I was listening to Transmission, a piece of music by Joy Division, and as usual it sent a shiver through me. If I listen to Ceremony, by Joy Division becoming New Order, straight afterwards, then I shiver even more. Music in many ways kept me sane before I was 20. It gave me a shivering space where I could really feel something, and know that I’d felt it, when all the rest of everything seemed like a conveyer belt to narcolepsy. It kept me awake, sometimes all night; or when I was awake it helped me come down again. Nick Drake, although I can barely listen to him now, it’s too painful and too almost sincere. Thank God I kept clear of macho self-pity. There’s no hope in that.
I was thinking about whether or not psychotherapists care about people. Many don’t, I suppose. They’re rather introverted but they still seem every able to help other people become more themselves – which, in my mind, is all you can do.
But it strikes me that there is a difference between caring for people and looking after them. There’s a certain kind of psychotherapist I have often met who seems vey invested in something about who their client should be. These people don’t care. They look after people.
Looking after people, in the sense I am describing here, usually involves inhibiting them in ways that are not available for discussion. It’s often done secretly or coercively and has a relationship with what has become called ‘co-dependence’. In a way it treats them as mad while the person doing the ‘looking after’ is somehow removed from having to look into their motives with the help of someone else. We are not transparent to ourselves: never.
It doesn’t have to be like this. I might ‘look after’ myself, for example; but even in that there’s a sense I am somehow divorced from myself as I do this. I’m selfish to a point that might extend beyond reason.
Develop your outdoor-eye. That is, every day try and find something special: something you notice, a cat walking across the road in a particular way, a kind of a plant, or a part of a tree, or a strange bird in the sky, or a familiar little bird looking at you. Look into its eye. Life can’t happen without something special.
This is especially true if you’re stuck looking at a screen all day. Screens are predictable and demand your attention because of what you’ve been trained to expect … so look out of the window.
I remember a training session where a psychologist delighted in telling me how straightforward his conversations with his clients were. ‘Your psychoanalytic language is pretty hard to get to get to grips with, pretty hard to understand,’ the trainer told me.
I agreed. ‘But I don’t usually talk about it with my clients,’ I told him. He looked surprised and I realised the thing he’d decided to talk to me about was something he didn’t actually have any experience of. ‘Then what do you say to them?’ he asked. ‘I don’t know,’ I told him. ‘Whatever there is to say. I mean, do you know what you’re going to say to me next?’ Unfortunately he did. He decided to get back to training me and gave me and the rest of the class some psycho-educational material about shame.
As he went about his business I felt more and more disengaged. Listening to someone describe shame as if it is a financial commodity, a mineral or whatever, something that has limits and parameters that are easily put into words is a depressing experience.
I’m reminded about all of this because I recently saw a client for the first time and spent much of the time helping him find a way to describe how he felt that wasn’t circumscribed by the psycho-educational (psych-ed) material foisted on him by the treatment centre he’d spent some time at. We got there eventually: the two of us in a room talking about how things were, right then, as opposed to how they might be if we kept calling on the glossary of, in the case, addiction.
Psych-ed can be helpful. We all like to know something about how we feel what we feel, think what we think and do what we do. In my experience, though, it usually gets in the way of someone’s life feeling improved. Knowledge can feel powerful … but how powerful it is depends on your relationship with it. I know how parliament works, but I can’t, for example, stop Brexit. My knowledge of parliament possibly even makes me feel worse about it.
Psych-ed can split you off from yourself. Schiz-ed. An unhappy soul can become a tortured unhappy soul because facts can end up given you nothing more than insight. What might help more is to cope with not knowing.
I could launch into a list of reasons why I think psych-ed weighs in on the side of an unhealthy therapeutic relationship (beginning with how the therapist is the one who always knows best, and facts, psych-ed facts, become incontestable). I could suggest a way of understanding life that doesn’t rely on psychological, genetic or social models. I could confess to my horror at some of the philosophical and logical confusions I have seen in most forms of psych-ed, and how these arose from as a need to make the unknowable … knowable.
But I won’t say any more than that.
Everything in life needs to be contested, some things are beyond words until you get to poetry, and psychologists are very rarely ever poets.
Before you ask what something means find out what’s happening. A green light might mean you’re better off not standing in the middle of the road wondering what’s going on.
I thought I might share this: an abstract for a paper at an EMDR conference. It’s a bit glib but I think it says something about how I work, and why.
As EMDR becomes more popular and its application becomes more diverse practitioners may find it helpful to consider some of the ways psychoanalytic therapists have explored therapeutic relationships. Freud’s work with trauma in the 1890s, enthused by his interest in mesmerism, in some ways bore a closer relationship to contemporary EMDR practice than to contemporary psychoanalytic psychotherapy. The metapsychology he developed, although at first-sight complex and sometimes arcane, offers EMDR practitioners a wealth of ways of thinking about their work without departing from the usual protocols.
