A few notes on truth and narrative in psychotherapy:
A question that often comes up when working with patients in psychotherapy is, Did this story really happen the way that the patient is describing it? And, if not, how and why is the discrepancy important?
We are all of us unreliable narrators of our own lives, as anyone who has argued with a parent or sibling over the sequence or content of past events can attest to. In therapy, it may not always be possible to consult family members or friends of the patient to find out 'what really happened,' whether because such individuals are unavailable (dead or absent), or the patient does not want the therapist to correspond with others in his life. Even if such individuals are available, a further question that may arise is whether or not their narrative is any more 'truthful' than the patient's.
Many arguments have been had over whether or not childhood traumata 'really' existed in specific cases (see, for example, Judith Herman's book, Trauma and Recovery for a thorough discussion of trauma, childhood memories, and Freud's renunciation of his theory of the origins of hysteria in childhood sexual abuse). Of course, there are events that happen that cannot be explained away by differing points of view. And when these events can be pinned down, all the better. However, family secrets are often exactly that - secrets - and the truth of them is harder to determine.
The inconsistencies in one's narrative are places that a therapist (at least one who is trained psychodynamically) is trained to look for, the knots in an otherwise smoothly woven story. Such inconsistencies do not necessarily mean that the patient is a liar; instead, they point to the places where some of the most fruitful therapeutic work can happen.
Confidential. For training purposes only. Do not circulate.
Date: Monday, 24.6.2002 11a.m.
Psychologist: Dr Carola Rivas, PhD
Patient: S.H., 25yo White male, cocaine and heroin user, mood disorder NOS. Session No. 12.
Carola Rivas: Good morning.
Sherlock Holmes: Good morning.
CR: I sensed that there was something very important that you were going to tell me last time.
SH: …
CR: What is that face?
SH: You can go ahead and ask me outright, you know. I'm not going to fall apart just because you ask me about my mother's death.
CR: What should I know about it?
SH: I told you that I blame my father.
CR: Yes. He was driving the car, was't he?
SH: Yes. He'd been drinking – everyone had been drinking. New Year's Eve.
CR: …
SH: I was the one who got the call to go down to the police station. But I've told you this before.
CR: You picked up the phone.
SH: They thought I was Mycroft.
CR: Why did you go down there alone? Wasn't there anyone who could go down there with you?
SH: You mean my nanny, perhaps? Or the housekeeper?
CR: Someone like that. Or Mycroft.
SH: I wanted to see for myself. I didn't want them telling me what had happened, lying to me like a child.
CR: Why would they lie to you?
SH: Because no one ever tells children the truth. As if I didn't know what was happening between my father and my mother.
CR: Which was…?
SH: They were – estranged. He was living in Sussex, she was in London.
CR: How did they explain that to you? Their separation, I mean.
SH: They said that Mummy needed to be in London to concentrate on her musical career.
CR: Sussex is not that far from London. Plenty of people live here and work in London. Couldn't your mother have done the same? Travelled to the city when she needed to?
SH: Now you see why I was suspicious.
CR: And where were you living at the time?
SH: With my father. I went to a local day school. My mother came back on Tuesdays, then returned to London Friday morning for weekend rehearsals, concerts. A musical career is not very amenable to family life.
CR: I can see how this might be – confusing, perhaps? You knew something else was going on, and no one would talk to you about it? Or did they?
SH: No.
CR: What about Mycroft?
SH: He was at uni.
CR: What did you think was going on with your parents?
SH: I thought my father was angry.
CR: …
SH: At me.
CR: At you ? Why?
SH: Because he never liked me.
CR: Why wouldn't he like you?
SH: If I am not an agreeable person at present, you can hardly believe me to have been at twelve years old.
CR: Few children are, at that age.
SH: He sent her away.
CR: He sent her away?
SH: She wouldn't have gone on her own.
CR: So…I don't know very much about your parents, but didn't your mother have a say in the matter?
SH: He made her miserable.
