Therapy Works: Our Lives Are Full of Meaning

I have a client, Jack, who first came to see me after a serious suicide attempt. Serious in this instance meaning that the means for suicide were deadly and Jack sincerely meant to use the deadly means. I am someone, among others who know him, who is glad he did not succeed.

Jack seems to feel quite strongly, as he spoke the first time we met, “I have had a good run. Nothing will ever be as good again as it has been.”

Jack often refers to therapy in playful, bordering-on-sarcastic terms that I am “the person [he] has to pay to listen to [his] stories.” I will say here as I often reply to Jack… I LIKE listening to Jack and his stories and his aliveness. And there IS aliveness in him.

Yet, Jack has a strong tendency, lifelong it appears, to see himself as a man who has had big aspirations and never met them, instead choosing a small, meaningless life. And the increasing difficulties of aging, of dealing with progressive physical limitations, are life events that Jack perceives as evidence that his best is in the past.

A true pain for Jack is his internal sense of his diminishing mental powers. He is quite detail oriented in relaying stories and he likes to remember specific names of people, places, events. A time or two in each session Jack will get quiet, serious, give a little disgusted guffaw at himself and think hard about a detail that is not coming easily to his mind. I have made clear to him my view that his memory for detail is Well Above Average as is and that I would not view these moments of not recalling particular facts as mental slippage so much as appropriate looseness about details that may not be necessary.

For example, I have told Jack the story I have heard told about Albert Einstein. Someone asked him for his telephone number and he looked in the phone book to retrieve it and the person said, “Here you are the smartest person in the world and you don’t even know your own phone number?” and Einstein is reported to have replied, “Why would I need to keep that detail in my head when I know where to look to get the information?” Nice story. It is helpful to me in letting myself not attend to certain facts at certain times. The story appears to have left Jack entirely unmoved. Not surprising … because his negative take on his declining mental powers is a major part of his way of understanding his life in these years. On this issue of recalling details, Jack is adamant in relaying, “A few years ago, I would have known that detail immediately.” And, of course, he may be right. And a major cause of the change may be that his cognitive powers are slipping, perhaps even dramatically.

Yet, there is also the possibility that the things Jack has trouble remembering are psychologically meaningful. I am thinking of the now-familiar idea of what are often called “Freudian slips.” While we use the term easily enough, I believe there are few of us willing to doggedly trust in the meaningfulness of our Unconscious, to dig into moments when we forget a name, a place, a word or phrase that we are sure we have had recollection of previously, and then to see what meaning these seeming lapses may suggest. Jack is particularly uninterested, to date, in what his memory pauses/difficulties may say to him about himself. I believe this is because he is rather over-committed to the idea that these moments point to his decline and dimunition. I will not go down to hopelessness with him, especially when there seems to me to be plenty of meaning calling for attention from his memory lapse moments.

Three weeks ago he came to his weekly session shaking his head and grousing that he had several hours one day that week when he just could not think of the word “eclipse.” (Note that he remembered the event and the word at session time.) He was clearly concerned, as he often mentions, that these moments are signs of impending Alzheimer’s disease – which Jack considers a fate worse than death … to be alive without the razor-like wit and mental power that has guided and guarded him.

I submit that this is a rather remarkably insightful beginning to a therapy session. Indeed, if I needed a core image of the help that Jack needs to live a better life, it may be to simply understand that he feels that his light, his power, his energy is “eclipsed,” blocked, limited.

And as I write this, perhaps you too feel with me a surge of hopefulness. Why? Because it strikes me to think on the nature of eclipses. The word eclipse itself indicates that there is a celestial light source, a sun, that is steady and trustworthy, but that can, at times, have something come between itself and the viewer. This isn’t a bad image of Jack’s life. He has a fairly bright source of liveliness, yet he feels keenly that other objects have gotten between him and his light source and he feels hopeless. Yet, the very word he simply could not remember, eclipse, has a meaning for him. Eclipses are temporary. They pass. The sun shines again, and usually sooner rather than much later. The sky can look dark just now Jack, yet your light need not, will not, be blocked permanently.

The very next session Jack came in with unusual energy and focus. He took his seat and without preamble stated that he was depressed because on his way into the session he had heard mention of Charlie Chaplin and that Chaplin’s “Little Tramp” character is considered by many to be an embodiment of the longings of many little folks to have success/joy/connection/happiness in life. Jack went on to explain his unhappiness. Hearing of Charlie Chaplin reminded him of a character he had read stories about in The New Yorker and all he could remember was that the last name seemed like “Itty.” The only meaning Jack attached to this episode is that his “God damned memory is fading.”