Perhaps one of Freud’s most interesting discoveries was that the ways therapists think about their work inevitably affects the therapeutic relationship. From cognitive interweaves to decisions about treatment planning, the timing of interventions, the depth of preparation required and how a client should be oriented post-treatment, a psychoanalytic attitude can expand awareness and foster confidence. Freud wrote about ‘wild psychoanalysis’: psychoanalytically informed interventions by doctors, nurses and others who may not have been trained in the full psychoanalytic method.
I will explore the implications of EMDR with a psychoanalytic attitude and look closely at three distinct ways of drawing on psychoanalysis: a form of history taking based on free association which I have found extremely helpful; EMDR as applied to dreams; and considering how our interventions may sometimes be less rational than we imagine.
The creepy rationalism of many psychotherapists, or therapists as they often call themselves, continues to disturb me. They’re like newsreaders: a strange sense of authority (absurd in any other context) that sounds so rational. What they are saying is usually built on a very thin but compelling layer of understanding, like someone who’s been to the moon and can describe what the earth looks like from the stars … but I wouldn’t trust an astronaut to tell me about life on earth. These New Sophists may sound rational, but endowing someone with reason will have more to do with how I listen than the presence of any intrinsic good sense.
Rational means endowed with reason. Logical means reasoning correctly. We can argue over what’s correct, but there’s no arguing with sophistry. Sophistry’s a drug that demands withdrawal and one of the best ways to do that is to listen for logic and then ask questions.
Heidi from Finland asked me if I could give another example of noticing a scene playing out, and how I worked with that. ‘What’s the relationship between trauma work and scenes?’ she asks. Perhaps I can answer her question and at the same time say something about how I regard working in the transference, why I believe it is so important to work in the present as much as possible, and something about why I find theory helpful.
Imagine a child growing up with a number of siblings. She develops a relationship with her parents where they come to depend on her helping them communicate. She has a difficult relationship with her siblings, who find her controlling, secretive and somehow, as one of them put it when they spoke as adults, ‘in a different place’.
Thirty years later, when I first worked with Christina, it wasn’t hard to find traces of these early relational dynamics playing out in her life. The work we did underlined for me the important relationship between trauma work and scenes.
What would you do? Let’s forget about trauma work and scenes for a moment and think about what your job as a therapist might be.
Part of your job as a therapist , if you come to work with a person like Christina, is to be as sensitive as possible to the dynamics you might get to know through you relationship with her, which might tell you about what she experienced in her early life. Thinking psychoanalytically that would involve considering the transference, and you own countertransference feelings (although I tend to conflate the two into the transference relationship). Other therapeutic modalities will have their own ways of doing something similar.
Using your intuition, rooted in your emotional relationship with your client, you will then need to help her identify the situations where the traces of her early life seem to be playing out, and to get to the conflicts and emotional struggles she is facing. The behaviour represented by the ‘scene’ you discover is symptomatic of the way she tried to cope in her early life, and how this affected her.
Don’t be seduced by the obvious scenes. She may well, as Christina was, be a manager at a large company and have developed separate relationships with two senior figures, and be distrusted by the people she manages, who also find her distant. I’ve found various scenes active in people’s lives.
We need to locate the scenes with the most affect – the ones that lie most directly upon the fault-line of her early life trauma (to use a phrase I would like to think about in great detail somewhere else), rather than ‘satellite scenes’, which have something in common with Freud’s ‘screen memories’.
In her relationships your client may also, as Christine was, be very close two two of her children and her husband might end up occupying originally played by her siblings. Scenes can be played in so many different ways. Take these two, with Tom Hiddlestone and Laurence Olivier.
Your job is then to hold in mind the early life behaviour while you explore the current scene with your client, reacting and acting out of all your imagined familiarity with the woman’s past even if you don’t take her there. Try to stay in the present and see what presents itself: where do her associations take you both? What do her feelings suggest? You could ask her, for example, what the sensation she notices inside her, when she describes the current scene in her life you are exploring, seems to say about her.
If that’s difficult try finding a creative way of getting to what a client’s beliefs about themselves, held in their feelings might be.
I remember asking Christine what it would be like to imagine her feelings, the sensation she had noticed, as an animal. What would it be like? It turned out to be an imaginary animal, the nature of what helped Christine subtly describe how she felt. We imagined what would happen if someone else was given the animal: what would it bring with it as a magical spell to cast upon its owner? What would that owner say about themselves once the spell took hold? ‘I am too overbearing,’ she said – and Christine found herself describing, very emotionally, how she felt she was too overbearing, and what she did to cope with this.
I never mentioned Christine’s childhood. She made a number of connections herself, most of which would have been beyond me; or if I had made them they would have horribly over-simplified the situation.
A conscious awareness of the past, even if it was a reconstruction of the kind of tableaux I used to love seeing as a child at the British museum, resided in me throughout this work. The anchor to the present resided in the client. Between us we found a way of working through something that connected the two.
I intended this as a short note, so I shall end it here. Almost.
Trauma work and scenes … something isn’t finished.
A thought that comes to me having written this relates to the need for a psychotherapist to understand something about theory even if they never talk theoretically with their client or their colleagues. The best psychotherapists and counsellors I know talk about the theory I know only as much as they would their favourite novels or films.
