Diploma in Counselling and Psychotherapy – year three, module one

‘Can we ever leave the past behind? 3058 words

Introduction

In this essay, approaches from Object Relations Theory and Erik Erikson’s theory of Life Stages are examined. The approaches are applied to illustrative clinical material taken from a fictional character. In addition, the essay uses Michael Jacob’s model of ‘The Triangle of Insight’ to facilitate the treatment and the exchanges that occur in supervision.

Elizabeth Pargetter[1]

Eight months after the sudden death of her husband and business partner Nigel, in a tragic accident, Elizabeth Pargetter (neé Archer) presented at her first counselling session. Whilst still experiencing the agony of her loss, she said that things were now beginning to move on in some parts of life. Her bond with the children, 11 year old twins Lily and Freddie, was strong and, although sometimes sad, they were coping well. The business, Lower Loxley – a stately home and conference centre, was also thriving and, after some initial reluctance, Elizabeth said that she has now taken on some very capable staff who had known Nigel and shared with her the history of the family and Lower Loxley Hall.

Elizabeth said that, whilst appearing outwardly to cope with the children and the business, there were areas in her life that were of great concern that she had not been able to talk to anyone about. She said that she knew these issues were about her loss and her continuing grief but she also said that she felt that they were about much more.

The therapist remained attentive but quiet – holding the space and allowing Elizabeth to ‘offload’ the burden she had obviously been carrying. Trembling slightly and holding back the tears Elizabeth explained:

‘Nigel has[2] always been present in my life; even before we got together he was always there, picking up the pieces being Nigel. He was so much part of my past that he actually forms part of who I am, part of my identity. He is part of me and so, when he died I actually lost a part of myself. I know people say that but now I really know what they mean.’

Crying freely now Elizabeth went on:

‘I can’t see a future without Nigel and, what really frightens me is that I don’t even know if I want to have a future without him. You probably think I am being stupid and selfish and I know that even having these thoughts is a betrayal of the children, our children and so a betrayal of Nigel, but it is how I feel.’

Having shared this burden, Elizabeth became a little calmer. The therapist was acutely aware of her own feelings and noticed that she had been feeling some of Elizabeth’s fear and despairs herself and was now actually experiencing a lifting of the burden as she sensed and observed the obvious relief for Elizabeth. The therapist recognised this as ‘projective identification’ and made a mental note to explore her own feelings in supervision. For the moment she just noted her own emotions and said:

‘I can see how much you needed to share those thoughts, how does it feel now?’

Elizabeth responded:

‘Yes it feels better to have said it and I am feeling a little lighter’

Then, after a few moments of shared silence, when Elizabeth had been immersed in her own thoughts she turned her gaze back onto the therapist and said:

‘Tell me, can we ever leave the past behind?’

The therapist thinks carefully about how to respond as she wants to recognise and demonstrate that she has heard Elizabeth’s obvious pain whilst also offering a realistic sense of hope for the future. She acknowledges Elizabeth’s great concerns:

‘I hear you say that, in losing Nigel, you feel you have lost part of yourself and of your identity’’

The therapist reassures Elizabeth that she does not think she is being stupid or selfish, on the contrary she comments on how well Elizabeth has managed over the last eight months.

In direct response to Elizabeth’s question the therapist says that in the present, the ‘here and now’, we can begin to see the past differently and allow ourselves to interpret the past in a way that allows us to carry on. She says that she feels they could work together to review the past and the present and find new ways for Elizabeth to meet the future with confidence. She says that, although it may not feel like it just now, it is possible that she will begin to think about the past differently and find ways to adapt it to her new circumstances so that, in time, it becomes a source of strength for her.

‘So you are saying,’ Elizabeth clarified, ‘that I can’t leave it behind, the past I mean, but I might be able to learn to see it differently?’

The therapist is aware that the connection between the past and present is complex and is keen to spend some time with Elizabeth exploring how she links her present to her past and to understand the role and impact of significant people and relationships at different stages of her development. She goes on to explain that, not only is our experience of the present being influenced by our past, but our memory of the past is also influenced by our present.

The therapist has in her mind the ‘triangle of insight’ as described by Michael Jacobs (1998). This model reinforces for the therapist the links between Elizabeth’s relationship with the therapist in the counselling room (which the therapist has already identified and set aside to explore in supervision) and her relationships in the past and the present. This includes the people who have been so significant for Elizabeth they have been ‘internalised’ and live on in her like Nigel and later on she discovers Cameron Fraser.

