Lost and Losted
A few days after 9/11 my wife and I drove to New York City to be with our daughters, one of whom had just started college, the other who had begun a new job at City Hall. The horror of the moment hung in the air—the world seemed to be coming apart at the seams—and we all needed to be together. We stayed at a favorite hotel, one with a familiar comfort that we badly needed. The city was still, calm; everyone quietly heartbroken, friendly, concerned, even courteous—respectful of whatever the other might be going through. We were all family.
Usually bustling, our hotel was only partly full, a crash pad mostly for exhausted relief workers searching around the clock through the rubble, hoping to find life, hoping to find anything at all. But the mission was not going well—and this was just now beginning to sink in: some people had fallen—or jumped—out of the towers, but others seemed erased, literally vaporized. Still, at the end of the day a search dog of remarkable charisma and warmth, a big black Labrador, greeted everyone in the lobby as if she were its host. People smiled at her wagging exuberance. We needed her vitality. Her owner had come from Canada to help out, and I felt grateful to them both.
A few days later, headed back to Boston, I bumped into the search worker and his dog. I patted the dog and thanked the searcher for helping out, telling him how much I appreciated his putting himself on the line: it must, I said, be hard. No, he replied, he was OK, it wasn’t too much for him, he had experience with disasters, but he worried about his dog. She is trained to find survivors, or at least bodies, but day after day they were coming up empty handed, finding no one at all—and she was becoming palpably depressed. Realizing she needed some urgent relief, some therapy, the wise owner and his team decided to hide—to bury—living search workers in the rubble so that his dog might find them. They knew her well, and they got it right—she perked up. And this also helped me understand her joy in greeting everyone at the hotel: finding us, that too was a kind of therapy.
This tail-wagging dog still remains a surprising memory for me, an uncanny condensed symbol that I come back to time and again. I still don’t know what it means, but surely this remarkable creature intuited the terrible sense of something wrong: for me she is an uncanny presence. The uncanny, by its nature, marks the moment when the world becomes strange and unstable, when we feel the familiar ground beneath us tremble. Trained to search for those gone missing, yes, I get her urgency. Maybe, we are not so different.
Lost and falling, the feeling that life is disorienting: none of us escapes the experience; strangeness shadows the human condition. For those clinicians who venture on to inpatient wards, lost-ness and the dense haze of strangeness are all around—and finding the other takes on a special urgency. Yet what does it mean to “find” another? And what does it feel like to find—and to be found? Feeling lost, one can also feel lost to oneself. And is this lost-ness to oneself also a way the unconscious speaks to us? Surely feeling lost is at the heart of our existential search for grounding. And so how does one find oneself? And why is another so important in this self-search?
This paper finds its grounding in two clinical moments, brief encounters on an inpatient ward. The fog of psychosis, desperation, and despair often covers the shock of unbearable feelings that can destroy a person’s world and leave her falling (
Margulies, 2015). But, here can be an opening for the clinician because a crucial, not-yet-spoken, intolerable story is often displayed as both a symptom and a sign, inscribed in the body, an uncanny symbol hidden in plain sight. And here, at this intersection with strangeness, may be a way in, and a way out.
The Scar, Vignette
Not much was known about the medical student’s patient except that he came close in his plan to kill himself—to “slice his neck.” He displayed an old, thick scar to show that he is deadly serious. Just admitted, the patient has a long history of poly-substance abuse, and, in his 50s, he has no work, no friends, and he feels that he is a failure in life. The medical student says, the patient has been tried on a “ton” of medications: large doses of antipsychotics, antidepressants of all classes, anti-anxiety agents—the works.
“A ton of medications:” I see this all of the time on the wards, and, no wonder, the staff is alarmed, and so the range of their pharmacologic interventions is also a sign—a marker—of their desperation, too. Things are dangerously out of control, and how can we help? The brutality of his scar pulls us into urgency. Slicing his neck becomes a shared symptom. Responding, we are inexorably drawn into an unconscious force field that enacts his essential struggle. Are we witnessing the self-staging of his execution? Just who is this man I am about to meet?
