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Why do I write?

I have been writing for a long time.

Why do I write this blog?

I really don’t know.

Oh, I can give all sorts of rationalizations and reasons, but….

There comes a time when many therapists who have been doing this for as long as I have, have to write.  It is not just an impulse or an urge.  It becomes an imperative, a matter of survival.

I recently read this passage by Michael Eigen, one of the few writers I read that is still living, “I suspect there are many psychoanalytic writers who write from the depths of their beings, hoping to create a therapist who can cure them, or communicate through deaths with another living flame.” 

What does a therapist do with all the truth and lies, all the impacts received from the patients he/she sits with day in, day out, session after session, hour after hour? 

I like to tell some patients, if appropriate, that I have had more therapy than anyone I treat.  While this is absolutely true, there appears for me to be a limit on how far this has taken me.  I have considered returning to therapy from time to time.  I even had a patient who when my wife died had the courage to give me a card of a psychologist to see.  The patient wanted to ensure I was taken care of, and she was concerned that I needed someone to talk to.  I briefly considered the offer, but declined.

In a novel I am trying to write there is a room where the main character goes at night.  It is a consulting room where he is analyzed by all the dead, great therapists–Freud, Bion, Klein, Jung.  Perhaps in my mind there is no one alive that could treat me except for myself.  I don’t think this is arrogance.  I have a particular way of working and a particular personality.  I did once a few years ago go to see a psychiatrist.  I carefully selected him from all of South Florida.  I thought he would be a good fit.  I had a particular thing that was bugging me.  When I brought it up, he dismissed it as unimportant.  I never went back.

I consider what I do for a living, whatever it is I do, as a privilege.  Patients come to see me session after session.  It takes courage to be a patient and continue wrestling with oneself week after week. It especially takes courage to be a patient of mine.  But I have infinite admiration and respect for the patients that allow me to be with them in the consulting room. 

But there is a price to be paid, both by the patient and myself.

I doubt the price I pay can be calculated or described.  It can merely be experienced, and different therapists pay different prices.  But here are some glimpses of what I imagine the price to be.

In graduate school we watched a famous video of three great psychologists-Carl Rogers, Fritz Perls and Albert Ellis, all having a single therapy session with the same female patient.  I recall how boring I found the video.  It was like watching two people randomly talking in a room.  I imagine that this would be how someone would find a session of mine if they could watch a video of it.  But I now realize that this is probably due to the fact that what is missing from the video is the actual experience of being in the consulting room with a live patient.  The experience is alternately jarring, deadening and otherwise.  But it is definitely alive–if I can tolerate being present and open to the experience and impact.

I used to, and still do, think that being a therapist offers the unique opportunity to deal with my cowardice and courage on a daily basis.  In every session there are moments where I have to choose to tolerate what is going on in the session or shrink away and evade the experience.  Most of the time I act with courage, but there are times cowardice wins out.  For all of us some experiences, impacts are more than we can bear.  Hopefully on those days, I learn to grow my capacity for courage by experiencing my cowardice.  Being a therapist is a continually humbling experience.

I had a mentor several years ago.  He was a brilliant psychiatrist who was truthful, courageous and honest. He was always willing to think for himself and speak his mind.  But these qualities created problems for him among his colleagues.  He would call me late at night and ask “Dr. Brody, why do they hate me?”  He was genuinely disturbed by the hatred and vicious attacks from other professionals that his work evoked.  He would eventually commit suicide, the ostensible reason being that he had a chronic, degenerative neurological disease.  But I wonder if the other reason for taking his own life was that the price he paid became too great.  How much hatred from one’s colleagues can any of us stand?  After he died, several of his detractors gleefully posted his autopsy report on various websites in a final attempt to discredit him.

I remember watching a movie, Equus, where a psychiatrist is treating a troubled teen who had committed some atrocity against horses.  As the movie unfolds, it becomes clear that the teen is troubled/possessed/tortured/fascinated by these horses and in one scene he actually blinds some horses.  The psychiatrist desperately tries to “cure” the teen, and is successful.  But the price paid is that while the teen is no longer possessed by the horses, the psychiatrist is now possessed by the horses.

These days I consider the price paid to be just the price of admission for the privilege of working with patients. 

 It cannot be avoided or “cured”. Which is, I guess, one reason I continue to write.

 Every privilege has a price.

Dr. Brody

The couple enters the consulting room.  They are my last appointment on Saturday.  I am tired having already seen eight patients, and I am ready to start my weekend.

