Holding Our Selves, Together.

ae531f95b8b84975534953bd803748bc17:10 on Wednesday. I’m sitting in clinical supervision, engaging in what has become a familiar debate with my supervisor in which she tries to convince me that I am doing an okay job as a therapist, and I try to convince her otherwise.

16:55 on Thursday. I am unravelling in my therapist’s room. Before I leave, she establishes where I am on the suicide continuum: thoughts, plans, actions. We set up points of contact for the next 72 hours and schedule an extra session for Monday.

09:00 on Saturday. My first patient of the day arrives. I exit my body and the mind that is trapped in torment and find, inexplicably, another mind of my own, one that can meet and hold the mind of another in this sacred intersubjective space we call therapy.

13:15 on Saturday. As I leave my practice, I feel myself disassembling. I go home and make contact with my therapist. I jot down notes to take to supervision, more ammunition against myself in our impossible debate.

Many of us who become psychotherapists are drawn to this profession because of our own experiences of suffering. We are Jung’s wounded healers. Those of us who are fortunate enough to get selected into training programmes must have demonstrated a capacity to be, if not All Together, then at least reflective of the ways in which we are not, and of how this might influence our work with our patients. Once qualified, it’s easy to believe, even if we know we should know better, that as therapists we should (surely) be spending most of our time in that All Together place, if we are to be of use to our patients.

I feel fairly certain that my own encounters with suffering have made me a better therapist. I like to think that my dark-and-twisty bits resonate subconsciously with the darkness and/or twistiness of my patients, freeing them to speak the unspeakable. The things I have seen in my depression, staring across the threshold of life and death, give me insight into what it might be like for those patients who are facing their own thresholds. Every hour that I sit with a patient, I am grateful for these experiences and for the remarkable privilege of this work.

But what if the suffering of the therapist’s past bleeds into the therapist’s present? What if the line between holding it all together and falling apart was never really a line at all? I think it’s safe to say that I am far more familiar with Falling Apart territory than the All Together terrain, despite how things may outwardly appear. Sometimes, the path out of that territory is clear. I have had episodes of depression that have forced me to take time off from my work, knowing that I was in no position to be helpful to others. But I am also aware that I live my life below the baseline, feeling more of a daily affinity with the Eeyores of the story than with the Pollyannas. Whether depressed or not, I remain in therapy, trying to find ways to live with my self that don’t leave me standing at the threshold. I fall quite frequently through the perforations in my precarious all-togetherness. And I have fallen now.

For most of my hours, days, week, my head looks and sounds much like a P.O.W. camp amidst a pointless civil war, bringing a very real quality to the sense of disintegration I feel. For one, sometimes two hours a week, my therapist tries to use words to hold bits of me together. For one hour a week, I grapple in supervision with the question of whether we can hold our patients if we are unable to hold ourselves.

And then. A patient walks through the door, sits in front of me. Suddenly, inexplicably, the mind I have lived in for all the hours before this is no longer there. Despite all that I have felt before and will feel after this session, I lose myself in the therapeutic work. For this one hour, I am outside of my head, engaged with the mind of my patient, absorbed in the relational space between us. For this one hour, I am held together by the holding I provide for my patient. For this one hour, I have dismantled myself and, somehow, put my self back together again.





Being, Witnessed.

images“There you are!” exclaimed the lady behind the counter in the takeaway shop close to my house. An enthusiastic greeting not typically encountered when placing my chicken-burger-and-small-chips-please order, and my bewildered expression must have conveyed my confusion. “You used to run past here every day and then I stopped seeing you. I was worried,” she clarified. I walked home feeling buoyed up.

A few weeks later, a security guard at our small local shopping centre: “Hey! Long time no see!” A creature of (rigid) habit, for years I had arrived at this centre at exactly 07:55 on a Saturday morning to attempt to beat my 10-minute weekly grocery shopping record before All the People arrived. Over the past year, I have mindfully stepped out of the rigidity of these routines, unaware that my absence would be noticed.

I have disadvantaged myself in many ways, living this routinised life. But these encounters made me aware of how routine can create a structure, a pattern in which we move through our lives that make us visible on the well-trodden pathways we literally and figuratively walk. It brought to mind the “If a tree falls in a forest…philosophical thought experiment about the (im)possibility of unperceived existence. As a single person who lives alone, this notion of being witnessed has been floating through my mind for some time and comes into sharp focus on days like today – a milestone, a birthday, a marker of life, of being-in-the-world.

