Moments of Meeting

In my experience, there is no one who would not benefit from being with another person who has the internal space to try to understand what his or her internal and external world is like. The moment of understanding can be so profound and important that it begins a healing process that the psyche may have been longing for, for many years.

When I see a patient for the first time, I am not primarily concerned with theory or categorising that person. I am listening with my whole being to what they are saying, what they are not saying and what their body is saying to mine. It could be someone talking about being unable to conceive a baby, or someone trying to deny a deep grief and carry on as normal but their body is breaking down under the stress. It could be someone bursting with indignation and murderous rage, or a timidity or rigidity as a result of boarding school at a very young age. Separation and managing without parents was a prerequisite of colonial English history. The price children paid was enormous.

Another aspect that repeats itself in my practice is the invisibility of neglect. Those adults who have been quiet, good children, in a family where the parents are in high drama. Where there really is no space for them to rebel or make demands. These children grow up not knowing who they are or who they could become, given the right sort of attention.

Adults trapped in a prenatal state of mind also enter therapy and the therapist is tasked with the job of locating where they are stuck, either by a birth experience or by overwhelming feelings from the mother during pregnancy or the death of a twin in the womb or something else. All these events may cause trauma to the forming child. They can also go unseen for lifetimes, causing chaos in a life.

In my practice, it has often been the case that a patient has not been able to tolerate any discord or difference between us. This indicates to me that the symbiotic period of the baby’s life was not satisfactory and for some reason, the mother was unable to follow the communication of the baby.

The therapists work is to help to establish a solid foundation of maternal attunement so that the person can tolerate first small differences, then bigger ones.

You can imagine how this issue plays out in a marriage. All hell breaks out when the symbiotic feeling breaks down. When a partner realises that the person they are married to is not the ‘twin’ or the merged person who understands them completely and fulfils their every wish. On a practical level, therapy is expensive but divorce more so. Both financially and emotionally.

After four decades of being first a Psychotherapist and then Jungian Analyst, working in private practice in London, England I would like to share a few thoughts. My doctoral thesis concentrated on a moment of silence in my consulting room between a patient and myself. I was interested in how as therapists we feel into the moment in an effort to understand the patient and the patient’s world. I was interested in how feelings pass between people and how moments of very deep contact, sometimes communion, happen. I felt that there was something more than transference and countertransference that I wanted to explore.

I am also a Homoeopath and involved with questions such as ‘Is Homoeopathy all placebo or is there something else involved?’ What is placebo - does it involve transference, countertransference or unconscious communication between two people or substance? Are quantum physics involved here? What are the limits of our present-day understanding?

I see the Homeopathic idea of Like Cures Like one which is applicable too in the therapy setting. As therapists, we do not expect to help someone by refusing to see their pain or their experience. A therapist who knows grief, as most of us do, can resonate with the grief of another. This is what I mean by like cures like. The patient can unconsciously pick up on that and feel heard. As therapists, we often use our bodies as instruments of resonance and healing. We try to put ourselves into someone else’s shoes, whilst still retaining the ability to think and be separate.

It is a process hard to describe and harder to teach and not all therapists/analysts work in this way. In my view it is akin to entering another dimension. Often it would be difficult to explain the depth and importance of the interaction. Sometimes we may leave the consulting room feeling as if we have been on another planet. It can be subtle and transformative.

What is it that promotes change in us? In my experience, being an analyst involves being consistently there, week after week, year after year, ploughing the field of listening and attempting to understand. It is both ordinary and extraordinary at the same time.

How do feelings pass between people and what is this thing ‘Being With’ someone and why is it so powerful in healing?

It is my belief that analyst and analysand, therapist and client, are not two closed systems with firm boundaries but open systems that allow movement between. We think of ourselves as separate but we may not be as separate as we think. On a quantum level, we flow into each other all the time. Is this how feelings and sensations pass between us? As therapists, we need to be aware of other disciplines and other ways of thinking in order not to become parochial in our understanding. Ideas such as ‘Entanglement’ may be another way of exploring how we are ‘infected’ by another person's feelings and internal state.

