“And So It Goes On” – a story of one therapy by Russell Rose

Sat in the waiting room of the clinic, wide-eyed big-haired and spindly-limbed, David’s anxiety was a presenting feature, most apparent in the firmness with which he was pressing the palms of his hands into his thighs, giving me the impression that his legs would shake furiously otherwise. Despite being fashionably well-dressed, he seemed shabby, a guy upon whom clothes could never quite hang right, not over those hunched shoulders and half-collapsed chest. His handshake was firmer than I expected though, and I was surprised when his manic neon-blue eyes made direct contact with mine. He’d decided to come to therapy following an argument with his girlfriend in which he had expressed a frustration at what he perceived to be her emotional neediness, only for her to retort with a brilliant line:

"You're the needy one, except that you're so fucking controlling you always get what you want before having to ask for it."

Both allegations had been a concern for him, as he didn't perceive himself as either needy or controlling. Coming from anyone else, he would have dismissed these accusations out of hand, and he might have done even with Julie had she not managed to open the wound further with the devastating news that:

“At times you remind me of your mother.“

Aged twenty-four, David worked in software-building and general computer cleverness, a job that was an extension of his adolescent preoccupation with computer-games, which had been his rebellion against the explicit and implicit firm guiding hand of his mother, who would have preferred him to have developed an interest in the arts, her great love and a pursuit that she advocated with a religious awe; a pursuit which David had largely managed to resist his entire life.

When I suggested the possibility that he may have rebelliously bitten off his cultural nose to spite his mother’s controlling face, he laughed at himself knowingly, but with a certain victorious pride. The sunken chest swelled, and I could see there the imprint of a strict disciplined and controlled response to being controlled. Even if his protesting impulse cost him dear, he had to win the battle.

I couldn’t quite make him out. He looked scared but fierce, deprived yet strong; and he amused, impressed, and irritated me. It was the masochist in him that got on my nerves, the side of his mind that would deprive himself of culture just to score some hollow victory over his mother, the side of him that would rather win by sabotaging himself than be spontaneously self-determining and alive.

Interestingly, Julie was also heavily involved in the arts. She read a lot, watched good movies, visited art museums, and had even dragged David to a couple of plays, which he'd reluctantly enjoyed, leaving me feeling both amused and annoyed by how he was co-opting Julie into a perpetuation of this symbolic version of his conflict with his mother whilst failing to acknowledge that, in this respect at least, both represented his own shadow, his own sabotaged yearning for cultural input.

His parents were both lecturing academics, his mother on psychology, his father on philosophy. The description of his father revealed a gentle man, kind and loving, but ethereal and unassertive. He floated about the world in a philosophical haze, pondering deeper meanings, passively tolerant of his wife’s inclination to organise his world. The image of his mother evoked in me was also of a loving and caring person, though perhaps one whose capacity to care was waylaid by a manic anxiety and its compulsive conversion into an irritable spotting of flaws, faults, and inexactitude in the people populating the world around her, and that she sought to correct from within an attitude that it just so happened that things were better for everyone when done her way.

His relationship with his mother was in some respects good, in that they were clearly very fond of each other, rather than merely dutiful but, with their primary mode of communication being through bickering, they were clearly embedded in conflict. The image I had was of them dancing between her need for control and his need to resist it, in a co-organisation and co-regulation whose apparent mutual opposition was in fact a co-dependence.

A visit from his parents inspired preparatory housework that Julie called hysterical, in the manic rather than the amusing sense, and which particularly irritated her, as he was determined to offer them a degree of hygiene and order far removed from anything that she herself could realistically expect to find upon a visit.

This occasional manic cleaning habit had developed in his adolescence. It might be imagined that the teenager finally gave in to the expectations of his mother, but it was in fact intended as a pre-emptive though, unfortunately, paradoxical strategy, in that his rebellion was to give her nothing to complain about, a goal he achieved though by acceding to her standards.

It wasn’t long before he came to see what Julie was trying to tell him, that he compulsively micro-manipulated. It was the petty ridiculousness that woke him up to it: they wouldn’t meet at 7.30, but at 7.45, putting a little bit less sugar in Julie’s tea than she wanted because he thought tea tasted best without sugar, and in general deciding things without conversation and, just like his mother, validating himself in the belief that his way was usually the best way. He was amazed by the discovery, and sailed the crest of this epiphany with excitement.

