Rocky Road

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Red, green, ol’ rocky road, tell me what you see;
Tell me inside out, tell me upside down,
All around the block, all around the town.
Red, green, ol’ rocky road, tell me what you see.

This great old folk song has recently regained the public’s ear due to its inclusion in the Coen Brothers’ film Inside Llewyn Davis. But I remember appreciating it long ago, when I first heard the Peter, Paul and Mary version. As a kid, all I had was my gut reaction to it – now, as I watch the film, knowing a little more about myself, and life, I realize that what is so evocative about the song for me is its attitude: the singer is contemplative — asking, not telling; open to experience, not closed; willing to trust and be surprised, not guarded and judgmental. He is saying “I want to know you,” not “What do you want of me now?”

What I didn’t know then was that this song was a part of my journey, because I see now that what I appreciated about it was how it beautifully expresses the therapist’s point of view. Tell me all about yourself: red and green, up and down, inside and out, rocky and smooth – I want to know how you see it, how you feel it. And yet, being interested, and open, is only part of doing therapy. There is a delicate balancing act involved – you are being hired as an expert in human behavior and change, and yet part of your job is to be willing to not know this person before you, to be surprised, to have it be the first time you have ever heard this exact story, to find and appreciate the unique in this person.

Every patient wants the reassurance of hearing, “Oh yes, I know exactly what to do with your type – I’ve heard it a million times before,” and yet of course, at the same time they don’t want this at all – they want to hear, “Hmmm, this is interesting – different, this is not obvious, this is a challenge.” So, the therapist’s delicate balancing act is to keep both of those things true at the same time, because they are both true at the same time.

It brings to mind a woman I used to see. In a therapy session, she was working through some very painful and confusing issues, and the way forward was not clear to her at that moment. But I knew she needed to stay with the process of not knowing, and I kept her at it. Suddenly, she looked up at me plaintively and said, “Do you know what you’re doing?”

I immediately answered, “I don’t know what I’m doing – but I know what to do.”

At that, we both laughed out loud, because as inane as it sounded, we both knew that it was true. Why did it break the spell of her desperation and reassure her? Because I was being real and human with her, because I had enough confidence in myself, and trust in her, to tell her the truth about not knowing in the moment, while also knowing that in the larger sense, I knew what I was doing.

This is the challenge of therapy, and the joy: to ask, not tell; to know, and not know, at the same time.

Red, green, ol’ rocky road – tell me what you see.

Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.

Alone

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We are all alone. You are alone, and so am I. Nobody else can live your life for you, or know exactly how you feel, or what is most important to you, or share precisely what goes on in your inner world. Nobody else can take that responsibility off your shoulders, take the risks for you, take the blame for you, or the outcomes of your decisions. You live in a world with others, but as an entity, a being, you are alone. As the old hymn goes:

You got to walk that lonesome valley;
You got to walk it by yourself;
Nobody here can walk it for you,
You got to walk it by yourself.

It’s almost cruel, isn’t it, stated that starkly? And human beings will do almost anything to soften, shift or deny that stark reality. Some classic favorites are drugs, alcohol, and sex. There are others, more sophisticated perhaps, that are used either unconsciously or for higher purposes: what we call “Psychological Problems” are, in large part, a clever, unconscious way for the individual to deny being all alone. Say you have parents who are unable to love, cruel, neglectful or emotionally disabled, leaving the child for all intents and purposes, all alone. What does the mind do? It comes up with a new paradigm: I am bad, I am unlovable. If I was just good enough, smart enough, nice enough, pretty enough, strong enough, they would love me. Now the perceived locus of control is in You, not the parent. True, you’ll never get ‘good enough’ to be loved, but that’s because of You, not them. Thus the fantasy, or potential, of bonding and connection is preserved in amber, “in hopes of better days,” as the psychiatrist Donald Winnicott once said so eloquently.

Religion sometimes provides another ‘higher level’ method of assuaging the pain and fear of being all alone. Jesus is with me always. Comforting, isn’t it? God is everywhere, and I am part of God. What a relief! Again, this is not to trivialize genuine spiritual beliefs, but you can see the distinct possibility that these beliefs can be used, or misused, to make our condition more bearable, whether or not Jesus is actually on the job.

Even Buddhism can be misused to mask our existential fears:

There is no self – self is just an illusion.

In this system, there is no ‘I’ in the first place, to be alone – ‘I’ am just a part of universal awareness, one with the universe, and division and separateness are just distortions of reality. Again, all spiritual systems are noble pursuits, but again, even noble pursuits can be misused. I have had therapy patients who are avid meditators come in for help and, when I tried to explain that their emotional problems were the result of a poor or distorted sense of self, tell me confidently, “Oh no – that is irrelevant, since there is no self.” Well, believe it or not, even Buddhists need a sense of self (in the ‘mundane’ psychological sense) to function well in the world!

But perhaps there is another clue in everything that I said above – a sense of belonging, a sense of being in the same boat with others. Religion provides this; spiritual traditions provide this; sex, even addictive sex, at least implies an ‘other’; even drug and alcohol addicts often derive a sense of identity in their usage. I have often thought that one of the major reasons why AA and NA work, is that they force addicts into functional emotional relationship with others: transparency and disclosure, the emotional give and take of humanity, rather than the “one-person system” of drugs and alcohol (“I don’t need anybody else in order to feel better – I’ve got my drugs to keep me warm”). Saying, right out loud, “I am an addict, and I need you,” is not just breaking the denial of the addiction itself, but just as importantly, the denial of the need for others that is implicit in the addictive lifestyle of using substances, rather than people, to ‘feel better’.

Today I remembered a passage from a book by Melody Beattie, who has written extensively on co-dependency. But this book (The Lessons of Love) is about her dealing with the loss of her son, and her daughter’s struggles with addiction. At one point, her daughter returns home from a recovery program. Her friends, who call themselves the Get Along Gang, have gathered to welcome her home. Melody is appreciative of the way the friends support each other. Her daughter explains:

We each go through different things…We know the other person doesn’t understand, because they haven’t been through exactly that same thing. But we listen, and we tell each other we don’t exactly understand. But we care. That’s what makes us a Get Along Gang. We help each other get along.

What a beautiful, and sophisticated, way of expressing what we can do about being “all alone”. There is no denial here, no distortion, no pie in the sky, no tricks, no cheating, no hidden carrying charges: just the straight skinny on the human condition and how to live with it. And I hope in my therapy practice that is what I am offering people.

As Jimmy, an ex-patient I saw as a teenager, once said to me many years later, “Thanks for giving me a safe place to face the truth.” You’re welcome, Jimmy – and thank you for the privilege of letting me be part of your facing the truth, because we are all afraid, we are all in the same boat. We are all that crazy creation – the animal that not only is subject to life and death, aloneness and loss, but has to KNOW it, too!

Yes, we are all alone. But we can be alone, together.

Note: All clinical vignettes herein are significantly altered to protect patient confidentiality and privacy.