Letter to a Young Student #9
Trauma and tragedy in the life of the psychotherapist
Posted Aug 19, 2013
I loved your last letter (#8), which shed light on the conversational style of The Abyss of Madness: it originated in a conversation! There is a hint of ambiguity still remaining, I noticed, regarding the real identity of your Dr. E. You are very funny about this. I want you to know I also think he might be a real person, and living in California. Go look for him sometime, Professor Atwood, and let me know how the search works out!
You said in an earlier letter that people who become interested in working with severe psychological disturbances most often have experienced significant trauma in their childhoods. I want to hear more about this. What are the traumas that are involved, and how do they relate to someone taking up a career in this field? Does this mean prospective psychotherapists should seek out their own personal therapy and hold back from actually working with patients until their own wounds are healed? Are there injuries of such magnitude that those suffering them will never be able to work as psychotherapists? I would so appreciate your thoughts on these questions.
Thank you again. Adam
There is a traumatic condition that has developed early in the lives of almost every psychotherapist I have known, or at least in the lives of those who become committed to working with very serious disorders. I will call this the situation of the lost childhood. There are two basic pathways along which it seems to occur.
The first and most frequent story is one in which a child is enlisted at a young age to support and sustain a depressed or otherwise emotionally troubled parent. I am speaking here of something extreme, wherein a reversal of roles takes place and the parent comes to depend on the child rather than the other way about. The identity of the son or daughter then crystallizes around making nurturant provisions, the activity of caregiving being the only way open to maintaining bonds of secure connection in the family. There has generally been an emotional void in the parent’s own background, and the child is then given the task of filling it. A compromise of the child’s autonomy and authenticity occurs as the little “psychotherapist” materializes, a slave to the needs of the mother and/or father. Impulses to disengage and pursue a separate life in this context are felt by the parent as unbearable injuries, always producing reactions of great distress and sometimes even of rage. When the child tries in some way to be a person in his or her own right, the parental response may be: “Why are you killing me?” This is a pathway closely resembling the one described by Alice Miller in her very fine book, The Drama of the Gifted Child. The “gift” to which she was referring here is the natural sensitivity and empathy of certain children that lead a wounded parent to draw them into this role. Miller’s original title for her book was Prisoners of Childhood, a very apt description of the imprisoning effect of such an upbringing, which includes the dissociation of important sectors of the child’s personality as the child is not allowed to become the person he or she might otherwise have been. You can see, Adam, that the most natural thing in the world for such an individual, later grown up, is to seek out a career in counseling and psychotherapy. Their training for the work has been occurring from an early age. Thus is generated what I call a Type 1 Clinician, one seen especially frequently in the field of psychoanalysis.
The second situation leading to this career is based not on serving the needs of a troubled parent, but rather on an experience of traumatic loss. Here too there is an imprisonment that takes place, and a resultant lost childhood that compromises the full development of the individual’s own unique personality.
The story runs as follows. A fundamentally loving relationship with one or both parents is in place in early life, a bond within which the emerging identity of the developing child is supported and the stability of family life is felt to be secure. An irrevocable change then occurs, something making it seem that formerly secure ties are lost, leaving the child bereft. A parent may grow ill and die, vanish for reasons unknown, be perceived as having disappointed or betrayed the child unforgivably, or undergo an emotional breakdown from which there is no recovery. The early world, now missing, becomes idealized in memory, contrasting sharply and painfully with the desolation that has taken its place. The longing for the parent who has inexplicably changed or disappeared intensifies and becomes unbearable. The loss of the mother or father at this point is restituted by an identification process, one in which the child becomes the one who has gone missing. A transformation of personal identity has thus taken place, in which the loving, rescuing qualities of the longed-for parental figure now reappear as aspects of the child’s own selfhood. By the magical act of turning oneself into the absent beloved one, the trauma of loss is undone and the shattered, chaotic world is set right. In this way a loving parental attitude is installed within the child’s personality, and his or her subsequent relationships in every sphere of life come to be dominated by a theme of caregiving. Any breakdown of the identification with the idealized figure leads to a resurgence of the chaos and pain of the original loss.
