I broke my own rule, the last day of our workshop. Instead of keeping my focus on one of the participant’s texts, I focused on her, on what the startling absence of feelings and information about her mother’s illness and her subsequent fostering out at age eleven, meant. The piece was stunning, really, constructed in two parts: in the first, she describes with a child’s heightened sensitivity to sense, her mother cooking and cleaning, and yet also suggests an adult’s point-of-view when she writes: I wonder what dreams my mother had other than marrying her sweetheart and leaving her natural art ability wash away into the old style washing machine? There are wonderful descriptions of the freedom and fun the family of eight children had, the chicken dumplings her mother cooked–I watch my mother in our small kitchen standing and patiently waiting as she stirs another pot of chicken and dumplings–and then the information that her mother became ill and all the children were sent to other homes. There is nothing here about how that little girl felt. In the second part, she goes on to describe how she was burdened by chores in her new home, and how she longed to take ballet lessons, but couldn’t. In the piece there are themes of oppression and freedom, of dreams of artistry dashed, and a seeming identification with the absent mother.
In the discussion of the text, I mentioned the “presence” of an absence in the piece. This woman, a breast cancer survivor, as well as the survivor of her childhood family diaspora and a young unhappy marriage and subsequent single-motherhood, said, “Well, you know, sometimes it is like Pandora’s box. You are just afraid of what might come out.” We talked a bit more about how some things were very hard to look at. It was generally agreed on that we must look, but that it was sometimes overwhelming to do so.
James Pennebaker has done research that strongly suggests that people who have experienced undisclosed traumatic events before the age of 17 are much more likely to be chronically ill, have cancer or heart conditions. It seems that many if not most of the cancer patients I work with have had traumatic backgrounds, and this patient certainly seemed to. But the tricky part of working with people who, for their survival’s sake, have “encrypted” trauma, is that everything in them does not want to open that Pandora’s box, even if they intellectually understand that it could lead towards healing.
I thought of her piece as a whole–the fluidity of compelling childhood memories, then the less compelling reportage of feeling both needed and overwhelmed in her new life, and the ending, which seemed to not be organic to the piece at all: I have learned how to better understand who I am and to accept what I need to do to build onto the next level of who and why I am. Notice the stilted language.
I think we would have been better served to stick to reading the text, and let the patient make her own conclusions, to help her see not only “the presence of an absence” but to non-judgementally observe the artistry: the two parts, the echoing themes of longing for freedom, of dashed hopes, the changes in language–the way it became less lived, more reportage. In this way, we reflect back to the patient, not what we think about her psychological state of mind, but what the text she has created conveys to us about her experience. This may seem like a fine distinction, but I think it has merit. She can then judge what she has written against what she wishes to convey, and from that stance perhaps move deeper into her own experience.
With many patients who have been traumatized, there is often a resistance to go back into their histories. In these cases, I have often found that writing fiction and not using the first person can help them get to the emotional truths of their experience in ways that going directly to their memories does not. In either case, though, it is important to read the text, not the patient.