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I woke up 5.30am this Sunday. Ready for the London Marathon. Heart pumping. Surely, it’s the best marathon in the world? I’m sure you know somebody who took part? Maybe you watched the marathon from the London streets, or maybe you watched the highlights from the comfort of your sofa?

It was going to be the biggest ever in terms of finishers. Maybe there would be some records broken? What time was I aiming for? Thanks for asking, but the best thing was I wasn’t going to have to run it! No having to forcing sickly sweet blackcurrant gels down my throat. No bright pink £200 bouncy trainers. No need to smear myself from head to toe with Vaseline. No need to focus on my breath or pace. No need to suffer, suffer, suffer.  No need to die, die, die. No need to push, push, push through the pain cave. I have run it three times before and was delighted to be on the sidelines this time.

Despite the early morning cold fog as I cycled to the start line, I knew it was going to be a sizzling day. I knew how much it would hurt those brave runners as they soldiered on through the sweltering afternoon city heat, slowly cooking, burning, melting. I had it easy. I was simply volunteering on one of the baggage trucks. All the fun of a marathon vibe, with none of the running. I was going to be a tiny cog in the logistical monster of this feel-good global event. I was going to help make sure that each of the 56,000 runners finished up with their valuables. Well, at least I was going to try and help a few of them. This was a nice distraction from my day job as a psychotherapist…but also strangely similar.

Psychotherapy and emotional baggage

As a psychotherapist, you could say, I help people with their “baggage”. I see lost cases, damaged cases, shiny cases, half-open cases, and tightly locked cases. Sometimes there are cases everyone leaps for off the baggage belt at the airport, and sometimes there are cases that nobody picks up. They just go around and around.

I examine the content of these cases, looking for interesting material. In the marathon, runners must use regulation see through plastic bags. But we can’t just peer into someone’s insides. We must get through a tough protective outer casing. Security locks, polythene wrapping, padlocks.

We can’t break into cases. We must get the patient to remember the codes. How can we help the patient feel comfortable enough to unlock some of this material in our company? Sometimes it can take five minutes; sometimes five years.

I look for clues in the content, and how it is arranged. Patients sometimes literally leave things behind in the consulting room. More often, they might wish to store some of their emotional baggage in my psychological storage facilities. I don’t have a truck, but I need to make sure I keep a space in my mind to provide adequate storage facilities.

The baggage truck

I arrived at Blackheath early, as instructed. The first thing I learned was this was a serious business. Our leader Emily, a seasoned volunteer, was clear: “Check the bag number matches the bib number on the runner’s vest. Make sure they tie bags up properly. Once you get a bag, don’t let the runner have it back! You won’t have time to go searching for their bags amongst the huge piles. You will be inundated. At 9.15am it will be chaos. The trucks will be leaving. Just take the bags. Once the trucks leave that’s it.”

Some of our group stepped into the trucks and donned a harness to keep them secure as the moved about with the luggage. When we are handling other people’s luggage, we can trip, and fall. I stood closer to the runners and took bags to pass up or throw to my fellow volunteers on the truck.

The early runner and spooky happenings

There were a few super organised runners who wanted to leave their bag with us at 7am. They were dressed in charity clothes, which they would later discard, to keep warm for the start. One man was dressed in a white synthetic outfit. He looked like he had travelled in from another galaxy. He explained he had bought a disposable painter’s overall. It was light weight, warm.

These early types were conscientious, they were planners. They had clearly considered every detail.  Controlled every controllable. Read every book, digested every forum, and thought through the race before running it. This reminded me of my running friend Claire Steward. I caught up with her over a coffee post-marathon. Her attention to detail is staggering and her results and numbers are often spooky. Einstein talked of quantum entanglement as being the answer to the universe’s riddles. Claire is a living example of marathon entanglement. She is 71. She ran her first marathon aged 51 and this was her 51^st marathon. She completed it in 4.44.44. She has mild COPD and was advised to have a double knee replacement five years ago. Her marathon data is a snapshot of her precise psyche!

The late runner and chaos

As I took the bags, I made small talk with the thronging runners. Have you tied your laces? What’s the race plan? Will you sprint the last 100 yards for me? Have you applied sun cream? What time are you aiming to run in? The runners were chatty. “I’ll run it in 2.48!”, “Just want to enjoy it.”

A few runners started to ask me for their bags back.  They had wanted to take out earphones, or put earphones back, or find a piece of kit. I was a soft touch, and managed to work with my fellow volunteer to let them have their bags back. It reminded me of psychotherapy. There are moments when a patient hands something over to the therapist, for consideration, or contemplation. But then the patient may want it back, to examine it themselves in their own mind. They may need it back for a few minutes, or longer. Of course, in psychoanalytic work whilst the therapist may help with interpretations, it is the patient who must come to their own conclusion.

