"It wasn't an accident that I came to you"

16 January 2018

Who do you turn to when you're in crisis? In her latest book – In Therapy: The Unfolding Story – psychoanalyst Susie Orbach shows us how therapy really works through a series of dramatised case studies, originally broadcast on BBC Radio 4. In the second of two extracts, we meet Douglas for a follow-up session with Susie, just before he has to deliver a difficult verdict.

Second session

Douglas: Hello.

Susie: Hello Douglas.

Douglas: Nice to see you again.

Susie: You too.

Douglas: Thank you. So, thank you for the last – thank you. I, um, I shall have to be in court in an hour and a half, and I have to sum up and I have to, really, I have to decide what I am going to do with this man who I find so challenging. So I am in a quandary really because I want to punish him severely and I suppose I feel that I should be punished too, and if I am lenient with him it is an injustice because the man is an appalling criminal. If I am hard with him, I am a complete hypocrite because he is only doing something that I have helped to create.

Susie: Could you tell me a little bit more about your relationship to the women you see him trafficking?

Douglas: My relationship with them.

Susie: Well, to women who you have bought sex from.

Douglas: Oh God. You see, I think I never quite understood why certain things that the world thinks are wrong are wrong. When I was younger, I was guilt-free really about using women in that way, and … Well, that’s not quite true.

The magic of therapy is that it allows space for the person to go back on themselves and question their actions and their motivation. Therapy is not a linear process where a line of enquiry is followed sequentially. It is about associations made, the stuck places, the hot spots, the confusion which we come at in different ways, and while a therapist may ask a question, it isn’t the answer per se that is important but what it can open up for the individual.

Susie: Uh-huh.

Douglas: My relationship with these girls is quite perfunctory, of course, because you don’t get to know them, but I did have romantic fantasies about a certain girl especially but – and I think in a way that allowed me to feel guilt-free because I thought, well, I am treating them as human, I am not violent, I pay them very well, I asked one of them to meet me outside, you know, which she refused – but I kind of feel that I was humane in my relationship with these girls, but there was one Polish girl who I got to know a bit, and who I realised was indeed trafficked, exploited and wanted me to help her. In fact, she was the last girl that I saw in this way.

Susie: How recent was this?

Douglas: This was a long time ago, ten years ago. Um, and I feel guilty about her because I didn’t quite realise at the time, but quite soon after I realised that she was frightened and in trouble, and needing to be liberated from the grip of a man like the man who is standing in the dock in front of me at this trial.

And I let her down because I did nothing. I think I was ashamed and embarrassed about the possibility of being discovered.

And so I walked away from that part of my life and buried it and left it, and I think it is these girls that I hear about now, this past week, have reignited this dilemma within me. I think I wanted love but I was paying for sex, and I kind of made that alright in my mind, and suddenly the anger has come up again with regard to this man and it is not alright.

Susie: Because not only does he exploit these women, but he exploits both their need for love and men’s need for love?

Douglas: Yes, exactly, and that is why I said about your being a feminist, or women I have talked to about these things, without of course telling them of my own particular involvement. But I find sometimes that certain people, they don’t see the man as a victim as well as the women.

Susie: Well, I wonder if you could see yourself as a victim.

Douglas: Yes I do, but then how can I be a victim?

Susie: Could you slow down a second, instead of rejecting it? This is a new idea for you, Douglas, and would you just consider it for more than a millisecond?

Douglas: Well, I have agreed with you. I mean I have agreed, I have agreed. You are right.

Douglas’s voice turns irate. His whole body looks inflamed. Some of his vulnerability has shown itself and made him uneasy. I’m still on the mission helping him see how anger becomes a portmanteau emotion, carrying many different feelings.

Susie: I think this is really helpful because you are showing me a piece of where the anger comes from.

Douglas: I feel that you are going to judge me and punish me.

Susie: I am actually more interested in trying to understand and…

Douglas: I think you are like – it wasn’t an accident that I came to you.

Susie: What, you came for punishment from a feminist? And you are paying me very well.

Douglas: You’re – I sit up there on the bench and I am very powerful. Um, and I am very aware of my power and I feel like a lonely child all at the same time.

Susie: And a lonely man?

Douglas: Yes, but I sit up there and I feel like a preposterous ten-year-old wearing a wig. Actually not ten, more like sixteen, um, with impossible – how can I do this job, how can I judge people’s emotions, behaviour, when I am so confused, and I think … I knew you were of a certain type, you are a woman, and I think I, ah, I, ah, yes, I don’t know.

Susie: Do you think you really came here to be beaten up?

Douglas: I expected…

Susie: Unless you think that is a form of help.

Douglas: No, it is not a form of help.

Susie: Right. So I think you…

Douglas: But I mean what I did was bad, and what I am doing now is bad and…

Susie: Well, I am interested in that, and I hope we will come to understand it, but at the moment I have got this very strong image, the one you just gave me, or gave us, of the young man sitting up there in fancy dress.

Douglas: Um.

Susie: As though there can’t be a vulnerable part of you at this age, as though you have to somehow diminish your vulnerability and speak of yourself as a sixteen-year-old rather than you as a grown man, with a big job, who feels vulnerable himself, and has complicated feelings.

