To coincide with The Death Detectives, an event taking place this evening at 18.30, we have invited the speakers to contribute their thoughts around the theme of Death to our blog. Here, psychoanalyst David Morgan shares a case study.
Murder of Monsieur Canon, 1914, Alphonse Bertillon © Archives de la Préfecture de police de Paris.
“Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.
Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.
Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.
Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.
And you, my father, there on that sad height,
Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.”
– Dylan Thomas, Do Not Go Gentle Into That Good Night (1951)
I want to tell you a story about how the struggle between life and death forces appear in an analyst’s consulting room.
I have found through my work as a psychoanalyst that we all work unconsciously to distort and blunt our acceptance of profound human experiences such as death but that traumatic events may destine some people unconsciously to devote all their efforts to subvert the recognition of these facts as an activity in place of living.
Psychoanalyst and philosopher, Roger Money-Kyrle, wrote that it is useful to consider three core facts of life which are; “the recognition of dependency, the recognition of a couple creating life as a profound creative act, and the recognition of the inevitability of time and ultimately death”.
He went on to say about this third fact that “to fear death is not the same as to recognise its inevitability, which is a fact forced on us much against our will by the repeated experience that no good (or bad) experience can ever last for ever—a fact perhaps never fully accepted”.
We are all defended against the painful recognition of these facts. However poor our experiences may have been, we must all have had some experience of nurturing and we are all the products of a procreative union that made us but inevitably excluded us. We lose love and hope and struggle to re-find it and we all fear exclusion and ultimately the exclusion that comes through death. It is only perhaps as we grope our way to understanding that good and nurturing experiences are all transient in reality but must be kept alive psychically that any of us are able to experience hope for ourselves and others.
My work leads me to believe that it is the process of the analyst bearing to face these facts afresh for themselves whilst bombarded with death-fear and resistance in the transference that may begin to allow inklings of digested realisation to be taken in by the other.
A clinical story
The personal details of this story are disguised to protect anonymity and the person who agreed to my using her material also now lives abroad.
I want to talk about the difficulties of managing as an psychoanalyst when working with people whose grasp on life is tenuous and who unconsciously enact and provoke enormous concerns particular for themselves and their families. I also want to think about whether it is possible or worthwhile to live in the ‘shadow of death’ that some work strenuously to remain under.
Rebecca was a bright and successful medic. She had become depressed and incapacitated in her work, socially isolated within the confines of her flat, and she was very lonely. She had tried to cope with this situation by becoming more involved with her work, but looking after others didn’t help and she felt unable to continue.
The intellectual defences that she had employed to get on and be successful in her life so far, including migrating from another country, speaking another language and excelling in exams, were beginning to fail her. She had also begun seriously to lose weight. She informed me that she had recently begun to frighten herself whilst alone in her flat, having hallucinations of her dead mother in the back garden looking in through the window at her.
She also imagined black birds flying through her flat. This felt both genuine, but accompanied by a memory of wanting to jump into her mother’s grave after her premature death.
In this melodramatic account of her state of mind it was possible to see both real feelings of pain and loneliness but also some evidence of her exciting herself over death. One way of managing the fear of it is to create horror movies. It’s shy young people who like the horror genre. An inner deathliness was in danger of taking her over. Despite my instant reaction of alarm about her weakened state and hopelessness about her, I decided to see her.
Rebecca had some traumatic experiences that left her capacity to manage the fear of loss of love and death disabled. In turn I felt myself also to be similarly disabled at times, and I was forced to begin with to live as they had done with visions of the chasm. As my work developed, understanding these fears in relation to my patients’ unconscious life played its part in enabling me to provide a more or less adequate container for her, and enabled her to begin to think and feel about these facts of life as they had not dared to before.
Rebecca was not from this country, she was the fourth child in a family of seven. Her mother developed breast cancer around the patient’s fifth birthday and this involved her being away for extensive treatments in a city some distance from the family home. Her mother’s anxiety for her children seemed to lead her, as often happens, to emphasise the need for her children to get on and make the most of their academic prowess. There was a strong family history of cancer and there had been several deaths. At least passing exams gives a semblance of control over things.