The Triangle of Insight

Therapist/counsellor

Past Relationships Present Relationships

The therapist is keen to understand any unresolved issues for Elizabeth, how she has encountered and dealt with grief in the past and how she would describe her relationship with her late husband. The therapist also feels that it is important to work with the positives that Elizabeth has presented and for the rest of the first session they explore in more detail the three parts that for Elizabeth make up the whole person:

• Elizabeth the successful business woman and manager of Lower Loxley Hall • Elizabeth the mother to Lily and Freddie and daughter of Jill • ‘Lizzie’ the wife and ‘soul mate’ of Nigel

Elizabeth is able to describe these three parts very clearly, she understands the different roles and how she separates them. She reports that she has been able to adjust to not having Nigel as a business partner and has now taken on a new manager at Lower Loxely. She is also adjusting to not having Nigel as a father for Lily and Freddie. However, it appears to the therapist that the identity of ‘Lizzie’ the wife and ‘soul mate’ requires Nigel to complement and complete the relationship and without this element at the moment there is a large void for Elizabeth.

Without Nigel, the third part of Elizabeth’s identity - ‘Lizzie’ - has ceased to exist for her because theirs was a highly differentiated relationship. Elizabeth brought the sense of responsibility, security and good-sense to the relationship and Nigel provided the fun, risk and playfulness. Nigel provided for Elizabeth the part of her own identity that she had repressed and now, without that part, she feels incomplete. For Elizabeth, Nigel clearly expressed the part of her that she had denied and ‘split-off’ in herself. So, having denied it in herself she had learnt to project it onto Nigel making him appear more reckless than he was.
The therapist and Elizabeth agree to work together and, at the next session, they explore Elizabeth’s life graph and stages of development. They discuss how healthy personality development may be based on reaching a reasonable balance between two opposing forces at each stage of development. What Erikson called the ‘syntonic’ and ‘dystonic’ (roughly translated as the positive and negative) of a series of ‘contrary dispositions’.

|Psychosocial Crisis Stage |Life Stage |age range, other descriptions |
| 1. Trust v Mistrust |Infancy |0-1½ yrs, baby, birth to walking |
| 2. Autonomy v Shame & Doubt |Early Childhood |1-3 yrs, toddler, toilet training |
| 3. Initiative v Guilt |Play Age |3-6 yrs, pre-school, nursery |
| 4. Industry v Inferiority |School Age |5-12 yrs, early school |
| 5. Identity v Role Confusion |Adolescence |9-18 yrs, puberty, teens |
| 6. Intimacy v Isolation |Young Adult |18-40, courting, early parenthood |
| 7. Generativity v Stagnation |Adulthood |30-65, middle age, parenting |
| 8. Integrity v Despair |Mature Age |50+, old age, grandparents |

Elizabeth explains that she was the youngest of four children and how she was born with a heart condition. She describes her early childhood as being protected by her mother, perhaps overprotected, like a fragile flower. She wonders if maybe she learnt to mistrust more than to trust people and relationships. She reflects that she does see the world as a hostile environment in which to try and survive and she begins to question whether she is now attempting to protect her children in the way her mother protected her.

They go on to discuss the basic virtues and supporting strengths that Erikson identifies from this first stage of development – ‘Hope and Drive’. At this point Elizabeth becomes very animated and describes the drive that has given her the determination to succeed and the strength to carry on after Nigel’s tragic accident.
They decide to draw a life graph to plot the ‘ups’ and ‘downs’ in Elizabeth’s life to date, to see if any patterns emerge for Elizabeth and to highlight any danger zones. She works through the main issues and dwells for some time on a particularly distressing episode when she was 25 years old involving a relationship with Cameron Fraser. She describes this as a disastrous and frightening episode in her life where she acted recklessly and went against the advice of her family. She trusted Cameron and was in the act of running away with him when he abandoned her at a motorway service station, pregnant and alone.

Elizabeth and the therapist begin to explore how she has continually struggled to find a balance between trust and mistrust. Elizabeth begins to question whether she may have adopted more extreme positions of either total trust or total mistrust. The therapist notices how, even 10 years after the episode with Cameron, Elizabeth is still berating herself for having been so hopelessly unrealistic and gullible. She says that, if she is ever in danger of losing control and putting herself in such a vulnerable position again, she only has to remind herself of Cameron Fraser. She says that the painful memory helps to keep her safe and that she has never done anything like that again.

The therapist prompts Elizabeth to think about whether that experience with Cameron has led her, quite understandably, to deny and repress that that part of her identity which makes her feel unsafe. They can both see how, in order to protect herself, she has resolved to act with caution and remain in control at all times. However, to take these insights further the therapist asks Elizabeth to consider whether, in falling in love with Nigel, she was able to find this ‘split-off’ part of herself in him. She responds by saying that is exactly what she did and that she spent so much time trying to control that part of him in order to keep them all safe.

‘But, as you know,’ she said, ‘I failed.’