Whilst his excitement and intrigue fuelled our working-alliance, it served to keep him distant from the actual experience of the very dynamics we were discussing. At first, I was drawn along by his apparent willingness, enjoying the ease with which he readily trusted my thoughts and observations to be of relevance, and admiring the speed with which he deconstructed himself theoretically. Finally though I realised that the controlling attitude that he was supposedly investigating and deconstructing was being enacted in his manner of deconstruction: he was taking control of every loosened feeling and interpreting it so that he could manage the intensity of his experience of it. I realised also that I had been feeling rather as a proud parent, watching the unfolding cleverness of my child, and I was put in mind of his academic parents, in that I imagined that they too had enjoyed David’s intellectual development, and had presumably also favoured this over emotional connectedness.

My collusive pride served to protect him from the anxiety that I had seen in him initially, and he was genuinely taken aback when I said that to me he seemed to be quite an anxious person. Bringing him into contact with this wasn’t difficult, as it only required me to point out the many moments when his spontaneous body was expressing a conflict that his mind might be unaware of. It was the pressing of the palms of his hands into his thighs that most grabbed his interest. He didn’t know that he was doing it, amazingly, but was aware that it was a habit of his father.

Mother and son bicker endlessly, it goes on too long for the father who starts rubbing his thighs, transferring the energy of his frustration into an activation of his legs that enables him to leave the room. Mother and son heed this as a sign that they need to calm down, father returns to the room, nothing more is said, no-one addresses any of it, and no-one recognises or apologises to anyone for anything.

A beautifully crafted triadic system, which supported both the burning-up of excess feeling and the equilibrium of a rhythmic predictability, in which each participant in one way or another had a voice heard, and each had to sustain a compromise for the greater good; but a system condemned to perpetuity, to circularity rather than spirality, never changing its shape, never going beyond what it already was.

Pausing our dialogue whenever we noticed him pressing into his thighs, we found a mind overwhelmed with speeding thoughts, usually fleeting but sharp judgements upon the minor derogations of others; or else an angry self-critical tirade, fuming at himself about something or another that he had or hadn’t done, said, or been. Tyrants ruled his mind, poor David, telling him things about himself and others that, even when true, rarely mattered much upon any kind of reasonable consideration.

As he began to distance himself from these judgements, to dis-identify with them, so he discovered the equally overwhelming anxiety in his body that had been both their fuel and their consequence, and so he began to experience the parental conflicts in his life as they were expressing themselves in his mind and body in a relational tapestry not too distinct from the triadic family scenario previously described.

We established that he was experiencing two quite separate layers of anxiety: one, more superficial, which he learned quickly to manage the more able he became to both clearly see and experience it: most of the time, his racing thoughts were associated with waves of anxiety which became pressurised sensations in his body that fairly quickly found a more comfortable equilibrium when he attended to them, using his respiratory pattern to manage their intensity; and after a while he almost looked pleased by a dose of anxiety to work through, perhaps in a manner that neither his mother nor father had been able, perhaps on behalf of them both.

On occasion, though, he descended into a more intensely fearful place, the little boy’s terrified eyes flitting around the room in search of something absent, his limbs twitching and his flesh shivering as the anxiety overwhelmed him. These wouldn’t last very long, maybe five minutes from beginning to end once I found that by placing the flat of one of my hands gently on his belly, the other lightly on his shoulder, I could gently reassure him back into the present moment.

These occasions affected me viscerally. He looked so young and frightened, unable really to speak, just scared and alone in some dark place. I felt so sad for him, and wished that I could step into a sense of what this story was out of the turgid yearning in my chest and the aching desolate pain in my belly.

David described not that much really, just that he couldn’t really find words to describe how he felt when he wasn’t feeling it, and when he was feeling it he seemed to have no words.

He often recounted stories that came to him following his more normal panic attacks, and we were usually able to find the link between his past and his present that had triggered the anxiety, but there were never stories told of any great drama; pretty much just different versions of the triadic family scenario. I didn’t understand what this more regressive panic was about, what scenario it related to, what caused it to surface, or what my role within it was. He came to the point whereby he could fairly reliably calm himself down when these happened, often by placing the flat of his own hand gently upon his belly, but it worried me to have such a powerful and free-floating dynamic in the air, unharnessed and uncontained by language.

As he became more able to manage his anxiety, so he became less fearful of it, and so it reduced as did, more gradually, his controlling mannerisms. He developed an experiential fascination with his feelings that, over a couple of years, took him into mindfulness meditation and yoga, and he opened his mind to the joys of non-philosophical culture, under the guidance of Julie, with whom he was enjoying an ever more satisfying and interesting relationship.