Today, most especially, I know that I am held in the minds of others. But during the day-to-day of living, whose consciousness am I held in? I am seamlessly, virtually connected and well-loved. Content in my introversion, in my quiet house with my book and my cats, I seldom feel lonely. But I am alone. And when I venture out into the world, spend time with friends who are partnered, who are parents, I have to confront this aloneness and the sadness it evokes. I am a solitary extra, standing on the outside and observing, witnessing with wonder the richness of lives that are so connected in the weaves of families, however constituted and defined. And, when the evening is over, I return alone to my little home, two feline faces greeting me at the window.

What and where is home in the world for solitary people? How are our lives continuously witnessed by others, if not by others-at-home? We start off in families, in childhood homes, in collectives of some kind. Many move through adulthood into families who become home: families weaving lives together, creating a narrative of shared memory, bits of you held in the minds and memories of others. However tenuous all connections and relationships might be, the (her)story of them cannot be erased. Sustained witnessing is what marriage and family allow, a kind of permanence to stories that build up a person’s life narrative. For those, like me, who remain unmarried and childless, physically distant from my family of origin, that narrative must be pieced together from moments of interaction, stepping into and out of the homes and stories of friends-with-families, of other solitary beings who are living their own solo stories.

Married-with-children is our society’s tried and trusted way of having our lives witnessed. The nuclear family – however conventionally or unconventionally constituted – is a one plus one-or-more unit. Notwithstanding the emotional risks of entering into such relationships, there is, in all the heartwarming and heartbreaking moments of shared lives, this one given: that you, or at least the absence of you, will be noticed. We have yet to find ways in our current society, I think, of creating a witnessed solo life, a collective narrative of being known that feels acceptable outside of this family unit frame of reference. There is a sense, in my experience at least, that existence that is not seen, heard, felt, known by a consistent other is somehow less-than. In his book Going Solo, Eric Klinenberg suggests that, “on those rare occasions when there is a public debate about the rise of living alone, commentators tend to present it as an unmitigated social problem, a sign of narcissism, fragmentation, and a diminished public life…In fact, the reality of this great social experiment in living alone is far more interesting — and far less isolating — than these conversations would have us believe”.

Part of this, I think, is a reverence for the family/pairing and a reviling of life-alone. Being on the outside of that conventional narrative is experienced as a loss of some kind, perhaps due to the absence of collectively legitimised alternatives. When I turned 40, I started telling friends and family that I am officially embracing the spinster-with-cats lifestyle. I vacillate between pride and pain on this. In the Middle Ages, spinster was a compliment, an acknowledgement of women who spun for a living and were financially self-sufficient. In our darker ages, it has far less complimentary undertones, based on “the modern attitude which casts voluntary aloneness as a toxic trifecta of sad, mad, and bad” (Sara Maitland, in How to be Alone). It is not lost on me that, despite writing several posts on mental health issues which come with a fair amount of stigma, this post has carried the most shame for me.

The alternative, on the other end of the continuum, is a Sex and the City narrative which, although sexier, is merely an amusing impossibility for this recluse-bordering-on-hermit. Where are all the storied possibilities in between, I wonder: narratives that allow us to be witnessed in validated ways, that give us freedom to embrace an alone-existence and not take on, instead, the messages that this is a defect of some kind, a less-than existence, and a necessarily lonely one. As Maitland argues, “If you tell people enough times that they are unhappy, incomplete, possibly insane and definitely selfish there is bound to come a grey morning when they wake up with the beginning of a nasty cold and wonder if they are lonely rather than simply ‘alone'”.

This solitary life is one that I have, to some extent, chosen for myself. I revel in having space and time open up around me on my own. There are many times I go out into the world wishing I could not be seen. But the risk of living this life alone is that without creating, with intention, possibilities for being witnessed, there is the sense sometimes of being that tree in the forest, falling down unheard.


Thresholds neverending.

valley_of_the_shadow_of_death_by_reyed33-d2zdga0Shock. Grief. Disbelief. Sadness. In the last four weeks, I have known of four people who have committed suicide. On the days that each of these four people took their lives, 40 seconds later someone else, somewhere in the world, did too. And 40 seconds after that, another. Perhaps, then, hearing of these suicides shouldn’t be so shocking. But of course I felt the publicly shared shock. The empathic, once-removed sadness. And yet…There was more to it than that. So I’ve been wondering why I have been so unsettled by this, so deeply affected. Why do the faces of these people keep floating through my head? This wasn’t my loss: what right do I have to this grief? And so I began to write.

