Adrienne said she’s having difficulty holding to our agreement that she reach out to me before cutting herself. The drive to self-injury feels “insatiable,” as she put it. She then told me the following dream: She was outside with her son, and they were having a great time together. She suddenly realized there were snakes everywhere, on all sides.
Most of them were small and harmless but as the dream went on, there were more and more of them. She tried very hard to remain calm, in order to get her son to safety, and finally succeeded. But Adrienne couldn’t go inside along with him.
She felt sad but oddly at peace, resigned to that fact. As she left her son behind, Adrienne knew there were too many snakes now for her to escape with her life. She walked directly toward the biggest, “most aggressive” one. As it struck her, she woke up.
In prior sessions, we’ve talked about the comforting aspect of cutting (being “at peace”), but now the more malignant side comes clear. She saves her son, but instead of taking care of herself as well, keeping herself alive, Adrienne hands herself over to the killer snake, the most “aggressive” one. Given her horribly deprived upbringing, she has so little internal goodness to hold onto; nihilistic destruction offers her an escape when the pain and loneliness become unbearable.
We also discussed the snakes as representing her disowned aggression. I was reminded of other self-injury clients I’ve worked with, where split-off rage became a central issue. With Adrienne, her anger seems very remote, though I sense it will begin to surface as we go forward. I know the degree of her rage frightens her.
I also wonder about the “insatiable” drive to self-injury, and whether we’re dealing with split-off and disowned neediness. She has no “mouth” herself (no concern, no needs or desire to live) but there are hundreds of angry mouths outside, about to attack. Another thought: is handing over her son a way of talking about how relinquishes her own concern and hope, putting it into the care of others? Me? Her friends?
Given the risk to her health, we agreed that she needs to come more frequently until we both feel she has a handle on the self-injury and can take better care of herself.
Snake photo available from Shutterstock.
This post currently has
You can read the comments or leave your own thoughts.
From Psych Central's website:
Perceiving the 'Real' Therapist | Therapy Case Notes (June 15, 2012)
Last reviewed: 28 Mar 2012