A woman in her mid-eighties brought me flowers from her garden for one of her early appointments. The flowers were lovely but I was a bit taken aback, so I asked her why she had brought them.
“I brought them so you won’t forget me,” she answered unhesitatingly.
On the one hand, this was poignant. She was deeply worried about being forgotten by others, this being tantamount to being wiped out of existence. On the other hand, this implied that I was one who was prone to forget. It was a criticism in floral form, reminding me of Freud’s noting that “gift” in German meant poison.
“You don’t need to bring flowers for me not to forget you. I won’t forget you even if you don’t bring flowers,” I responded.
This exchange had no effect on her behavior at all. Each week she came with a gift of another small vase with flowers from her garden in it. The flowers were lovely but I continued to be a bit taken aback. She gave me watering instructions. She brought a cactus on the verge of blooming. She brought a huge red hibiscus flower,
cautioning me that I couldn’t expect it to last for more than a day, but it was so beautiful that it was worth bringing even if it would last just one day. She brought me many other kinds of flowers which had a special spot on the sill of a window in my office.
Over the months that followed the initial gift, I learned more about the parade of flowers that came to my office. I accepted the flowers and admired them. I didn’t conduct an interrogation about all the things that might lie behind the succession of gifts. Mostly I listened.
She told me that the flowers were one of her chief pleasures. She told me that there were so many things that she no longer could do, so the flowers in her garden took on ever more importance. They consoled her for her losses, although nothing could really console her. She had always loved flowers. This went back to her childhood in Europe. She thought the flowers were surpassingly beautiful and wanted me to admire them so that she did not have to admire them alone.
During our work together she had episodes of very serious and frightening illness involving sojourns in the hospital that awakened memories of the most frightening aspects of her childhood in Europe. With enormous pluck, she returned to the routine of appointments and flowers.
She talked about death and, as much as she talked about death, she talked about how people did not want to talk about death. They hid from the subject and, when she brought death up and called it by name, then they hid from her, as if she had become dreadful in the instant.
As she became older and sicker and more frail, a frailty there was no way to hide, she felt people, with a few exceptions, fading away from her. If she was not forgotten, then she felt she was ignored. One of her themes was that it distressed and infuriated her that people who were very old and very sick were left very alone,
They were, for all practical purposes, shunned as they were making their approaches to death.
She did what she could to succor friends of her age group who were ill and alone.
In fact, she felt very alone herself. Relationships were what made her feel that she was alive, that she existed. As the net of her relationships contracted, this felt to her like an existential threat. In a way, she was very good at being by herself and keeping herself interested, but, in another way, the absence of warm bodied, warm minded and warm hearted others made her feel forgotten like a flower that is not watered and begins to shrivel up.
So I came to understand the flowers, not completely, but more than I had in the beginning. As I understood them more, I also understood more about this lady, who was in her way tenaciously in bloom, tenaciously fighting to remain alive and relevant, connected even after a long lifetime of harrowing losses.
A young man verging on turning sixteen started therapy after a brief hospital stay. He had made a worrisome suicide gesture. He was beset by raging obsessions and compulsions which compromised his functioning in many different spheres. I was
initially worried that what might underlie his presentation was a devastating psychotic illness.
One day in the second month of his therapy he brought in a four inch high statue of a man.
“Here,” he said, “this is for you. I made him out of paper clips and solder.”
The economy of means was striking, but more that that, it was the way the perfectly proportioned little man was charged with feeling that struck me. Also, the gracefulness of the figure, with hands and feet and a heart that all but beat inside the little man’s chest.
All this improvised at home from paper clips and solder.
The effect of the outstretched right arm with a hand that conveyed a feeling midway between longing and assertion reminded me of Rodin’s St. John the Baptist. This hand was one you could take off from and also one you could land on. The little man simultaneously held his ground and seemed to be propelled forward. This creation of paper-clips and solder, the most humdrum of materials, met the criteria for a work of art. It was animated and it had a very distinctive identity. Looking at it, it was not hard to see it at other scales.
This was a self-representation simultaneously of who my patient was and who he was not, of who he aspired to be and who he was blocked in becoming. This figure told me more about my patient than words. It was a gesture that broke through the chaos of the obsessions and the compulsions that were virtually contortions. It showed me a domain of quiet and resourceful capacity that I really had not known existed.
My enjoyment and surprise went well beyond my capacity to disguise. My appreciation was instantaneous and obvious.
This was a moment and a momentous moment.
The gift sealed something between us. What was sealed was an unspoken compact of trust. Trust is not a matter of words so much, but rather of attitudes, what lies both above and below words. It is a matter of what surrounds them and what gives them actual lived meaning.
This young man did very well in therapy. He was a natural, someone with so much to say who had been dying for someone to listen to him and bear witness to his project in living.
He gave me so many gifts over the time that we worked together. These were not so much tangible gifts, although there were some of those, but rather intangible gifts.
He pointed out that one of the things that was distinctive about him was that “no matter how bad things got and things got very bad, I was able to keep my observer in orbit.” In other words, he was, in Sullivan’s phrase, always a participant observer in his life.
This sensitized me to something that I always looked for in patients afterwards, the question of whether they had a self-observing capacity that was operational or whether it had crashed or never been supported so that it had failed to develop.
Life without a self-observing capacity is a good bit lonelier. Reflection is kin to play. It might even be said that self-reflection, the capacity to be both mirror and person simultaneously, is a form of play. With a self-observing capacity, persons can be in play inside themselves with themselves. This is a degree of freedom. Of course, it also makes possible a good deal in terms of being with and playing with and observing with others.
So this was a function that therapy supported even as it was a function that supported therapy. It was not a matter of targeted interventions but rather of something vital in the ebb and flow of the communications between us. It was a matter of atmosphere more than of specific acts.
After a good many years of therapy, he said to me, “You know, whether or not my parents had divorced, my job would have been just the same, that is, to get to know each one of them as an individual, as the person he or she actually is.”
This was the theorem that summarized many many hours of psychotherapy and many years of living and developing. It was the result of a very long chew on a very difficult bone. It was a gift to me as well as an achievement for him because it summarized so much in a way that was so accessible.
In fact, a good deal of what I say to patients, a good deal of the specific language that I use comes from what other patients have given me over the years. Specific language makes a real difference. What a therapist has in his toolbox to convey important ideas is important. One of the advantages of experience is that the toolbox tends to have a greater number and a larger variety of tools in it.
That early sculpture of a miniature man made of staples and solder proved to be a key to unheralded inner riches, a creative capacity to work on the sculptor’s self and on the world around him that was formidable..