Let’s Talk about Dreams

This painting by Edward Robert Hughes makes me think of the oddness of dream images. And so today I want to start to talk about dreams.

A few years ago I found  Yorem Kaufman’s The Way of the Image. It is a lovely little book of essays about dreams, images and therapy. The first 2 essays, “The Way of the Image Part 1” and part 2 are about his way of looking at dreams and about how he works with dreams in therapy, an actual technique essay, something a bit uncommon in Jungian writing.Then in the 3rd essay he writes about the analyst as he or she appears in dreams. These three essays are rich and deeply rewarding for anyone seriously interested in dreams and working with them. 

A few juicy bits from Kaufman:

“Everything that has ever been created was preceded by an image— streets, a blender, theory of relativity. Thus, we have the power of images for immense good or horrible destruction. All the history of mankind is, in essence, the unfolding of a series of images.”*

“…every individual has within themselves a unique set of images peculiarly their own. They speak ultimately to them. Although such images may be shared with others, and those others may be affected, they will not be affected equally, and they will not share in the transformative energy to the same degree. It is both the science and art of analysis to find this unique imaginal language for every analysand.”*

“I am saying that the images that an analysand brings to the analysis, in whatever form, be it dreams, his behavior, body language, etc., contain, in addition to whatever psychic messages that they bring, also a set of instructions to the analyst as to what is the best, and sometimes the only, way to conduct the analysis. Contrary to what may have emerged at the dawn of the psychoanalytic movement, there is no single technique that would be suitable for every analysand. It has been a source of continuous astonishment and awe for me that in more than 30 years of practice, I have found that I work with every analysand in different ways.”*

Over the next little while I’ll write the essays and add my thoughts. If you have a Kindle Unlimited account, this lovely book is available free. I hope some of you will read along with me and that we can talk about the book together. 

If you don’t record your dreams, consider starting. Keep paper and a pencil or pen by your bedside and as soon as you awaken, write whatever dream or bits of dream you can capture. 

 

*Kaufmann, Yoram  (2009-07-16). The Way of the Image  Zahav Books Inc.. Kindle Edition.

Mistakes

“People do not grow in sterile containers with perfect analysts; they grow in messy human relationships with analysts who try their best to do right by their patients  but whose best must frequently consist of reparative efforts vis-á-vis the difficulties they have created.”

Therapists make mistakes. I make mistakes. How do we recover from the mistakes that we make? We recover by recognizing that of course we make mistakes because we are human and it is how we learn. I have been in this work for more than 40  years and I still make mistakes — different ones, but mistakes nonetheless. 

We must start with accepting the patient’s feelings of hurt or anger or other feelings affected by our error. Which means at least initially not trying to get the patient to understand or accept an explanation of our good intentions— we have to avoid yielding to the very human effort to defend and explain. When we do that — try to explain — it is  really for the therapist, an attempt to soothe ourselves and to see ourself again in a positive light. 

 Initially I need to be able to simply accept that I made a mistake, be willing to own that mistake. Optimally the relationship is solid enough that my mistake does not end it and we have the opportunity to work through it, to look at what happened and why and how it came to be experienced painfully. 

Sometimes the therapist’s mistake breaks the relationship. What do we do then? Well, we have to sit with it, reflect on what happened to see what we can learn from it. Maybe got some supervision to see if looking at the situation with another pair of eyes illuminates it for us. We learn what we can from it and let the patient go. Pursuing trying to get her to hear the explanation starts to be its own problem.  

A wise supervisor once told me that we fail our patients in exactly the way they need to be failed and the trick is to be able to work through that. And he was right. Years ago I had a new patient come to me after having fired two previous therapists — one who fell asleep in a session with him and another he found unsympathetic. So I knew I started on thin ice, that he was looking for me to fail him also. One day he called and left me a message that he had to reschedule. I called back and left a message saying only my name and a time he could reach me. He got furious and said I had violated confidentiality by leaving the message so his roommate could hear. Now I knew I had left no indicator of who I was or why I was calling, but it didn’t matter because *for him* I failed. No amount of reasoning mattered. So we failed to work it through. I did learn to check with new patients about whether or not it was all right to leave a message if I had to get in touch by phone. And these days with the ubiquity of mobile phones, the chances that a message I might leave will be heard by someone other than the intended recipient is pretty small.

