The Runaway Bunny  by Margaret Wise Brown, pictures by Clement Hurd

Difficult patients are difficult for their chronically intermittent, sometimes seemingly relentless, attacks on the work and on the therapist’s competence: “This isn’t working;” “Nothing has changed;” “Analysis is useless;” and, more pointedly, “You don’t care about me;” “You only care about the money;” “You don’t know what you’re doing;” “You suck!” Commonly, there are also frequent threats to quit analysis, often expressed with the threat of suicide.

To keep my balance and to survive (neither withdraw nor retaliate, in the Winnicottian sense), that is to persevere without thinking: “Here we go again;” “Who needs this anyway?”; or “Good riddance,” I recall the delightful children's book, The Runaway Bunny (1942) by Margaret Wise Brown, probably better known for her Goodnight Moon.

The Runaway Bunny is a felicitous analogy for working with patients who want us to believe that we are unimportant to them. The runaway bunny

              said to his mother, “I am running away.”
              “If you run away,” said his mother, “I will run after you.” …

              “If you run after me,” said the little bunny,
              “I will become a fish in a trout stream
               And I will swim away from you.”

              “If you become a fish in a trout stream,” said the mother,
              “I will become a fisherman and I will fish for you.”

              “If you become a fisherman,” said the little bunny,
              “I will become a rock on the mountain, high above you.”

              “If you become a rock on the mountain, high above me,”
              said his mother, “I will become a mountain climber,
              and I will climb to where you are.”

And so on for a crocus in a hidden garden, a bird flying away, a sailboat sailing away, his mother always finds a way to stay in connection with her little bunny.

                   “Shucks,” said the bunny, “I might just as well
                   stay where I am and be your little bunny.”

I can imagine this gives reassurance to an adventurous or angry, small child, that her/his mother will always come for it. With this on my mind, I hold the faith of commitment to the relationship and to the work.

Perhaps this attitude is implicitly conveyed, a balm of certitude for a patient who has experienced unpredictable or abandoning parents. Perhaps it is explicitly conveyed, “I will be here tomorrow at the appointed time.” Either way, it is my job, I think, to remain steadfast and keep faith when the patient conveys, with an onslaught of doubt and vituperation, her/his hopelessness, anger, or disappointment in me and in the work. A candidate asked, when I convey this attitude in class, if I were a masochist, or a saint. Neither, and I referred the candidate to Ghent’s 1990 paper on Masochism, Submission, Surrender.

Recently, after unrelenting, expressed hopelessness, a patient  said to me, “I think I am doomed with or without you -- but I’d rather be doomed with you.” And after a few wiped tears, he added, “You’re the person I want to be doomed with,” and smiled.