When modern psychoanalysts write about their patients they always seem to focus on moments of their own brilliance: the big breakthrough; that sparklingly insightful interpretation of a patient’s words that brings the patient to a moment of tearful epiphany, transforming their life from here to eternity. The tectonic shift. “After that, Miss B was more openly emotional and often cried during sessions. We began to make real progress.” Poor Miss B.
Years (and years) ago, I used to feel as though my analyst was trying very hard to make me cry. I valiantly defied him. In the rare sessions when he won (I spent ages thinking I was allergic to something in his house because my eyes would water on the couch even though I wasn’t aware of feeling sad) he would look all sympathetic and supportive and I’d think—“Bastard!” I could almost hear him writing his paper: “Miss A cried today, proving that I am a psychoanalytic genius.” (NB: Freud didn’t write like this. He happily catalogued his catastrophic failures.)
Of course, my analyst wasn’t trying to make me cry. He probably was pleased when I did though; pleased that my super-chatty-God-I’m-witty defence was cracking and revealing something more authentic. As a therapist it does feel like a bit of a victory when a very heavily defended patient shows some real emotion, and it can signify a breakthrough. But on the patient end of things it felt cruel, as though I had to be desperate, devastated and defeated to get better. Perverse.
So, my very own Miss G always arrives apparently straight out of hair and make-up, teeth super white, smiling, glam and upbeat. The upbeat schtick usually lasts about five minutes before a slump, tears and bitter self-flagellation. This week she wasn’t wearing the armour (in other words, she looked much more normal), and was already weepy. “All the stuff we’ve been talking about has brought up so much emotion. All these things I’d sort of known but never put two and two together. I feel like I’m falling apart,” she said. Miss G wondered if she should check into a psychiatric hospital. “I’m having a breakdown,” she concluded.
This, sitting in a little institutional room with me, overlooking a railway track and a pub that always seems to be closed, was certainly the worst moment of her life. In the notes, I wrote something like: “Breakthrough with Miss G. Real Progress. Now in touch with a lot of disturbance and sorrow she’s had to hide all her life.” And it struck me how annoyingly shrinky I’ve become, how different my ideas about that session must be from Miss G’s. She thinks she is breaking down. I think we are breaking through.
I imagine that the sessions a patient enjoys and feels helped by are rarely the ones the therapist feels are really productive. The therapist is looking for moments of real connection with the patient, a genuine emotional shift, clarity, insight. The patient might be looking for someone to be sympathetic, to agree with her (the patient is me in this scenario) to collude with her view of the world (all men are bastards). When the therapist provides these things he may well feel he is failing as a therapist, has been seduced into playing the patient’s game rather than really understanding her, really challenging her to see reality as it is rather than through the prism of her hard-wired fantasies about everything. It’s strange to spend an intense 50 minutes with someone and to have such differing views of what went on in that analytic hour.
By the way, Miss G was, of course, completely cured by my profound understanding and deep insight… (Well, give me another decade.)