Sometimes with the best intentions, like Humpty Dumpty, all the king’s horses and all the king’s men cannot put the therapy back again.

It is hard to let go but what I want for a patient may not be what is best for her in her eyes — and those are the eyes that count. If she came back, I would be able to feel good, vindicated in some way — and sometimes patients do come back– but at the time, I have to live with the blow to my pride and my sense of my professional self. It is in these humbling experiences where we learn most. 

Muddling Through

For the last couple of weeks I have written about traditions and their importance for the holidays. Today I am thinking about the song, “Have Yourself a Merry Little Christmas.”

The first time I remember really hearing the lyrics to the song was when I was in college. I was home with my parents. At the time they were going through a very tough period and it was a far from joyous holiday. They lived in suburban D.C. then. It was Christmas Eve, raining and we went to a sad little restaurant for lunch. I heard the song and it resonated so deeply with the mood I was experiencing. Though no one said it, I knew each of us was hoping that the next year all their troubles would be out of sight. 

The song comes from the movie, “Meet Me in St. Louis” with Judy Garland who of course sings it. It happens that this movie is one of my daughter’s all time favorites so I have seen it many times. It’s not the song that most people remember from the movie — “The Trolley Song” is the one most people associate with it.

So many of the songs we hear and sing to celebrate this season are about joy and celebration, but his one and one other, “I’ll Be Home for Christmas” stand out because they strike a different note — one of sadness. Not coincidently both songs came out during WW II.

Here are the lyrics, as sung by Judy Garland, in the movie and try to see them in the context of our current situation. In 1944, when the movie came out, the future was very uncertain and many were separated from loved ones, a situation not unlike ours today.

“Have yourself a merry little Christmas,
Let your heart be light,
Next year all our troubles will be out of sight.

Have yourself a merry little Christmas,
Make the Yuletide gay,
Next year all our troubles will be miles away.

Once again as in olden days,
Happy golden days of yore,
Faithful friends who are dear to us
Will be near to us once more.

Some day soon we all will be together,
If the fates allow,
Until then we’ll have to muddle through somehow,
So have yourself a merry little Christmas now.”
~Hugh Martin

The circumstances in which we are living — over 315,000 people in the US dead from the virus as of this writing– and our anxiety about its spread, the admonitions to avoid travel and to stay at home, seem so similar to the mood my parents talked about of WW II. Last weekend my husband and I drove to where my adult children live to drop off their Christmas gifts. It was a chance to get out of the house, something we both needed. And it was wonderful to see them. But as we drove away from my daughter and her husband, I felt an ache — the ache of having been able to see them, talk with them for a bit outdoors, separated by distance and masks and unable to do the natural hug and touch that is so much a part of being with family. My whole body ached from that necessary distance. 

My son and his family, my daughter and her husband, and I and my husband — we all have Christmas trees decorated with ornaments accumulated over the years. Each one conjures up memories of Christmases past, times when we could be together and laugh and hug and be with each other. This year it seems especially important to honor those traditions in every way that we can given the limitations COVID-19 has imposed. This evening my husband and I will choose one of the many Christmas movies out this year and watch it and I will talk with him about what it was like when my kids were little. Tomorrow we will virtually gather together via Zoom. We will open presents. Laugh. Enjoy what we can and do our best to muddle through and have a merry little Christmas now.

I wish for you, whatever your traditions around this time of year — whether Christmas or Solstice or Hanukkah or just winter — that you immerse yourselves in them. That you, as I and my family will, hold on the hope that next year we really will all be able to be together, that fates will indeed allow that. And for this year, like me, you will muddle through. Celebrate being alive. Share love and kindness. And if the sadness and stress and worry become too much, reach out. You can find me via email. And I will be here.

Merry Christmas! Happy Holidays!