As he comes through the door, I’m struck by discrepancies: he seems a proud-shy man, handsome with a rough elegance, but he seems underwater, dazed by his medications—and I wonder if we’ll be able to carry on a conversation, if I will be able to reach through this haze. But, I think, maybe he’s more dazed by life than by the drugs; surely he’s fallen into a nightmare. His shirt collar is opened to an extensive, angry, red scar, it is out there and meant to be seen, defining him and shaping anyone who comes close, whether acknowledged or not. I wonder: will we be able to connect—and do I want to?—do I want go to that place, that symbol, now right here between us?
I thank him for meeting with me and the students, but, I tell him that he seems tired, is it OK for us to talk? He responds quickly, even eagerly—“Sure!”—letting me know that he is struggling to come to the surface toward me. There is a light in his eyes, intelligence shining through and across some gulf. I think of Lazarus, back from the dead, someone in between, liminal, literally on the doorstep between two worlds, vacillating for a moment. No need for chit-chat, I think—here is a man from the depths—and so I ask him: “Just what is it like to come so close to killing yourself, to reach out and touch death by your own hand?”
When he nearly died, he tells me, he felt relief, no pain, and free from all the suffering. Life had become too hard. And here he wells up, sad—then, he gets sadder still, quiet, and struggling to hold back his tears.
“It couldn’t always have been this way,” I say, “there must have been a time when you still had dreams for yourself.”
“Oh yeah,” he responds, “when I was a teenager, I wanted to be a doctor, but that was an impossibility in my environment.”
“Please, tell me, what does that mean?”
He tells me of his father’s abuse and contempt. “He used to scream at me: ‘You’re nothing! And you’ll always be nothing.’ (He’s quiet…) My father hated me. He just hated me.”
“Why?”
His father was mean and nasty, a drunk who would “beat the shit out of me, yelling at me that I was nothing and I’d become nothing.” At some point, he says, “I just gave up, and dropped out of high school.” And with that he got heavy into drugs, a new direction.
I say, “You got the ‘fuck-its.’”
He laughs, “Oh yeah, big time—the ‘fuck-its,” and he partied, quite literally, as if there was no tomorrow.
“Tell me why slicing your neck is the way you wanted to die. It seems so filled with hatred, as if it’s execution style.”
“Oh yeah! I can hate myself. I want to punish and do away with myself (he slashes his hand across his neck), and I call myself names: You bastard!”
I say, “I get it”—because I suddenly do, and so I say: “I’ll bet your father called you names, too.”
“You’re right. Oh yeah! He called me (hotly): ‘you little bastard!’—Yeah!—(coldly) ‘you little bastard.’”
Me, softly: “‘You little bastard’—like you weren’t his son, a ‘bastard’, he disowned you, as if he hated you.”
“Oh yeah, he hated me all right. He hated my guts.”….
It’s now in the room, hate, like a ghost; so I move us inwards: “So, when you want to hurt yourself, kill yourself, and slice your neck, and you start calling yourself a bastard—you’re channeling your father. He’s alive, inside of you. Inside of you, hating you.”
“Yeah … I’m just a little bastard who should die.” Sadness washes over us both—I feel it badly—and he starts to cry softly.
We are both back there—but he is back there, caught. And so now I go towards him, to take him by the hand through words, and to weave us back outwards into the world: “So the scar on your neck, there for everybody to see, is a living symbol of your father’s hating you, and of you hating you. It’s like you’re wearing a sign.”
“… Yeah … I guess it is. I hadn’t thought about it that way … but, yeah … you’re right. And, yeah, I never wanted to hide that scar. I want it out there, all of the time.”
His symptom, I think, is also his badge, his identity, who he is; the scar defines him: He is the damned—and I decide to put this out there:
“So you want others to know, the world to know, of your father’s hating you, of you hating you—it’s a symbol to remind you and everyone else of just who you are: someone to hate.”
“Yeah … I do.” And here he cries.