CR: What do you mean by that, exactly?
SH: Must I really tell you every excruciating detail? The crying spells, the arguments, the sudden departures for London?
CR: So she left?
SH: It was his fault.
CR: …
SH: Do you doubt me?
CR: I don't doubt that you felt that it happened that way. But I am still confused.
SH: Really? I would have thought that a psychologist would know to expect crimes of passion.
CR: What was the crime?
SH: Her death.
CR: I still don't understand. You said your father was to blame. He was driving the car. Was it an accident?
SH: You don't think I would tell you if I had figured it out? Ha! I wouldn't keep it a secret if I had.
CR: …
SH: That's exactly the problem. I don't know how it happened. But it did. Murder, man-slaughter, death by slow exhaustion and helplessness – he was responsible.
CR: …
SH: How do I know, you persist in asking me. I can see it in your face. You want to disprove me of my conviction that he was responsible.
CR: …
SH: Mycroft has tried for thirteen years and I assure you, if he hasn't got anywhere, you are unlikely to, either.
CR: Tried what?
SH: Tried to convince me it was all in my imagination. But I didn't imagine it. I heard what he said to her. I've read the police files. He was clever, though.
CR: What did he say to her?
SH: That she would have to take responsibility for what she had done.
CR: Meaning?
SH: Don't be so obtuse! For the affair she was having.
CR: I'm afraid I don't see the connection.
SH: I heard them fighting on Boxing Day. They were still keeping up the pretense of things being fine. Mycroft was home for the December holidays; he didn't see what I had seen all that autumn.
CR: …
SH: The fights. The flights. Violeta leaving for the train station, suit-case in hand. Saying good-bye to me. Telling me – telling me –
CR: What? What did she say?
SH: That she had a rehearsal – the Brandenburg Concertos – and would be back soon. But she didn't need to rehearse the Brandenburgs. She wasn't playing harpsichord anymore, in those days.
CR: What are you saying? That she didn't need to be there?
SH: Obviously not. It was a ruse.
CR: …
SH: …
CR: Sherlock?
SH: …
CR: …
SH: Fuck off! I don't have to explain this to you, do I? Just hand me the tissues.
CR: …
SH: …
[Tape is silent for approx. 5 mins]
CR: She never came back, did she?
SH: She came back on Tuesdays. I told you.
CR: Yes, you did. What I meant was, she never really came back to your family, did she?
SH: …
CR: …
SH: That much should be apparent.
CR: And Mycroft didn't believe you about – about the cause of her death. How did that go?
SH: He told me that there was no evidence that it had been intentional.
CR: Was there?
SH: I've searched through every page of her file, ordered copies of the coroner's report. There must be something that I've overlooked!
CR: Sherlock.
SH: Carola.
CR: What difference does it make?
SH: Are you an idiot ? It makes all the difference in the world.
CR: Forgive me. I didn't mean to imply that it was irrelevant. What I mean is – what difference does it make to you, whether or not it was intentional? How would that change things now?
SH: If he killed her, then I was right and Mycroft was wrong.
CR: Is that what this is about? You being right?
SH: Him being wrong. He is so insufferable when he thinks he is right. He's been insufferable for thirteen years. But that's not all of it, of course not.
CR: And if you prove him wrong? Then what?
SH: What do you mean? Then it means that I was right, all of these years. Our father murdered our mother. Mycroft was a fool, in denial.
CR: But you weren't.
SH: They thought I was crazy, grief-stricken.
CR: I would have been surprised if you weren't. Grief-stricken, I mean. Your mother had just died in a car crash – accidental or not, that was an enormous loss.
SH: Complicated grief reaction?
CR: Did someone say that's what was happening to you?
SH: My first therapist.
CR: Could be the case. Hard to tell in retrospect.
SH: Memory is so deceptive, isn't it?
CR: …
SH: Why are you looking at me like that?
CR: You doubt yourself. You doubt your own perceptions of what happened.
SH: I know what happened.