This too can eventuate in a most terrible captivity, for the trajectory of the child’s own development here has been interrupted and frozen by the need to stand in for the parent who has been lost. Who that child might have been or wanted to become as a distinctive person is thereby sidelined as the identification solidifies. Once again, Adam, I hope you can appreciate how easy it would be for such a person to fall into a career as a psychotherapist. This is the situation of a Type 2 Clinician.
There would also be mixed cases, in which the early developmental history of the psychotherapist included both kinds of experiences, traumatic emotional exploitation by a disturbed parent and traumatic loss. I am myself an example of the second type, with the central loss being that of my mother when I was a boy. The great theorist D. W. Winnicott, if I have understood him correctly, was a clinician of the first type, affected most importantly by a mother who suffered from severe depressions. Which of my scenarios fits your life, Adam? Obviously there may be other pathways to choosing a life of service to the emotionally disturbed, but almost all of the clinicians I have known fall into one or both of my categories.
It runs through my mind as I write to you that the great German philosopher Friedrich Nietzsche exemplifies the life theme I have called Type 2. He lost his beloved father at the age of 4, and reacted to the death by becoming his father once more; in the process however the child he had been disappeared as an active presence in his life. That is the downfall of this solution to loss: identifying with and thereby substituting for the missing parent leads to the disincarnation of the original child, whose independent hopes and dreams never have a chance to crystallize or be pursued. Nietzsche, catapulted at a young age into a precocious paternal maturity, became a psychotherapist for civilization itself, a kind of father-figure (Zarathustra) for all humanity in its journey into an uncertain future. His prodigious creativity spiraled forth from the tensions generated by his personal tragedy, and so did his eventual madness and destruction.
Anyone embarking on a career aiming to help people come to terms with their traumatic life situations and histories needs to do everything possible to address his or her own. In the early history of psychoanalysis, a requirement was established that analysts in training complete their own personal analyses before they could be officially certified. This seemed like a good idea at the time, decreed by Freud and Jung. These fathers of our field, however, exempted themselves from this requirement, which I think should upset analysts tremendously. Here is the problem. The analyst’s unprocessed trauma, like the parent’s, is inevitably passed on to the next generation. Freud and Jung, by refraining from applying their injunction to themselves, guaranteed that specific areas of their unconsciousness – those pertaining to their unhealed wounds - would be visited upon their descendants. This is why our field’s continuing interest in the lives of its progenitors is so important. Identifying zones of incompleteness in their self-analyses holds out the possibility of our emancipation from all they were unable to understand.
Clinicians must be aware of what has happened in their lives and grieve the losses they have incurred. Nothing else will do. You ask, Adam, if one must delay one’s clinical work until a healing has taken place. The healing of the traumas of which I am speaking is a lifetime project, and so the important thing is that the journey commence. Mourning needs to occur, both for the parent who was lost or was never there in the first place, and as well for the unobstructed childhood that never had a chance to unfold. The psychotherapist’s healing will be a theme in all of his or her work, most often in the background, but included nevertheless in any constructive developments in the lives of his or her patients. Psychotherapy is not a procedure performed upon one person by another; it is a dialogue between personal universes, and it transforms both. Our field has not caught up to this idea, but the time is coming in which it will be regarded as axiomatic.
Your final question about injuries so extreme as to preclude a career as a psychotherapist is unanswerable. No one can say in advance which traumas can be healed and which cannot. This will be determined not just by the details of what has happened in someone’s life, but also by the resources that become available in contending with the situation. If there is a relational home for the suffering one needs to endure – given by family members, friends, close colleagues, perhaps a psychotherapist – very profound healing of even the most severe of traumas often becomes possible. Your question about the potential therapist’s emotional injuries could be turned around, Adam: Is it possible for a person to become an effective psychotherapist without having passed through significantly traumatic experiences? I suspect the answer is No. A look into the childhood histories of the great psychoanalytic personality theorists reveals things that are consistent with my thoughts here. I suggest you study all of that, deeply.
Once again, Adam, I hope these reflections are useful to you.