Nancy McWilliams admits in her book Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process that she can sometimes be a masochist with a depressive personality, which can gear itself up towards rescuing her clients from themselves.
In her section “Therapeutic Implications of the Diagnosis of Obsessive or Compulsive Personality,” she says “… by accepting compulsively self-harming people into analytic treatment unconditionally, the therapist may unwittingly contribute to their fantasies that therapy will operate magically, without their having at some point to exert self-control …”
This is known universally in Therapy World as “rescue fantasies.” Sometimes there is a repeat pattern of trauma in therapy where the obsessive, compulsive self-harming client with abandonment issues regresses and imploringly begs the therapist for extracurricular activities, and the therapist panics and enables the client to regress further by trying to pull them out of their regression with a magical cure, trying to rescue the client by crawling into their fantasies and merging with them. This can cause the client to withdraw and disintegrate or verbally attack the therapist in a sadistic manner due to feelings of overwhelming engulfment. This is where the cure can be worse than the disease.
A fabulous book to read is Nancy McWilliams’ Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process (a bit of light-reading for insomniacs). She describes various personality structures and one of them is a paranoid-masochist. Someone who thinks everyone is out to get him/her and then does their damnedest to make sure that is exactly what happens; the person who buys a gun for protection, but ends up shooting themselves in the foot.
She embarrassingly, but very charmingly, recalls being in the grips of a rescue fantasy towards a young paranoid-masochistic client who needed transport to get to therapy and she was so eager to be seen as the good mother towards him, she lent him her car and quite predictably he ended up driving it into a tree. My therapist recently drew my attention to this example.
On the last day of Hakomi, our facilitator read out loud this passage for us.
The following is an excerpt from the book Mortal Lessons by Richard Seltzer, MD. Seltzer is talking here of his experiences seeing Dr. Yeshe Donden, a Tibetan physician, as he reads the pulse of a patient at Yale Hospital.
The second day of the three day Hakomi workshop was like coming home. I relaxed considerably once I realized that Vicki Emms was not in attendance. I had found my safe place.
During high school my only safe place was the library. Among many others I read Gerald Durrell, James Herriot, the Silver Brumby series, Pennington’s Seventeenth Summer series and eventually discovered Stephen King. I sought refuge in books but not in schoolwork. I was the quintessential library refugee. Vicki Emms and her henchmen were not readers or deep thinkers. For these damaged girls, mindless violence equated to wholeness, self-satisfaction and soul-integration.
I remember my first day of high school in January 1975. I arrived in the old green MTT school bus to be greeted by a tough-looking older girl who ran alongside the bus shaking her fist at me. I knew it was me she was meeting and greeting as she was making firm and constant eye-contact, rather like a super-heated, vaporizing laser-beam. Quite a feat considering the bus was still moving rather quickly at the time. When I got off the bus, she collared me and said she was going to beat the living shit out of me at a time decided and designated by herself that I was not going to be privy to. It would happen when I least expected it. The strange part about this was that I had never met Vicki Emms before in my life but she apparently knew a lot about me from my so-called friends at primary school.
So last weekend when the Hakomi instructor at my three-day Hakomi Psychotherapy Mindfulness Workshop compared the first day of Hakomi to the first day of high school, I was already there, most mindfully aware of two people inside me attending Hakomi that day — my thirteen-year-old self and my current adult observing ego.