Who am I and what do you see?

This has been a thought provoking week about the question of identity. I’ve been to two different art galleries, Tate Britain and the National Portrait Gallery. Tate Britain is showing a collection of paintings by Lucien Freud and others whilst the National Portrait Gallery has a permanent exhibition of twentieth century notables. There were many pictures that caught my attention in both galleries. In the National Portrait Gallery it was the picture of Amy Winehouse, painted by Marleen Dumas, that moved me. She  seems to have caught the varying aspects of Amy Winehouse in one portrait – her vulnerability as well as her strength, amongst other qualities. One of the featured artists in the Tate’s “All too Human” exhibition was David Bomberg. The blurb that goes with this exhibition noted that Bomberg et al “… maintained an emphasis on the rendering of the physical experience of a person or a landscape rather than just a recording of their appearance.” I had never considered the meaning of a portrait. I took it to be a simple image of a person or landscape, albeit that each painter or photographer used a different way to describe what they saw. It hadn’t occurred to me that a painting might also be an observation about the experience of meeting that person or space. It would be very interesting to hear from anyone who is involved in the visual arts.

My responses to these exhibitions lead me to reflect on my clinical work. I invariably note my responses to a patient, particularly if it’s a new assessment. I equally try to capture their responses to me and my interventions. So I will often say something like “It seems to me that what might be happening here is …” based on my experience of that person. (Technically this is Transferenceand Counter-Transferencein psychoanalytic jargon.) When I was a Nursing Lecturer I used to interview students who were hoping to do a nurse training. It was a different experience. We met such a range of students wanting to become psychiatric nurses. Some of their responses to a question were memorable. One who stands out was a girl who was asked how she might manage a patient who was dangerously disturbed and potentially violent. (I had a picture of David and Goliath in my mind’s eye.) I had an idea of a range of possible answers. The one she gave stopped me in my tracks. “I would let the love of Jesus pour out of my heart and into his.” I and my colleagues were speechless. How to respond in a “professional” manner? We managed to make a non-comital sound and moved on with the interview. We did not offer this girl a training place. In our feedback we tried to point out that a response about the love of Jesus was fine but it needed to be allied with other responses as well. (At the time her response to the feedback did not suggest she was going to be able to hear what were telling her. I have no idea what happened subsequently.)

Another story also came to mind when thinking about this blog. It too is about a student whom I interviewed. We asked the group to tell us about an experience they had had that had been important in some way. Various stories were given and one student told us about the death of his young son a couple of years ago. “It was painful at the time but we’ve moved on now” was his summary. He appeared unmoved now by this death. He was a Malaysian who had been in the armed forces for several years. We chose not to offer him a place for several reasons, one of which was his seeming lack of awareness of how he portrayed his reactions to the death of his son. We subsequently saw him for a feedback session. I gave him my reasons for our decision but wanted to help him think about what we were saying. After ten minutes with him it became apparent that he was deeply moved by his son’s death but had thought that a display of grief was unmanly. His fantasy was that we expected him to have “got over it” by now, hence his seeming detachedness. We pointed out that as a nurse, if he was going to be effective, he needed to show his patients that he was moved by their distress and difficulties. I hope he took something positive from his interview. He had the potential to become a good nurse.

I cite these two students as examples of my responding not only to what they said, but also to my experience of them. The “Jesus” girl whilst doubtless confident of her ability to allow Jesus’ love to pour out of her heart, came across as naive and unthinking. Her world view seemed simplistic. I am happy to have religious believers become nurses. I am happy to think that a nurse might choose to pray for a patient – albeit in their own time. But spirituality needs to be linked with practical nursing skills. The other student came across as unthinking and uncaring, yet something about my experience of him lead me to explore further and to discover a man who was deeply touched but who thought that he had to appear to be over a difficult and painful event. With time and support I think he could have made a good nurse.  Therapy is a dynamic process. My patients talk to me. I meet them and try to understand my responses to this meeting, given what I know of them and their history. It is often the case that when I comment about how they seem to be responding to me, this opens up new areas for exploration. It also challenges me as the therapist. What is it in me that is responding in a particular way to this person?  It’s why we have supervision and are expected to have our own therapy. Both can be very challenging!

The point i’m hoping to make here is that good psychotherapy goes beyond listening just to my patients words – important though these are. There is in this encounter a going beyond words. One tries to capture the experience of the encounter in such a way as to bring into consciousness material that may be unconscious on both sides. It seems  to me that this is what good artists attempt. Which is why I’ll leave the last “word” to the portrait of Amy Winehouse.

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Speaking Truth to Power

In my last piece I wrote about St. Paul’s view that “we wrestle not against flesh and blood, but against principalities and powers…” I linked this idea to the ways in which generational values come to be handed on. It is usually those values that are least helpful that get transmitted. The values that could be creative and life affirming seem to get filtered out.

I’ve written before about the power of naming something or someone. If I know your true name, then I have power over you. I hold your soul captive. This is how I interpret Paul’s message. I am held captive by the principalities and powers of anger, anxiety, depression. There is a long mythic tradition of ” binding” demonic forces by knowing their true name. The story of the Gadarene swine seems to fit with this tradition. Once the man was free from his afflictions, he was back in his right mind and able to function as a human being. Not trapped in a world of ” demonic” forces.

In my therapy room I meet lots of demons. Demons of silence that won’t allow a person to think about themselves because any alternative story is forbidden. Like Cinderella longing to go to the Ball, but not allowing herself to even consider the idea. She was exiled to the principality of ” Duty” “Depression” and “No Hope”. Fortunately she had enough of her homeland in her to find Hope,

When I see a new patient, there is always the struggle between how much work they want to do and the amount of work I hope they might achieve. Leaving behind somewhere that has become Home is always difficult. Part of my work is to speak truth to Power. To challenge the powers that keep so many people trapped. (It’s hard to write about this aspect of the work. One ends up sounding like a fervid religious preacher offering to cast out demons. Or a touchy feely Californian New Age guru.)