Carrying the big black bag

James, a young man, approached me with a big black rucksack. He was hoping that his parents would have taken this from him, but due to train issues, they hadn’t been able to meet him. Normally, that would mean he would have to leave the rucksack at the recycling facilities. It was like he was being prised from a living, breathing thing. I imagined all the journeys he had shared with his big black well-used rucksack. I caved in. I put myself in his shoes. I told him I could take his empty rucksack for safe keeping and that he could collect if from me in the future. We swapped numbers. He seemed palpably relieved. I put my own smaller rucksack into his enormous one and carried it about with me for the rest of the day. James, please call me or text me to pick it up! As a therapist, we might carry baggage for decades. Sometimes am old patient calls us out of the blue. We find we can always find their case, usually in pristine condition, and hand it back to them.

The sprint, the end

Towards the end of the day, people started to panic.  They hadn’t left enough time and were getting changed in front of the baggage trucks! Gels, phones, socks, hoodies, fancy dress costumes were flying in all directions. We were no longer able to carefully sort and put bags in the exact numerical sections. MOVE IT.  NOW!  THE TRUCK IS GOING!  The tempo and energy levels shot up. Runners sprinted to the truck from all directions. I was now taking on baggage, but with less care and attention.  I was throwing it on to the truck with wild abandon. I was wondering if this was akin to working at an airline desk before a flight is about to leave. I had to give some people bad news that the trucks would be leaving without their baggage.

Chaos. Excitement. The finish line. The end of the session. The baggage handlers are not here forever. Some patients like to finish the session a few minutes early; some like to run over. Some bring super-size baggage, some only carry hand baggage. As therapists we must weigh it all up and handle with care. So next time you’re in the consulting room, have a think about type case you are. Get your code or keys ready, and take a chance, open that case!

“Don’t look down Ajay!” shouted my friend/torturer Michael as we clambered over craggy rocks in 50mph winds.

My heart was beating so fast that I was sure I could see it actually pumping through my many layers of clothing.

I could taste my own adrenaline mixed in the boiled egg we had eaten on our last break.

This was a bit different to siting in comfy therapist chair. I was both smiling and crying simultaneously.

This was my annual get away with friends. I had decided this years’ edition would be a hike, to avoid the jeopardy involved in bikes, skiing, running and so on. I chose people based on the following criteria:

1. Could they walk all day long?

2. Could they avoid ending up in A&E?

3. Would they be good company?

4. Could they wash up/buy a round unprompted?

But to be honest the main criteria was A&E avoidance. In midlife, this was not a simple ask.  Over-inflated or deflated egos, failing bodies, and a quest for adventure make a dangerous and potential painful cocktail. If anyone was going to be the group patient, I decided, surely it was my turn! I was having a few days off and everyone else could take care of me. Hiking was the safest and easiest group activity. Hiking is basically walking with a piece of cheese in your back pocket, and posing with a pair of technical “hiking boots” – that surely is NOT dangerous! Barely a sport. More a convivial way of standing up with a bit of gentle swaying I reasoned to myself.

To make the decision easier, a friend had moved from my part of South London to Keswick in the Lake District, and was keen to guide us and share his backyard with us. He is an experienced climber, hard as nails, and runs 100 mile ultra marathons in his spare time in the cold and dark. So we knew we were in good – if somewhat cold and weathered –hands. However whenever I asked him what we would be doing he would say, shaman-like, “dunno.”  I guess he knew that our city-based ego-centric ways would be useless here in the wild lakes. We were in the hands of the weather gods! He pulled up specialist weather reports only for the initiated that used phrases I had never heard of before like “whiteout” and “zero visibility”… What was I thinking?!

Fortunately, I was well prepared for the job (£7 Lidl bargain black ribbed base layer and an old £5 polyester running top). The wind was howling as I scrambled across Haystacks (not the fluffy rural idyllic golden sort but a severe brooding grey rocky sort) in the Lake District. Storm Bert sounded like a friendly uncle but this was unlike any weather I have experienced in the UK!  There was slush and ice all around. I recalled some of the words I had come across when doom scrolling Mountain rescue reports before coming up…hypothermia….cragfast…fatality…

For a few a hallucinated seconds I imagined I was in the death zone (above 8000 metres) on Everest grinding out steps into a head wind (yes I do get carried away sometimes), when in truth I was five hours from London (thank you Avanti trains) and probably 500 metres above sea level. The air was full of rain and bluster. I was both hot and cold as my last minute Decathlon arctic hiking pants panic buy was slowly cooking me from the inside. My hat and glasses had been blown clean off my bearded face. I scrambled about on all fours, like a clueless goat, trying to recover them, whilst both trying to look heroic, as Michael was taking pictures, and without falling off the edge of the ridge.

Yes reader, I was having the time of my life! I wasn’t at the level of those incomprehensible people who walk on top of the world’s highest buildings, but this sure did beat walking up and down the stairs to my consulting rooms.

This was a different type of drama than the one I often encounter in the hushed and private container of the consulting room. I know that when the Greek gods of relationship – Zeus and Hera – have an argument, thunderbolts roll!! But there is something different from living in the realm of text and language compared with throwing yourself in to an actual storm! Therapists often deal with powerful archetypal materials – raging internal storms, frosty sexual relations, psychological tsunamis – to name just a few. In such cases we need to keep our footing, to avoid being blown away in the ensuing psychic storms. We need bolts drilled into the cliff face to prevent us from falling into the abyss. We think that if we can hold on for long enough there is a chance for the sun to breakthrough, eventually.