 

What I’m doing today

We got snow the other day, not as much here as further south of us. Though this photo is not new, it looks very much like that today. So today is a good day to wrap Christmas gifts and make Chinese curry buns for my kids. In more normal years we see my son and his family sometime around the 17th which is my granddaughter’s birthday. And we go to my daughter’s for Christmas dinner. But, as we all know this is no normal year. Tomorrow we will drive down to Portland then to the tiny town where my daughter lives and drop off presents. It will be hard not to hug them but at  least we will see them, albeit at a bit of a distance. And we will get out of our house for a bit.

I used to have a section of my blog for recipes — that was many years ago now. The following for Chinese curry buns is not only a favorite of my kids but also the most requested recipe I posted. Today I bring you that recipe once more.

This recipe is adapted from Dim Sum: The Delicious Secrets of Home-Cooked Chinese Tea Lunch, out of print but probably available used.

Dough:

1 T. dry yeast

1 3/4 C warm water

3/4 C sugar

1 tsp baking powder

6 1/2 C all purpose flour

Dissolve yeast and sugar in warm water. Immediately add the baking powder and then the flour. Knead until the dough becomes elastic ad smooth. Place in a big bowl, cover with damp cloth and allow to rise until dough doubles in bulk. Punch it down and it is ready to stuff.

Filling:

1 lb ground pork

2 stalks green onion, finely chopped

1-2 T curry powder

1 T. hoisin sauce

1 T. catsup

1 T. soy sauce

1 T. oil

Brown the pork in oil. Add all the seasonings and then the green onion. Mix well. Chill completely.

To make buns, divide dough into around 36-48 balls. You may then roll out each ball into a disk or shape with your hands. Try to leave the center somewhat thicker than the edges. Place a spoonful of filling in the center of the disk. Then bring the edges up and into the center. The dough should self-seal as you do this. Check to make certain no liquid leaks out. Then place sealed side down on greased cooking sheet. Set buns 2 inches apart and allow to rise for an hour.

Brush buns with mixture of 1 beaten egg white, 1 tsp. water, 1/4 tsp. sugar. Bake at 350F for 20-25 minutes or until golden brown.

Enjoy! If your family is like mine, they will be gone in a flash!

 

Traditions(cue Fiddler on the Roof)!

Christmas 1951

As you can see, the photo is my family’s Christmas brunch in 1951. The brunch was my grandmother’s annual event. Everyone in the family who could attended. I am the little girl in red sitting on the floor on the left . Today I am the only person in the photo who is still alive, not so surprising given that it was taken almost 70 years ago.

Families develop traditions to mark holidays and birthdays and other significant events. Some last for several generations. My grandmother’s Christmas brunch ended when she died — all of the members of the family scattered over the years so it would not be possible to gather like we did that year.

In my family, of course we developed holiday traditions. Foods I always prepared — like the Mexican wedding cookies my mother always made, though she shaped hers like fingers, or molasses sugar cookies using my grandmother’s recipe written in her hand on a now yellowed index card.

You never know when you do things that this thing might become a tradition. Like the fact that starting when my son was 4 and my daughter 7, we went to the movies on Christmas Eve. What started as a way to distract my son who was obsessed with Santa and wound up tight as could be with excitement. It was only the next year that we discovered we had started a tradition, one that continued for many years, surviving a divorce and the coming of new family members. Even this year of confinement, my husband and I will settle down Christmas Eve and watch a movie, to keep in our own small way what has become a charming memory of a little boy who had so much trouble containing his excitement.

 

This morning I awoke to a text with the photo above from my son. He announced the continuation of another sort of odd and maybe charming family tradition, the Birthday Cereal. When he and his sister were kids, any trip to the supermarket threatened the argument and much whining about why heavily sugared cereal was not on the menu at our house. I don’t remember just when or how I decided that they could choose on their birthday a box of the forbidden cereal of their choice but decide I did and so a family tradition was born. And as their birthdays are separated by just 2 months, judicious conferring and selection meant that this forbidden fruit could be stretched out over quite a while. So this morning he and my daughter and I had a fun text conversation about cereals of their youth. Great start to this snowy day.

Today is my granddaughter’s 6th birthday. It seems she chose Lucky Charms. May the tradition go on and on! Happy Birthday, Hope!

 

Tools for the journey

Tools for the journey: How does one go about facing the reality of aging and dying?