It was a feature of the early months that she had many colds and flus, which she seemed to catch easily and hold onto. She always looked cold and weak and as if she needed to wear more clothes, which evoked in me an interesting state of mind, one of exasperation at her helplessness rather than concern about her self-neglect. Over time I came to understand these early feelings of mine were related to her relationship with a mother who simply had no capacity to take care of her and who wanted her to take care of herself.
I initially found seeing her rather draining, as presumably, her mother had found looking after her family draining when she needed to be looked after herself. At an early age she was sent to a boarding school, following in the footsteps of her sisters. Throughout her time there she did well academically whilst at the same time managing to be rebellious. Her mother did die after a long struggle when Rebecca was 20. This tragically was closely followed by her father’s death after only six months. It seemed that he couldn’t survive mother’s passing. Rebecca responded to all this by working hard academically.
Rebecca’s history showed very considerable emotional privation and there had clearly been a divorce between her work-self and her emotions.
I think this dynamic is a part of working with many people who fill up the dark holes in their lives by distancing them from any need for others by creating relationships with substances, things, ideas that obviate the need for dangerous love, and its corollary vulnerability. Indeed they often create loss and pain in the people around them whilst they pursue preoccupations that fill their minds and bodies, whilst the real person is excluded and diminished.
In our second meeting she told me that in her view she would be unable to conceive of getting help from me and continuing to work. Instead she had been looking at advertisements to become a street cleaner for her local borough, this cleaning up other peoples’ stuff evolved from an unconscious phantasy of cleaning other people’s mess up rather than dealing with her own.
She posed a dilemma as I did think it was reasonable for her to consider not working whilst she was clearly in such a vulnerable state. On the other hand, she had no financial cushion to fall back on. Her alternative job choice was evidently dangerous as it was then the middle of winter and her current physical health was very fragile.
I was confronted immediately by my reactions to her depleted mental and physical states. I began to realise that she was insistently bringing the reality of death and deadly states into my room. To manage this first dilemma of life and death, I could only fall back on my theory and the setting. I was in no position to make decisions for her, my task was just to try and see how she responded to our working together. I said that “she seemed to find it difficult to conceive of both getting help and helping herself; it seemed that it had to be one or the other.”
Again, I came to see this as a re-enactment of the experience being with a mother who could not help. She was forever tempted to regress to infantile dependency in order, I think, to try to find someone to depend on. With great difficulty she continued to work. The pattern of her employment followed a similar path, in that she would often feel over-burdened and expected to do too much.
The first two years of our work was quite harrowing. It seemed that I had to live with her within the anxiety that she might die. She was deeply depressed, always with a cold, had very little money and was without any apparent social or family contacts.
The first dream she ever brought seemed to be a fairly accurate representation of her internal state.
“I am standing on a stage and I am overlooking a swimming pool full of dead male bodies. They had all died due to some mysterious disease and seemed to be floating horrible substance. In the distance a little boat is coming toward me that is picking up the dead bodies.”
Rebecca was unable to think or say more about this powerful dream but I was able to use it to help me understand more about her. I kept in mind that the waters seemed to be a negative version of “the waters of the unconscious”… “Dangerous waters” in which you don’t swim.
I saw the dead people as symbols of her frozen, dissociated emotions, especially feelings, which seemed to have been annihilated. That they were men seemed significant. I felt her identification with her dying mother had left her with the sense that she herself was deadly. The boat, I thought might be seen as an ego, or the hope of a thinking ego that might develop and that might pick-up, i.e. understand her dead, frozen self. I wondered if I might be partly represented by the boat, but It was a daunting task. This ‘aid’ in her mind clearly came with the price of risk of very severe contamination.
