Life of the mind: The talking cure

"When we have words to describe our emotional state, things immediately feel more manageable"
February 15, 2017

My teenaged son phoned me up on his way home from school last week. I was in rural Iceland and walking back to my little hut in a blizzard, having just been for a swim in a hot, eggy outdoor pool and watched a group of women in bikinis doing aqua aerobics in steam and snow. Their instructor, shouting through the snowstorm from the side, was in full ski gear. I felt a very long way away from the boy calling.

He had a bad cold and told me he felt dizzy and his legs didn’t work properly. He sounded OK so I wasn’t worried, but I said he should get home, have toast and watch telly from under the duvet. “You feel a bit wobbly,” I said. “People quite often say they feel a bit wobbly when they’re ill or upset.” He was pleased with this and agreed that “wobbly” was exactly how he felt. Then we chatted about school and lava fields until he got home.

This is already turning into one of those annoying shrinky essays I hate. Therapist relates the details (always fictionalised anyway) of a very disturbed patient and then tells us the brilliant interpretation he/she offered after which the patient was completely cured. Yuh.

Anyway, it occurred to me that when we are trying to comfort or calm someone we offer interpretations in quite a psychotherapeutic way without knowing it. Or, rather, that psychotherapeutic interpretations are an extension of the way we (in the best circumstances) speak to each other already.

When we have words to describe our emotional state, things immediately feel more manageable. Obviously this is easier said than done. I have a patient who has no idea whether or not she likes or dislikes types of food, people, physical sensations, whether or not she is really in pain—she has no vocabulary for this stuff. Defining what it is we hate and fear in President Trump and writing it on a sign feels therapeutic, especially when we find we are not alone. (Whether or not it has any effect on the man and his activities…).

On my first visit to a psychotherapist in 1989, I told her about the chronic hypochondria that kept me awake at night and the feeling of impending doom that overwhelmed me at dusk (early afternoon in an English winter). At the end of our session she told me I was suffering from “existential angst and chronic separation anxiety.” I didn’t really know what this meant and I still don’t. (Separation anxiety is one of those shrinky phrases that is overused to the point of meaninglessness), but I was pleased to have a name for my terrifying symptoms.

One can (and many do) go a lot further with this. Jacques Lacan and Jacques Derrida wrote extensively on how language distances us from our real thoughts and feelings in an almost defensive way (the fact that it makes us feel better to have named something, perhaps is even indicative of that), and the “différance” of Derrida has a lot in common with the “unthought known” of Christopher Bollas—that is, the moment between feeling and its expression that psychoanalysis tries to capture.

However, when someone says “I’ve got a terrible headache,” and we say “You’re probably very stressed,” or “You must be tired after all that work/travel/whatever,” we’re trying to repackage something into a digestible form that will make the symptom of the sufferer more bearable. This (as opposed to “Take a paracetamol” which would be the equivalent of “Here’s some anti-depressants”) is perhaps the basis of psychotherapeutic interpretation.