I attended a Zoom workshop on aging this past weekend. None of us can avoid the process of aging though the effort to deny it is fierce. I was surprised at how many of the participants in the workshop I attended were most concerned about changes in appearance, especially wrinkles, as the focus of their feelings about growing older. But aging is far more than the appearance of gray hair, of facial wrinkles, of body changes of all kinds, though all of those physical signs are important. 

The process of aging offers ample opportunity to confront and deal with the changes this period brings. As our body changes, our energy diminishes and we witness the passing of time in so many small ways we are often shocked into the awareness that youth is not forever and that death really is on our future “to do” list. Face lifts, makeup, and hair coloring can create the illusion of youth, yes. But take a look at the hands of someone over 60 or so and those hands tell the tale of age that artifice seeks to conceal.

It is hard to avoid the pressures to appear youthful. How often do we see in movies or on television actors, especially women, who look over 40? Confronted with so many images of youth and so few of age, it is easy to fall into feeling that aging is a curse.

But aging also offers us a gift, an opportunity to go deep, to resolve painful issues, to work through regrets, to figure out exactly what we believe and value, and to move to a place of accepting and embracing our lives as we have lived them.

Facing aging can be difficult. It is a gradual process, reluctantly undertaken, for most people. There are practices that can help, that can open this process and assist in confronting and dealing with ourselves growing older. Following are some brief descriptions of practices that can help. Give yourself the gift of facilitating your own journey and take on some of them.

 Quiet: Seek every opportunity to sit in the quiet. Turn down the volume on the external world. Turn down the inner voices that chatter relentlessly. Sit in the quiet and listen. Just listen. As many of us now are more or less confined to home in the face of the pandemic, there is likely ample time for sitting in the quiet of our now much less busy lives.

Deep Breathing: Breath is our life force. When we focus on our breathing it brings our attention back to ourselves, into our bodies and an awareness of the inner world. Focus on the process of breathing and feel the breath of life move through your body. Slow and deepen your breathing, inhaling through your nose and exhaling through the mouth. Feel your mind calm. Allow what thoughts and feelings come arise to surface. Notice them and let them go. 

Journal Writing: Develop a practice of writing about the thoughts and feelings that arise each day. If there are unresolved issues or conflicts bubbling beneath the surface write them. Follow your feelings where they lead. 

Be in Nature: Spend some quiet time outside. Walk more. Turn off the phone and headphones. Listen and observe. 

Meditation: Develop a meditation practice. There are many different types of mediation and meditation methods. Choose one that feels comfortable to you or enlist the help of a meditation class or teacher. Buy a book on how to meditate. There are many meditation apps that can help you develop a practice. I have found the Calm app to be very helpful, but there are others as well. 

These tools are not magic but they can make the work of dealing with growing old and facing the inevitability of death more manageable by making room for that work to be conscious. The image at the top pf this post is of a fading flower. It is the aging of a beautiful deep red amaryllis. It is easy to see the beauty in the vibrant red flower when it first opens. But I was taken by another kind of beauty I saw as the flower faded and slowly died. And so it is with us as we relinquish the beauty of youth for a different kind of beauty, the beauty of age.

Thinking About Thanksgiving

It’s Thanksgiving Day. I come from a New England family, Mayflower descendants even so Thanksgiving was always sort of “our” holiday. After we moved back to the States from Japan, where my father was stationed during the Korean War, he was mistakenly sent to Ft. Knox, KY and we were there Thanksgiving the year I was 8. While he waited for new orders, my dad was put in charge of the mess halls for reasons known only to the Army. We were to eat there with the troops but I got the mumps and so we missed that. I remember my mother learned from the mess hall cooks to cook the turkey in a paper bag that year. Other than that year, all of the Thanksgivings of my childhood blend together. 

Not being a big turkey lover, I confess I found it hard to wholeheartedly embrace the feast. It seemed to me to be mostly about me doing a huge amount of cooking for a meal that lasted only a fraction of the time it took to prepare — and then came the clean up. And I have felt growing ambivalence about the myths surrounding Thanksgiving, the myths that make my people the heroes and good guys and the Native Americans at best ignorant savages. 

