I am listening to the psychiatric resident describe her session with her patient. She is well along in her training, reasonably poised and reasonably convinced in her approach. She is telling a story and, in this story, she comes off as both kind and competent, The patient comes off as a bit confused, clumsy, dependent, not very good either at thinking or feeling. The patient seems pale and out of focus. I keep wanting to sharpen the focus to make the patent clearer. Of course I can’t do this. I am mildly annoyed that I can’t – mildly annoyed at the patient, at the resident and at myself. I ask myself, “Why do you ask for the impossible? Why can’t you just be patient and let things be what they are and find their own natural pace of development? I am sitting in my rocking chair. I am, as more than one patient has pointed out, “on my rocker.” My rocker is a beautiful hand made cherry rocker with flexible back slats so constructed as to provide considerable unobtrusive lumbar support. The chair is the vanquisher of the back troubles that were incipient when I got it. For this, I am very grateful to it and to my wife at whose instigation I got it. It is the single most expensive piece of furniture I have ever bought. I remember how acutely uncomfortable I was waiting for it to arrive from northern California nine months after I had ordered it, how worried I was that after all the expenditure of money and effort I would hate it. I do... read more
I sometimes urge that I should be titled the Vicar of Towson, since I specialize in vicarious experience, sitting and listening and living with what people tell me. I do this on the grounds of Sheppard Pratt, one of America’s great old and very beautiful mental hospitals. Just outside my office is a beautiful old ornamental cherry tree. I have lived in Towson immediately north of Baltimore for more than twenty-five years now. I am acquainted in depth and detail with many parts of town where I have never been or through which I have passed only occasionally – Dundalk, Glen Burnie, Pikesville, Pig Town, Randallstown and so forth. There are houses and and dinning rooms and basements and kitchens and bedrooms and yards and woods and school rooms that live vividly in my mind although I have never seen them and they existed in other times and other places. I have lived vicariously, too, in foreign countries – Israel, Iran, Zimbabwe,France, England, Trinidad, Argentina and more Proust wrote that “the only real voyage of discovery consists not in seeing new landscapes, but in having new eyes, in seeing the universe with the eyes of another, of hundreds of others, in seeing the hundreds of universes that each of them sees.” Psychotherapy is an art of such listening that the other can world forth a world, this world being his world – and have it shared, not statically, but so that it can live and breath, declare itself and grow. Psychotherapy is a partnership in presence. A good psychotherapist is a gifted story listener. In his great ballad about... read more
The eighteenth century French poet Jean Pierre Claris de Florian wrote, “Plaisir d’amour ne dure qu’un moment/ Chagrin d’amour dure toute la vie.” (Pleasure of love lasts only a moment; the sorrow of love lasts all of life) “ The twentieth century duo of bossa nova composer Tom Jobim and lyricist Vicinius de Moraes produced the lovely and haunting “Felicidade,” which begins, “Tristeza nao tem fin; felicidade, sim” (Sadness has no end; happiness, yes) How these two sets of lines, written centuries apart at a great geographical remove from each other resonate not so much in our minds alone but also profoundly in our hearts. Brazilian audiences often applaud with great fervor when Felicidade is being performed.There is no way to put into words how Tom Jobim’s music works, with its limber rhythms and understated fluency. But the music has a flavor that might almost be called a happy melancholy, a wise appreciation of what life is and of our situation in this life which is so rich and yet also limited. The pleasure of love and happiness are always limited in their tenure. We know this before, during and after. It is a knowledge against which we struggle, even one against which we revolt. Yet the struggle and the revolt are to no avail. We can no more give them up than we can prevail in them. We are well and truly caught. It is a part of our nature that we struggle and that we revolt against the fleeting nature of the pleasure of love, of our happiness. After the pleasure of love, after the intimate glory... read more
Don Quixote, the incomparable, comic, tragic, absurd, possessed by his destiny, dispossessed of his life by his destiny, an explorer who leaves home to find himself but loses himself in trying to find himself, someone perpetually homeless and proud of this homelessness as a quest for the impossible but imaginable. Sancho Panza, a man like other men, moored in a web of human relationships, not so very grand, but very real, a nobody who is somebody by reason of how he carries being a nobody, being as close to the earth as any other clod, capable of a loyalty that is itself a kind of realization of the imaginary, someone who lives as himself but not so much for his own sake. A distinguished, tall, thin. extremely learned, very ill elderly man came to see me looking for I didn’t at the time know exactly what and I still don’t know exactly what it was that he was seeking. I find myself thinking he was looking to be made whole. In life as in the law this concept of being made whole is no simple one. This man yearned to be restored to being who he thought he was. Actually it went far beyond yearning to an insistence that bordered not only on religious faith but on an idiosyncratic religious fanaticism – “I can only be if I am who I take myself to be, even if who I take myself to be is not only complicated but also multiplex, fabulous.” Ailing had been an integral part of his life, reaching back into childhood. Part of ailing was an... read more
I have worked on the telephone with patients from twenty-five to seventy-five, men and women of diverse backgrounds and dispositions. I have always started with them in the office and then good reasons intervened to make it make sense to go on on the telephone. This work has spanned states, countries, hemispheres, the complexities of time zones. It is a testimony to how remarkably robust communications infrastructure has become that this has been possible. There are limits, too. I have never tried working with a patient who was acutely or chronically suicidal in this way. I have never tried working with a floridly psychotic patient. One woman who was on the other side of Mississippi from where I am here in Baltimoreused to end each session by saying quite brightly, “See you next time.” It was some time before it struck me just how remarkable this sign off was because in the usual sense related to the visual apparatus it was precisely seeing each other that we could not do and would not do. But, of course, I think she meant another kind of seeing, one constituted by emotional presence in relationship mediated by inner attachment processes that guide imagination. So I found myself slowly wondering how presence is constituted. We often speak of it as if it had primarily to do with shared location in space and time. But perhaps it is much more imaginary than that. Yes, it requires some back and forth as a condition,but many different kinds of back and forth are possible. I realized that I had patients who came to see me in... read more
