Friday, August 04, 2006

EVEN COWGIRLS GET THE BLUES

...and today the death of an old friend has me down and more than usually introspective. In fact, it started me thinking about one of my favorite passages in the Father Brown mysteries of G.K.Chesterton, where he is cajoled into revealing the mysterious secret of his success in solving so many murder cases:
Father Brown groaned. He put his head on his hands and remained a moment, as if full of a silent convulsion of thought. Then he lifted his head and said in a dull voice:
"Very well. I must tell the secret."
His eyes rolled darkly over the whole darling scene, from the red eyes of the little stove to the stark expanse of the ancient wall, over which were standing out, more and more brightly, the strong stars of the south.
"The secret is," he said: and then stopped as if unable to go on. Then he began again and said:
"You see, it was I who killed all those people."
"What?"epeated the other, in a small voice out of a vast silence.
"You see, I had murdered them all myself," explained Father Brown patiently. "So, of course, I knew how it was done."
"Grandison Chance had risen to his great height like a man lifted to the ceiling by a sort of slow explosion. Staring down at the other he repeated his incredulous question.
"I had planned out each of the crimes very carefully," went on Father Brown. "I had thought out exactly how a thing like that could be done, and in what style or state of mind a man could really do it. And when I was quite sure that I felt exactly like the murderer myself, of course I knew whe he was."


I used to quote this passage to psychiatric residents when I taught them about transference and countertransference and insight. Father Brown's insight was a profound revelation to me when I first read it about 30 years ago or so. It explained so much to me about why I was so at home in psychiatry (I had originally planned on becoming a surgeon) and was even considered a good one by my colleagues. I actually had never thought much about it when I was younger; and was simply glad that I was able to connect to the most disordered people. I especially have an affinity with what is now called the "Cluster B" personalities--the hysterics, narcissists, borderlines, and sociopaths. Father Brown made me understand why.

Like Father Brown, I had very little difficulty in making myself feel exactly like they felt. Their pathology was my own. Their motives and disordered thinking were not mysterious to me at all, but were mirrored in my own psyche.

As the good Father was fully aware, we are all capable of committing murders and any other atrocity because of the simple fact that we are human ourselves; and as I have come to be aware over the years, the inner darkness and chaos that swallows up many of my patients, exists within me also.

You cannot be a good psychiatrist unless you are willing to acknowledge this fundamental truth and use it in a constructive way in your relationships with those who come to you for help.

It is a most humbling revelation. When I first experienced it, it was merely an intellectual insight. A few months later, when my best friend and a fellow doctor committed suicide and her mother blamed me for not noticing her depression--it hit me hard, as if I had been sucker-punched.

I have done many good things in my life, I think; but I have also been guilty of bad--even horrible behavior; been deliberately malicious and destructive; and responsible for innumerable stupid and petty evils.

The best I can say in my own defense is that I think I am a better person for all of it. I have fewer illusions about myself certainly, and as I have accepted more and more responsibility for my own behavior, I have been able to forgive myself for the imperfection--and humanity?-- of my emotions.

Like Father Brown, I do my best work when I am fully able to grasp what is going on inside of my patients. The only thing that often separates me from them is that, by acknowledgin my crazier feelings-- and even accepting them as part of myself-- has given me the ability to control the most damaging consequences of their expression.

So what does all this self-reflection and musing have to do with the death of a friend?

Today, when I got the call from a mutual friend, I almost didn't believe it. But then, it really felt like it must be true. My friend John committed suicide, finally succumbing to the inner demons he was unable to control. I have not seen him in years, but once we shared with each other those demons; laughed about them, minimized them and thought we had locked them away forever from having any influence over us.

His death has made me go down into the dark cellar of my own soul, where I have been confronting those distressing spirits of my self; checking the locks that keep them under control for the most part; and shoring up the walls of the various compartments that I placed them in.

I have been talking today with a new occupant down there; a demon with John's angelic face. Eventually, after he and I finish our discussion, I will leave him in the darkness and ascend once more into the light.

Bear with me.

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