When I first became a Psychotherapist, I thought that I was the person who was ok and that the patient was the person who was not ok and that it was my job to help them. How arrogant are the young! Life, as I realise now, is one long journey towards Individuation and that learning about yourself and resolving dilemmas continues. My experience has been that it is sometimes possible to share a deep sense of understanding in a simple conversation with a stranger on a brief bus journey. Analytic insight may happen in other places than the consulting room. The world is full of need for the light of insight and depth.

I am not intending this to be a theoretical model for therapists, just introducing some ideas that have captured my imagination and questioning mind over the years of working with people. I have never been interested in the duelling between theorists and the jostling for powerful positions in the organisational life of therapy institutions. As I get older, I am more and more convinced that energy can be better spent trying to work without ego and with an acceptance of ordinariness.

Sometimes, as a profession, we can appear too theoretical and not at all accessible. This devalues the wonderful individual work that goes on throughout the world.

There are ‘moments of meeting’ which have a different quality to them. I believe this to be different to attunement. Research is showing that these moments are more valuable therapeutically than transformations involving knowledge or insights.

Analytic responses involving a therapist saying ‘You are telling me ……’ show technique as uppermost. Patients are sometimes frustrated by these, wanting a more authentic response from a real person. Stern believes the ‘moments of meeting’ to be the key to change and do demand a more authentic response from the therapist. Knowing about someone is not the same as knowing someone. A moment of meeting may take months or years of work leading up to this important event, which is recognised by both participants. At these moments, the roles of therapist and patient recede and personhood comes to the fore whilst still remaining professional.

When thinking about what creates the conditions for moments of meeting it is hard to pin down. I believe it to be a willingness on the part of the analyst to be ordinary, without agenda, without the desire to be top dog, or clever, or even useful. Being useful creates a hierarchy, even with good intent. To be on the same level as the patient, not thinking that you know it all. To be understood by the patient on a deeply unconscious level, as struggling alongside them in order to understand what they need.

We are all shot through with our histories. Our cultures, class, colour, positions in the family. We take this everywhere with us. And certainly into the consulting room.

Issues of race and class, which have been long absent from discussion in analytic circles are now demanding focus. At long last. Very few black people enter analysis and I can count on the fingers of one hand the number of black analysts visible in the analytic world in London. I am aware of the elitist history of the Analytic movement. It is only in the last year that a conference has introduced class as an important issue in the consulting room. It has been present in mine for many years. I am interested in power, the dynamics of power and the abuse of power. I am interested in gender politics and power.

These are issues that hurt us, motivate us and are part of the fabric of our lives. No one comes into therapy saying that they are hurt by the class system but feelings of inferiority, superiority and judgemental attitudes are shot through society and have to be made visible and thought about in the consulting room.

On day one of therapy, the patient will be making assessments of the analyst’s position in society, the size of the house if she works from home, the location, her accent, colour, dress, furniture. This may be the background on the first day when the patient may be full of other concerns, but it will be present. Feelings such as envy, inferiority, superiority, contempt will also be present.

We do not know enough about the moments of meeting to say for sure what it is that triggers healing. We do recognise it when it happens.

As therapists, we are involved in an alchemical process which we cannot control. It is akin to a potter glazing a pot and putting it into the kiln. A third element enters into the mix and the result may not be what you had imagined. We also are part of transforming a patients internal life and in that process we too are transformed. I am touched and changed by my patients as they are by me. We are in this together.

Angela Fell has had a London practice seeing patients for once, twice, three and four times a week sessions for nearly four decades. She is a Training Analyst for the WPF and AGIP.

She completed a Doctorate in Analytical Psychology in 2007 and is a member of the Society of Analytical Psychology and a registered member of BCP and UKCP.

She completed an Infant Observation in 1999 and qualified as an Integrative Psychotherapist in 1987 and a Homoeopath in 1985. On the way to this point, she qualified as a teacher and has a BA.

In the first ten years of her working life, she worked on the streets of Vauxhall and Brixton with young people who were not attaching to school or work. She helped start a free school, establish a community recycling project for unemployed young people and a children’s rights project. She ran a refuge for women experiencing domestic violence and worked for Lambeth Community Law Centre, running groups to enable people to get access to better housing.

She has acted as a Consultant for The Law Society and for youth projects in London.

Angela Fell: Copyright July 2018