Counselling and Psychotherapy in Clifton, Bristol
|Writing||26th July 2017|
I've written a novel, Les Ruses de l'Histoire, available here; the English version is called Paris '93, available here.
I've also written a number of articles. The following first appeared in Therapy Today, July 2006, vol 17, no 6, which is the professional journal of the British Association for Counselling and Psychotherapy.
Crowd or bonus?
Working through interpreters brings the possibility of losing something in translation but can also bring traditional family-like benefits.
I have been working as a therapist with asylum seekers for three years now, and I would like to go back to my very first experience of working with interpreters. I am sitting in the consulting room with two people* I have just met: one is an asylum seeker, and the other is an interpreter whom I have only seen for half an hour the previous day. They arrive together, suggesting to me that they already share a bond, and from the outset I experience the interpreter as an obstacle to the still unformed relationship with the client. The interpreter has power over me — he speaks my client's native language, an African dialect. I have a vague sense that the interpreter is there to block access to the client. But I start to glimpse something of my client that is beyond verbal communication and I welcome the impact of his physicality on me. My countertransference reads the way he enters the consulting room, the way he sits, his averted downward gaze… And I think again — what a shame that we have to rely on a third body (literally) for us to make contact.
The only way I have to assess whether the interpreter is not betraying what the client says is my approximate perception of the length of the translation. If my question is brief — and I try to make it very brief in order not to confuse the interpreter — the translation has to be brief. If the answer is long, the translation has to be long! I weigh the words in terms of quantity and not in terms of conveying emotions and meanings.
Then I hear what seems to me a long answer. I look at my client while he is speaking: his bodily response, breathing and tone of voice tell me something about the volcano of anger dissimulated under the polite tone of voice. The translation of all this comes back to me via the interpreter in a rather short and unemotional sentence. What has been lost in translation? My paranoid-schizoid part is triggered and I read a tacit complicity — if not collusion — between the interpreter and the client, from which I feel excluded.
Later on in the session, the interpreter takes the initiative to ask my client something that will remain untranslated. I feel more and more like an observer while core issues are dealt with behind my back but, ironically, just in front of me. It feels very crowded and out of control. The interpreter seems to be leading the session, which looks like a cross-examination. I think of Buber and I am filled with despair: how can I ever experience the healing of an I-Thou moment in this overcrowded setting? I have to process not only the countertransference with the client but also with the interpreter. I also have to bear in mind that some interpreters have themselves gone through devastating and damaging experiences that can come into play in the triangle.
Including the third person
Severe traumas like rape and torture are unbearable to expose and need the intimacy of the safe therapeutic space in order to be processed. How can this space include a third person who cannot be just a translator, a witness, an observer or a voyeur?
To interpret means ‘to convey or represent the spirit or meaning of’ from the Latin root interpres: ‘negotiator, one who explains’. The task of the interpreter is not to translate word for word. As an experienced professional translator told me: ‘A good translation involves re-formulation.’
From my experience as a therapist who works in two languages (French and English), the use of language can be treacherous and words may be playful, offensive, distorted, deformed, seductive, secretive, protective… A French-speaking client told me at the beginning of the first session that she had a few ‘small worries’. (I am giving here a literal translation of what she said.) Further, painful explorations revealed that my client had been tortured and gang-raped in her country. I wondered why she had chosen the words ‘small worries’, which seemed to me too innocuous to convey the damaging trauma she went through. Her grasp of French was limited — consequently, were these the only words available to her? Was it a way of protecting herself from being re-traumatised? But above all I experienced that her body was agonising, and her pain was trapped in the gulf between an uttered word and its deep-down emotional meaning. This experience taught me something new about the treachery of words.
When I imagine what can happen during some interviews with asylum seekers at the Home Office, I have my reservations about how facts and feelings might be translated. I believe my clients when they complain bitterly that they have been misrepresented by interpreters during Home Office interviews.
Beyond the ‘standard’ language, every client has their own language. In the course of therapy, client and therapist/counsellor create a common language. For instance, I am confused when clients ask me before the Christmas break: ‘Are you going home?’ — implying that I am going back to France. For some clients, ‘home’ is the native country. For me, ‘home’ is where I ‘feel at home’. I think more and more that working with interpreters implies that therapists/counsellors and interpreters have to find a common language that enables three people to dialogue at a deep level.