Douglas: I think the difference is that this counsel who is arguing for this man – well, I know things about him, he has a complicated emotional life – but when I hear him, when I see him, he gets under my skin. It is as though I am looking at an adult with issues, with complications, and he makes me feel like a child, and that is the difference really. It is not like being an adult with vulnerability. I feel like a child sitting there, and I feel – the rage I feel, the tearfulness I feel when I had to call the recess, it was like being a child afflicted by a storm of emotion that I had no control over or context or perspective.

Susie: But actually it was very wise for you to call the recess, wasn’t it?

Douglas: Well, I mean, it wasn’t…

Susie: You were trying to take care of the situation, trying to take care of…

Douglas: I wasn’t wise, it wasn’t wise. It was just, if I hadn’t done it I would have been sobbing in court.

Susie: Well, I guess that wouldn’t have gone over big, so the fact that you knew…

Douglas: Well, it would have.

Susie: The fact that you knew that you might have been sobbing actually helps us a lot because sobbing is quite different from rage.

Douglas: Yes, they go together.

Susie: Well, do they?

Douglas: Rage leads to sadness, leads to rage, yes, they live together, one is the reverse of the other, two sides of the same coin.

Susie: Well, I’m intrigued by that because one bit doesn’t seem to get much expression. What you have told me so far is that rage is the thing that gets expression. The sob is hidden.

Douglas: Well, I can’t sob in court.

Susie: No, I accept that, but I think you are sobbing inside somewhere, and that is almost hidden from you and that is causing you difficulties.

Douglas: Um.

Susie: So that’s worse than the rage, I don’t mean in the public forum, I mean inside of you.

Douglas: Yes.

Now I feel we have done some parsing. We have been able to take apart what is bundled up by Douglas’s response of rage. We have been able to identify his shame about his past behaviour, his disgust at the trafficker, his feelings of illegitimacy to judge another and his sobs about his predicament. I didn’t pick up on what he knew of the defence counsel’s ‘complicated emotional life’ because it would have broken the flow of dealing with the recognition of his own vulnerability, and that was primary. I was interested in what he was seeing or projecting on to the defence counsel that he thought he got away with while Douglas was beset with upset, anger and confusion. I set that aside in favour of exploring the feelings that came up that constitute his anger.

In my first session Douglas was angry because he didn’t know how therapy worked, so now we have some of the elements of the bundle called rage which was scaring him. It is like a pressure sitting on top of a mix of contradictory feelings.

Susie: You hurt in a lot of different ways. You are confused, and the rage is a kind of cover story for you endeavouring to hold yourself together, except it has got cracks in it.

Douglas: Um, yes … I, um, yes.

Susie: We have got to stop shortly, but one of the things that I am thinking about that must make this summing up so very difficult for you is that you want to convey empathy for the girls, the women, but you have kind of empathy deficit in relation to yourself, so you come in with the rage, and that is part of your dilemma.

Douglas: Yes, because I want to punish him as well, I want to punish him very severely, so…

Susie: But is there an interesting way of talking about the women’s lives that would help you in this?

Douglas: In what way?

Susie: Well I’m not that au fait with summing up frankly, but I am thinking about not just the legal kernel here, but the fact of these women who you feel very affected by, who you feel have been so exploited, and wondering is there a way of you thinking about them in the summing up.

Douglas: Yes.

Susie: That might allow you some more space so that the rage doesn’t overwhelm you.

Douglas: Yes, I think, yes, I think I have this. I dreamt about it the other day. In fact I was in court and somebody at the back stood up and said I know what you’ve done, and how can I sentence the man, how can I sentence the man. I am sentencing him for violence but I am really sentencing him for casual cruelty and lack of empathy, that’s the word you said.

Susie: Yes, but he is there because of GBH, because of the trafficking, the actual rounding up of women and the transporting of them.

Douglas: Yes, but they…

Susie: And the vulnerability of the women and the vulnerability they experience that you are trying to address.

Douglas: Um.

Susie: And privately the vulnerability of you, and other men who seek them. Look, we are going to have to stop now. I would like to see you on Thursday, and then if we wish to carry on after this emergency, we can discuss arrangements.

Douglas: Yes, that would be good, thank you.

Susie: OK.

Douglas: I shall think of you when I am in court. Thank you.

The sessions feel rushed on reading them, but in the room we had established a rapport which opened up some thinking and feeling space which levered Douglas out of his isolation and fear. I was moved by his ability to consider what was coming up in the sessions and I had every hope that he would be able to join up the 16-year-old in fancy dress with the substantial middle-aged man he is. Developing some compassion for his own difficulties and naming them were important in the very short term. As our sessions progressed, I sensed that the themes we talked of would be what we would look at in-depth, as we reflected on his history and the way it had closed down certain emotions for him.

I am aware that the practice of adversarial law is one kind of enquiry and that psychoanalytic therapy is another. In one, to put it crudely, we are looking to judge right and wrong. The crime has to be punished. In therapy, we hear multiple truths with different weights to them. The constraints of his summing up have legal ramifications, and not surprisingly Douglas expects to be judged in the therapy room both because of his work and because he is not accustomed to the modes of thinking in the consulting room which are about understanding not judgement per se.

 Front cover of the book 'In Therapy, The Unfolding Story' by Susie Orbach.

This extract is taken from In Therapy: The Unfolding Story by Susie Orbach, published by Wellcome Collection.