while looking at it. Week to week, month to month, I couldn’t remember Mary’s childhood history but that at age three, her mother abandoned the family. Other facts about being the less-favored child, sibling rivalry, teen rebellion, always fell out of my mind, though I reviewed the chart periodically. She may have been bipolar, but that couldn’t be ascertained: On rare occasions she would have a hellish tantrum, destroying an apartment. In time, she would alienate everyone in her circle in ways she could never grasp. She used methamphetamine through her later teens, twenties, thirties, then it waned. She was sabotaged by a transient psychotic or psychosomatic interloper: One arm stopped working, or she was convinced it had. She could no longer keep a job. Like many complexly troubled women, one insult – of physical capacity or of a relationship – began the unraveling of her competence and energy: “That’s when I fell apart.” Always on the verge of homelessness, she found this and that neurotic man she remembered from her past, moved into his place, moved out. Maybe this was my purest therapy, as I had nothing to grasp but the smoke of her dependency and depression, her childlike voice, the lightning flash of her tantrums. What had happened to her?

She attended every week, always with a sad and confused story. Sometimes she lay on the couch and just rested. I once played her a program of classical lullabies.

While therapy at its deepest is those supplies the child needed when she was first hurt, we are on a different road now and have to live without essential healing of our past. I believe I have shown that if a therapist even slightly introduces the past then moves on, the client will feel a deeper more embracing reality in the room which subliminally gives her some gravity, some mastery, some childhood friendship immanent in the friendly adult conversation.