Working with asylum seekers has provoked both thought and feeling. At times, I used to ask myself if I preferred to work without an interpreter, even if the client's grasp of English was poor, and when I sensed that the lack of words was not an obstacle to making contact at a deep level.
However, after various experiences with interpreters, my thoughts have become more nuanced. I have now been working with the same two interpreters for nearly three years, and I can only praise the working alliances we have built up together. The potential intimacy between two people has to make some space for the arrival of a third person. I am thinking of the arrival of a child in a couple who have to learn how to share responsibilities, care and nurture. This is why I have come to the conclusion that something is inevitably lost in translation, and that something invaluable, precious and immensely supportive is gained from the triad. The shared mutual respect and understanding for the aims of the therapeutic alliance in the long run provides a safe environment akin to the traditional family of the client. This can help some asylum seekers to restore the meaning of their lives after the destructive and traumatic experiences they have been through.
* Some details have been changed to maintain confidentiality.
The following article appeared in the Bath Centre for Psychotherapy and Counselling Association (internal) Newsletter, Autumn 2002, vol 3, no 3.
The Reader: Shame, mis-attunement and atonement
“The geological layers of our lives rest so tightly one on top of the other that we always come up against earlier events in later ones, not as matter that has been fully formed and pushed aside, but absolutely present and alive.” — Bernhard Schlink, The Reader
This work on shame is based on the novel The Reader by Bernhard Schlink.
I see shame as a phenomenon embedded in the impossibility of relating to others and of making contact.. Kaufman “speaks of the experience of shame as a rupture in the “interpersonal bridge” between us and another, and so shame has “a relational character”. From a Gestalt perspective, “Gestalt’s main focus is an analysis of contact processes, the interactional processes between self and other that shame governs”. So “shame is a major regulator of the boundary between self and other” (Lee and Wheeler). The polarity of shame is support, which allows the human being to move away from the old organisations of the self, and to grow. Shame has been internalised and integrated into basic beliefs about the self and the possibilities of contact with others. These introjections become fixed. Recovering the ability to change means facing the shame that holds these introjections in place. This can happen if the environment gives enough support.
The nature of shame is “to hide” — Hanna concealed from others the defectiveness of her own self. She pulls herself in or away from others (retroflexion) and she uses strategies and defences to cope with, and above all avoid, her experience of shame. Her strategies seem like deflection (making her feelings go in a different direction by hitting them) manifested in controlling and projecting the blame on others, and internal withdrawal. These are camouflage to distract others and herself from noticing her experience of the phenomenon of shame. Hanna’s shame is so deeply integrated into the experience of self that she cannot even acknowledge it and become attuned to the phenomenon of shame. Kaufman talks about a “sickness of the soul” - “The binding effect of shame involves the whole self… Exposure itself eradicates the words, thereby causing shame to be almost incommunicable to others. Feeling exposed opens the self to painful, inner scrutiny”. It is unthinkable and intolerable for Hanna to establish connections with her environment. She would rather die and in a way, that is what she does — she dies of shame, or shame kills her. Whatever the interpretation, she buries her shame with her self.
Who is Hanna? She does not give any information about herself – it is as if she has no past. When Michael wants to know, she keeps repeating, “The things you ask, kid”. We know very little about her: “She had grown up in a German community in Rumania, then came to Berlin at the age of sixteen, taken a job at the Siemens factory, and ended up in the army at twenty-one. Since the end of the war she had done all manner of jobs to get by... She had no family. She was thirty-six.” (Schlink). I took from this passage that her basic self-object needs were not met, and after that, she had wandered from one place to another.
So the war is over, we are in Berlin, Hanna is thirty-six, Michael is fifteen, and they meet. For six months they have been experiencing a unique and passionate affair. Their encounter follows a ritual imposed by Hanna — just the two of them in enclosed places — her flat or hotel rooms. It is as if their love relationship could not survive the light of the outside world: “So reading to her, showering with her, making love to her, and then lying next to her for a while afterwards - that became the ritual in our meetings.” (Schlink) Their encounter had to go through this rite of initiation to make contact. “Reading to her”, imposed by Hanna, seems to be the contact boundary in their betweenness. When Michael reads to Hanna, she is fully in the experience, as if she has I-thou moments with the words she listens to.” We took the long journey together.” (Schlink) “Showering with her”, she needs to clean him and herself from their original sin (or shame?), so that they can experience themselves as new, fresh, pure and intact, and then enjoy each other’s company. The first time they make love is after a bath that she gives him because he was covered with coal (a dark and dirty substance). Whose shame is washed away? This matters: lust springs from this contact in the bath.