At the time I interpreted to her that the dream seemed to indicate her fear that her mind and thoughts would be lethal to anyone who came into contact with her, particularly men including me. She lived in fear of repelling me, and the men she began to meet.
Another dream later in our work shows, I think, how Rebecca was beginning to use our work.
“I am lying on a bed on the side of a partition, on the other side of which is an old nun on a trampoline who is jumping up and down, trying to see over at me.”
By this time we were able to think together about this view of a rather frustrated, possibly celibate person excitedly trying to reach her. The nun seemed to me clearly to be a reference to her own celibate, perhaps child like self, but it could also be an unflattering attack on me, her analyst, as a celibate and impotent person, which in this phase I often felt myself to be. But we could not ignore the manifest shape of the dream in which someone was jumping up and down to see something and in the manner of dreams this, I felt, was her becoming excited about being close to someone who at least seemed to be interested to see her, even if she had to turn them into an old nun or herself into a sexless being.
Over time her conception of herself as a lethal being began to emerge. I would say that she brought her deadness for the first time to someone who she hoped might convert it into thought and life. There was some illness at one point and this forced us both to confront her mortal (as well as now sexual) body, and after considerable work this led her into engaging with her own and my mortality as real things to be thought about.
This brought in turn grief for her mother and father’s deaths.
This seemed to me to come from recognition of Money-Kyrle’s facts of life, namely that her she was the result of a procreative act and that she had somewhere inside her knowledge of something good that they had given her before they cruelly died.
Bearing the facts of life
At times her fear for me, joined with my own fear for me and us and I, would mirror her in finding thought about our mortality overwhelming. Again, I depended on the setting and my own analytic perspective to help us.
At times she experienced real terror that if we talk about death the inevitable happens. It was of vital importance at these times that I was prepared to entertain the uncomfortable idea of my own death and my own limitations. It was an exploration of my capacity to cope with the thought of death and dying without defensively interpreting this fear away, or reassuring her, or indeed expiring on the spot.
This question about life and death became the focus of a great deal of exploration with me.
How do I, an older man, live with the knowledge of my own mortality, a reasonable question for someone whose own people seemed to have been dogged by and succumbed to such fears all her life?
This exploration of my capacity to cope with her streams of emotion about my death was an important ongoing aspect of her analysis.
As I survived, her ambivalence towards life abated and her fear that I would reject her increased. We could see this perhaps, to quote early Freud, as “hysterical misery turned to common unhappiness”.
For these sorts of people the facts of life are intolerable, as they have never experienced a mind able to think about long enough rather than succumb to their power of these facts. This left her in a world where she could only enact their problems. It was essential with both that she was eventually able to manage terrors around the fear of death and disintegration so that these frightening thoughts could become symbolised in the patient’s own material.
As a human I know that I struggle too at times to accept the three facts of life, particularly the last one. The tool that I make use of is my belief in psychoanalysis. Like Rebecca, we all need mental space in which to deal with them.
“Rage against the dying of the light!!”
– David Morgan
David Morgan is a consultant psychotherapist and psychoanalyst NHS and private practice. Training analyst/therapist and supervisor for the British Psychoanalytic Association and British Psychotherapy Foundation, and a Fellow of the British Psychoanalytical Society. He is Hon. Lecturer at City University, London. Director of (PiP) Public interest Psychology. He provides consultation to the public and private sector, including organisations of a political and social nature, and is a regular speaker at conferences. He enjoys lecturing and teaching and has contributed to radio programmes on Whistleblowing, Van Gogh (Radio 4) and the Political Mind(ABC). Recently he has lectured on Narcissism (London School of Economics), Poetry; Hypnotism; Louise Bourgeois (Freud Museum) Perversion (City University), Whistleblowing and Dissent, (Institute of Psychoanalysis & Wessex Training Oxford). Sleep Paralysis (Dana Centre), and War States (UCL). He has recently published in the New Internationalist. He was co-editor with Stan Ruszczynski of Lectures on Violence, Perversion, and Delinquency (Karnac, 2007).