Patients Who Haunt the Therapist

It’s almost Halloween. Time to talk of a patient who haunts me.

I put her in the category of Greek tragedy. After you do therapy for a while, you get a sense of a singular place called “Grim Future;” and a person, admirable in many ways, whose tragic flaw will take her there. Usually, you only witness the first few acts of the drama.

But you are certain, even though the data say therapists are flawed predictors.

These are the patients with whom you are powerless. Not a good thing for a peculiar profession, one hoping to prevent disaster, enable happiness.

She was a university student. Her parents actually did the leg-work to find a therapist to “fix” her. I came recommended, though an odd choice for a family steeped in “hellfire and brimstone” faith, the folks who strangle nearby innocents with certainty of the right and wrong of everything. Their rigidity frightened me, people who sat so tightly wound in my office I thought they might vaporize. Hisssssssssssssssss!

I’d be seeing the daughter, however, I said to myself. I told them she would be my patient, not they; once I evaluated her and assuming I believed good might be done. I “would not, could not” (as Dr. Seuss says) report back to them; short of imminent risk of self-harm or danger to someone else. They seemed to agree.

She walked in and springtime came with her. A silvery thing, she lit the room, though I cannot explain how. A “presence.” Therapists take in everything or try to.

This young woman was tall, perhaps 5’10” and willowy; black hair against porcelain skin, a pleasant face. Her complexion was so fair I could almost see through her. Someone else had, I suspected, and seen there was no will in her to resist much of anything.

She was not the most expressive person I ever treated, more sadly placid. Not serene, but the kind of calm derived from having the fight drained from you. Almost weary. Her parents had sucked the life out of her. Think vampires. The wind would take her where it chose. Right now she had youth and beauty, but as they say about the short careers in the National Football League (NFL), the three initials really mean “not for long.” Of course, I didn’t understand all this immediately.

Her parents wanted her to follow some “serious,” academic track. She was a dancer. They wanted her earthbound. She wished to leap. Bad combination.

Many of us try to get the love we couldn’t get at home, don’t we, at least for a while? My patient was looking for such affection. Her folks didn’t like her boyfriend: he was not a member of their suburban, uppity class, and worse (to them) freighted with a minority heritage. But before you feel too sympathetic toward him, you must learn more.

I discovered he had introduced her to cocaine, which he also used: a drug, for her, like a key for her internal lock. There she found release, relief, and ecstasy. There, she was no longer anyone’s hostage. But, of course, she’d simply gone from being her parents’ chattel to that of the boyfriend and the drug.

Treatment didn’t go on for long. The job of freeing a person from parental dominance or a lover’s grip must wait if simply getting through the day is difficult.  I explored addiction treatment with her. I don’t recall if she began or not, but her interest was only dutiful. Soon enough her parents discovered her use and blamed me for not telling them. Therapy ended.

The character of Alfieri, in Arthur Miller’s A View From the Bridge, says the following:

There are times when you want to spread an alarm, but nothing has happened. I knew, I knew then and there – I could have finished the whole story that afternoon. It wasn’t as though there was a mystery to unravel, I could see every step coming, step after step, like a dark figure walking down a hall toward a certain door. I knew where (she) was heading for, and I knew where (she) was going to end. And I sat here many afternoons asking myself why, being an intelligent man, I was so powerless to stop it. And I even went to a certain old lady in the neighborhood, a very wise old woman, and I told her, and she only nodded and said, ‘Pray for (her) …’

The cynics say counselors are only interested in money, making a fine living off the pain of others. Well, some few are, but most of us want the best for everyone, not just our patients. We are rewarded by human contact and flourishing.

Yes, we cannot help without a therapeutic distance. The invisible boundary doesn’t inoculate us all the time. People we know, in and out of therapy, get inside. It happens to us as to you. We are not sculpted from stone.

Halloween is an odd day to be thinking of prayer, but apt perhaps. This year, when you tuck your candy-buzzed child into bed, and after all your treats have been gobbled up by greedy little monsters, sit back and rest and be grateful if no ghosts haunt you. Then, if you have a picture of this fragile creature because my story was well-told, pray for the (now, no longer young) woman, if she lives.

And for your counselor. This, from an ex-therapist who doesn’t believe in God.