I’m thinking of a printing engineer I used to know who, when called to the site of a problem, would spend some time listening to the machine that seemed to be malfunctioning. This man knew how the machines worked in extraordinary detail. Not only that, he understood the process of printing inside out; and even of publishing. If you spoke to him he could give you a history of a book (from its life as a part of a tree to its place on a shelf in a bookshop) that was so entertaining, and so particular, taking into account the subject of the book, the place in the world it was made, the time it was written, the political circumstances, the kind of transport systems available … and so on. The engineer loved his work.
My point is that when he arrived to mend a machine, all the engineer had to do was listen and he usually had the problem solved quickly. Sometimes he didn’t even have to take the machine apart: the problem lay in the way it was being operated. He knew his theory, and he loved his work, and he could fix a printing machine without once looking at a circuitry diagram, an operating manual or a service history.
I prefer to work with people like him. Trauma work and scenes: think of yourself as an actor trying to convey the trauma in a play. How would you play a scene? The best actors seem to know a lot about how theatre or cinema work … and if as a psychotherapist you can’t conceive of yourself as playing a part in your client’s dramas, the scene of the psychotherapy, you may be missing a lot. You may even be playing your part without realising it (although I have to say there’s some of this in every psychotherapy I can remember, which I have only been able to get in touch with after the event; and probably some I will never know about).
Trauma work and scenes: I wonder sometimes about my need for repetition.
Stock market ‘carnage’ is an effect of addiction. Addiction affects all areas of life. In many ways it is life: unavoidable, like colds, getting old, and death. All we can do is understand it better and learn to live with it; and if we do we will be less anxious. If we are less anxious we will better be ourselves without trying to draw on things outside ourselves to make us feel better.
If you borrow to invest you are effectively drawing off nothing, and with low interest rates investors have been doing exactly that. Now there is a fear of interest rates rising investors are scrambling to deal with their debt-chains.
The stock market crash: it’s an emotional thing. Don’t get caught up in being rational if you want to make sense of it. It doesn’t make sense: it makes chaos, which is what addiction does. Addiction is a drive towards extinction, to non-presence. Freud called it the death drive. It’s overwhelming. It’s what’s happen if you are eaten up by anxiety.
I went to see the Giacometti show at the Tate yesterday and found all the fear of the world in most of the things he made. I recognised, in my own unease as I walked through the gallery, the soul-substance of TV and the Internet. The many special forms of fear that drive viewers or users: jealousy, envy, competitiveness, loneliness and misogyny, each with their awful textures, like kinds of intention I could almost separate into different painful, hateful senses of space, time, distance and intensity. I saw the actual forms of television sets and computers in his sculptures. There were also his tiny figures, framed so much like we are these days, in no broader context than a screen, and sometimes a very small screen. Not the Silver Screen but the greasy, smudged thing on a phone. I’m glad I didn’t go on my own.
I’ve been thinking about narcissism lately and ended up watching Now, Voyager yesterday and selected excerpts form the Alien films this morning. None of this ran together in the way I have just written it until I began writing the words ‘narcissistic feed’, but there we go. Narcissism isn’t necessarily a bad thing: thinking about what you like to eat, wear, say and do; if I didn’t I would, in an awful sense, disappear. There’d be nothing of me on show and no return from that in the world to give me a sense of having a life that’s mine. Of course narcissism can be overdone and, from time to time, most of us overdo it – unless we underdo it, which I might come to at another time: underdo as in written our of life or written over someone else, no doubt a particularly egregious narcissist. We forget that we don’t actually know better than other people, or that we know them half as well as we might imagine. All kinds of narcissism rely on a feed from the outside world, from the kind of ‘that’s a nice hat’ comment to the more disturbing ‘you’re mine’ behaviour which characterises those egregious types I mentioned. If you want to see what happens when narcissism becomes a difficult thing watch what happens to Charlotte Vale, or the crew of the Nostromo in Alien. Narcissists take a dim view of those around them trying to assert themselves: it interrupts the feed. Charlotte or Kane could have stayed in their cabins, but instead they went looking for adventure. Differentiation, the move from a ‘we’ to an ‘I’, recognising the other, will always in some way be worrying (not being comfortable as an ‘I’ leaves you feeling anxious). You know you’ve got a problem when someone insists on ‘we’, not necessarily if they get worried about the ‘I’ … we all do that. The ‘I’ demands a leap into the unknown unless I believe, secretly, we really are always a we, inseparable and conjoined. Wilfred Bion wrote about Experiences in Groups, not ‘experiences of groups’. Groups are an experience rather than an entity – as The Three Musketeers would have done well to remember. I got worried about something like this yesterday. When I was a boy hooked on watching Sunday afternoon matinee films Now, Voyager had only existed for thirty years … rather like the relationship between now and another film I love: Withnail and I. And so I was reminded that I am 50 again. The ‘we’ of Tom Tomaszewski, me in all of my incarnations, still hasn’t quite become used to this ‘I’, the 50-year old one.