Thursday, May 20, 2021

Electives: Students Present: Somatization in Group Therapy, Part IIB, Fotini's Story

 Foteini’s case study:


I am going to present how my personal story - the treatment of my son’s heart arrhythmia - brought ‘arrhythmia’ to the coordination of the group. Andrienne Harris noted that our wounds must serve as tools, but sometimes they are obstacles impeding our capacity to engage deeply in the analytic process. Bion believed that two minds are needed to think about the most unpleasant thoughts of the one. But access to the most secret areas demands courage. 

What happened in the group happened in parallel process to my personal life: I split my feelings of loneliness and shame from the group’s projective identification of me in an omnipotent position. 


It was at the end of the third year of a group therapy that Alkinoi and I became coordinators. The group included 11 members and 2 therapists; the sessions took place once a week for 1.5 hours. Before the session from which the present analytic material emerged, the members had empathetically discussed absent parents, somatizations, common traumatic experiences of abuses, fantasies of destruction and projections of aggression. I returned to the group after an absence during which my child had been hospitalized to have his cardiac arrhythmia cauterized. His first episode was at the age of 5; I still remember the strong pulse heard from his chest. I could not offer him any kind of help except to hold him tight in my arms until we took him to hospital. From that day, and for the years following, every time he asked me to go next to him, calling “mama”, my body froze until I was certain that he was all right. Feelings of fear, helplessness, agony, and shame invaded me. My son felt the same way, but back then I was not aware of his worry, which was enacted by bursts of anger and a pervasive fierceness. During that period, I was more concerned with dealing with his behavior than with his inner feelings. I was responding from the ‘outside’ and not from the ‘inside’ - as Levine wrote. 


It was especially painful and shameful for me to be able to help other families with similar issues while at the same time I could not find a way to connect with my child. It was not that we did not have moments of love or that I could not see his sweetness. It was extremely hard when speaking of Winnicott’s way to hold him in a continuous and stable way. Seeing motherhood so romantically in our civilization, causes a greater burden to the mothers of our occupation who have to fight with the role of being good enough mothers and the role of being good enough therapists.

Entering the room to start the group session, I noted that I was confused, as if I were in a dream. Some members looked at me furtively. I fantasized that they thought I was exhausted, that they were convinced that I was devastated, and I would not even be “present” at the session. I felt embarrassed and I did not know why. My body was weak. For a long time I remained silent. I couldn't connect, showing that something unbearable was happening. Even before words could explain it, my motionless body echoed that something was coming. A therapeutic impasse and at the same time a moment of deep engagement. 


The group members had been informed about my absence at the previous session by Alkinoi, as my son’s hospitalization happened suddenly and I had no time to inform the group about my absence. A special condition that prevailed in the group for weeks, for which the members had consented, is that a mother attended the sessions with her baby. My child’s arrhythmia was synchronized with the ‘arrhythmia’ of the group and my own ‘psychic arrhythmia.’ While I was trying to find my position in the group, I realized that I was in a terrible split. What kind of mother am I? Am I a “good” mother, who gives priority to my real child, or am I a “bad” mother, who is absent for my symbolic children? If I remained in the group, would I be bad for my son and good for my group? In my real life, another child had been left aside, my younger son, and my huge agony was that he might also be exposed to danger or that his personal needs might be left behind. 


Nevertheless, at that moment I managed to share with the group a small part of my vulnerability. Idealizing what a mother needs to do to pull through, I pretended to endure, without speaking of my vulnerability, without being perfectly honest or spontaneous. The limits became a blur. How can we invite in our inner selves which torture us from the inside, filling us with self-hatred and self-deception; which trigger repetitions of an unbearable therapeutic impasse, attempting inappropriate forms of heroic rescue? What are we willing to risk: allow ourselves to affect and to be affected instead of remaining closed, fighting with our fears of being strange and defective? Or remain near the subtle details of our own experience and use them in an analytically sensitive way? Up till the moment I returned to the session, after my son's problem of arrhythmia had been resolved, I was not fully aware of the degree of difficulties concerning the relationship with my child. Even in my own therapy, individual and group, I experienced feelings of shame in revealing how difficult it was to deal with this situation, how angry it made me feel, worrying if my therapist would judge me as a bad mother. Unconsciously, I was terrified of my own hostility and destructiveness. However, in this session, even though my intent was to connect with the group members, I was detached, without showing my weak mark.


-Fotini Dourmoura


Next time (Part III) we write about reinterpreting the enactment.



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