As they sit down, the woman makes a reference to her late husband, who I had treated years ago.  I hear the comment, but it doesn’t apparently register.

Then she makes another reference to her late husband.  Again I hear the words, but they don’t apparently register.

Except. 

Except.

Except…. My body starts to shake and convulse.  I have no idea what is going on.  I am lost in whatever my body is trying to scream at me.  What is going on?  What has impacted me?  What the hell is going on with me?  Is it my tiredness?  Is it something going on with me personally that has nothing to do with these patients?  I can’t grasp it.  I can’t make sense of this shock/surprise.  There are no words, images or anything to connect the experience with.  I try to listen to what the couple is saying looking for clues as I try and tolerate what is happening to me.

The shaking continues throughout the session.

The session ends and the couple thanks me.  They feel it was a good session.  But I am still shaking.

The male patient and I have to use the restroom.  In the restroom he tells me that he knew the late husband’s family.  Again, I hear the words but they don’t register.  I just want to go home and maybe the shaking will stop.

It doesn’t.

It stays with me for hours.

Finally as I am trying to go to sleep, half in and half out of this world, the name of the late husband comes to my mind and the shaking stops.  I finally got it I think.  Now I remember the opening comments of the woman and the closing comments of her male companion.

I am upset with myself because I couldn’t put this together during the session.  Apparently I was sensing/feeling/experiencing something connected with the late husband.  Something that had not yet been conceived or thought–something unthinkable.

I write my thoughts to the woman.  I wonder if she will think I am crazy.  She sends a polite response thanking me for being of assistance during the session.

This was an odd experience for me-just an unconnected pure bodily sensation.  Odd in the sense that I frequently will sense things in a session-a thought or image of a person.  Whatever this is, it does not appear to be connected to what the patient is discussing.  I usually muster the courage to inquire of the patient about what I am sensing, and usually it turns out to be accurate.  Something that was there in the patient but had not yet been conceived or thought about so it could not be put into words.  I have come to trust this “sense” in me, but at times I do wonder if I have gone over the edge and I am just deluding myself.  Perhpas I am just tired, seen too many patients, lost my mind?  But I don’t think so.

The rational explanation I give myself for this “sensing” is that one of Freud’s great discoveries was the unconscious.  Something unknown which could only be inferred yet exists inside each of us and can control our thoughts and actions.  Freud wrote ” …one must cast a beam of intense darkness so that something which has hitherto been obscured by the glare of the illumination can glitter all the more in the darkness”. And then W.R. Bion conceptualized what he termed “O”.  “O” is unknowable, ineffable and represents the ultimate truth or reality waiting to be experienced, but can never be known.

Recently I was attempting to describe what I do to a friend.  I was explaining that I try to not listen to the words that the patient is saying, but to what is not there.  She commented, “the empty spaces”.  Which is precisely it.

New patients frequently assume that therapy works like going to see a medical doctor.  They tell the doctor what their symptoms are, the doctor diagnoses the problem and treats it.  But therapy ain’t like that.  So after a new patient finishes telling me what their symptoms/problems are and they look at me with that expectant look that I am going to diagnose their malady and fix/cure them, I usually shock/ surprise them and say something like, “That’s what you know/think is the problem. But if you knew what the problem is then you wouldn’t be in my office.  The problem wouldn’t exist. I am more interested in what you don’t know about this”.

After the shock has worn off, or perhaps in the midst of it, I attempt to convey that therapy is not like going to see a medical doctor.  That we are not dealing with physical ailments. We are dealing with the human mind.  And the mind is not sensible.  Thoughts, feelings can’t be seen, touched, heard, etc., only sensed and experienced.

Some patients can tolerate this shock and decide to continue working with me in search of the unknown, the unthinkable, the empty spaces.

Others only want my answers to solve their problems.  They usually don’t continue with me but find another therapist to diagnose their ailment and tell them how to fix their problem.

I remember another patient.  He was an older gentleman.  He called me one day and told me he wanted to see me because he was depressed.  He came to his sessions in an electric wheelchair having been physically ill for some time.  We did some work together and his depression was lessening.  His medical state had stabilized.  One day, I do not know why, I sensed that I had to discuss dying with him.  The issue had never been discussed, and there was no apparent reason for my doing this.  We had the discussion, and he felt relieved.  He died several days later in the hospital.