But suicide is an emotive topic, to both write and read about. So first, a disclaimer: This is a personal post. About one person’s experience of depression and the effect of just the word suicide on the physical and emotional memory of that experience. It makes no assumptions and no judgements about what others have been through. It does not diminish the suffering and pain felt by those left in suicide’s wake. But if this post has resonance with just one person who has been there, or who is perhaps trying to understand being there, that will be enough.

In the aftermath of a death by suicide, perhaps especially very public or high profile ones, many are left struggling to understand it. Trying to make sense of it, to find explanations, as we all tend to do in the face of tragedy. And underlying some of this is that question to which the answer seems impossible to comprehend: what could lead someone to that place? A place where the desperate and painful and awful act of ending life seems to be the choice that is made. A decision to remove oneself from the world. In our public and personal narratives, one can often find the (mis)conception that some people are or should be immune to such things. They had achieved so much in their lives. They were a successful academic, a prominent researcher. They were a health professional, a doctor, a psychologist. They helped others with this sort of thing. They knew how and where to find help. And then those become reasons: Mental illness and suicide on the rise among academics. Among medical professionals. In South Africa. In the world.

Perhaps there is also something self-protective in trying to find reasons. In blaming this or attributing that. We can never know what combination of things will have led someone there. But reasons give us armour. They give us things we can identify, pinpoint, avoid: if I can protect myself from this, or if I don’t live like that, then I might never get to that place. If I can change this or fix that, someone I love might never return there. Depression, of course, is often one of these reasons. And here is where the statistics are publicised. The prevalence of mental illness, the epidemic of depression. The nature of the disease is highlighted again, in order to cast blame away from the person who was in the grips of it. But it still somehow seems a difficult one to get inside of, a state of mind impossible to understand from outside of it. Hard even for those who have been there to articulate the experience of the there.

And then there are those of us who understand it too well. Who know. Because we’ve been there, to that place. Walked the line, sometimes tried hard to cross it, between wanting to live and wanting to die. Who know that there is choice and there is not-choice. So, when I hear about another person’s suicidal act or suicide, a mixture of thoughts and feelings whisper their way into me: This time it wasn’t me. Relief. That could have been me. Sadness. That could still be me. Fear.

In a much-loved film from my childhood, The Neverending Story, there is a scene where Atreyu, on a quest to save Fantasia, must pass through the mirror gate, which means facing his true self. In the movie, being able to pass through the gate is a good thing: Atreyu’s true self does not send him screaming from the gate and he makes progress on his journey towards finding the answers he is looking for. When I think of this mirror gate, I think instead of the threshold between life and death. For me, it’s the familiar place of depression. The true self I face in my depression does not send me away in fear; it is so unbearable to look at and accept that it convinces me that the only ‘escape’ from this self is to cross over the threshold from life to death. It is a harrowing image of self-loathing, hopelessness, despair, futility, torment. To borrow more metaphors from The Neverending Story, it is simultaneously drowning in a swamp of sadness and being consumed by The Nothing.

This is a threshold at which many of us who are at the mercy of depression have stood, a threshold some have tried repeatedly to pass through. And some of us live with the awareness that we may find ourselves at that threshold again. So suicides affect us with an unsettled sorrow. There is profound sadness, a resonating kind of grief, having a sense of what that person might have been going through. But for me there is also a sense that hearing of another person’s suicide infects as well as affects. They are like whispers to those memories, to those emotions. They remind us that, once you’ve been to that threshold many times before, the odds are higher that you’ll find yourself there again. If this is sounding a-volitional, it’s because it is: once I fall into a landmine of depression, I cannot predict or control how far I will fall. I know what to do, of course – increase my meds, see my therapist more often, ask friends to hold onto bits of me – but even in doing these things, I fall.

To think that I might become suicidal again is frightening. For me and for those who care about me. When someone commits suicide, many often ask, how could they do that to their family, to their friends, to people who loved them? In my experience, this is a complex, difficult question, with even more complex, difficult answers. I don’t think any one of us can put ourselves in the place that person would have been in when they made the impossible decision to take their own life. But what I do know is this: it is both a choice and a non-choice. We try to understand it, try to make sense of it using our rational senses. But this is the thing: Depression, by its nature, is irrational. There is no sense to it. Suicide is not a sense-ible act. It is one of being overwhelmed by all senses and overwhelmed by the absence of any senses.