My town was among the first in Maine to rename Columbus Day to Indigenous Peoples Day. And that movement has grown, not without pushback but slowly the change grows. It is time now to face the reality of Thanksgiving. 

The holiday arrives in the midst of a national struggle over racial justice, and a pandemic that has landed with particular force on marginalized communities of color. The crises have fueled an intense re-examination of the roots of persistent inequities in American life. NY Times

Against this background, I have been reflecting about how we do need a thanksgiving but one not so connected to our history of racial injustice.

Every day we are confronted with the horrible mounting death toll from this pandemic. As I write today, the toll is at 262,000 souls. And rising. It is unimaginable. I try to visualize the number — little lights all over the map going out one by one. In my small town, recently the woman who tended the garden in Post Office Square became one of those numbers. We all must live with the anxiety of knowing that this invisible force, this virus is everywhere in our lives. Many, hopefully most of us wear masks, avoid unnecessary trips outside of our homes, do whatever we can to protect ourselves and our loved ones. Many of us have forgone spending this holiday with family in order to avoid travel and the spread of infection. But millions have not heeded the warnings from public health officials. Still the death toll rises and likely there will be a spike around Christmas. To fully realize what is happening is to face into horror — so many people dead. So many people ill. A terrible toll exacted from doctors and nurses caring for the ill. 

It came to me the other day what we might do at the end of this, maybe a year from now if the effort to vaccinate everyone has succeeded and we enter a recovery period. When the crisis has ended, I feel we will need two events to mark what we have passed through: first a National Day of Mourning to publicly acknowledge our dead and our grief. And then a day of Thanksgiving that we survived, we passed through this terrible time. 

I am just one person living in a small town in Maine. I have no idea how to bring these events into existence. By writing this, by linking to it on FaceBook and Twitter, maybe enough of you will share my idea and maybe we can together actually make it happen. Feel free to share the link with anyone you believe might be interested. Please share your feelings and thoughts in the comments below.

What would I do?

Like many of you the tensions surrounding the election and the renewed intensity of the pandemic sapped my creative energies for a while. So for the past couple of weeks I have been reading, knitting and watching Netflix to take care of myself. I hope that you have also been tending to your needs.

Today I woke up and I feel ready to write again. So here goes as I consider what to do when a patient presents a really thorny issue that might reach into  the territory of a moral dilemma.

A while back, someone asked me how a psychotherapist deals with the situation in which something the patient has come to understand she would really like to do to improve or change her life is likely to cause suffering to someone in that patient’s life? Situations like this are not uncommon, as for example someone wants to divorce her husband, an action which will doubtless cause upheaval and pain for all involved.  

But this questions contains, I believe, a misperception about what therapy is about and what the role of the therapist is.  

A new patient comes to me. I gather a bit of basic data and then ask her to tell me why she is here, to tell the story in whatever way makes sense for her. I listen. Very rarely is what I hear framed as a moral dilemma. I ask and ask many times during the time we work together “What is the life you want?”, because this is a pivotal issue. And as she frame possible actions, I ask if that action will take her closer to the life she wants. And we do that process again and again. I don’t tell anyone what to do. I am not really a problem solver.  

I deal with what is the life the person wants, what keeps them from having that life, and how/if it can be achieved and what the cost of achieving it might be. In my years of practice, to the best of my knowledge, I have never seen a pedophile or rapist or person who engages in behavior that I think is beyond the pale — those people don’t come in for therapy, at least not to me. Once I saw a person who might have been a murderer. I checked with colleagues and the appropriate state agency to see what my responsibility was to him and to the community. I saw him 3 times and discharged him to a more appropriate facility. That was a professional decision not a moral one.  

So how do psychotherapists navigate these waters?  

I don’t give answers when asked what people should do. I can help them look at why they want to do it and what the consequences are and whether it will get them what they want. But I do not make the decision.  

In two sets of conditions, I am bound to act on what I hear. If I am told by someone that they abuse someone or are abused, in most states, I am mandated to report the abuse. If someone threatens the life of another, case law says I must inform the authorities, but statute does not — so I consult and then report or not. Otherwise, my task is to listen.  