This brief encounter is interrupted all of a sudden by Hanna’s disappearance. Michael is left with his immense pain which turns into bitterness. Years later he says, “When I saw Hanna again, it was in a courtroom.” (Schlink). Michael was by now a law student dealing with the Nazi past and the camps. During Hanna’s trial, Michael found out about Hannah’s secret shame: Hanna was illiterate.
Hanna’s fake self pleaded guilty for a crime she had not committed and she got a life sentence. She left the dock with this attitude: “She looked straight ahead and through everything. A proud, wounded, lost, and infinitely tired look. A look that wished to see nothing and no one.” (Schlink). There is in Hanna a basic and intrinsic inability to make contact, and she lives in complete isolation.
These are the self-organisational strategies or “contact styles” (Lee and Wheeler) that she uses to deal with her shame: avoidance, lying, fleeing, hiding and struggling. “She must have been completely exhausted. Her struggle was not limited to the trial. She was struggling, as she always had struggled, not to show what she could do but to hide what she couldn’t do. A life made up of advances that were actually frantic retreats and victories that were concealed defeats.” (Schlink). She has chosen jobs that did not involve literacy skills, but controlling skills (tram conductor or camp guard). Perhaps that was her way of having a grip on the external world. When she was offered promotions that required literacy, she moved to another place. She spent her life struggling to avoid being found out.
Hanna has lost a part of herself that she disavows, and this pushes her to compliance with the verdict. At the trial, she had admitted to writing the report to escape a confrontation with handwriting. The final place she has chosen to live in, and to die in, is in prison: another enclosed world, where making contact with the outside world is by definition impossible. Michael did not meet her despite what we could see as atonement (however seductive). In fact, he made reparation for himself. When he sent her tapes in prison with his reading, he was longing for the past relationship and was trying to recreate it. Yet this had an impact on her, as she had become literate in prison. Having said that, I am inclined to think that the closed environment of prison could have provided the safety she needed to move her horizon for a while. “Security is the visceral experience of having our physical and emotional vulnerabilities protected.” (Erskine) Outside prison this might not have happened. However, Michael was lacking in empathic attunement with Hanna: he never wrote to her. Despite what he says: “Illiteracy is dependence. By finding the courage to learn to read and write, Hanna had advanced from dependence to independence, a step towards liberation.” (Schlink) Michael did not confirm Hanna in her move towards independence and liberation — he maintained her dependence by ignoring her new developmental needs. Her becoming self was not validated. This makes me think of a parent who keeps holding his toddler’s hand, and does not acknowledge that he can walk, run and jump by himself. The relationship did not enter the ground of mutuality. The prison governor told Michael, “She so hoped you would write… Why did you never write?” (Schlink) Her core life belief could not have been modified. “Attunement involves the empathic awareness of the other’s need for security within the relationship plus a reciprocal response to that need.” (Erskine) Michael never acknowledged that he had been impacted by Hanna. Hanna is still “it” in the relationship with Michael: he becomes the rescuer (saviour?), and she remains the poor helpee.
One ventures to think that her achievement in becoming literate was a distraction from facing her shame. She shifted from experiencing shame to struggling for perfection. All through the years in prison, she was just coping with her defences. Moreover, she gave up, and contemplated death when she was given the opportunity to get out of imprisonment. Taking (back) her life was her last resort and final escape. She could not go beyond her fixed horizon. Before her release from prison, Michael wanted to confront her about her past story of illiteracy, but his inquiry was selfish. He asked for an explanation because he felt guilty of considering her as “it” in his life: he was giving her a ‘niche’ instead of a place. Her answer deflected his question: “Does that bother you very much?” (Schlink) . This was another rupture in an aborted dialogue.