It turns out I have read some of the stories about Walter Mitty. I let Jack sit with his frustration about remembering the name a few moments but then felt best to tell him that, “I think I know the name, would you like me to tell you?” He did. Next he wanted to recall the name of the author. Neither of us could recall, yet by working together we came to the name “Thurow,” which both of us knew wasn’t exactly right yet each of us felt was fairly close. (I enjoyed that later that day I had a phone call on my business phone and the only words spoken on the message, and again you may anticipate this if you have heard of Walter Mitty, the only words were the author’s name: “James Thurber.” That Jack would follow up on the name and call me to tell me – not the first time he has done this, by the way – is a testament to his exactitude about such recollections. Which is, to my mind, a neat characteristic of his. And too, there is still the compelling meaning of the memory slippages themselves.)

I submit that for two weeks running the events that Jack brought immediately into his sessions, both of which for him at the conscious level were about declining powers of memory, were and are tremendously meaningful statements about Jack’s state of mind and emotions. First, he is eclipsed (and the redeeming implication that eclipses are not permanent). Second, we may have a glimpse into the winsome longings and hopes and fears of the man who is Jack. He, like Chaplin’s Little Tramp and like Thurber’s Walter Mitty, is an ordinary or even seemingly less-than-ordinary fellow with Big Dreams!

A moment to say what I recall about Walter Mitty. Walter Mitty was a character James Thurber created who felt bored by his work and dominated by his wife. Mitty was prone to moments of deep daydreaming where he would imagine himself in various heroic roles. Once as the Captain of a ship I recall him saying, “We’re going through!” “But we can’t make it,” the fearful crew members cry out. “We’re going through,” the intrepid Mitty replies as he successfully navigates through the sea adventure. Walter Mitty responded to his deeply felt dreams by pulling them inside of himself and fantasizing. Listening to Jack recalling this character yet slightly mis-recalling his name as “Itty” – as in “itty bitty”? – I think suggests that a fruitful area for Jack’s therapy is to explore the dreams Jack has had for his life, how he has relegated them to the world of fantasy, and how he may reenergize his life to some degree by dreaming of what is possible for him given his real life limitations and real life abilities.

Ultimately, in this case, what is most significant is what Jack is willing to see and feel and envision for his own life. And therapy with Jack is at most times a slogging forward rather than a triumphant leaping from insight to insight. This seems only natural since Jack has had a lifetime to acquire the habits of seeing himself and the world in the ways that he does. Therapy often seems to require a kind of patience and dogged faith in the patient from the therapist. In Jack’s case it comes rather easily to me, since to me he is such a likable, interesting human being.

So, I will hold onto a sense that Jack’s memory “lapses” have more meaning than merely memory diminishment. When he forgets something, particularly something that nags at him and he has the felt sense that he does know and should recall this particular detail, it is a time to Pay Attention, rather than engage in self-judgment and anxiety. And I believe that even if Jack himself rejects such understandings of himself, that my holding this view of him and his lapses is meaningfully helpful to him.

(Time for a short story. Have you the reader seen the movie, “Silence of the Lambs,” with Jodie Foster? In it, she interviews Hannibal Lecter and he, as a psychiatrist, is able to see things about her and her past and pick at her in ways that bring her to tears. I have always found it meaningful thinking of how she pulls herself upright and redirects him by saying, “You see a lot, Doctor. Now, are you willing to direct that laser like intellect back on yourself?” I recall this story at times when I want to withdraw my projections and externalizations and refocus my attention on the one person I can work with best: myself. In a similar way, I like to think of Jack with his powerful mind and his powerful defenses making a conscious decision to use the strength of his mind to understand himself and to increase his freedom in his remaining days of living into greater self-understanding, self-compassion, and self-expression.)

For myself as a therapist and as a person, I know that whatever Jack is able to understand and take in about his unconscious life and meanings, no matter what Jack may or may not gather for himself … I will be grateful to him for giving me the examples of an Eclipse and the Little Tramp and Walter Mitty. These insightful images of hopeful hearts yearning for meaningful, adventurous, alive lives, especially as these images came in the guise of mere memory lapses, these examples remind me to look for the meanings in ALL of my experiences of life.