Dr. Brody

He is waiting to be discovered.

By me, or someone or something, but not by himself.  I imagine him to be looking out at me from a fortified bunker where all I can see are his two eyes.  The rest of him is protected/entombed by the bunker–fully encased in cement.

But his “problem”  is that he is a cutter.  He has been for years.  And this is why his parents bring him to me–to stop the cutting that now consumes them.

I don’t really imagine that his “problem” is his cutting, his self-mutilation. To him, his cutting is his salvation.  It is his answer to an experience he has been wrestling with for a long time.  He will clutch his salvation at all costs, but there is a price to being saved–to having found the answer to his riddle.  Part of the price is that people will try and take his salvation away.  Parents, professionals, friends will all become obsessed with wanting him to stop cutting and give up his salvation.

But he doesn’t want me to discover his cutting–this is obvious to both of us, and I know that the matter is not anyway about the cutting.  If I focus on the cutting it will only be a distraction leading to a dead-end.  He wants me to discover him entombed in his cement bunker, as if the cutting is a sign to look here.  I imagine he thinks I have a key to rescue him from his bunker.  Some magic power to see beyond the cutting to where he really is.  He tells me that I am the only therapist he has seen that didn’t try to get him to stop cutting.  He finds this curious and perhaps a bit hopeful.

I meet with his parents.  They are very concerned about the cutting and getting him to stop.  I try to communicate my perspective that the cutting is not the problem, and that in fact the cutting is their son’s salvation.  It is his answer to some other question and he won’t give up his salvation.  I explain to the parents that salvation is rarely relinquished voluntarily, instead it is clutched to with all one’s life and vigor.  So trying to get their son to stop his cutting will be futile.  Of course, I could be wrong about this, but I don’t think I am.  It is similar to anorexic patients I have treated.  The anorexic’s ability to not eat is their salvation.  In spite of the fact that some anorexics will eventually starve themselves to death, they won’t give up their salvation.  But everyone else, professionals, friends and family are so horrified and consumed by the wasting away of the patient that they will do anything to get the patient to eat, usually with no success.  The patient continues to waste away.

I see/sense that the parents are dismayed by my approach.  They want me to stop the cutting–that’s all.  I have failed to connect with them in a way that would allow them to see past the cutting.  The cutting consumes them to the point that they no longer see their son–only his scarred and mutilated arms.

I will not have much time with him.  His parents will hospitalize him in a facility that they think will be able to stop the cutting.  Someplace that will allow them to stop being consumed. 

Cutters, anorexics, alcoholics all seem to have found their salvation–their answer.  The problem for them is that their answer horrifies everyone around them.  Everyone wants them to stop and let go of their salvation.  Everyone around them can only see the destruction wrought by their salvation, not what else is there. 

When I treat patients like these, patients who have found their salvation, I try to be careful to not become like everyone else in their life.  I try not to want them to relinquish their salvation.  At times this is difficult at best.  I experience pressure from parents, friends and other professionals to “save” the patient from themselves.  At times I will wonder if I am mistaken in my perspective and perhaps they are right.  I should be trying to “save” the patient and stop trying to discover what I imagine they want me to.  But in the end I know I cannot “save” anyone from themselves. I am no match for “salvation”.

So what do I think this “salvation” is all about?  What do I imagine that the cutter, the anorexic and the alcoholic are waiting and wanting me to discover?  At times I think is has to do with wanting.  What do I do with my wants?  It appears that these patients have managed to erase all their wants.  Their wants have been replaced by their “salvation”.  They have no wants.  In fact, the only people that want in these dramas are their family, friends and professionals.  They do the wanting so the patient doesn’t have to.  Which I why I try my best to not “want” anything from these patients.  This of course drives the family crazy because they not only want me to “save” the patient, they also want me to “save” them from wanting and being consumed by the patient’s salvation. 

I frequently find that what these patients have been waiting for me to discover is their secret wants.  Those enormous hungers and longing that they have buried and locked away in some cement bunker.  Those unfulfilled, unfulfillable desires that can’t be put into words or thought about.

Perhaps if I discover this, then the patient may have the opportunity to discover that secret wants may be resolved without resorting to salvation.  There is always a price for “salvation”.

I often think of the cutter and wonder if he is still waiting to be discovered.  We didn’t have enough time to achieve this.

Dr. Brody

When the patient walks through the door…

When the patient walks through the door…

When the patient walks through the door into the consulting room will I be ready to meet/discover them?  Who are they today?

