After a month I resigned again. Doctors, pills. Even eating was hard. I did not talk. Just slept. My husband was surprisingly tactful. I started talking and smiling. Only a year later I felt better. Since then, as soon as there is a stressful situation, I change my job. I have changed ten places already. I dont work anywhere for more than six months.»
Back to the actual. It is impossible to stay in the rock any longer, it threatens death. The patient thinks what to do, so do I. Maybe she should call for help.
«Did you try to call for help?»
«What is the use to shout if I know that here people cant get here?»
«Perhaps, someone will be able,» we continue conversation searching for more real way out.
«My head is over an abyss, the river is roaring, and I hear whats behind me,» says L. M.
«Should we go in the opposite direction?»
«Its impossible.»
«Maybe just to relax and to take the weight.» I suggest her (meaning to die and to be reborn, to experience her own death to live).
«This is unacceptable for me.»
It turns out that to get out it is necessary to turn into someone or something, as in a fairy tale. We come to a joint conclusion.
«A stream? A bird? A snake?»
«A stream, going to a mountain river,» decides L. M., but immediately she gets scared. «I can fail to reach the river But in any case, I start to flow.» She exhales.
«Are you out in an open place?»
«Yes, but my soul remained there. My desire is to take a knife and scrape it off. It is a balloon of some kind not scraped off. The place, where my body was, is a cave now. My soul is in it, witnessing from above. I cannot see myself. Ball that you have to push, to pull away from those walls. Transparent. Its like a river of fire down there. I did not notice it before Maybe my soul is afraid? There is no blue coolness, but fiery tongues of flame, like lava.»
«Maybe you can go right or left, if you change your volume?» I suggest.
«Like whom? An ant!» L. M. exclaims and continues her description. «I get out of this cave (It is a huge space for an ant!) and go right. I see cracks in the ground, on the rocks A long road. I dont see any sky, nothing else,» the patient is perplexed.
«Youre an ant,» I guess. «So, you cant see beyond the surface of the stones and the soil!»
«Ive overcome a small stone,» reports L. M. and exhales. «But it is felt as a huge mountain!»
L. M. does not understand where to go next.
«Back?»
«No. There is a river below. To the right! Yes, to the right Now I am in my proper person, trying to go right. No people, no one, nothing. But I have the feeling that, if I go this way, I will reach some place. I must find it I will walk along this path.»
She finishes the session and opens her eyes, now glowing with a completely different light.
Comment. Identifying the «fairy tale, in which a person lives, can be productive. The contact with that patient was interrupted for external reasons after a short cycle of meetings. It was obvious to me that the neurotic facade was hiding (or opening?) serious constitutional problems: emotional instability, sensitivity. The leading characterological radical was cycloidal, «expressed in her appearance (round face, plumpness). Also, L. M. had a thin neck, which questioned her ability to adapt successfully without supporting work.
Four years later I was talking to her again. L. M. testified that, thanks to our sessions, in many cases she was able to stop her anxiety by asking herself: What do I feel? Do I feed it or not? etc., And thus, she saved herself from much stress. However, there was no complete peace of mind. Moreover, six months ago she was in the hospital, being treated with amitriptyline, so she gained weight. She did not have any psychotherapy since then. She worked in two other places. In one case, she resigned because of the difficulties in fulfilling a new job, in the other because of the dissolution of the company. She experienced increased stress because of the difficulties in acquiring additional skills and qualifications at new places of work and because of problems with her relatives with her daughter.
I asked L. M. to describe her present «landscape of feelings. She easily continued the description:
«A high steep bank of the river. The sun is shining ahead. There is a thick forest behind, which is hard to go through. I can go left or right. I am in the state of a deep thought.»
She recollects that for a long time she was thinking about the phrase: «You cannot enter the same river twice» until she decided to talk to her husband. Now she wants to enter this bright river, but the cliff is so high and steep!
«What does this river symbolize for you?» «Its a symbol of the future.»
«Suppose you are already in the river, what happened?»
«If I went into the river, it would, probably, be easier for me.»
«Why?»
«I would feel saved from thirst and heat.»
«So, are feeling heat now?»
«Terrible heat. My soul burns».
«Coals or open flame?»
«Flame.»
«What your state does of it express?
«Anxiety for loved ones.»
«How many such «alarms do you have?»
«Five: unsuccessful marriage of my daughter; absence work and fear of work; the relations with my mother-in-law; worries for the husband, for his health, for my younger daughter.»
«How many percent of your force does it take?»
«Fifty, at least. I am thinking about it all the time. When I am talking to someone and thinking about the problems, my fear is amplified. When I have a pleasant talk (I have a neighbor who can reassure), the flame ceases. When I talk to my daughter, the flames blazes.»
Comment. Note that all the experiences of L. M. are actual and real. Her daughter, for example, is unhappy in marriage. She is in the position of a slave with a stingy husband, who is much older than she and blackmails her, threatening to take away their child.
L. M.s reaction itself is natural. But the intensity of her worries about the unresolved problems harms her own health and the very solution of those problems.
The diagnosis of cyclothymia in this case is not excluded, taking into consideration the constitutional features of the patient.
As a doctor, I was pleased to hear that she had irrevocably left the «cave in the granite rock. Her hesitation in entering the river of the future was a problem. Working on her «landscape, it would be necessary to achieve «smoothing of a cliff, so that she could feel herself close to water, or in the water.
Although the «landscape work can be effective, it is, in my opinion, not the best one. The most convenient way to achieve levelling, «smoothing of the cliff is by identifying the feasibility of such worries, by redirecting sensations of heat-heaviness inside the body. The landscape will be changed by inner calmness.
A stone in seaweed
Working with the images who are you? and where are you? are like working with concentric circles from a stone thrown into water. If you want to get the stone that on the bottom of the reservoir, it is better to dive into its center. The seaweed, growing around, can be mixed up, and the search under water can be difficult.
The advantage of turning to inner feelings is that they convey information about the main thing, which is the state of the one who sees everything directly, not implicitly. Everyone is in the landscape, which they are ready to be in.