One of my fears during the first weeks that followed Jay’s death was that I might become too depressed to return to work, and become unable to concentrate upon other people’s unhappiness. This, it transpired, was also a common fear for many of my patients. But that did not happen. As soon as I returned to London, I discovered that my desire to work and become re-engaged with my patients was, apart from my family, the most important thing in my life. I am grateful that it never became a question of having to work but that I was still motivated out of a desire, or a passion to work. The origin of the word ‘patient’ is to suffer and the Shorter Oxford Dictionary offers the following: ‘Bearing or enduring (evil of any kind) with composure; exercising or possessing patience…quietly awaiting the course or issue of events…Persistent, constant, unwearied in the face of difficulties and hindrances’. To varying degrees these are all vital qualities that have to be forged in the consulting room, out of the mire of our being, for any meaningful outcome of therapy and whatever it is that I wish to help my patients achieve is also relevant to achieve for myself.
Why might I have wished to take a different course and to hide my suffering from my familiars and fellow sufferers? To begin with many patients presented me with the same answer again and again, ‘ I will never be able to talk to you about my own problems which are insignificant and indulgent now that I know what you have been through’. Some were terrified by the word murder and others said, ‘How on earth can you feel like listening to me droning on about my boring old self?’ ‘Aren’t you feeling distracted?’
I have never believed that human misery can be measured. Some of the worst damage that I have witnessed inflicted on individuals has been due to chronic and low levels of emotional abuse which have gone undetected for many years, and long term experiences of living in a ‘double bind’ rather than the consequences of an acute trauma. To begin with I had to offer my patients the opportunity to see that although my family would carry the scars of its violent bereavement for life this did not mean that we had to become its victims. I had to reassure them that with the long term but temporary re-organisation of my working week into four days it would be possible to redistribute my time between them and my family appropriately. I had to let them know that I had not forgotten all the small details of their own lives and wounds, that I had not lost my desire to return to the uniqueness of those dialogues which I still felt and continue to feel privileged to share. And they believed me. Well, nobody decided to terminate therapy with me. For some people my visible vulnerability also became my strength, for others it became an anxiety, but a shared anxiety, which could also act as a threshold to an honest dialogue and to their increased consciousness about the random nature of our lives. For one particular patient I am about to quote verbatim, I now know that my disclosure changed the course of his therapy, which I only found out many years later. (I have to admit how angry I become about a number of patients’ experiences who have found their way into my consulting room for a second therapy and who have had therapists or analysts who have concealed diagnoses of terminal illness, trauma, or temporary breakdown from them, and even refused to discuss their patient’s observations by batting them off with a transference interpretation. I perceive this to be abuse).