The Writing Cure

Most people don’t understand the loneliness of the analyst. After all, we are never alone. Every forty-five (or fifty) minutes the bell rings and, like good Pavlovian subjects, we respond. Whatever just transpired, be it inspiring, unexceptional, or tragic (among many other possibilities), we ready our minds for the next occupant. We are rented by the hour, a circumstance that links us to the oldest profession. Constantly partnered, we are yet in danger of a form of loneliness that, at least in my experience, can be acutely painful. Writing offers me one of the very few effective balms.

What differentiates loneliness from aloneness, and makes it so hard to bear for all human beings? Fromm-Reichmann (1959) emphasizes that the profoundly lonely have given up hope that they will connect with others in the future. In addition, they see no redemptive purpose or meaning in their painful state. Loneliness can feel like an endless solitary confinement. Often it is accompanied by a shameful sense of meriting our isolation. Most of us, myself included, can call up bleak moments from early adolescence when loneliness felt more like a fate than a state.

Elsewhere (Buechler 1998, p. 138), applying Winnicott’s thinking (1958) to the analyst’s experience, I have suggested that the profoundly lonely analyst has failed to internalize a good enough “chorus” of empathic supervisors, colleagues, and other modulating influences. Profound loneliness can be the product of an overly harsh superego, criticizing every clinical interchange, alienating the analyst from him- or herself.

But even analysts who are well provided with empathic professional internal objects can suffer acute loneliness. With some patients, in some hours, we can feel they will never understand our experience as we do. We will be permanently alone with it. Perhaps we feel that the patient refuses to consider our perspective out of self-esteem concerns, or because it might lead to unwanted feelings of dependence, or out of a pressing repetition compulsion. Whatever the cause, whatever conscious and unconscious contribution each participant has made, when analyst and patient drastically differ in how they understand the analyst’s behavior, both participants may feel profoundly lonely. While our professional training (Freud 1912, p. 118) tells us that we are obligated to hold up a mirror to the patient, I don’t think this eradicates our own need to feel seen as some facsimile of our familiar selves, if not in the patient’s eyes, at least in our own.

My own loneliest moments have come when I have felt that I lost myself in a session. Casually I might say, “I was not myself.” However jaunty the colloquial expression might sound, the actual experience is the opposite of jaunty, at least for me. Should my training and many years of clinical experience have rendered me proof against such challenges to my professional and personal identity? Some would say they should have insulated me more than they seem to have done. There are times when I feel like a cubist portrait of myself. All the familiar parts are there, but some are exaggerated and unaligned.

But writing gives me a chance to find myself again. Through writing I discover what I think and feel. Sometimes finding words for my clinical experience helps me make sense to myself. I get to express who I consciously meant to be, what I was trying to do, and why. I may still feel puzzled, disappointed, or anxious that, to use Harry Stack Sullivan’s terms, a bad me, or even not me (1953), has held sway in my behavior. But with a more fleshed-out narrative I feel more whole. I am one step closer to integrating an unfamiliar part of myself. I have a chance to grow. The balance of what has transpired has shifted. Now, along with whatever pain the clinical experience occasioned, there are gains, potentially for the treatment, the patient, and myself.

From another perspective, my emotional balance has shifted. I have long believed that our feelings form a system (Buechler 1993), with a shift in any emotion affecting the levels of all the others. Writing often enhances my curiosity, which in this way of thinking is itself an emotion (Izard 1971; Buechler 1995). Curiosity can turn potentially shaming, anxiety-provoking, guilt-inducing moments into chances to wonder and explore, and, eventually, gain greater awareness of myself as “simply human” (Sullivan 1953).

The synergy between writing and clinical work enhances both. Writing can help us realize the potential for growth that is inherent in many problematic clinical exchanges. A disconcerting moment becomes an opportunity to welcome the stranger in myself.

Often I find myself remembering the advice that Rainer Maria Rilke gave to the “young poet” who had asked him whether or not to pursue writing as a career. Rilke wisely asked if the young man must write: “ask yourself in the stillest hour of your night: must I write? Delve into yourself for a deep answer. And if this should be affirmative, if you may meet this earnest question with a strong and simple ‘I must,’ then build your life according to this necessity” (1934, pp. 18–19).

Like the young poet, my answer to Rilke’s challenge is always “yes.”