Supervision

The therapist and her supervisor decide to use the ‘triangle of insight’ to help them explore the case from the three linked perspectives of:

• the therapist/client relationship • past relationships • present relationships

The Therapist/client relationship

The therapist says she has struggled to make sense of what happened during the first session with Elizabeth when she had experienced Elizabeth’s fear and despair as if it had been her own. She says that she was aware that she was reacting to Elizabeth’s vulnerability and describes how she had actually wanted to get up and wrap herself round Elizabeth like a protective blanket, as if they had become one person.
The supervisor says that projective identification involves the projection of thoughts, feelings, attitudes and motivations from one person to another. She says it is at once a form of communication and a defence mechanism that permeates the psychotherapeutic relationship and sometimes we are more ‘tuned-in’ to it than others.
The term was coined by Melanie Klein who believed that the infant starts life in the ‘Paranoid Schizoid Position’ and divides the world into good or bad. Then, at around four months, Klein believes the child begins to adopt the ‘Depressive Position’ and recognises mixed feelings of hostility and love towards the same whole object. According the Klein, distressing or ‘bad’ aspects or ‘good’ parts of oneself can be projected into others and this can often be out of conscious awareness of both the client and therapist.
She says that projective identification is a primitive, pre-verbal mode of communicating and relating. The infant cannot say how he feels; instead he makes his mother experience the same feeling. Both are deeply connected with each other. The healthy mother will react in a way that will facilitate the infant's growth. The same happens in the therapeutic setting.
The supervisor advises the therapist to remain vigilant and to continue to notice what she is feeling in the sessions and what she is trying to be. She urges the therapist to continue to try and understand and interpret the client’s projections even though at the moment they may appear to have multiple meanings.
Hannah Segal writes:
‘In projective identification parts of the self and internal objects are split off and projected into the external object, which then becomes possessed by, controlled and identified with the projected parts. Projective identification has manifold aims: it may be directed toward the ideal object to avoid separation, or it may be directed toward the bad object to gain control of the source of danger. Various parts of the self may be projected, with various aims: bad parts of the self may be projected in order to get rid of them as well as to attack and destroy the object, good parts may be projected to avoid separation or to keep them safe from bad things inside or to improve the external object through a kind of primitive projective reparation.’ (1974 p27)
Past relationships

The therapist describes how Elizabeth’s relationship with Nigel had grown and developed over time to find a type of ‘depressive position’. They had adjusted, coped with the highs and lows and gradually learned to live with the ambivalence. She also describes how they were differentiated as a couple and that their personality differences would probably have been perceived as complementary by their friends and family: Elizabeth being the solid, sensible one and Nigel a little irresponsible but fun loving.

The Supervisor said that, when romantic partners are differentiated in this ways the intimacy between them will tend to occur without a loss of individuality. These couples will feel close to each other but will also encourage each other’s personal growth. Even though Elizabeth is feeling the loss of a part of her identity just now, both supervisor and therapist felt that Elizabeth had retained her individuality in the relationship and were optimistic for the future. In addition, the therapist reported that she felt that Elizabeth was reviewing and reliving the past in therapy and finding new ways to adapt to the new circumstances of her present and future.

‘Where the relationship has been felt overall to be a good, caring and loving one, then of course that person will be greatly missed: but in time sadness will be combined with the pleasure that comes from recalling positive memories, and from the internalised figure bringing sustenance and strength to the self.’ (Jacobs 1985 p192)

Present relationships

The therapist told her supervisor that she had just finished reading a novel - ‘Before I Go to Sleep’ by SJ Watson - where the central character has a faulty memory that deletes her history whilst she sleeps. She wakes up every morning completely disorientated, not knowing who she is or anything about her life. This novel came to mind when Elizabeth asked: ‘Can we ever leave the past behind?’

The supervisor refers again to Michael Jacobs who says:

‘The past is only relevant in as much as it is present, still in the mind of the client. It is also present in that type of ‘living laboratory’ of therapy in which counsellors and therapists are presented with opportunities to re-experience with their clients certain aspects of their presenting past; in which the effects of the past can be reviewed; and through which the effects can be to some extent adapted to the new circumstances of the present and the future’. (Jacobs 1985 p194)

The therapist left supervision reassured but with much to ponder.

References

Erikson, Erik H (1982) The Life Cycle Completed

Jacobs, Michael (1985) The Presenting Past

Malach Pines. Ayala (2005) Falling in Love – Why we Choose the Lovers We Choose

Segal, Hannah (1974) Introduction to the Work of Melanie Klein
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[1] Elizabeth Pargetter is a fictional character from the BBC radio 4 series ‘The Archers’
[2] The therapist notes that Elizabeth is using the present tense in referring to Nigel

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Internalised ‘objects’

In here Out there

Back then

Elizabeth Pargetter (neé Archer) born 21 April 1967 – Life Graph drawn in the summer 2011

2007

+ve

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X
P
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N
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10

20

30

40

50

YEARS

a

b

c

d

e

f

g

a = Grandfather dies (1986)

b = Lost her way and crisis with ‘A’ Levels (1986/7)

c = Disastrous relationship, - abandoned by Cameron Fraser and has an abortion (1992)

d = Nigel supports ‘Lizzie’. Relationship with Nigel begins and they marry in 1994 – problems with mother-in-law (Julia)

e = Twins are born (1999)

f = difficulties with mother-in-law continue and she dies (2005)

g = Nigel falls from roof in tragic accident and dies (2011)

1977

1987

1997

2017