Psychotherapy – some thoughts

When I worked as a psychiatrist, I would sometimes have a medical student attached to the firm for two months, and the student would sit in on many of my clinics. At the end of one attachment I was surprised by a student who asked me ‘So what is psychotherapy?’ I thought it had been obvious that in forming a rapport, and listening attentively, with occasional interventions either for clarification or to reflect back tensions and contradictions, I was practising a simple form of psychotherapy. (Perhaps students had been in my blind spot as I used to focus hard on my patients. At least it only happened once). As a hard pressed NHS adult psychiatrist, my opportunities for work over many sessions, sometimes over years, were limited, although I did always try and have one or two long cases going.

I have written one poem, which tries to convey something of the process of psychotherapy. It came about after I had seen a splendid exhibition in Bristol about the two brothers and artists Paul and John Nash who were both traumatised by their mother’s severe mental illness, and then further by involvement as combatants and artists in the Great War. The poem is an imagined monologue by John (1893-1977) after the death of his brother Paul (1889-1946), reflecting on the crucial role Paul played in helping him through his difficult early life. For two reasons the exhibition put me in mind of my late father. His own mother had also had a severe mental illness which had left its marks. Secondly, in the exhibition was a watercolour and ink picture by Paul, called Tench Pond in a Gale. One of my father’s fondest childhood memories was of catching a tench in a net in a pond in Hadley Wood, taking it home and keeping it for several years in the garden pond.

I should mention that an excellent book, Brothers in Arms by Paul Gough and published by Sansom and Co. published to coincide with the Exhibition in 2014 provided background for the writing of the poem, Death of an Older Brother.

I will post the entire poem on my next blog. Here is a short extract set out as prose:-

There were gaps, of course, some overlapping, some uniquely one’s own…Looking back it’s as if there’s dead ground, an absence that drags. And stories, like the ones we found we could tell as we told them… Syntax isn’t a net which can lift a tench from a pond, no amount of telling makes things so.

Finally – professionals working with people with mental health problems should be mindful that these hurting individuals don’t just come to see us, they come to be seen.

Published by davidcookpoet

I am a husband, father and grandfather. I retired from a busy working life as an adult psychiatrist in 2014. My interests are in literature, philosophy, modern jazz and horse racing. I might represent those four fields by Shakespeare, Kant, Charlie Parker and Lester Piggott. Like nearly all of us, I can identify a number of formative experiences, one of which was a psychotic episode in my first year as a psychiatrist. This reinforced an already established interest in mystical experience, and a sense of how little human beings know. My intellectual bugbear is reductive materialism, and I am surprised at the lack of moral imagination of those who promulgate such views. It seems to me they need to consider ,perhaps by exposure, just why totalitarianism is so horrific.

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