by Bev Thomas
There was also a small hospital wrist band. Dated two years after the birth certificate. He tells me there were no more photos after that.
‘It was as if time stopped.’
‘What happened?’
‘I don’t know,’ he sighs. ‘I guess he got sick. Went into hospital. Never came out.’
‘You have no memories of him at all?’
He shakes his head.
There’s a pause. He looks preoccupied. Then after a few moments of contemplation, it’s as if he makes a decision. He reaches into his pocket, with a careful slow movement.
‘I’ve never shown this to anyone else,’ he says.
He pulls out a photograph that he places on the table. He nudges it towards me and looks up at me. A face that’s expectant. I feel the weight of anticipation.
It’s a picture of a woman with a baby, taken side on.
‘May I?’ I say, reaching for it.
He nods.
The woman has long dark hair and she’s lifting the baby into the air. The baby’s in a blue romper suit. His face is stretched into a big gurgle of a smile. The two of them are locked in a gaze. There are people in the background, but it’s as if no one else is there. Her arms are lifting him up, and the baby is reaching his hands in to pat her cheeks. They are both laughing and smiling at each other. A picture of joy. Their faces transfixed. Like a bright white beam of love was flowing between them.
‘My mum and Michael,’ he says. ‘You can almost feel it – can’t you? Their love. Their happiness,’ he says. ‘How could I compete with that? How could anyone compete with that?’
There’s a palpable heaviness in the room.
He tells me about finding the picture. ‘Suddenly, it all made sense. Everything fell into place.’
He said at first he felt like he couldn’t breathe. ‘I was dizzy and giddy, like I was going to fall.’ Then he said he felt relief. Realised that all his efforts were pointless. That anything he did or didn’t do was never going to make a difference.
He leans forwards. ‘It was my Third Act Epiphany,’ he says theatrically. ‘I stole it that day, slipped it into the pocket of my shorts. She must have known it was missing – but she never mentioned it. Michael’s name was never mentioned in our house. And yet after that, I could feel him in the house. The emptiness. The void. The gap. It was him.’
I stare down at the picture, still pinched between my fingers. I think about Nicholas. Tom as a baby. Michael and his mother. It’s an undeniably happy picture. But while she is looking at Michael, she is not looking at Dan. I feel a wave of unbearable sadness. For the mother. For the tragedy that felled this family. And for Dan. The small boy left behind. Uncertain, anxious, bewildered and desperate for his mother’s love. Trying constantly to find ways to get the spotlight of her love, her interest, and then her care, to be turned back on him. Yet whatever he did, the light didn’t shine his way. I feel the well of tears. The heaviness of his loss and how his desperation calcified into self-loathing that became wilful acts of self-harm.
‘I’m so sorry,’ I say.
His head is down. He rubs at his eyes.
‘And when you saw this picture – did you remember anything?’
A small shake of his head.
‘It explained everything, though. The feeling I had growing up. That there was always something missing.’
We sit for a moment in silence.
‘The death of a child is traumatic,’ I say, ‘but what you describe are parents who seemed unable to recover from their trauma. Seemed unable to fulfil the basic job of parenting. To love and care for and protect their child. It was negligence that was a form of abuse.’
I’m conscious of saying the word again. Gently this time. The need to nudge it back into the room.
‘It sounds like they were traumatised by their grief. Do you think it’s possible that your mother was depressed? And unable to care for you as a result?’
He pauses. ‘I’ve thought about that. And I’d like to say that was true – but I have memories of my parents together. Happy. Just the two of them. Sometimes, I imagine the death of a child can make the surviving child more precious. It was the opposite with me. I think it would have been easier if they’d been left with no children.’
There’s a long silence.
He tells me that in the days after he’d seen the picture, after the initial relief, he had other sorts of feelings. ‘An ache,’ he says and he puts a hand on his belly, ‘and it spread all the way up, until I could hardly eat or speak. I kept looking at the picture of Michael. I felt so jealous.’
He shrugs. ‘That’s when I decided to let it go.’
‘Let it go?’
‘I started to cut myself. It was a release. The bad feeling calmed right down.’
‘And what were you feeling?’
‘Rage,’ he says.
‘So, the bad feeling, the rage – was turned on yourself?’
He nods.
‘The joy of family life,’ and as he sits back in his chair, he makes a gentle hissing sound.
He sees my frown.
‘Sophie’s choice? There’s always one kid that gets sent to the gas chamber,’ he says.
‘Is that what it felt like?’ I ask. ‘A death sentence, not to be chosen?’
He looks down at his fingers, picking at the skin around his nails. He pulls sharply and blood rushes to the surface in a small crescent of red.
When he asks the question, it comes out of nowhere and lands with a thud in my chest.
‘Do you have kids?’ he asks casually, all eyes on me.
In that moment, I see a small boy getting himself lost at the fairground while his parents looked the other way. I think of the photograph. A mother and baby son shining with happiness. The glow of love that never came his way. I look at his face. It looks pleading, desperate.
Do you have kids?
‘No,’ I say, shaking my head, ‘I don’t.’
He raises his finger to his lips and sucks the blood away.