If I am not, then I will meet the patient I saw in the last session and in the session before that ad infinitum.  Same problems, same patient, different day.  Like the patient is one of the chairs in my waiting room–never changing, always there, always the same.

I had a supervisor in graduate school that said that every session had to be “minted” anew.  Each session was fresh and had to be discovered–like starting from zero.  I didn’t understand that back then, but I think I do now.

There is a scene from the movie “The Natural” where Robert Redford realizes that his pitcher is throwing the baseball game.  So Redford tells the pitcher, “Give ’em the real stuff”.

Here is a scene from the consulting room:

He starts twice-weekly treatment complaining of anxiety and depression.  He eventually reduces treatment to once weekly and then will end treatment.  From the outside looking in every session appeared to be all the same.  Same complaints, same problems, same lack of movement or progress.  I could see that he was different from session to session, but I was unable to have him allow himself to discover that he was different–that the same complaints and problems were really all a way to hide the “real stuff”.  He was so desperately afraid of discovering/revealing the “real stuff” that he ferociously clung to his unchanging problems, complaints and feelings.

I imagine that when we are babies we discover a lot–sometimes what we find is terrifying, sometimes joyous, and everything in between.  

But then we grow(?) , the process of discovery frequently is ignored or becomes calcified and hardened.  We prefer to discover the latest technology, what’s on TV, what’s playing at the movies.  But the discoveries of ourself are left in the dust sometimes to be triggered by a shock-wave from life that inadvertently gives us a peek at the “real stuff”.  Perhaps this is what drives people to enter therapy.  They are shocked at the discovery and want to understand it or make it go away.

I understand that discovering the “real stuff” is a painful and potentially dangerous process. We all need to balance our sense of security and identity with the process of uncovering the “real stuff”.  Too much “real stuff” can upset the apple cart.  It can lead to divorce, a breakdown or breakthrough or a sudden change in our lives.  There is a certain security in believing that we are constant.  That we are who we are.  That there is no more to discover about ourselves.  We all desperately cling to our unchanging life circumstances as a sense of security, even if our lives are dull and unsatisfying.  There is a certain sense of security in knowing that this is the way it’s supposed to be.

Another view is that life is not constant, nor are we.  That there is an endless supply of the “real stuff” waiting to be discovered. And that the only constants are objects–chairs, trees, etc.  But hurricanes quickly destroy this notion, for a brief time.

But if we are not constant, if we are not finite, if we are not pieces of furniture, then what?  Where are we to get a sense of security from? 

I am always in awe of couples I see that start every session with the same argument they have been having for years.  I usually get the courage to tell them how I marvel at their ability to keep their relationship in the very same place.  I also will tell them that a relationship is alive and it takes a great deal of energy and persistence to keep it from growing and changing–to avoid the discovery of the “real stuff”.   While this avoids any growth or change in the relationship, it also provides a sense of security.  The security that comes from knowing the unchanging landscape of my life is a never-ending argument with my partner.  But then what would be the cost of changing this?

Most patients, at the beginning of therapy, tell me that they are willing to do anything to get rid of their problems and change their lives.  I believe that consciously this is what they want–anything to remove the pain.

I also believe that the “anything” that may be required is to discover their “real stuff”, and these discoveries will be mightily resisted.

Dr. Brody

He is a renown professional in his field. I tell him that he will someday win the Nobel prize. His problem that haunts him is a particular type of woman/relationship. He has had a series of affairs. Always the same. It starts with a crushing attraction, like being pulled into a gravitational field and thrown out of orbit, followed by ecstasy and bliss. His own thoughts are replaced by incessant thoughts and fantasies of her. He is distracted and can only think of her. He becomes imprisoned by these thoughts of her as if his own thoughts have been replaced/vanished and these other thoughts have taken over his mind. The affair eventually dies out and when he has taken his mind back it all makes no sense to him. Until the next affair.

She calls for an appointment. I have not seen her in years. Her last course of therapy dealt with her marital relationship. Now she is divorced and wants to discuss a new relationship. She says that all relationships fail. And that this new man has too many “red flags”, but there is something about the way he makes her feel–something that she has never felt before.  She continues the relationship and becomes enthralled/entranced by him. She experiences great joy and cannot stop thinking and fantasizing about him.  She can’t sleep or eat waiting for the next contact.  Her mind has been captured.  When the relationship ends, she becomes depressed.  She says that it was not the loss of the man that depressed her, but the loss of the fantasy.