This is a paradox I live with: that I spend half of my life wanting to die and the other half being afraid of death – wanting, I suppose, to live. The former is most often as a result of depression. The latter I understand to be the corollary of suffering from depression and of the suicidal ideation that comes with it. Tomorrow, or next month, or next year, I might find myself in that place again. And so, during these rare times when I am Okay, I clutch onto life. Fearfully. Not spectacularly, not adventurously. Just quietly, cautiously. And gratefully. That, today at least, my internal world does not include a mirror gate.




Degrees of erasure.


If you follow any PhD-related Twitter threads, you’ll know that the mental health of PhD students is a hot topic. It is not new news that we are a relatively unhappy, struggly bunch. I don’t think this is specific to doing a PhD, with the challenges of being in ‘academia’ receiving as much if not more attention. Guidance abounds on how to manage both the PhD and academic life in ways that don’t pose serious risks to one’s mental health. Balance and all that. Common sense stuff, really, although harder in application than in principle. But because I can be somewhat contrary here, this is a post about how to manage doing a PhD in ways that will almost guarantee mental illness. Consider it a message of foreboding, a sort of DO NOT GO BEYOND THIS POINT sign hanging wearily off a tree in the darkening part of the forest.

First, an analogy or two. Until I submitted my PhD at the end of last year, I was part of a PhD group (support group, if you will). Some of the discussions we had in this group were around the value of metaphors in capturing the experience of doing a PhD, or different parts of it. Writing a thesis has been compared to baking a cake, or moulding a sculpture. There are bits of it that have been described as a swamp of sadness. It is no secret to those who know me that my PhD experience was awfully awful. The best way I have been able to describe the lived experience of it is by comparing it to a civil war. While most of me was held up in a prisoner of war camp, detained in solitary confinement and tortured by the other most of me, the remaining bits were running around outside torching all the lovely buildings and bombing all the lovely parks that had taken so many years to cultivate, leaving nothing but a wasteland in their wake.

And, on the day that I submitted the corrections for my PhD, allied forces arrived and rescued me, releasing me back into normal society and my regular life. There was much celebration and jubilation in the streets. There was a welcome home parade. There may have been trumpets. But when you’ve lived in a torturous kind of solitary confinement for so long, life above ground, in ordinary society, is too bright and loud and foreign. And when all the structures you used to have to live in – those lovely buildings and lovely parks – have been burnt to the ground, you no longer have a template for being human-in-the-world. So while those around you celebrate, you wonder if there’s a way of getting back to the camp, where existence was tortured but familiar. Where you knew how to be in a way that now feels entirely lost to you.

Ambivalent feelings post-PhD are, I believe, quite normal. What I have noticed, though, is that there seems to be at the very least a tangible sense of relief. Having spent many months, and sometimes years, shackled to your PC in trying to do this One Thing, the freedom of no longer having to suspend your life to work on that thing is surely exhilarating. But what if completing your PhD is subjectively not the happy achievement that everyone assumes, understandably, that it must be? Although not explicitly said, the conversations I imagine people are silently having with me go something like, “So, you were miserable while you were doing your PhD, and now your PhD has gone away and you have finally got the degree, and you’re still miserable?” I wish I could say that the degree-awarded letter I received a few days ago made a dent in this. It didn’t. If anything, it made me feel worse: guilty for not feeling joy, for not recognising and embracing the privilege that working towards and obtaining this degree is. For not feeling proud and clever and capable – all the stuff that, surely, a Dr-somebody should be.

Instead, I find myself sitting in a burnt out landmine, wearily asking Google why I’m feeling this way, warily writing this post. Could this be burn-out? An understandable kind of post-traumatic stress reaction that has been identified as somewhat common, physically, mentally and emotionally? Have I broken my body by sending so much adrenaline and cortisol up into it to sustain the kind of pace that only a constant fight-or-flight response could sustain? Or have I broken my work self, now swinging to the opposite extreme and having the reaction of a petulant child whenever adult-me tries to get me to work? I do seem to only operate on two modes of self control more generally in my life: utter extreme or none at all. I’m either all in, all the time, denying myself any other way of being or being in the world, or I’m all out. At the moment, this all-out pretty much just looks like an amoeba that flops about from minute to minute and day to day, with one small thought bubble above its head: eh. On the inside, the self-disciplined (read: torturer) bit of my self may have lost its weapons and its power to flagellate amoeba-me into actually Doing Things. But it still has its words. And those words are used with powerful effect to paralyse the floppy amoeba into further self-hatey floppiness. It’s a bit of a cycle, and it’s particularly vicious.

