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... read more
“I’m whining. I should just stop it. It’s an ugly sound. No one wants to hear it. It would be better if I were just gagged.” “All I do is complain. I don’t know why that is, but it gets tedious. I can tell by the look on your face that you hate it. You listen because I pay you. I know there are better things to do than complain.” It is possible, of course, to whine about whining and to complain about complaining. I have puzzled over the years about how to respond to these regressive sallies. I call them “regressive sallies” because they aim to close down psychic space, to preempt any investigation that aims to reach psychological depth. Instead of proposing to listen to themselves, the patients who propose these solutions through will power are trying to shut themselves up, to shut themselves down, to shut themselves in.. The Free Online Dictionary defines “whining” as “to utter a plaintive, high pitched protracted sound as in pain, fear, supplication or complaint.This is a reasonable place to start, although whining can be applied to sounds that are not so high-pitched, not so protracted. It can be applied to what would be described as normal speech were it not tinged with overtones of reproach and accusation. Whining has to do with frustration and rage. Whining has in common with itching that it has a direct route to the limbic system. When a person whines, we feel a distinctive kind of discomfort that reflects and propagates in the interpersonal field the acute discomfort of the whiner. Two important ingredients... read more
There is no “talk” therapy without “listen” therapy. Patients are as likely to say that they want a therapist who talks as they are to say that they want a therapist who listens. Of course, there are patients who can talk but not listen and also patients who can listen but not talk. Or at least there are patients whose predilections are heavily skewed in favor either of talking or of listening. Ideally both therapist and patient are competent in both modes, both able to speak and to listen. This makes a reliable and rich back and forth possible. It supports the ecology of exploratory conversation. For the first ten years of my career as a psychotherapist I was tormented by a voice in my head that kept ranting at me during sessions that I talked too much. The voice was humiliating without having any particular corrective impact. It simply served to make me miserable as I continued to say what I had to say. The position advocated by this voice was one, I believe, that my mother would have endorsed when I was growing up. I had many questions, many more in my head than I expressed or could have expressed. But I had ways of expressing that I had doubts, that I was intrigued, that I needed to know more, that explanations presented to me did not seem to hang together, that I had seen moments that had become mysteries. I was in many ways a nuisance and a burden to my mother. She surely thought I asked too much in both senses of the word. But... read more
T was a very disturbed, attractive, bright young woman, chronically suicidal, sometimes intensely suicidal. She was almost always in despair, perhaps always there. In the days when this was possible for someone whose family was not enormously wealthy, she spent long periods of time in the hospital. She was a management problem, cutting, burning, eloping from the hospital. In general she terrorized the nursing staff charged with taking care of her. Their terror followed her terror as her behavior transmitted terror very effectively. The nursing staff took its job seriously. In addition, many of them genuinely liked T, who could be charming and interesting as well as dangerously out of control. The nursing staff may have hated T because she regularly threatened to expose their powerlessness and incompetence. But they also loved her, so the conflict was heightened in them. Certainly there was a sadistic element in T’s behavior, a way in which she was so out of control that she needed to tyrannize over those who tried totake care of her. T had a horrendous history that was definitely operative in her predicaments of the moment. There really is no point in reciting it in any detail. She was actually a very sensitive person who had experienced both neglect and abuse. She actively resisted looking at her history and how it worked on the present and in the present. She was too beset “right now” for this other enterprise of internal self-observation. She could do a little, but recoiled even as she did so. A few of her most disturbing memories were externally corroborated during her time in... read more
1.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... read more