*
As I walk to Robert’s after the session, the lie sits heavy on my chest. I turn the moment over and over in my head. I think of all the ways I could have answered the question. I think of all the ways I have answered the question in the past.
Sometimes it’s been buried in a series of questions that sound casual and nonchalant. ‘Are you married? Where are you going on holiday? Do you cycle to work, or get the bus? Do you live locally?’ The seemingly innocuous questions are all about power. One of my patients, Ellen Taylor, whose daughter was critically ill in hospital, was able to put it into words. ‘You know the terrible thoughts I have. The things I want to do to myself. The despair I feel. You know things my closest friends don’t know. You know everything about me – and I know nothing about you. I don’t even know if you have children.’
Sometimes, the question can feel more accusatory, as it once did in a mother and baby unit with sleep-deprived mothers. I was helping them develop sleep routines for their babies, a task that was challenging, given their own complex issues around attachment and abandonment. Trish, the mother who sat in front of me, had dark rims under her eyes. Her eyes swam in front of the charts I’d asked her to fill in the preceding week. ‘Do you even have a baby?’ she snapped.
Usually, questions that probe the personal life of a therapist are not searching for concrete answers. They hint at something more elusive. An unconscious search for certainty, safety and trust. The flesh and bones of real children aren’t the issue. It’s about being an imagined child. It’s about their own experience of being parented. The issue is more about their concern, their terror. Will you be there for me? Can you help? Can I trust you? Can you be a good enough mother to me through this experience? Will you let me down as others have done in the past? The rule of thumb is to understand the meaning behind the question. To use it in the work. To think beyond the pull to answer the concrete question. The rule of thumb is not to lie.
*
>
When I’m sitting with Robert, I tell him all about the last two sessions with Dan. I tell him about the sad loneliness of his childhood. I talk about his parents. The curious way he described their abusive and neglectful behaviour, ‘indifferent’, and ‘not to their taste’. We talk about the revelation of a dead brother. His parents’ grief. How they were unable to think of his needs. ‘They seemed not to care. They were negligent,’ I say, more fiercely than I’d intended.
I describe Dan’s self-harm, and as I do, the image that haunts me returns. A small boy alone in the kitchen, rooting through the cupboards for sharp utensils. I tell the fairground story and as I talk, I notice how Robert sits forwards on his chair. He stops writing notes. He places his hands carefully in his lap, as if to give me his full attention.
‘I’m sure there are other worse things,’ I say. ‘I feel a kind of dread of what might come next.’
I pause to clear my throat. There’s a stillness in the room as Robert waits.
‘I’m not sure I want to hear about them.’
Robert nods thoughtfully. He makes no comment, but I see him squirrelling it away.
Robert talks about self-harm as a defence against emotions that can feel overwhelming.
‘Like the rage?’
He nods. ‘He’ll have a fantasy that his rage will be out of control. Unmanageable. Annihilating. Easier to simply block it off, through pain.’
He thinks for a moment. ‘He was six, you say, when he first hurt himself?’
I nod.
‘Young,’ he says. ‘It’s unusual. And worrying.’ He takes off his glasses and cleans them as he thinks.
‘Putting himself at risk in the ways you’ve described, it’s like a “death wish”,’ he says.
We talk about his compartmentalisation.
‘Splitting off his rage seemed to work well for him – until the rape. Then everything caved in. It opened the lid,’ I say, ‘no wonder it was traumatic.’
‘Sometimes there’s a predominant feeling – was there one for him around the rape? Did you get a sense of that?’
I think back to the session.
‘He talked about feeling small … and powerless …’
I stop for a moment, remembering. ‘There was a thing with a lighter. A fear that he was going to be burned. He wasn’t – but he talked about a strong sense of shame.’
‘Shame?’
‘It’s been a theme,’ I nod, ‘that he’s to blame. Is responsible in some way.’
‘For the rape?’
‘Yes – but also the way his mother behaved. In one session, he talked about karma. Then denied it the next.’
Robert makes a note, then he’s quiet as he flicks back over the pages, re-reading notes from our previous sessions.
‘And what do you feel?’
‘Lots of things – but at the moment, pulled in to help him. To look after him.’
He nods. ‘To be the mother he didn’t have. He was young when he shut down.’
To be the mother he didn’t have.
I tell him about the gifts. ‘Anonymous,’ I say, ‘but I’m pretty sure they’re from him. Plants first. Then a hamster.’
‘A hamster?’ he repeats, his eyebrows rising in surprise.
I nod.
He thinks for a moment.
‘He gives you living things to look after. To keep alive. Can you take care of him? – he wants to know.’
I’m careful with the next bit, when I tell him how the story about his childhood left me full of his anger. ‘I felt a sense of outrage. It was the way he was telling the story. Excusing their behaviour. Protecting his mother.’ I fiddle with the edge of my jumper. ‘It was powerful. I got very caught up in something. Like I was left holding all the bad angry feelings. Like a bomb in my lap.’
‘That will be your focus,’ he agrees, ‘handing him back the bomb. Helping him understand that it doesn’t have to go off. Doesn’t have to annihilate him.’
There seems to be something that’s troubling Robert, something he can’t quite work out.