When the only way you have been able to Perform and Adult for the past year or so is by locking yourself in a torture chamber and waterboarding yourself, this a problem for performing and adulting going forward. This, the mean voices tell me, is not some understandable psychological, physical, emotional reaction to what was essentially a year of self-annihilation. It is pure laziness. It proves that all the notions that you had during the PhD that you are in fact not capable of doing such are true. It has not left you with the skills they say a PhD should equip you with. In your case, this has all just been one long ruse (impostor syndrome, on steroids). Sure, there was persistence and perseverance under the most extreme kinds of awfulness. But all that means is that the degree you obtained was not in fact in (insert topic here), but rather in sheer, inhuman self-discipline and grit. And in doing so, you managed to break said self-discipline and grit, along with any other bits of you that had started to actually feel like they belonged in the world. So, here you are, five years later, in all ways less-than than you were before.

But, say some of the softer, much quieter voices, what about depression? Isn’t there the possibility that the kind of year you have just emerged from took a toll much deeper than a few weeks’ break over the Christmas vacation was ever going to resolve? In some ways, that would be the best-case-scenario conclusion to reach here, the one where I am now in the familiar, biologically-driven cycle of a depressive episode. The PhD, for me, was something of a trauma and I managed it in the least constructive way possible. This would certainly qualify as a trigger for an episode of major depression. I was due for one anyway. But here’s the thing. Depression magnifies all the worst things you already believe about yourself. So it can be hard to know when you’ve crossed that line into an Actual Episode, or whether this is just you being your usual dark and twisty self. My best indicator is usually losing the ability to function, where getting up and getting dressed and going to work – let alone doing any of the work that feels suddenly entirely overwhelming – takes superhuman effort, which only occasionally results in me being able to actually get up and get dressed and go to work. Or go anywhere, really. And right now, I am still able to do this most days. I’ve just managed to pull off finishing a whole PhD, for goodness sake. That qualifies, I think, as quite high up on the functionality scale. And tends to complicate the whole is-this-an-episode-no-it-can’t-be-just-pull-yourself-together narrative.

And then: there are questions of purpose, of what value I contribute to the world. For a very long time now, the only purpose I had was to complete this torturous PhD. But doing so has not made me feel any cleverer or better or more worthy. And if, while completing this PhD, I managed to burn down any other small bits of me that might have been useful in the world, what I am left with? The lack of purpose and the what now? do seem to be somewhat typical of the post-PhD experience. But when your entire self becomes wrapped up and defined by this thing, at the expense of all other things, the post-PhD is not simply a case of finding other things to do, other ways to fill and spend one’s time, reconnecting with the bits of yourself that had to go silent while you worked intensively on this thing. You know, the pragmatic stuff, like resting and reading and going out into the world and eating cake and Being Social. All of which might start to mirror, again, the lost or neglected bits of yourself back to you. It’s also about trawling through the burnt out rubble to begin to put the structures of your self back together again. Spraying a bit of graffiti on the smoldering buildings to pretty them up a little until the hard labour of reconstruction is complete. A task that, in the face of depleted energy and depleted everything, feels impossible to get off the ground.

So where does this leave this newly-doctorated me? This one, Google was less helpful with. I wish I could easily say or see that this is clearly depression of the familiar and biological-imbalance kind, which gives me a familiar plan for treating it, hoping that perhaps this imbalance is what causes me to spend so much of my time wanting to stop existing. But what it if is not that? If what all the mean voices are telling me – that I am fundamentally disordered and useless and incapable of regular human things – are true, how do I push forward in spite of that? Especially in the face of the bright and shiny new doctor title that is supposed to represent the opposite of those things. Writing this post seems to have been the only Proper Thing my weary brain has been able to do since submitting my PhD. And I’ve spent a fair amount of time thinking about why I felt compelled, first, to write it, and second, to Put it Out There in some public way. Laying bare the poor-me tale that follows. Writing these posts have often been a way of helping me to make sense of the experiences I have. Writing them in something of a public forum allows me to write for a benign, if silent, audience, which is what makes it possible to write them at all (the mean voices in my head would never allow for it to be written just for me). There is also always the hope that my own n=1 experience might hold resonance for someone else, that even one small bit of this might help someone else feel less alone in their struggles. But if I’m honest, this time, I’m writing this one to the benign audience, for me. In the hopes that I’ll be the person who feels less alone and less oh-my-god-what-is-wrong-with-you-you-are-so-dis-ordered, precisely because some part of this might ring true for someone else.


[Image credit: https://fineartamerica.com/profiles/mario-sanchez-nevado.html]