CR: There was no room for you to doubt yourself, because everyone else doubted you.
SH: …
CR: ...
SH: What do you mean?
CR: They told you that you were mistaken, that it had been an accident after all, and because no one took you seriously, you had to buttress your position with arguments, facts, deductions. Because you were a child. And there was no room for the ordinary doubts that anyone would feel, the anger at the injustice of it all, because you had to work so hard to be taken seriously.
SH: What else could I have done?
CR: I don't know that you could have done anything else, being the person that you are.
SH: Oh, so it was all 'destined' to be? I can't believe you'd think that.
CR: Not that it was destined. Just that –
SH: Yes? I'm eagerly awaiting your interpretation.
CR: You knew that something was wrong between your parents.
SH: Yes.
CR: That their marriage was…unhappy. But no one would say that outright to you. No one would trust you with that knowledge, even though you could see it for yourself.
SH: They always denied it.
CR: Who did?
SH: My mother. Father. Mycroft. Told me I was imagining things.
CR: But you weren't, were you? Imagining things.
SH: No. I heard them. I saw her leave. Mycroft didn't. He was at uni.
CR: You were the only one who was around to see what was happening.
SH: Yes.
CR: But they told you it wasn't true.
SH: They lied to me.
CR: And you were twelve years old. Mycroft was – nineteen? And your father much older, of course.
SH: She was gone. She couldn't speak for herself. And Father didn't want to talk about her.
CR: What did you say to him?
SH: I told him he had killed her. He sent me off to Germany, for that.
CR: Yes, I can see how that might not have gone over so well.
SH: You can't imagine.
CR: …
SH: …
CR: Why are you smiling?
SH: I was remembering something.
CR: What?
SH: It was when my father caught me smoking for the first time, cigarettes.
CR: This was shortly after...?
SH: During summer holidays, I was back in Sussex.
CR: …
SH: I spent an afternoon perfecting the art of the smoke ring.
CR: Very impressive.
SH: How doth the little crocodile improve his shining tail. And pour the waters of the Nile, on every golden scale.
CR: Alice!
SH: The caterpillar, actually.
CR: …
SH: Why are you smiling?
CR: You quoting Alice - the caterpillar. And I want to hear the rest of the story, the smoke rings.
SH: At him, of course. That's how it ended. He found me behind the house, half-delirious with nicotine - I hadn't built up any kind of tolerance, back then, of course I hadn't, I was twelve, thirteen years old! So I was strangely energetic, charged with the drug and my own conviction thatI would catch him out some day. And when he came upon me, I told him so, told him that I knew that my mother's death hadn't been an accident. Told him he'd have to leave me alone, or I'd tell.
CR: …
SH: How cheerfully he seems to grin, how neatly spreads his claws. And welcomes little fishes in, with gently smiling jaws...
CR: …
SH: ...
CR: What did he do?
SH: He tried to take the ciggy from me.
CR: And?
SH: I blew smoke rings in his face. All that practice - couldn't let it go to waste.
CR: Certainly not.
SH: But it worked. He did leave me alone, mostly. Holding people's secrets over their heads has that effect, generally.
CR: What effect?
SH: Of leaving me alone.
CR: Is that what you want? To be left alone?
SH: Rather that than -
CR: …
SH: ...
CR: Than what?
SH: Nevermind. But it still consumes me, sometimes.
CR: …
SH: I'm talking about my mother's death now, Carola. Do keep up.
CR: …
SH: ...
CR: I would be surprised if you didn't think about it. If it didn't consume you, as you say.
SH: I may never know what truly happened.
CR: No.
SH: And that is what bothers me the most.
CR: The not knowing.
SH: Yes. The not knowing. Yes.
CR: …
SH: …
CR: No, you may never know.
SH: …
CR: …
SH: That's how it is, then?
CR: …
SH: Well, are we through?
CR: Finished? Yes, for today.
SH: Until Wednesday, then.
CR: Good-bye.