Can the mind be captured?  Can your mind be captured?  Can the mind be treated like an object, a piece of furniture to be manipulated, owned, sold, controlled, possessed, discarded and placed in storage?  I imagine this may be the experience these two patients were dealing with.

It has also struck me that I have been probably dealing professionally with this phenomenon, if it exists, for a long time. Of course this has not been the bulk of my practice, but more like a sub-specialty. In the 1980’s I treated cases of domestic violence.  In those days therapists had an anecdotal story that an abused woman finally leaves her battering male partner and goes to a domestic violence shelter.  A good samaritan appears and whisks the woman off to a room filled with 100 men-99 good guys and one batterer.  The woman is only attracted to the batterer.  The same applies to abused men.  They apparently have a built-in radar for women who will capture their mind.

I dealt with ex-cult members.  These were patients that had been members of cults and had usually been “extracted” from the cult by family.  The cult member would never have left voluntarily.  I had one rule in working with these patients–no further contact with the cult.  I knew at some level that if they had any contact with the cult, their mind would be recaptured.

More recently, I have dealt with children who have been described as “brainwashed” in the midst of their parents’ child custody battle.  One teenager told me that his father was so mean, abusive and cruel to him that if he had to sit in my waiting room with his father he would kill himself.  Of course he sat in my waiting room with his father and didn’t kill himself.  The case was interesting because mom had abandoned the teenager years ago.  She just vanished.  Then one day, several years later, mom appears and takes the child to another state where the teenager promptly tells the authorities a litany of atrocities that dad has done to him.  The authorities immediately give custody of the teenager to mom.  When I interviewed the teenager, I asked him to tell me about dad.  Without hesitation, he related a series of horrible things dad had done to him over the years–breaking objects over the teenager’s head, insulting the teenager, spanking the teenager.  Finally the teenager told me that dad would hold the teenagers two hands over a flame and burn his flesh.  In several recent burnings, dad had caused the teenager to receive “third-degree” burns over both his hands.  I asked the teenager to show me his hands–they were unscarred and clean.

I am attempting to write about a false experience. This is not to be confused with “falling in love” or “love”, whatever that may be.  That is a benign experience in comparison to what I am describing.  What I am describing is perhaps a perverse form of falling in love.  It is not benign, but malignant because the intention is not to love, but to capture someone else’s mind.  While the description of the experience may sound similar, it is not.  What I am describing is a facsimile of the “true” experience.  Perhaps it can be described as a wolf in sheep’s clothing, the predator disguised as love.

Which makes me wonder if we all are not pre-disposed/impelled to having our minds captured.  To being whisked away in feelings of ecstasy and joy.

If such a phenomenon exists, what would be the root of such an experience? I can’t know, but my imagination wanders to babies and mothers.  Perhaps in the womb babies experience a once-in-a-lifetime  at-onement.  The ultimate pleasure of being totally inside someone else.  There are not two, only one.  Of course this “spell” is broken by coming into this world–born.  But perhaps babies have had such an ecstatic experience and spend their lives looking for it again.  Freud apparently thought so because he considered birth the primal anxiety and the root of all anxiety.  And Otto Rank, who wrote “The Trauma of Birth”, created his theory of personality on this event.

Patients who apparently have had these types of experiences, after they have regained their minds.  After they have recaptured their thoughts.  After they have been able to dis-connect from the intense tractor beam of the other that they have been subject to.  After they have come “back to their senses”., usually tell me things like “Why didn’t I see it?”  or “Why didn’t I see the red flags?”  or “How could I have been so stupid?”  or “Why didn’t I listen to my gut?”

As I listen to these statements, I sometimes find myself wondering what will happen the next time?  The next time their mind gets captured?  Will they succumb or resist?  Will they be able to discern the real from the facsimile?  Will they have learned anything from the experience?

A patient recently said to me when discussing their relationships, “I don’t often get what I want, but I always find what I expect”.

Dr. Brody

Some babies can’t wait. They have to get out now and are born pre-mature. Other babies wait too long and don’t want to come out. They have to be pulled out. And then some babies never get the opportunity to wait. They are born still-born.

Whether these are actual experiences and if they effect the personality, I am unsure. But there is something about waiting.

He is a stockbroker. His problem is that he waits too long. He can’t “pull the trigger” and sell the stock.