‘Any relationships?’
‘He mentioned someone. A woman. But he didn’t elaborate.’ I shake my head. ‘He seems ambivalent about friendships. He’s been let down.’
‘And his attachment issues – how do they manifest in the room with you?’
‘The usual,’ I shrug. ‘He retreats and withdraws. He came late one day. Early another.’
I tell him how it’s taken time for him to trust the process, that it’s only now I feel like he’s present in the room, willing to engage and work. But that it feels fragile – could turn at any moment.
‘Nothing else?’
I tell him he wanted to be offered more than the standard six sessions.
‘What did you say?’
‘I offered him more. I think it was about trust. I wanted him to commit to the process.’
I feel myself over-explaining, but if Robert notices, or thinks it odd, he makes no comment. Another nut to store away.
‘Any other attempts to push boundaries in the session?’
I shake my head. ‘Not so far,’ I say, and my stomach feels leaden.
Do you have kids?
It’s as if the lie I told Dan sits between us in the room. It grows bigger, taking on a shape of its own, calling for attention, like a demanding child. I feel uncomfortable in my seat. My cheeks flush. My throat feels dry. I reach for the glass of water.
‘Are you all right?’ Robert enquires gently, and he asks with such kindness and concern that I have the sudden urge to tell him what’s happened. Instead, I flap a hand in front of my face. ‘It’s hot,’ I say. And perhaps it’s his disinclination to probe into what might be the uncharted territory of a menopausal woman, but he doesn’t press me further, and simply reaches behind him to open the window.
The guilt burns my cheeks. In an attempt to hide my face, I reach down for a pen from my bag.
I’ve never lied to a patient before. I lied because he was desperate.
I lied because I wanted him to feel special.
I lied because I wanted to feel special to him.
‘Any recent self-harm?’
‘He still cuts regularly. But it’s controlled. I’d categorise him “low risk”.’
Robert waits for a moment.
‘Seems highly unlikely this man has got to adulthood without his defences breaking down. What about his previous contact with mental health services? Any hospitalisation in the past?’
And that’s when it happens. That stricken hollow feeling.
‘I haven’t seen his notes yet,’ I say.
There’s a beat. Robert looks up, surprised.
‘I keep missing the GP,’ I say, ‘there seems to be a problem with getting the notes from the previous practice. The one in Bristol. There was an admin person off sick.’ I hear the excuses. The edge of defensiveness in my voice. ‘It sounds like an administrative error. The place in Bristol’s a small single-handed practice,’ I add, ‘probably still operating paper notes. In the process of updating to an electronic system. Welcome to the twenty-first century.’
Robert nods. It feels cursory. ‘Well, as you know, it would be useful to get hold of them,’ he says, looking directly at me, ‘as soon as possible.’
I feel admonished. Unprepared. Like a child in class without a pencil case.
Perhaps it’s my guilt, my keenness to move away from the thing I have not done well, but I find myself moving on to the film references. And as I do, it strikes me that I am using them in the session with Robert in much the same way as Dan does in his sessions with me. A barrier. A block to feeling exposed.
‘I’m still struggling with all these film references,’ I say, flipping open my file. ‘I feel pulled in. I’m still finding them confusing. I said I felt they were a distraction.’
‘How did he respond?’
‘He was angry. Said if I paid more attention to the films, I might find them a revelation.’
&nbs
p; ‘A revelation?’
‘Yes.’
Robert asks me to list the ones I remember.
‘They seem so random,’ I say, ‘mostly old films. Classics. Not much that’s recent – last session he talked about Sophie’s Choice,’ I say, ‘then there was Dead Poets Society. Ordinary People – he’s mentioned a few times. He’s writing up an essay on it. Thelma and Louise,’ I add, remembering his trip to West Wittering that I’m now not sure he ever took.
‘There are others – I don’t really remember. Early on, there was One Flew Over the Cuckoo’s Nest,’ I say. ‘He mentioned Billy something or other, he likened himself to this character, after he’d had the severe panic attack in our session. Each time, I’m busy trying to remember the film and he’s whoosh – he’s onto something else – and yet, I keep being drawn back to them as if—’
‘Billy Bibbit,’ Robert interrupts, ‘the character in Cuckoo’s Nest.’
I nod. ‘That’s him.’
‘I don’t know all the films,’ he says, ‘but I know this one very well. He’s a patient. And along with others, he’s given a new lease of life when the McMurphy character, Jack Nicholson, comes into the ward. At the end, Billy sleeps with one of the girls McMurphy has smuggled in. He’s made to feel dreadful shame by Nurse Ratched. She tells Billy she’ll have to tell his mother. For Billy, it’s the very worst thing. The shame, the notion of both disappointing her and being rejected by his mother, is too much. He kills himself.’
I’m startled by his words. ‘Kills himself?’
I’m in the conversation, making all the right sounds and noises, but my desire to leave the room is so intense, I’m not really concentrating at all. The information that he gives me does not land. Instead, it floats off, as my mind stays firmly focused on the clock behind his head.
‘See if you can get a push on those medical notes,’ he says as we both stand up. ‘I can’t help feel there’s a piece missing.’
I move towards the door.