Since Adrienne’s snake dream, we’ve been making gradual progress in tapping into her unconscious anger. I’ve helped her become more aware of the rage often lurking behind self-pity and on several occasions now, she has been able to detect the hidden rage herself. In discussing her repeated insistence that I’d rather get rid of her and take on a less difficult client at my new (higher) fee, I’ve pointed out the hidden insult, the hostile suggestion that I’d drop a client to make 25 bucks more an hour. It’s a complex message, of course, reflecting her sense of worthlessness, the conviction that no one could truly care about her for who she is. At the same time, she’s angry and I feel it. Adrienne’s anger feels closer and closer to the surface as time goes on.
For Adrienne, and for others who self-injure, the emotional challenge is to tolerate all that anger as it pushes into consciousness. As a child, what do you do with profound rage when you’re surrounded by people with virtually no emotional capacity, who continually abandon and abuse you? How are you supposed to develop the mental capacity to tolerate all that feeling? Self-harm seems to me to be both a defense against unbearable feelings and at the same time an expression of them. It’s paradoxical but undoubtedly true from my experience. With all of my self-injury clients, the urge to cuts arises when frustration and anger (as well as other painful feelings) become unbearable. These clients want to get rid of those feelings, but the violent, destructive means of doing so actually expresses those very feelings, albeit unconsciously. The long hard work of psychotherapy with self-injury clients involves helping them to develop the mental capacity to tolerate those feelings on a conscious level. No small challenge.
I feel that I’ve captured this dynamic very well in my new Cinderella. The impotent rage she feels at the hands of her mother, the peasant boy and later her husband connect to her growing drive toward self-injury. These passages are so effective, in fact, that several readers with a history of self-injury have told me that they felt triggered by them and had to put the book down. I don’t want to trigger or upset anyone, but the fact that I’ve truly captured this painful experience makes me proud.