One of my mentors (TE) was a psychiatrist of immense intellect and a laser’s capacity to cut to a psychiatric diagnosis. His brilliance as a diagnostician, however, did not extend to gently bringing his well-defended patients down the therapeutic path.
This man was a surgeon of the mind.
Surgeons leave scars.
Think of psychotherapy’s beginning as a kind of dance, with the patient in motion like Salome, covered with seven veils. Her wraps and shifting movement are for protection, not seduction. The client, female or male, is wary, and the covering — any covering — guards against invasion.
Should a doctor rip the gauzy garments away, he does an injury. Without a shield, the individual is exposed, terrified, and likely to flee treatment.
Too much too soon.
A thoughtful mental health professional doesn’t drain a protective moat until the client develops the courage to take on the scary world outside his castle (or inside his head). The counselor must avoid retraumatizing the sufferer, in effect flooding him with emotions he is unprepared for.
The irony of hurting when you mean to help could not be more poignant or more terrible.
Young therapists can miss this. So do managed care companies when they want you to push treatment as fast as possible (to cut its cost) or medicate the insured party for the identical reason. TE was guilty of ignoring the same therapeutic speed bump.
The challenge of focusing on life’s dark side was understood by the mathematical genius Blaise Pascal, who died just before the age of 40 in 1662. The Frenchman recognized the need to divert oneself from contemplation of the human condition. Students of clinical psychology might still benefit from his words. For example:
Being unable to cure death, wretchedness, and ignorance, men have decided, in order to be happy, not to think about such things.
Or this:
I have often said that the sole cause of man’s unhappiness is that he does not know how to stay quietly in his room.
In short, the world can overwhelm creatures as small and vulnerable as ourselves. Those in most need of distraction are among the least inclined to make use of this necessary method in the pursuit of equanimity.
Pascal again:
However sad a man may be, if you can persuade him to take up some diversion he will be happy while it lasts, and however happy a man may be, if he lacks diversion and has no absorbing passion or entertainment to keep boredom away, he will soon be depressed and unhappy. Without diversion there is no joy; with diversion there is no sadness.
I’d say Pascal goes too far, but his point is a worthy one. I can name many people who seem content (at least for the moment) because they don’t think about the shadow following them down the street. Perhaps trouble at work or home, with children, or the big concern:
Death.
A memorable patient of mine found escape in distraction and denial, eating enough carbohydrates to push her well into obesity and diabetes. Yet, while feeding, she felt at peace. During stressful moments, this lady believed she deserved a treat as compensation for her upset.
The therapist seeks a balance between accepting the other’s ever-ready psychological defenses and gradually helping them to recognize the long-term damage they are doing to themselves by not facing problems. With the sizable woman in question, it was quite a tightrope walk.
I find myself on both sides of the balance beam.
Socrates was right when he said, “The unexamined life is not worth living.” So, however, was Pascal, by implying the deleterious effects of too much examination, rumination, and painful memory. The truth is hard to swallow, as the kid in the top photo is about to discover.
Were I to create my own mantra, I’d alter the inscription on the Temple of Apollo, which reads: “Know Thyself.”
A less pithy version would be:
“Know thyself, but not all in one bite.
“Remember: Your potential for self-awareness is bigger than your stomach for it.”
