What is less normal is to feel able to admit to not coping, feeling confused and overwhelmed The traditional way of writing about patients is to disguise them to the point of unidentifiability, usually by conflation, and then to refer to them as Miss A or Mister B. The background and problems of this essentially non-existent patient will be outlined in incredibly general terms and then the therapist’s most brilliant (and probably equally non-existent) interpretations will be quoted. Following these gems of infinite wisdom, we are told, Miss A and Mister B went on to live marvellously fulfilling lives as a result of their therapist’s unsurpassed excellence. In real life though, patients often get stuck or are extremely hard to reach, so well defended that it can feel as if there really is no way in or, from the patient’s point of view, no way out of the carefully constructed lead sarcophagus. One hugely popular defence that serves to reinforce the aforementioned sarcophagus is: “Well, everyone does that… don’t they?” I’ve got a patient at the moment who will tell me something awful, say, about being bullied at work, and then she’ll say, “Well, all bosses are like that,” and refuse further discussion. If I say, “That sounds very upsetting,” she gets irritated. “Come on, don’t tell me you’ve never had a difficult boss?” She then feels she’s won the argument, parried examination and been declared “normal.” By extension, I have been proved unnecessary and useless. She can continue with her life-long grin-and-bear-it coping strategy. This goes on session after session. Nothing is up for discussion. Everything unpleasant is simply “normal.” And yet she keeps coming, because some part of her is desperate for change. The trouble with the “Am I normal?” question is that a “Yes” answer isn’t, or shouldn’t be, reassuring. It’s normal to be bullied at school, to be sexually abused, to have addiction problems, to suffer insomnia, to feel anxious all the time, to be racist and misogynistic, to hit children, and so on. Normal doesn’t mean it feels OK, and it doesn’t mean there is no other way to feel, behave or cope. It was once very normal for children to be caned at school. It caused enormous suffering and distress. Was it normal? Yes. Does that mean we shouldn’t question and discuss it? No. A colleague told me that “is my child normal?” is one of the questions that nags at him as a parent. This is probably a projection of the “am I normal?” anxiety into the child as an extension of self. The question is an anxious one about stigma and the perceived need not to exhibit distress for fear of humiliation. Patients worry about being mad and want to be reassured that seeing a therapist doesn’t necessarily equal insanity (it equals distress). Parents want their children to flourish in what can be intimidating and stressful surroundings. Is it normal not to be able to cope with life? Is it normal to struggle at school? Obviously, yes. What is less normal is to feel able to admit to not coping, feeling confused and overwhelmed, stressed and anxious, to ask for help. Given that different societies and even different schools next door to each other, demand very different attitudes and behaviours, it is near impossible to feel completely normal, especially when we are struggling. A lot of therapy involves accepting what we are actually like instead of punishing ourselves for not being how we’ve been taught we ought to be (usually an impossible ideal of perfection and emotional neutrality). Are you normal? Almost certainly, but the better question would be: do you feel OK?
