In my last piece I wrote about Mark, a photography student, who struggled to take seriously himself, his work or his therapy. I wrote about the ways in which we worked together to bring to his conscious mind some of the reasons behind this attitude. In this blog I want to write about another piece of work that had a less successful outcome.

Joshua (not his real name) was “sent” to me by his family for anger management. There had been a family gathering during which Joshua got very angry with one of his grandchildren for being “naughty” (The child was about four years old.) The strength of Joshua’s reaction scared both the child and his mother, and the family told Joshua the unless he did something about his anger, he would not be allowed to see the grandchildren. This was enough incentive for him to come and see me.

Joshua was a big man in his early fifties who had worked as an HGV driver all his adult life. He carried with him a definite sense of “Don’t mess with me or you’ll regret it” even though his speech was moderate. Everything about him was intimidating and for the first time as a therapist, I found myself looking for a non existent panic button. I asked about the incident that had prompted him to come and see me. The little boy in question had been standing in front of the TV and hadn’t moved when told to by his mother. The child was then told that if he didn’t do as his mother asked Grandpa Joshua would be bought in. The child still didn’t move, so Grandpa intervened by getting out of his chair, picking up the child and moving him to another part of the room. He obviously did this in such a manner as to frighten both the child and its mother. (It seems the other family members who were present also found Joshua’s behaviour worrying, since they too insisted that he do something about his anger. (In fairness to Joshua, he was “only” doing what his family had asked. They had him in the role of “enforcer” when it suited them.)

I asked Joshua what he thought of the incident. “It shouldn’t have happened” was his reply, which I took to be a positive comment. Then he continued “His mother spoils him. Doesn’t give him enough discipline. My kids didn’t need telling twice when they were growing up.” This was followed by the classic phrase “A good clip around the ear never did anyone any harm.” Oh! My heart sank. This was not a man who was going to like any challenge from me. (I again wished I’d been back in the relative safety of a psychiatric unit with its equivalent of a crash team for psychiatric emergencies, panic alarms and powerful drugs.)

I tried again “How do you feel about scaring your grandson and upsetting the family?”

“It will blow over. These things happen sometimes. They don’t mean anything” was his reply. This was not therapy as I knew it. I carried on for another 50 minutes before finishing

“Did he want another session?”

“Yes”

I explained my rules . That I expected him to see me at a set time each week.

“No. Can’t do that. I never know from week to week where they’ll send me.”

Could he not arrange things so that he could at least phone me at a set time?

“No. I’ve got schedules to meet”

At this point I said that I wasn’t prepared to see him unless he agreed to my terms. He was sorry but, no, he just couldn’t do this. He left the room with an air that said I was obviously a waste of time and money and that it was my loss for being so inflexible. Needless to say he didn’t come back.

Two different stories with two different outcomes. Both had come from difficult families and both were struggling with their place in the world. Both had chosen me as against another therapist. The main difference was that Mark was able to see his need and hear what I was saying to him. He chose Kierkegaard’s leap of faith. Joshua was unwilling to change.

I’ve talked of the difficulty I’m having with a broken femur. It’s just so much easier not to move. To leave the breakfast table uncleared. Not to make a cup of tea for myself and my wife. But if I do this I lose my ability to move. I acquire a mindset that says “I can’t” and the quality of my life is impinged on. My favourite toast is the Jewish one “L’chaim. To Life.’ Perhaps I should put that on the wall of my treatment room. “L’chaim” since it says in two words all that can be said about the purpose of the work that I do. “To Life”