Jan 26, 2008 | Imaginative, Psychiatric Writings |
On a recent visit to Cleveland we met with Paul Voorhies-Meerschaum, the chairman and chief executive officer of Creative Forgetting Technologies. Voorhies-Meerschaum greeted us in an old warehouse in the flats. In the heyday of steelmaking, it had belonged to Republic Steel. A pudgy, rumpled man in his middle forties, Voorhies-Meerschaum did an eighteen year stint with TRW before leaving to start his own company. He had a reputation as a software and development whiz there. The tag was that he knew what a program wanted to do and how it wanted to do it long before the program had any inkling of its own style and possibilities. “We got this building cheap,” Voorhies-Meerscahum told us. “We got it dirt cheap. We got it because nobody wanted it. This might be the exact center of the rust belt right here. We’ve fixed it up a little bit, but not too much. We like its flavor. Although it doesn’t know it, it has its own kind of wisdom and experience. We’ve got two hundred and fifty people working here and the place is so huge, it’s no trouble fitting them in. “We had a hell of a battle with the city about it, but that was actually fun in its own way. They try so hard to pretend that they don’t need jobs, employers and investments that you wonder if they haven’t convinced themselves. That’s a little scary. They woke up when we told them we’d pay cash for the building and we’d pay the full assessed value on the books. They never expected to get anything. “We’re concerned with...
Oct 10, 2007 | Clinical, Psychiatric Writings |
“I don’t know when shame came to live in my house,” observed a woman in her early fifties, “but once it did, it moved from room to room until it had taken over the whole house.” Although she did not say this in so many words, the implication was that once shame “had taken over her whole house,” there was no place for her to live. If we live in our minds, as surely we do, although not only there, then she was psychicly a homeless person, rendered so by her shame. Notice, too, that her shame is dynamic. It moves from room to room. It takes over. It grows and thrives at her expense. It is a very dangerous parasitic life form. Remember, too, that houses often stand for selves. These are often every bit as ramshackle as old homes, every bit as difficult to maintain. Where might shame come from? How does it enter our homes, ourselves? One place to start is with the name, itself, “shame.” The Oxford English Dictionary traces one speculative origin of the word “shame” back through a pre-Teutonic “skem” which in turn connects to “hame”, “A covering, esp. a natural covering, integument; skin, membrane, slough (of a serpent). It also quotes Darwin, in Emotions XII 321, “Under a keen sense of shame, there is a strong desire for concealment.” I am not learned enough to know if there is a word for shame in every language, but I can venture that most have such a word and if some do not, then the underlying cultures would be very interesting for the study...
Jul 7, 2007 | Clinical, Psychiatric Writings |
To great personal benefit and at great personal cost, I have worked intensively in both inpatient and outpatient settings and in schools with borderline persons over the past thirty years.. What drove me to do this? What have I gained from it? What did it cost me? I hope you will forgive my framing this essay about borderline patients in such personal terms. I even hope that you will find it useful. I am sure many of you have had encounters, longer and shorter, with borderline patients that have left you wondering not only about the patients but about yourselves. A resident working with a borderline patient told me in supervision that she, herself, was holding her jaw so fiercely clenched that it hurt. “I’m so angry,” she said, “and this anger just isn’t me. “ I listened and thought, “No, it’s not,” and “Yes, I’m afraid it is.” This was one of Sheppard’s outstanding residents, a leader in her class, a leader in the environmental movement, who went on to do good work under difficult circumstances for the Indian Health Services in the Southwest. Certainly, that clenched jaw anger was not part of her normal experience of herself. It was not part of her preferred experience of herself. But she had experienced difficult abandonment early in her life, existential hurts from which there was no appeal and to which response in modulated symbolic terms does not come easily. Actually, when we are little, such modulation and response are beyond us. This is why the care of very young children is so important. In caring for them we help...
Jun 28, 2007 | Imaginative, Psychiatric Writings |
“It was terrifying last night, Aunt Becca. I wouldn’t believe it if I hadn’t seen it with my own eyes. I got up because I heard her. I wondered what she was doing at two o’clock in the morning. I know she hasn’t been sleeping well. She went down the stairs She looked like she was floating in that pale green nightgown. I followed her. I don’t think she knew herself what she was doing. “Maybe she was walking in her sleep. She stopped just in front of the big living room window and looked out over the rhododendron bushes onto the front lawn. I stood behind her watching. The moonlight was shining down on the snow. It was so bright you could see the shadows of the branches of the trees.“Then she turned to go back upstairs. She saw me. Maybe she recognized me. I’m not sure. It wasn’t as if it made any difference that I was her own mother. No, I might have been a stranger on the street, a statue. She would have said what she said to the wall or to a chair if I hadn’t been there. Her voice was so soft it could have been a ghost’s. “‘Look at me,’ she said, not a trace of an expression on her face, ‘I’m already not here.’“When I told Eddie about it, he looked at me like I was nuts. ‘Are you sure it wasn’t a dream?’ he asked me.““‘No, you idiot,’ I was tempted to answer him. ‘I’m not sure it wasn’t a dream. That’s why my blood ran cold. Because I was...
May 28, 2007 | Clinical, Psychiatric Writings |
Grief is an essential active internal process of emotional recycling that helps make us available for new living and new ways of living after loss, which is sure to come because it is part of the natural order of things. “Man is born to troubles as the sparks fly up from the fire,” says Job’s wise friend Eliphaz. Grief is central to how we modify ourselves to meet changed circumstances, often ones that fly in the face of our wishes and that we never imagined. As a man who had lost his wife suddenly in a freak accident put it to me about a year later, “Doc, this sure ain’t the way that I drew it up.” Loss is the dark and difficult side of attachment, which is such a fundamental in human life. We attach because we are built to attach. We attach because evolution has shaped our genius for attachment out of the primary materials of the mother-child mammalian bond. Striking footage exists of a group of elephants coming on their annual traverse of their territory back to where a female had died the previous year. One of the deceased elephant’s daughters, herself already fully grown, breaks away just a bit from the group and then lingers near the spot where her mother expired. With her trunk she nuzzles at a skull bare of flesh and bleached white, gently turning it over. So she makes contact with the remains of her mother, passes a few moments there with what is left of her mother – inside and out – and then submits to the necessity that life...
May 27, 2007 | Clinical, Psychiatric Writings |
I. One possibly quite useful way to think about shame is as an effort to ward off imagined loneliness that can produce real loneliness, even lethal isolation. “I can not be or seem this way or I will lose everyone and everything. I will find myself floating on an ice floe. I will send this part of myself, this experience, this feeling into exile lest I be myself exiled.” In a sense this is not so different than chopping off a leg in order to be free of the trap. Perhaps there is a short run freedom, even a life-saving freedom, but the leg is lost and that has terrible, crippling consequences. Shame is an ordinary and yet dire predicament for the self. It is hard to emphasize enough just how dire the predicament is. Shame is an inner ostracism that not only sets the shamed one apart from others, but also alienates him from a part of himself. The drama of shame is such that any incursion near the forbidden territory renews the original insult, producing once more a situation in which neither flight nor fight is a viable alternative. The pain of shame can be intense and repeated endlessly without any clear outward indication of what is transpiring. Shame is an anti-communicative stereotypy, the same pain over and over again without any real gain. It can set up particular experiences of hurt and rejection in the mind as institutions, engendering tenacious expectations of future hurt and rejection. Shame can spread, too, down associative pathways, until there is no psychic domain that is not under its sway. Shame...