The top painting is Marie, by Peder Severin Krøyer. The second image is The Ghost, by Tsukioka Yoshitoshi. Both are sourced from Wikimedia Commons.

The Simple Beauty of a Power Outage

Powerless.

They said it would be over by the next day; the Commonwealth Edison recorded message said so, that is, about the power outage that began at about 9 PM Tuesday night, June 21, 2011.

It would be over by Wednesday. An estimate? A guess? A hope? Of course, there was the caveat that it could go on until Friday night or maybe even longer. Storms, tornadoes, fallen trees, and downed power-lines had done it. Nothing to do but wait. And so we did nothing, my wife and I.

https://i0.wp.com/upload.wikimedia.org/wikipedia/commons/thumb/6/6f/Bright_Darkness.JPG/500px-Bright_Darkness.JPG

The first thing we noticed was the quiet. Quieter than the usual quiet, which, it turns out, isn’t really still. No music, no TV, no radio, no computer (with its “You’ve got mail” greeting), no air conditioning; just the low-frequency chugging of a few distant gasoline powered generators. Everything by candlelight and flashlight. Time to sleep: earlier than usual, more dictated by the sun than by the clock.

Wednesday morning. Still no power. It is still still. How dependent are we on electricity? What about the food? The stuff in the refrigerator and the freezer? It is cool out, not to worry — yet. We will get ice, pack it in the freezer and refrigerator if we need to.

Things are slowing down. Listening to bird sound and song — pretty nice. The quiet seems to simplify things. The rooms look different by candlelight. The shadow of a lamp, not the usual light-giving object itself, but the elongated, misshapen outline of the object on the other side of a candle, cast against the wall.

Easier to think. Easier to read: no distractions. And then there is the pleasure of sitting in the dark or in the half-light, just listening to the small squeaks and creaks of the house; the small sound of footsteps, your breath and your heartbeat — all the things so easily missed, so meditative.

https://i1.wp.com/upload.wikimedia.org/wikipedia/commons/thumb/8/86/Remiz_pendulinus_-Estonia_-singing_by_partly_built_nest-8_cropped.jpg/500px-Remiz_pendulinus_-Estonia_-singing_by_partly_built_nest-8_cropped.jpg

The latest Edison recording said that the power was expected by 10 this Thursday morning. “Check that,” as Cubs announcer Jack Brickhouse used to say — now the prediction is 2 PM. And later a real person at Edison tells me that we should be back to normal by 11 PM tonight, still Thursday. Maybe another trip to get ice will be needed.

Bored? Not at all. It is remarkable how interesting little things can be: the perspiration accumulating on your upper lip after you’ve lifted weights; the physical sensation of your feet as they touch the floor; the feedback from muscles and joints simply doing their job, if you are paying attention; the tiny sounds your neck makes when you turn your head; the air around your fingers as your open hands extend beyond the touch of the chair’s arm rests.

In T. S. Elliot’s words from Burnt Norton, I arrived

At the still point of the turning world. Neither flesh nor fleshless;
Neither from nor towards; at the still point, there the dance is…

Friday morning, 6:03. The power company’s message now says that they think we will be back in business by 5:30 PM. Over 440,000 “customers” have been without power, meaning that many more people have been affected than originally reported. One-hundred-sixty crews from other states are working on the problem, along with the Illinois contingent of 440 repair groups.

By now I’ve finished Sissela Bok’s Exploring Happiness: From Aristotle to Brain Science and am on the home stretch of Philip Roth’s Sabbath’s Theater. Thank goodness for the Light Wedge battery-powered reading accessories provided by my youngest daughter. Much better than candlelight.

The planned week off from work is stretched, but not by impatience; rather, by the ratcheting down of the slave-driving electronic grid and its attendant, inessential distractions. I have less to do, but more focus in doing it. A bit like an earlier time, I suppose — most of human history, after all, was lived by nature’s tempo, not according to man’s technologically created stopwatch. No electronically calibrated exercycle to use, so I walk more.

