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Tuesday, September 1, 2015

Making of a Child Psychiatrist: (19) Back to School

As I noted earlier, I have always had a healthy interest in sex, and had explored the school library for information. Of course Freud in his ‘Psychopathology…’ book (as in much earlier material) reflects that many of the occasions we have problems in life, like forgetting or slips of the tongue, or anxious-making dreams, are related to unacceptable or unwanted ideas coming into to our minds unbidden, and thence being rejected. Given his era, and Victorian taboo, he relates much of this to sexuality. I am sure this has been true in my own life as well.
There is a whole chapter in his book given over to ‘Childhood and Screen Memories’, and I was enthralled. I am certain that reading this began an exploration of my ‘4% syndrome’. I have described this earlier, in a nutshell my belief that I would never be good enough to please my father. This ostensibly originated 4 years earlier at the end of my first year of high school. I believe, in fact, it draws on much earlier material. I think the repeated feeling associated with the ‘syndrome’ is of being a failure and, although this may surprise the reader (given where I got to in my professional career), I have often felt this sense of inadequacy very strongly.
On the face of it the ‘screen’ was about never being able to please. In fact I think it represents my very strong feelings of hating my father relating to that time, feelings I was well aware of at the time, and embarrassed to even consider. Every thing I did at home seemed wrong. I was constantly being criticised. I can remember quite clearly wishing he would not arrive home, would have some sort of accident. I preferred it when he was away, because we (my sister Andrea and I) had our mother to ourselves, and she had always been soft and caring, a natural foil for Mr. Irritable.
But Freud’s book made me think that perhaps my manner toward my father was at least partially to blame. I tried to avoid discussing things with him, tried to be busy elsewhere, thought his advice was unhelpful. And I am certain I knew, at the time, where that came from, even if the full story took me time and distance to totally unravel. My father was posted to Manston in Kent in 1945, and organised accommodation for us in Westgate, but in February 1945 (when I was 10 months) he was posted to Egypt, and not allowed to return until August of 1948, when I was just over 4 years old. My mother’s mother, a sole parent since my grandfather’s death in 1921, died in October of 1945 from cancer, 8 months after my father had gone overseas. I would have been 18 months old, my vague memory being one of kicking crunchy ‘gravel’ underfoot at a time of sadness (maybe linked to a photo from the time). My memory tells me that my mother and I subsequently became very close; perhaps to be expected. She was bereft, with initially little local support, and I was her sole companion. And she was mine. I think my story, from an earlier chapter, of being rude to a kindly elderly gentlemen, says it all: “She is mine; go away!”
So I have strong images from being in the flat with my mother, being physically close, and sleeping in her bed from time to time. There is an oft-repeated apocryphal story from shortly after my father returned. He told me to do something. I turned to my mother, and said: “Do I have to do what that man says?” No recognition of a bond. This was ‘a stranger, an older male who had stolen my mother’. I know deep down that the resentful feelings date from that time. I wanted him out the house. I wanted her back. So in retrospect, I think the meaning of my ‘4% syndrome’ is something close to my father intimating: “You will never be good enough to take on your mother, while I am here”. All beautiful ‘oedipal’!
So, in reading Freud’s book, I know I gained some early insight to the situation, even if it took further working and reworking it through my early life.
Did I feel guilt at the time; that is at 16? I think what had happened is that I had already made a strong transfer of affection over about 2 years to Jan, who was to become my life partner. I had begun a process of being accepted into her family, in particular by her father, Reg, who was a benign and gentle man, always open and keen to share his skills. He also appeared to appreciate having a boy begin to join his family of three daughters, having always wanted a son. I spent as much of my time as I could around the Hughes family. I was included far more than might be expected. I joined the family for a ‘first ever’ skiing holiday in Leysin, near Geneva in Switzerland when 15, and the following year for a large Hughes extended family skiing holiday in Saas Fee, near Zermatt in Switzerland when 16. These are stories we may or may not explore as this book unfolds.
Let me just return to Freud’s book, and a wonderful chapter on ‘bungled actions’. When I first read this, it resonated strongly. I have already told the story about my woodworking skills, and the time I ‘chiselled my hand’ at home. My father had told me how to hold his chisel, and never to point it at parts of yourself or anyone else. We had been taught this at school in second year, and I was irritated by my father’s advice, however well-meaning. Within minutes I had opened up a gash in my left hand. This example came back to my 16-year old self, and I immediately knew that I was prone to setting things up in such a way as to get it wrong, especially if I felt that I did not deserve whatever was going on in the context. It was a message to my cocky self: “You think you are so clever, but see, you are not as good as you think you are!”
The example I gave before regarding the fluorescein in the fish tank was another example, and I recognised this immediately when reading the chapter. I had been the last person in the biology lab the afternoon before, when I put the fluorescein in, and several people would have noted that, including the biology teacher. We had been using fluorescein to stain some samples a couple of days before, and I had joked about the yellow fingers. I knew I had done something bad. I think at some level I must have known the fish might die. But there was more. Mr. Bateman had recently told me I was not performing well, and that if I did not pull my socks up, I would fail biology. I was angry with him, but knew he was right. I was more angry with myself, for being so lazy and distracted. I set myself up to be discovered.
So, does Freud’s little book have relevance in today’s Child Psychiatry? Over the years in my teaching I have tried to instil some of these basic ideas related to the unconscious, and sent generations back to the original book on advice that it is a ‘fun’ book with serious implications. I have no idea how many would have had the time or inclination to work at understanding the richness the book gives us in our daily work with people struggling to understand themselves and others.
So let me give you one example from my current practice, and you can make up your own minds whether it is worth the journey. DT is an ex-serviceman who saw some dreadful events in his time overseas. One image that remains with him is that of a small child who had lost a foot in an IED explosion. He does not know if she lived or died, and has talked about returning to find out, such is the depth of his feeling, and his need to move on. DT reports recurrent dreams about this that severely trouble him and that he cannot shake off. In a recent one he saw the image of his daughter, now a similar age to the other child, superimposed on the dead child. He shook, and wept. We discussed the images and other details further, and he could make no sense of them. Tentatively, I wondered whether the mingling of images was important to him. Could it be that he feared that his daughter might be damaged in a similar way, and that if the other child had died, it would somehow increase the chance his daughter might die. He sat bemused for moments, burst into tears again, and then slowly relaxed staring at me intently. He heaved a sigh. “How could you have worked that out? That feels so right...” We went on to discuss the dream again in some depth, and then other matters. As I understand it the dream, and its power to terrify, have not returned.

I believe that my journey to be able to work with this man and his multiple traumas, began when I was 16.

More to come...

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