He is an abuser. His problem is that he can’t wait at all. He can’t allow experiences to build and impact him. He needs to control life and attempts to do so via action. He is continually in motion.

I imagine that there is a tension between waiting and doing. Either can be a defense against the other. One waits too long to avoid acting or one acts to avoid waiting. But in my experience it is waiting that is more problematic.

Patients, most patients, eventually look at me and ask “What do I do?” When I respond with “Why do you have to do anything, why not just wait?”, they are usually unsatisfied with this solution.

Of course then they ask, “Wait for what?” This is the question. And the answer may hold the key to why waiting is such torture.

On my good days in the consulting room I can wait. Wait for something to emerge without the need to control the experience. I guess on those days I have faith. Faith that if I can tolerate waiting and not knowing an experience will emerge from some unknown place. Unknown to both myself and the patient. I imagine that this unknown “truth”  has been waiting for the patient to arrive. If only I can stay out of the way and wait.

Beginning patients often ask “Where do I start?”, or immediately sit down and recite their list of what they think they came to talk about. Other, more seasoned patients make lists to bring in what they want to discuss. And others rehearse mentally on their way to the session. There are many ways to avoid waiting for the truth to emerge.

Recently a patient who had been to many other therapists discussed stopping treatment. They said that they had told me all they had to say-their story. They said that “there would be nothing to talk about”. We continued therapy and we stumbled across a long-buried truth that had been waiting for them to arrive. The patient said “Now I understand what therapy is about”.

The problem for both myself and the patient is waiting.

If one or both of us can wait, then who knows what we can discover?  A baby born too soon, too late, not at all, or perhaps the truth that has been waiting for us all along.

Dr. Brody

I am sitting in the witness box and the judge asks the clerk to swear me in. The clerk asks me to raise my right hand and swear that I will speak “the truth, the whole truth and nothing but the truth”. Of course I know this is a lie on many levels. Once words are spoken the truth becomes a lie.

Besides, the court system is not capable of determining “the truth”, whatever that maybe. In some ways the court system mimics the human mind, I think. Neither are designed or possibly capable of experiencing the truth. Instead, the court system and the human mind produce substitutes, facsimilies for the truth–lies. We appear to be more comfortable with the substitute than the genuine.

As my father, an attorney, advised me from an early age, “If you are looking for truth or justice do not step foot inside a court of law”.

Of course in the consulting room truth and lies abound. Here are a few examples.

He has been referred by the court system because of domestic violence. He sits down and asks if I mind that he is carrying his 9 millimeter with him. I tell him my rule, no handguns in the office–his or mine. After the first visit, I learn that his wife has moved to the batterred woman’s shelter, and he is arrested outside the shelter. The police find a trunkful of dynamite that he was going to use to blow up the shelter. Months later I see the couple in the supermarket. They are holding hands, exchanging kisses, like people in love often do. I wonder about the glue that holds them together. Is it made up of lies or the truth?

Another couple comes to therapy because they complain of a vague sense of dissatisfaction with the marital relationship. Both are professional, educated and polite. They describe a feeling of drifiting apart after the excitement of building careers and raising kids. They also tell me that they never fight or argue. I begin to wonder how that can be without doing violence to the partners and killing the relationship? Where is their anger and hate? What lies/substitutes have they had to create to avoid a fight? At least the domestic violence couple could relate through their anger and hate.

I begin to wonder how much truth and how much lies can a relationship stand/need? It is probably a mixture of the two, some can tolerate more truth, some need more lies. But there does seem to be a point at which the relationship either explodes and or implodes and becomes deadly or dead. Is it too much truth or too many lies?

I often think we all use our relationships to hide from the truth. This is probably one of the most reliable means of killing ourselves, our partners and our relationships. We all commit such varied acts of violence against ourselves and others to avoid the truth. It is amazing sometimes that we can come back.

Dr. Brody

When I was younger and people or patients would ask me why I became a therapist I used to say flippantly that my first A in a college course was in Psychology.

Today I don’t believe that that was the truth, but it was a convenient way to hide from what was seeking me out. I just was mistaken in thinking I was seeking it out.

To be a therapist for as long as I have been one one must have been called to it, or one is just going through the motions. That’s not to say that there are not times I am going through the motions–playing doctor so to speak, but this is usually when I am tired or disturbed by something that is occuring. When I have reached the limit of my ability to be open to what the experience in the consulting room is.