His relationship with his parents changed considerably from the first occasion when he told his mother that she was being controlling because she was so anxious, an allegation that she was initially far more hesitant about accepting than he had been, and resisted for some time until a mild nervous breakdown caught up with her, and she sunk into a depression that then took her into therapy. This change to his mother had a considerable impact on David’s increasingly calm and evolving relationship with himself, in that it provoked his deeper anxiety, and for a couple of months he came to therapy three times a week. I suggested that there might be a link between his mother’s depression and his panics, and he decided to talk to her, to ask about any history of depression, especially in the early pre-verbal stages of his life.

She met him with open tearful eyes that melted his heart, and told him that she had gone into a depression following his birth, and had stayed there for six months or so. His father had stepped up to the plate and done a lot of the early nurturing; which presumably included placing a flat of his hand on the boy’s belly. It had been a terrible time for her, incarcerated in a thick cloud, her new-born in sight but unreachable, and when she finally managed to crawl from the swamp she found herself to be somewhat more anxious than she’d been before she’d sunk into its midst.

As the story unfolded, her mother had also been depressive, at least since her husband died leaving her pregnant with David’s mother-to-be. He remembered his grandmother as someone who fussed around, as his mother did, caring but anxious, and who always seemed, now that he thought about it, a little far away. She never re-married nor, so far as anyone knew, ever again courted. The family had money, so there was no need to work, and she passed her life tidying her immaculate house and having the occasional pleasant pursed-lipped coffee morning with the local ladies.

I felt depressed thinking about her and I felt depressed thinking about David’s mother being brought up in that grim, solemn atmosphere of perpetual tacit enshadowed grief. The family secret, the elephant in the room, was depression, beginning in earnest at least back to the tail-end of the second world war. It was clearly unresolved in David’s Grandmother, and had been until now unaddressed in his mother. The baton had been passed-down through the relational generations, and David and his mother stepped firmly into the opportunity to change how it was that the past was living within and between them. They got to know each other well, and became in many respects good friends with an emotional language. They both became well, and more or less in tandem, being central to each other’s support-system in a manner that they had been unable to achieve once upon a time.

His father though remained on the outside. David made more effort with him, and they went for a beer together once in a while, but he retained a private introspection that remained impenetrable, and that kept him apart from the renewed intimacy in the family.

In some ways I felt sad about this, and was aware that I hadn’t worked much with David or myself when it came to his father’s dynamic, despite retrospectively acknowledging more overlap between us than I would have imagined likely. The philosophical haze that I described him as being in could have been a description applied to my own father, and also to me, more especially when I had been David’s age, when I was still very much caught in the anxious resonance of having been born of an anxious mother who was herself born during the incendiary London of the second world war while her father was away fighting in it.

I had nurtured David through his mother’s depression, as his father had through his wife’s, and we had both somehow stepped away from the spotlight of the story, both become engaged onlookers in supporting David’s relationship with his mother. I knew that it suited me to leave myself out of the story, as it’s a pattern that’s familiar, and I could sense that the same was true for David’s father also. In unwinding one pattern we had reinforced another. One re-enactment unravelled, as another becomes lost in a blindspot.

The last I heard from David was when he emailed me to say that he and Julie were to be married, and that his father was to be his best man. I found this odd, in the way that I do when a woman describes her mother as her best friend, until I realised that another thing that we had failed to address was his lack of peer friendships.

As a psychotherapist of twenty years experience, I am still so regularly struck by how inevitable it is that my apparent successes conceal my failings, how one re-enactment can unfold to leave another unnoticed. We construct each other into each other’s stories with such a multi-layered complexity, and still today I forget that I should distrust nothing so much as my feeling of peaceful satisfaction in the face of a seemingly completed process.

I became a relatively well-developed version of David’s father, way more psychologically sophisticated, for sure, but nevertheless an onlooker rather than a participant, which in many ways could be my description of how I experienced my parents during my own upbringing; caring and there, but not really dynamically engaged.

I related to David in the way that he related to himself, in the way that he was related to as a child, and in the way that I was related to as a child. We co-constructed each other into each other’s stories and, whilst I know this to be inevitable in a therapeutic relationship, I feel annoyed at myself for remaining so unconscious of this underlying dynamic, and for leaving so much of his relational wound untouched by our work together.

When I started writing this story, I felt good about it, but now as I finish writing it, I don’t so much. Beyond the annoyance, I’m left feeling sad; and I imagine that this is probably how David’s father feels in his private introspective moments.

And so it goes on.