Dec 31, 2015 | Blank Verse |
This April we have brought you along with us hiking these headlands you never knew you have been with us each step of the way, sometimes light, sometimes heavy, sometimes a dance of variegated shapes in the fog’s sheen, sometimes transparent, sometimes a suggestion; you have been here and you have been not here, both at once, so I have tried with each footfall to reconcile the two, failing as I knew I would the wildflowers are out celebrating the first spring after you and so many tule elk have gone to join you in this great drought and beauty is everywhere all around including the black hawks that dot the fog and also my joy in each breath we’ll walk some more, then more and then no more, but, while we walk, we’ll bring, sing you with...
Dec 20, 2015 | Clinical |
I am listening to a psychiatric resident describe her therapy session with a patient in her late fifties, someone whose attachments are unusual and unsatisfactory. Parents, spouse, children, step-children all present difficulties for this patient, who would like to bring people together and have them, if not cherish each other then at least get along without too much hostility and disharmony. She does a lot of work to bring this about, taking care of diverse people in diverse ways. She does a lot of cooking in addition to her full time job which she enjoys and where she is recognized in a way that she is not in her personal life. The patient’s tone as the resident mimics it is a pale sort of whining, with some anger, but definitely on the mousy side. This is not a person who puts her foot down. She is trapped in her relationships and yet they are where she dwells. She is not about to issue ultimatums to her husband or anyone else. She fears psychological homelessness. She is attached to the qualified loneliness of what she knows as opposed to the possible radical loneliness of major change. She has come to psychotherapy for help which she rejects with each breath even as she seeks it. The resident who is kind, in her late twenties, interested, wanting to be of use,is completely baffled by the patient. She says she has no idea what to say, so thatshe finds herself falling back on that ancient friend of the psychotherapist: “Um-hm,um-hm”. She can’t imagine what the patient is getting out of the sessions but...
Dec 17, 2015 | Clinical |
I am pushing seventy, so that I find myself in what may be prime time for a psychiatrist who takes psychotherapy seriously and works with people in blocks of three quarters of an hour or an hour, instead of fifteen minute snaps, and across years and sometimes decades, not weeks or months. So possibly I am not just old but old fashioned. However, to describe something as old fashioned is not necessarily to deny it value. After all, the Pythagorean theorem was born long before any one now alive was conceived. However, as one gets older, it is hard not to reflect on getting older. Many years ago the New York Times ran a piece by a retired psychiatrist who said that he had stopped practicing because he wanted to have time to read the great novels whose pages he had not yet turned. The point of the essay was his remorseful discovery that the characters and situations in these novels, their plots and perplexities, were nowhere nearly as interesting to him as his patients had been. He meant his reflections as a cautionary tale, a navigational aid to help others from going astray as he had. His words were generous. Why are patients so interesting? In large part this is because we are interested in them. It is not only the devil that is in the details, but also life itself. Whether it is characters in a book or actual embodied persons in the consulting room, it is the organ of imagination that we use to take them up and in. Proust’s Baron Charlus and Hamlet and...
Oct 18, 2015 | Free Verse |
The cat licks her paw to a Beethoven piano sonata then lowers her cheek and goes to sleep I sit and wrestle with my strangeness I am and am not all at once and the piano keeps on...
Sep 5, 2015 | Free Verse, Poetry |
Strange anything at all exists. What is, is! Profound tautology, but I can’t find a curtain to pull to let me see behind “is” Wittgenstein snorts like an impatient horse, “Haven’t you ever heard of getting snared in a language game?” This is the form fashionable in the West of what in Indo-Persian lore once was called a “tilism” * a magical landscape that can pass for real and hold you for a very long time, even your whole life. A substantial part of the beam of my attention, is always held in wonder that a pen can be, that I am, that a green shirt can be, that light and robins can be… I’m dazed by what other people take for granted. I’m a child or a fool or both mixed up together. The wonder of water and palm trees and the blue of sky And dark and stars and the ever unrolling scroll of dreams. I admit it: I’ve been lost all my life and this is where I’ve lived and this is who I’ve been An undeclared mystic *See the “Adventures of Amir...
Aug 23, 2015 | Clinical, Psychiatric Writings |
Each patient resonates differently. Resonance is a matter both of the inner strings of the therapist and of the inner strings of the patient. When a note is truck near a piano, it often sets strings singing, waking sound from them by elective affinities. It is a matter of a string’s recognizing something of itself in the waves of sound that reach it. So it is between patient and therapist. Resonance explores links and kinships that may not be obvious. One was a young guy, big, burly, voluble when his mood was not so low that it interfered with his getting out of bed. He was unmarried, without a girl friend. He had no children. He had hallucinations, delusions. Sometimes he did things hat made perfect sense to him, but only to him because he had his own distinctive take on what was going on around him. Or you could call it his own idiosyncratic rake on things. He was sometimes too much for himself, often too much for others. His size scared people, as did his intensity, suggesting that he was out of control. Most often, when others saw him as out of control, he was not quite out of control, near there but not having reached it. He had suicidal impulses, not just when he was down, but also when he was flying high. Yet he had never gone too far and injured himself or anyone else. He could not tolerate sitting still in an office and talking. So we walked and walked and walked and talked as we walked, noticing what was...
Aug 22, 2015 | Free Verse, Poetry |
too much to read, much too much to read I watch the leaves falling from the trees like words from the pages of books the sun has written I, too, am a book that the sun has written winter will be soon and white and cold I’ve lost track of what I once may have known I’m like that oak becoming naked I’ve lost track of most of my questions they’ve fallen from me like leaves from a tree I keep on reading my way beyond me I am the bare bones of who I once...