A patient recently asked me for my definition of therapy. I replied something like, “Two people sitting in a room”. It is what the two people make out of that time and space that I believe is the core of therapy.

As for the calling, I don’t beleive it can be known. Oh I can look at my resume and life and see paths and directions I took, apparently seeking something. But it wasn’t until I stopped searching and looking that something found me.

I can’t really describe it in words, but here are some recent examples from the consulting room that perhaps catches a glimpse of what I am attempting to put into words.

It is her first appointment and she starts with commenting on how “serious” I am. I attempt to investigate what she means, but it goes nowhere. Towards the end of the session she describes that her marriage, which is in trouble, was based “on fun” only. I comment that “there was no room for seriouness”. She agrees and regrets it.

He has suffered a terrible loss some years ago, and is still haunted by it. He can’t shake it. It possesses him and torments him. He keeps repeating the phrase “One more day. What I would have given for one more day with him”. I feel the enormity of his sadness and grief. The session ends and I am cleaning up the office to go home. I am in the bathroom cleaning my coffeemaker, but I am still feeling the phrase “One more day”. Tears begin to form, and I feel like crying.

Dr. Brody

I never learned to ride a bike.

The story/myth/reason/excuse I remember was that my grandfather was teaching my older sister to ride. She started to fall and when he went to catch her he hurt his back.

A patient tells me of a recurrent dream/nightmare/image/vision he has: He is in an endless canyon–just clear clean walls on all sides. No floor. No top. He is falling wildly. Frantically. madly. But there is nothing to hold on to. He jut keeps falling. Endlessly. Forever.

When my wife was in ICU for the fourth time, I was spend time with her. As the days moved on she appeared to be falling away. Going to a place I did not know. Sleeping. Unresponsive. No talking. I remember standing over her and thinking this is what a baby must feel like. Asleep. Can’t talk or communicate. Just there open to all sensations and experiences and powerless to stop any of them or even scream. It was a timeless place. Time is hard to tell in ICU. People come in and out at seemingly randomness. People do things to her. Stick things in her. Turn her. Move her. Feel her. Turn lights on and off. Empty catheter bags. Puts drugs into her. Was she there? Could she tell?

Her sister comes in and falls to pieces. “We’re losing her. We have to get her out of here.” We convince the doctors to let us take her home.

She comes back. Returns. We talk about it and she makes me promise that I will never take her back to ICU. Ever. She explains that she has come up to a line every time she has been in ICU and it has taken too much out of her. She fears that the next time she will cross that line.

A few months later she crosses that line. She is home. Falling. Falling again. Prepared to cross that line. But she has to allow herself to fall and let go of this life. She struggles briefly and is ready. She allows herself to fall and crosses the line.

I now wonder if there isn’t some primal fear in all of us of falling.  Perhaps this is why we hold on so tightly–to relationships, feelings, ideas, hopes and dreams.

What would happen if we let ourselves fall.  Would someone catch us?  Would we fall to pieces?  Would we fall in love?

Perhaps it is time for me to learn to ride a bike.

Dr. Brody

Do you believe in ghosts?

It was her second appointment, having been referred by her primary care physician for depression in the aftermath of the break-up of a chotic romance.

She entered the consulting room and somehow I found her seated in a chair. But I didn’t see her walk or move. It was as if she just magically transported herself from the waiting room to the chair. She began to talk about her childhhood, her recent failed relationship, other failed relatioships, her work…. What was remarkable as I listened to her was how unremarkable her story was. No feelings, no history of abuse, trauma or neglect. No meaning to any of it. Just nothing. As the minutes continued to move, I became aware of a fantasy that if I were to reach out and touch her, my hand would go right through her and she would disappear–vanish.

And vanish she did. She never returned for another appointment, and sometimes I wonder if she was ever there or did I hallucinate her?

Since then I have become more aware of other “ghosts” in people I meet with. Things, presences, somethings that haunt, possess and torment. The people who I am attempting to describe talk about being haunted or possessed by something they cannot put into words. Something they desperately want to escape from and get rid of. Something that may recede at times, but never really dies or goes away. Something ghostly that remains alive or still-born inside them waiting for ….

I imagine now that we all may have “ghosts” like these. Some more than others. Dead spots that remain with us awaiting to be re-born so that they may have some rest. Of course this is what most of fear. To give life back to what haunts us.

But how else do you kill a ghost?

Dr. Brody