Remember how, when you were a kid in the car with your folks and a train stopped the traffic at the railroad crossing? How neat it was to look at all the different cars going by? How it made your eyes crazy with back-and-forth movement? How if the train was long enough you started to count the cars, all of them or just particular types like box cars or cattle cars? How some of the names on the sides of the cars suggested far away places — different states that you’d never been to? When did being “stuck” at a train crossing become an inconvenience and not a delight, something that slowed you down, something to get angry about?

https://i2.wp.com/upload.wikimedia.org/wikipedia/commons/thumb/5/53/Gundelsheim_-_Class_50_and_Freight_Train.jpg/500px-Gundelsheim_-_Class_50_and_Freight_Train.jpg

Two-thirteen PM Friday afternoon. The dishwasher is whirring! The lights are flashing! The power is back! Wow, electricity! The dazzle of a working computer, of artificial light, of TV!

That won’t last, of course. It didn’t even literally last because we lost power again one week later, again at night, although only for a few hours.

The long powerless interlude was pretty nice, partly because it wasn’t a flood or a tsunami; partly because we had hot water and motorized transportation; partly because it wasn’t too hot. Happily, as little as it was, it didn’t go on forever. Just long enough to give some perspective.

Take nothing for granted.

The photo reproduced at the top is called Old Bottles of Wine Aging by Candle Light, by Steffan Hausmann. The second photo is Sky at Sunset from Brancoli’s Crux on December 26, 2007 by Luccio Torre. Next is A European Penduline Tit in Estonia on June 19, 2010, the work of Alastair Rae. The final image is of a Class 50 steam locomotive near Gundelsheim Station, Germany taken on April 4, 1970 by Roger Wollstadt. All are sourced from Wikimedia Commons.

The African Dip: Thoughts on Passive-Aggressiveness, Powerlessness, and Acceptance

The  Flying Turns

My dad occasionally took me to a legendary Chicago amusement park called Riverview when I was a little boy. I was dazzled by the roller coasters, the “Waterbug” ride, and something called the “Rotor.” The latter required you to enter a circular room which spun on a central axis until the velocity and centrifugal force were sufficient to pin you against the wall, just as the floor dropped away.

But, as small as I was, it is a sideshow called The Dip that I remember most vividly. Today I’d like to use this politically incorrect carnival attraction as a spring-board to a few thoughts on the expression of indirect anger that sometimes is called “passive-aggressive,” as well as a therapeutic approach to setting aside the temporary upsets that are a part of any life.

Black men in cages. That is what “The Dip” involved.

Unbelievable, perhaps, as we think about it in 2010. Each man sat on a stool inside the cage. In front of the cage, off to the side a bit,  stood a small circular metal target that was attached in some fashion to the stool, perhaps electronically, but more likely mechanically.

For less than a dollar, you could purchase three balls to throw at the target, one at a time. If you struck the target solidly, the stool on which the man sat collapsed, and he dropped into a pool of water underneath the cage. You might have seen similar “dunk tanks” at various fund-raising events, often giving students the chance to dunk their teachers.

Harmless fun? Not so in the case of a black man doing the sitting and a white man trying to knock him off his seat.

This sideshow was once reportedly called, “Dunk the N****r,” later “The African Dip,” and finally “The Dip.” It was eventually shut down by a combination of Negro outrage and the increasing disgust of white people to the offensiveness of its implicit racism.

The black men were in a relatively powerless situation — almost literally, “sitting ducks.” But, they did what the situation allowed them to do so as to unsettle, tease, and otherwise disrupt the white pitcher’s aim. The Negroes were careful not to say anything too frankly insulting, lest they stir up the racism (and potential for less veiled violence) that was at the heart of the event.

But they would and could get away with belittling their adversaries athletic skill or throwing ability in a way that was amusing. If their comments distracted the opposition at all — got them to laugh (or the crowd to laugh at them) — or caused a break in the hurler’s concentration, the chance of staying on the seat improved a bit.

According to Chuck Wlodarczyk in his book Riverview: Gone But Not Forgotten, the caged men’s banter could include comments about one’s appearance: “If you were heavy, they’d call you ‘meatball.’ If you were thin, they might have called you ‘toothpick.’ If you were with a girl, they might have said ‘Hey fella, that ain’t the same girl you were with yesterday!'”