According to Erskine, “Shame and self-righteousness are intrapsychic dynamics that help the individual defend against a rupture in relationship.” (Erskine) Hanna’s fixed core script belief is, “Nobody understands me”: “I always had the feeling that no one understood me anyway, that no one knew who I was and what made me do this or that. And you know, when no one understands you, then no one can call you to account… but the dead can. They understand.” (Schlink) In other words, she is “not fit for human belonging”. Hanna has lost her voice for expressing her needs. The transaction operates in this way: it gives Hanna some relief from the internal criticism of feelings and beliefs that have been introjected. This criticism is projected on others, and so Hanna can carry on with the denial of the original need for contact in relationships. She finds refuge in a fantasy world where dead people will make contact with her. There is also perhaps the hope that someone will take responsibility. “Simultaneously, shame is an expression of an unaware hope that the other person will take the responsibility to repair the rupture in relation. Self-righteousness involves a denial of the need for relationship.” (Erskine) Her final hidden fantasies conveyed in her will are a desperate attempt to escape humiliation and shame by justifying herself. Hanna perhaps wanted to be considered with respect and to make an impact. Erskine sees in this “a partial release of disavowed and retroflected anger”. Hanna is not able to show her anger towards the injustice of others since the acceptance of it would kill her. “What did she gain from this false self-image which ensnared her and crippled her and paralyzed her? With the energy she put into maintaining the lie, she could have learned to read and write long ago.” (Schlink) As Winnicott says, losing the defences that hold the false self might be dangerous.
The shame phenomenon in a shaming environment has never been brought to awareness through a dialogue between Michael and Hanna. Michael comes from a privileged background and he himself has to face his own shame in his complex relationship to his father, and to the Nazi past in Germany. Shame remains locked up within each camp. What is happening in the field is not acknowledged : this remains opaque between them.
I love this book, but I am angry and upset each time I dialogue with the characters and the writer. Like the prison governor I keep feeling: “Her death is a blow to me, you see, and at the moment I’m very angry, with Frau Schmitz [Hanna], and with you [Michael]. But let’s go.” (Schlink) I cannot go anywhere until I come to terms with the fact that some relationships fail to lead to healing despite their intensity. Passion is not enough. This, in any case, is what lies between Hanna, Michael and me.
Some thoughts about the book The Examined Life by Stephen Grosz
This book had a lot of media coverage when it came out earlier this year. It consists of a series of client stories heard in the consulting room. I read it avidly, intrigued by how our profession is portrayed in books (and in the media in general.)
The writing style is simple and clear. The book has chapter headings recapitulating in a few words the basic meanings of some of Grosz’s understanding of life experiences, for example ‘The bigger the front’ (read the book to see what it means!) or ‘How lovesickness keeps us from love.’ However, I read each chapter more as a detective story with a denouement, rather than as a life experience. It is as if each story has to have an ending (and very often a happy ending!) And sometimes I didn’t know what to make of them. For example, Grosz meets by accident a client several years after the end of therapy and the client introduces him to his wife. Does Grosz intend to underline that the client was now married, and that this is a positive outcome? If the marriage had not happened, would this have been a less desirable turn of events?
In Grosz’s recounting, content seems to dominate – I would have liked to hear more about the therapeutic process. The author does make clear that when therapy reaches an impasse, exploration of the past seems to be the obvious way to move forward.
At one point, Grosz says he had been wrong about a particular interpretation. By approaching psychotherapy and psychoanalysis in this way, he implies that he could have been right. As a therapist, is it important to ‘issue’ a right or wrong interpretation? Isn’t this more in the experience of the client?
Grosz himself remains enigmatic, and the patient just seems to be an object for analysis. What about the therapeutic relationship? Grosz does talk about himself, but not in the context of interacting with clients.
Grosz mentions where he practises (Hampstead!) and the long journey he once made across London to see a supervisor (one of the best, of course!) Is it necessary for him to say that he takes his job so seriously that he is prepared to make long journeys to supervision? Is this not what we all do, metaphorically and literally?
The boundaries relating to the disclosed material are porous to say the least. There is no mention of disguising clients’ details. And is it appropriate to use material about a woman he met on a plane?
One of the strengths of the book is that there is no jargon, except for two key concepts (transference and split) which are clearly explained. This is a very good approach for the lay public. Having said that, Irvin Yalom, Susie Orbach and even Oliver Sacks have given powerful and convincing accounts of what happens in the consulting room. I am thinking also of the intensity of the fictitious therapist Paul Weston in the TV series ‘In Treatment’. It’s true that Weston is portrayed as behaving in unorthodox ways and that he is often unboundaried, but at least he is fully alive, present and engaged.
By contrast, Stephen Grosz leaves me with the impression that I am dealing with an academic-type storyteller. Something is missing from his account: the power of the therapeutic encounter in the consulting room.
To sum up, I have some reservations about Grosz’s way of working, but the book does have its place on the shelves of the general reading public.
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