(His father has come alive in the room, present to us both, a ghost; but father is also part of a scene from the past, replaying like an endless video loop. So, I think, let’s look at this scene together, let’s now go there again, bring it to us and into focus, but more, let’s enter that childhood scene, that memory, together.) And so I say: “When you drink and hate yourself and want to die, and you slice your neck, when you start screaming at yourself, ‘You little bastard!’ at the same time you’re recreating your father inside of you. But you’re also recreating the experience of you as a boy being with your father, how it was back then, and how it felt to you. It’s like you are back there with him, back then.”
Tears run down his face—and it feels as if we are back there, back then, but also right here, right now. He says “Yeah … Yeah … That’s spot on … The whole thing.”
He has taken me to the center of his symptom, his scar as a scene of abuse, his grief, his identity, his badge, his conflict at the heart of who he is. We are there, and I want us to stabilize this coming together so that we both can be with—and stay with—the intensity. To combat the fragmenting forces of mind, we need now to deepen and extend this scene, to weave it outward and inward, forward and backward in time (to link, as Bion might say)—and all through his intolerable feelings, which are pulling him apart. And so I ask him if his tears are familiar to him, is he able to let himself be with them, stay with them, does he, will he, let himself cry?
Now he’s crying deeply, sobbing. “Yeah … Yeah … I do cry … I miss my father … Yeah. I miss him.”
A sudden curve in the road: He misses his father! We’ve lurched to a new place, also one to enter, one to expand: “I know this must be painful—but, if you’re ok with it, tell me about missing your father. Help me know about this father you now miss.”
“I loved him. He was different the last seven years of his life. And I … loved him. And when I was a boy, and he wasn’t drinking, I know he loved me, too. We had some good times, too. We did!”
“Wow! What you’re helping me see is just how impossible and sad this was—and still is—because your father loved and hated you at the same time. Now how could a boy, how could any boy, how could you, make sense of this? How could you even begin to understand a father who hates and loves you at the very same time?”
6“You’re right all right, it’s confusing. As a boy, I didn’t understand. I thought I was evil, just bad. Real bad. I thought there was something evil inside of me.”
“So, when you want to slice your neck, you’re killing off that evilness, that evil boy, inside of you.”
“Yeah, I feel the evil is still inside of me.”
I want now to situate and question that boyhood understanding, still with him, and still threatening to destroy him. I want to destabilize that conviction, and open it up to the light of day: “Now how could a boy ever understand that the father he loved would hate him?”
“Well, I figured with my father that he loved me—so I must be bad, evil, for him to hate me. And that’s not all, I’ve thought this all my life with other people, too. So I’m critical of me when people are bad to me—it must be me. It has to be me—something is inside of me that deserves to be hated.”
“So inside you feel there’s an evil boy and, at the same time, you’re the father who hates that evil boy, and you should kill him.”
“Yeah!” He wells up and sobs. And we sit silently for a while, sad, taking in the sadness of that boy then, and this man now ….
We are nearing the end of our too brief time together: “How does it feel for us to talk?”
“It’s intense, it’s sad. But it’s good to talk about, I need to talk about it—I’ve avoided talking about this. But it’s a part of me.”
“You know, you’re grieving—and I bet all of your life you’ve been grieving. But, still, you don’t really know how, maybe you never learned how, to grieve.”
“I go to my father’s grave, and I miss him, and I cry. And I cry a lot.”
Still going to his father’s grave, like a heartbroken boy! I say: “How in the world do you grieve the father who loved and hated you and who you loved and hated, too!”
He sobs …
“And so you carry with you this scar. And this scar keeps your father present, alive and with you, that father you still love. And hate. And, at the same time, you feel you deserve this scar, because you feel he was right, and you are evil … “
He is quiet, reflective: “I never cover up my neck—I’ve always wanted it to be seen. I always wanted it out there.”
We are silent again, taking it all in, being together with the intolerable. He thanks me for talking to him—it was helpful, he’s never talked to anybody in this way, and it feels better.
And I thank him, too, for sharing his life with me and the students. I end with: “I’m glad you are here in the hospital, that you didn’t choose to die. You’re ripe to talk about your life. Now you need to find your way into therapy. And we can help you with that—even though you’ll want to run from it. But now is the time. I hope you make your way.”