You don’t have to be a black man in a cage to have some experience of expressing anger indirectly. We’ve all done it. It takes many forms: talking behind someone’s back and mocking that person, being sarcastic, complaining to a co-worker’s superior rather than to the offender’s face, neglecting tasks you have been assigned unfairly, and procrastinating. These passive-aggressive words or acts are rarely very satisfying. The anger doesn’t dissipate; the grudging discontent usually continues; nothing positive happens.

The sense of powerlessness and lack of control that the passive-aggressive individual experiences can come to dominate that person’s emotional life, rather than allowing him to put effort into changing the power dynamic or to remove himself from a position of weakness.

Unfortunately, for some of those who feel powerless and injured, even a passive-aggressive action seems impossible. Consequently, they take a more uniformly passive role. They defer to others, try to avoid giving offense, act meekly, and position themselves under the radar. All that does, however, is give them second class status, just as it informs bullies that they are easy targets.

Someone in this situation, who repeatedly feels mistreated but isn’t able to take on those who inflict the injuries directly, needs to ask himself a few questions. Why do I put up with it? What am I afraid of? Am I really as powerless as I feel? Am I perhaps overreacting? What would happen if I were more direct? Is there any way to get out of the situation I am in?

Cognitive Behavior Therapy (CBT), which aims to quell and counter irrational thoughts, is often helpful in dealing with a lack of self-assertion and the fear that is usually associated with it. Equally, it gives you practice (sometimes using role-playing within the therapy session) in a gradually ascending hierarchy of challenging situations that require an assertive response.

Some CBT therapists, much like ancient Stoic philosophers, employ an “acceptance-based” psychotherapy and integrate this Zen-like element into their treatment. Why, they might ask you, do you so value the minor indignities of daily life and of opinions and behavior of boorish persons? Is it really a good idea to spend the limited time of your life being upset over rudeness from a tardy repairman or a fender-bender accident you didn’t cause — things that will be of no significance in a week, a month, a year?

Put differently, there will always be injustice, and some of it must simply be accepted as the nature of life and of living. Not every fight is worth fighting about, not every slight is intended. If your skin is so thin that you are regularly being upset by people, perhaps you are valuing the approval and opinions of others too much.

For those who ask “Why me?” those same therapists might say, “Why not you — you are alive, aren’t you, so you are subject to all the same things that can affect any other person.” And, as the Stoic philosophers and Zen practitioners would tell us, if we can accept this vulnerability as part and parcel of living, thereby assigning it less meaning and taking it less personally, our lives will be more satisfying — less fraught with anguish, anger, and hurt.

This is not to say society should have tolerated the indignity and racism of “The Dip.” There are times when the indirect, but pointed wit of the caged men is the best course of action; and, many occasions when the force of your personality must be brought to bear by confronting injustice. But some combination of directness in taking on unfairness and forbearance in accepting things — in allowing oneself not to sweat the small stuff — tends to produce as good a result as life will allow.

Of course, you have to figure out what the small stuff is and what other things really do matter to you.

Meditation is usually a part of the treatment enabling you to stay in the moment, and let go of your attachment to passing feelings and thoughts, worries and regrets, and anticipations and fears. To be preoccupied with just such temporary upsets causes you not to be able to fully experience what is going on in the present and determine what is really of importance in your life.

By encouraging and training you in meditation, the counselor  is attempting to give you a method to achieve a state of psychological enlightenment that (without using words) helps you to distinguish the transitory aggravations, disappointments, worries and anxieties of life from whatever matters the most to you, so you can put your effort into the things of greatest value in your life.

Some final questions:

  1. Do you often find yourself fighting over things others consider to be small?
  2. Do you frequently feel put-upon but are capable only of a passive-aggressive response?
  3. Do you (too easily and too often) assume a fetal position with others (metaphorically speaking), who come to think of you as an easy target and treat you badly (in part) because they know you will not stand up for yourself?

If you have answered any of these questions in the affirmative, you might benefit from asking a couple of other questions:

  1. What does this mode of living cost me?
  2. Am I willing to do the work necessary to change?

If the cost is substantial and you are eager to change, then a therapist can be of assistance. Only then will you be ready to get out of the cage, real or not, in which you find yourself.

The image above is the Flying Turns, a toboggan-style ride that was one of the many attractions that made Riverview Park famous.