Life of the mind: saviour syndrome

I have a patient who reminds me a bit of Amy Winehouse. She dresses in a way that’s ultra-feminine but aggressive at the same time. “What do you mean? It’s just how I dress.” Just! I love just! It comes up all the time in therapy. Nothing is just anything (not even a cigar). She is fantastically self-destructive. “Why shouldn’t I drink and do drugs? I’m not hurting anyone else?” She is terribly sad. “Isn’t everyone? And nothing you say will change the past anyway.” She is chronically lonely. “Everyone always leaves. But that’s life, right?” I think I used to be a bit like her.

When Winehouse died, in 2011, I remember saying to my children: “Silly girl! I wish she’d have come to stay with us. I’d have made garlicky roast chicken and lemon tart and given her a cuddle.” I think I half-believed that this might have worked, contrary to everything I already knew about psychotherapy. There are cuddles-and-sympathy therapists, the kind lampooned on television—plump women in cardigans and fat beads. They listen sympathetically and smile warmly. It doesn’t work, of course. Care is something you can get from your friends. Therapy isn’t. For the cloying approach to work you’d have to be dealing with someone able to accept sympathy (not Amy), and then you’d have to deny all the stuff the patient brings up in you that isn’t sympathy, so the whole thing’s a lie, basically. I remember hating my analyst for not seeming to be on my side in reported conflicts with work or lovers, and despising him for sounding all mock sympathetic (I later realised it may not have been fake) when I was sad.

But some patients, like my Amy patient, really make you want to put your arms round them, tell them it’s all going to be OK. The job of therapy is to try and understand that countertransference, to think about why and how the patient is making you feel that, and what it means about them. Sometimes though, when someone is sitting there looking lost, covered in tattoos and piercings, angry and sad, the desire to help instead of to think is overwhelming.

Obviously, you don’t need to have or be a therapist to play out your omnipotent saviour fantasy. Lots of people feel empowered by trying to save someone weaker (projecting their own vulnerability onto someone else), and lots of people wait around to be rescued (denying their adulthood by projecting it into someone else). But what happens if the weaker person recovers strength? Or the strong person’s weakness is revealed? Carnage ensues. That’s what. I would do anything to make my analyst give me a hug and tell me what to bloody well do about stuff. I’m sick of thinking about it. But that’s the frustrating limitation of the job and, perhaps, of life. In the end, as therapist or patient, we have to accept our helplessness. I want to explain to my daughter how she’s going to feel after 20 years of smoking and have it sink in, convince my (ex) husband that life’s short and it’s OK to be jolly. But all I can really do is try to understand my Amy Winehouse patient, my kids, friends, ex… and, yup, that too—myself.

Anna Blundy is a writer training to be a psychotherapist. The situations described are composite. Confidentiality has not been breached