The work is in naming and having that name acknowledged. “Yes. I am angry about such and such.” ” No. That shouldn’t have happened.” “Yes. It was abuse.” By allowing the speaking of Truth to Power, the individual is affirmed.

Which might be a way of thinking about the Christmas story.

Principalities and Powers

Saint Paul wrote that we wrestle not against flesh and blood but against principalities and powers,

This seems to be one way of thinking about the way values seem to get embedded. Whenever I assess a man for Anger Management there will be generations of men behind him sharing their values and instilling in him a view of how men behave and conduct themselves. Usually these values include emotional and physical abuse as a way of enforcing a power structure. These men then grow up with a view of themselves as needing to be ” hard”. Hard on their children and hard on their wives. Sometimes the control is physical, sometimes emotional. But always about control.

Similarly when I assess a woman who has come for help with anxiety or depression, there will be mothers and grandmothers who instil a view of a woman’s place and function. This will be that they are there primarily to serve their husband or children. ( To serve. Not to complement or share, but to serve. As one patient put it, her task was to help her husband become the man she saw that he could be!)

Saint Paul understood his battle to be with the spiritual forces that he thought lay behind everyday life and society. He saw these values as demonic and anti Life..

Looking at the Brexit decision, I’m almost inclined to follow him.

In broad terms, he had a point. Violence, rage, crippling anxiety and depression are anti Life. Which might be one way of characterising the demonic. That which is anti Life. Which begs the question of “Why?” Why does a man come to believe that violence is the only way to live? Where does he decide that hitting his wife and children are good ways to live?

Where does a woman decide that her task is to sacrifice all for her husband/ father/ family?

It seems that there is an alternative value system that ensnares us in its thinking. I recognise it in myself. My wife works full time in a job that she enjoys and which is demanding. I’m retired and work fewer hours. But if we run out of something at home, my all too frequent reaction is ” Why hasn’t Jenny done the shopping?” (I do try to remind myself that I am quite capable of going shopping.) And I consider myself to be a modern man. Some values run deep!

So how to understand the principalities and powers at work here? Much of the difficulty seems to stem from a sense of insecurity. I’ve yet to meet a man for whom Anger was a problem who was able to value himself very much. In all the men I’ve worked with, there was an underlying sense of low self worth. ” I’m just thick. I’m only fit to be a navvy” is how several of my men have put it. And even on the building sites, there’s no respite. Any comment on their work, justified or otherwise, is experienced as criticism. Any criticism wipes out their entire being, confirming their view that they are indeed ” only fit to be a fucking navvy.” Take this away and it’s hardly surprising that violence erupts in some form. If my self esteem is so fragile, then anyone or anything that threatens that will be met with an extreme response.

With depressed and anxious women self esteem also seems to be involved but in more subtle ways. We know how misogynistic our society can be. A woman’s place is still in the home. No matter how many important decisions she makes at work, a woman can still be undone if she forgets the milk! ( I wonder who does the shopping for Theresa May? I remember David Cameron shopping in Aylesbury. A large, black SUV parked illegally at the top of our street. No parking ticket was issued! His bodyguards got out first, followed by Cameron as he did a bit of shopping in Aylesbury. An everyday trip to the shops such as we all do.)

Women still see themselves as being subservient to men. The patient who told me she saw her task as helping her husband to be the man she thought he could be, was expressing a maxim from her mother and grandmother- which is usually as far back as records go. In this case all three generations had seen their marriages fail as the men they had chosen turned out to have agendas that didn’t match those of their wives. In each case the present generation managed to instil the message ” Do as I say and ignore what you see.” with no good outcomes.

We seem to be back to principalities and powers. Of powerful unseen forces shaping successive generations and influencing behaviour and values. Perhaps one way of characterising the work of the therapist is that we speak Truth to Power.

Evensong

” Grant to thy faithful people pardon and peace…” Words from Evening Prayer or Evensong. As a benediction at the end of a day or a week it’s hard to better. I rather like the idea of having this on my headstone. Along with “Go not gently into that dark night” and Winnicott’s ” I hope I’m alive when I die.” ( I’m going to need a lot of space on my headstone!) It seems a lovely way of summing up all the hopes and wishes that we hold for someone.

In my counselling work I often want to offer this blessing to so many of my patients. It’s an aspect of the work that many of us perform. Pronouncing a blessing for our patients. It forms an Amen at the end of a session. A way of affirming our belief in our patient and in the work.

” Pardon and peace” are so often absent in my patients worlds. Angry men who are the sons and grandsons of violent men. Anxious and depressed women who are the product of mothers and grandmothers who were anxious and depressed. The pardon and peace they need to hear has never been spoken. What they heard was rage, bravado. A refusal of any sign of vulnerability or need. ( This is mostly the case in those men who come to me for Anger Management. Being the hard man was more acceptable than being able to be “needy”.)

The women who come bringing their anxiety and depression are often just as trapped in a story about how they should be. “Seen and not heard” is often how they feel treated. (Underlying their depression is a rage equal to any ” anger management” men. Simply that women so often internalise their distress where men are more prone to act it out.)

 It seems that giving oneself the gift of “Pardon and peace” takes a deal of courage. “Do I deserve it? What does it mean? Can I keep hold of it?” Kierkegaard talked of the Leap of Faith. He was thinking of God. As a counsellor my task is a little easier. I invite my patients to trust that our work together can result in Pardon and peace.

Paul Tillich described God as the Ground of our Being. Perhaps this where we arrive when we receive and grant Pardon and Peace. We find the Ground of our Being. Whatever that Ground might look like.