Psychoanalysis and psychoanalytic psychotherapy in Dublin

We all of us accept the restorative power of sharing our problems in a safe space, of talking them through with an intimate stranger. Sometimes, however, it can be difficult to find the words to symbolise a trauma that has remained un-spoken for a long time, to find the words for an experience whose name has been registered only in nightmares. The therapist may also struggle to discover an image or a metaphor that facilitates communication and the exploration of anxiety-provoking topics.

When a client describes himself or herself as feeling “at the end of their rope” or “at the end of their tether”, I ask them to imagine themselves suspended on a tightrope without a safety net.

Tightropes and safety nets, these images are readily recognised by most of us. Whether from childhood afternoons at the circus or a corporate team-building exercise, these are constructions we can visualise and comprehend easily. In the consultation room, such metaphors have offered me a safe medium within which to address suicidal thoughts and feelings of hopelessness and isolation, for example.

The stories I hear in my clinic are all different, each one particular to the experience of that client in relation to a unique set of connections and contingencies. When a client suffers depression or any other mental illness, that unique narrative is disrupted and he or she may not feel supported by the recognition and acceptance of others. They may instead feel as if they are on a tightrope, their only options being to go forward or reverse blindly… all while suspended above a perilous abyss. This delicate balancing act demands their full concentration, lest they fall off and be forever lost. They can only depend upon themselves and their contact with this thin wedge of rope to hold them safely. It is an existence based upon only either/or choices, each one a lonely life-or-death reality.

With an awareness of this safety net, balancing on the tightrope is not so precarious. It becomes possible to pause, to reflect upon oneself, to change the ‘either/or’ scenario to one that’s framed by ‘both/and’. If you become unbalanced, knowing that the safety net is there can be sufficient to allow a moment’s extra consideration. For someone whose existence is reduced to the difference between ‘either’ and ‘or’, that moment may mean the difference between holding on and letting go. Some tightrope-walkers arrive at a peak of lonely isolation where they cannot visualise how the other end of the rope is secured and they cannot see a way back, either. They use phrases like ‘I’ve burned my bridges with them’, or ‘They won’t take me back’. At this perilously lonely point, the only alternative to the tightrope might appear to be letting themselves fall.

But we are not born alone. We are born in the presence of another human being, into a family, within a community. This is what Freud taught us in his essay, ’Civilisation and its Discontents’. Belonging, bonding, being connected to a group constructs a series of safety nets for us, from the moment of our birth.

Our lives are spent making connections and bonds with others. Some are enduring and some are fleeting; some are crucial to our survival and some are a passing fancy; some we struggle to remember and others we work very hard to forget. Each of these connections forms a knot; it ties us to a significant memory whether painful or pleasurable. Each of these knots registers our presence with that person, that experience, in that place, at that time.

Depression, anxiety, and stress attack these connections and bonds. The negative self-talk that characterises depressive reactions undermines our capacity and our motivation to engage successfully in a social context. When it is a daily battle just to get out of bed, to get dressed, to go to work, there is little energy left over for maintaining social contacts. Friends and family will persist beyond the point at which casual associates give up but eventually a new symptom emerges: social isolation. Our social interactions are essential contributors to our mental well-being. Being recognised, being desired, being named, being made to feel worthwhile by an other is to become part of civilisation, installed in what Lacan called the Symbolic Order.

The safety net can take various forms, depending upon the individual’s relational matrix. Our family structures and our friendships construct safety nets held together by common memories and significant anniversaries, for instance.

Consider the client whose achievement each day is simply to get to work. When his or her world is reduced to that either/or of the tightrope position, a problem at work quickly becomes his or her sole responsibility. He blames himself, compounding the problem with his own self-criticism. The possibility of drawing on help from colleagues or delegating parts of the issue cannot even occur to someone balancing delicately alone on a tightrope. Yet, every corporate structure is a matrix of supportive colleagues and willing subordinates whose function it is to assist: a ‘safety net’.

For a teacher confronted by a difficult student there is the Year Head, the Guidance Counsellor, the Principal, the Home School Liaison Officer… At the end of each loop of the net is a securely-tied knot which in turn is linked to others. This matrix allows that teacher to ‘relax, reflect and respond’ to the situation from within a consistent network where different response strategies may co-exist harmoniously to construct a new safety net for the student as well as the teacher.

Depression is a stark reality. It is bleak and it is overwhelming and it is isolating. Hopelessness, guilt and self-loathing are heavy burdens to carry alone. It is a disorder that challenges the loving attachments that give our lives meaning. When depression preoccupies your mind, it takes practice to recognise and then to have confidence in your safety nets. The first meeting with a therapist may be an attempt to secure a tightrope. But over time, being held in the therapeutic relationship facilitates the recognition and building of new connections to others, leading to the construction of a series of safety nets, each broader and more dependable than the last.