I am not Dr. Phil. I am not a priest. It is VERY hard sometimes not to try to tell people what to do. Because the work I do is not short term and because I usually work with people over the course of months, and  years, we have time to sort through issues, to examine them from as many sides as possible. And ultimately what they do is up to them. 

“The principle aim of psychotherapy is not to transport one to an impossible state of happiness, but to help (the client) acquire steadfastness and patience in the face of suffering. “
-C.G. Jung

Be Still My Heart

What was rumored a few weeks ago is becoming a reality — In Treatment Season 4! Uzo Aduba (Emmy® winner for “Mrs. America” and “Orange is the New Black”) will play the lead role of the therapist at the center of the season, Dr. Brooke Lawrence.

Back in 2008 when the series first ran and this site was new, I became a big fan and wrote about each episode as it ran. You can find these posts still by selecting In Treatment above and choosing the season you wish to read about. If you haven’t seen this series, I urge you to do so — it is available on DVD and if you subscribe to HBO Max, is available there. And of course, do read my posts and ask questions and comment — more discussion is welcome.

In my mind, this is the best dramatic presentation of therapy I have seen. Of course the therapy is compacted and made more dramatic for purposes of the drama. But still, it is faithful to the basics.

In sadder news, Daniel Menaker, who wrote my favorite novel about psychoanalysis (this is a genre, you ask??), died this week. His book,The Treatment, which was also made into a movie, is based on his own analysis. The book is funny and moving and well worth the read.

Therapists and Fat

 As a therapist I am very interested in how therapists respond to fat patients and how fatness is viewed psychotherapeutically. I have had some interesting experiences myself with therapists who made assumptions about me and the issues I wanted to work on based on my size rather than what I said. It is  interesting to me that the literature is relatively silent on this subject. I have searched long and hard to find pieces written by therapists about their reactions to fat patients and written by fat therapists about patients’ reactions to them — the picking are pretty slim.

One of the books I stumbled upon is Eating Problems: A Feminist Psychoanalytic Treatment Model. I am impressed that the articles in this book do not take what I would consider a fat negative posture at all, but offer the author’s thoughts and experiences with patients — anorexic, bulimic, fat and everything in between — in light of feminist theory and with a deep understanding of cultural forces we must all contend with. The net result is an approach that offered me some fresh insights into my own history and some very useful material I can use with my patients.

Here is a statement that it seems to me describes what underlies so much of the negative feelings every fat woman and many who only fear being fat that I know has struggled with at least some of her life:

“A fat body is cruelly stigmatizing in this culture. It is treated, seen, and felt as an object of disgust and fear. Many disabilities are so treated and seen; but fatness is also seen as reason to blame the fat person who ate her way into “freakishness”.  ” p. 154

I found myself nodding in agreement frequently as I read this book, underlining many paragraphs and sitting and reflecting on the ideas therein. If you are a therapist, I recommend this one. And consider this:

The therapist can feel concern about weight, but to be invested in weight loss as a goal is to be aligned with the cultural and internal saboteur.” P. 70

 When therapy works, when patient and therapist are able to influence each other, both do change. In the case of dealing with fat, usually it would be that the fat patient becomes free enough of the cultural fat complex, a fish able to see the water, and who then can dare to confront her therapist’s attitudes and beliefs. She can begin to tell her story in her own voice. Jane Burka asks:

If my body is present and significant for me and for my patients, but remains outside the discourse of the therapy, what kind of taboo have my patients and I created? 

A great deal of change is needed for it to become the norm rather than the exception for a fat therapy patient to be perceived as a person who should be asked what she wants to work on, for her not to be subject to the suggestion that she could/should lose at least a little weight, for it to enter the mind of the therapist that this patient may not see her weight per se as the problem in her life, even though she experiences the negative effects of stigma and bias. Or that it may be that she needs most to deal with the pain, the trauma of having a stigmatized body. In a little book published in the late 80s, Fat Oppression and Psychotherapy, Laura Brown puts her finger on a problem: “…while it was acceptable for clients to be fat women, therapists as so-called models of good functioning, we’re required to stay thin.”