Climbers often wear the skin out on their hands and fill the cracks with glue. Therapist’s don’t use their hands, but need to keep a psychic grip on things.  Just like solo climbing is extremely dangerous, and potentially fatal, so perhaps is a solo therapist working alone. A safer arrangement is for a therapist to be tethered to other therapists, in order to manage material that would blow them off their feet.

And so it was in the Lakes. Storm Bert died out. My group of eight friends, assembled over many decades, joked and talked. This trip had been several months in the planning. Several hundred WhatsApp messages had covered train times, routes, kit, marinades, wine and beer preferences.  We wrestled with the following questions:

• Does the house have salt and pepper? (no)
• Are there toilet rolls? (a few)
• Does the house provide towels? (no)
• Is there wifi? (no)
• Is there an electrical car charging point? (no)
• Is the road icy and dangerous to walk on at night? (yes, I fell over and lived out my fantasy of being looked after in the wilds without actually hurting myself)
• How do we split the bill? (In my favour)

I guess the group messages were about the administration of taking care of the group.  Alongside the adventure of hiking in Storm Bert, we balanced more introverted questions of kit and cooking. There is a wonderful thing in groups, that each person is able to contribute something; each person finds their place.

All in all I recommend throwing yourself into a bit of “weather” alone or with friends. And then going home and putting on the fire, or wrapping up warm.  There is something in those sublime extremities, feeling small in the face of Storm Bert and the wild landscapes of the Lake District that will stay with me a whole lifetime.

I am mad about tennis. This is a new found middle aged love affair. If psychotherapy is my vocation, tennis is my avocation. It makes me whole. To send myself to sleep, I dream of hitting a crisp forehand. Again and again. I watch YouTube videos on how to serve big. I have tickets for Queens, and Wimbledon. I am so jealous of my hitting partner, who went to see the Australian Open men’s and women’s finals. He live streamed Keys as she walked around the Rod Laver Stadium, carrying her huge silver trophy. As middle aged men, we only ever communicate by text and WhatsApp. This was one of the few times in fifteen years he actually called me! In that moment we were tennis fans, overcome by emotion. Sure, at times the tournament, with all its tears and tantrums, reminded me of a real life Squid Games. But, to be honest I found it moving too.

There is an enchanted parallel universe running underneath my everyday grey existence. Somedays I imagine I am talking to the players. Somedays, I swagger around, imagining I can serve the ball at 200 kph. Freud talked about sex, and Jung about spirit. But what about the Tennis Drive? Is the squishy yellow ball a baby? Or the malleable human ego? All that sweltering athleticism. Libido in buckets. Skin, our largest organ, on show. Sublimation. Life. Death. Breakdown. Breakpoint. Breakthrough. Racquet smashing. Tears. Swearing. Outbursts. The meaning of life itself. It has both sex and spirit! Some analysts talk about tennis, penetration and sexual conquest. Others talk about its religious and archetypal dimension. Who knows? All I know is that it does something for me. In my book tennis coaches and players have solved the ancient mind-body problem. The philosopher Descartes figured, “Cogito Ergo Sum.”  I think therefore I am. But surely it should be I hit therefore I am? 

Every morning, you can find me watching Eurosport with my bowl of porridge. During the cold windy days of January I have welcomed the heat of night time Australian tennis. What a relief. I don’t need a cold shower. No Mr Wim Hof for me! But I need to see a sun drenched crackling backhand to make me feel alive! By profession, I am a psychoanalytical psychotherapist. Yet, if you cut me I bleed the brick red colour of Roland Garros clay tennis courts. I’d swap the collected works of Mr Freud for the catch phrase of the world’s best tennis player, Jannik Sinner:

“I like to dance in the pressure storm”

I treasure a slick coffee table book Tennis Courts by Nick Pachelli. It has pictures of courts from tropical and mundane locations around the world. When I get a break, I imagine visiting them, one by one. Did you know that the radical psychiatrist R.D. Laing died on a tennis court in St Tropez? Did you know that the relational psychotherapist Stephen Mitchell, was a great player? He argued that therapy involved two subjectivities! The mystical analyst Wilfred Bion asked us to imagine watching a tennis match with no lights on! He said all that we would be able to see are the holes in the net. It was his way of getting therapists to stay in state of not-knowing!

For me tennis is even more central to my work. I see the therapeutic encounter very much like a tennis game. In a tennis match 60-90 percent of the time is “dead time”; in therapy there may be lots of silences. There are different types of silences on the court, and in the consulting room. But the sometimes there are long rallies. Verbal lobs. Furious smashes. Words buzz across the room. In those moments no theory is any use at all! In therapy and tennis you have to trust your instinct and go for it. You can think about what happened later!

As I was writing this piece, I ventured down to my tennis club. The wonderful club coach, Hamid, was free. I asked him for some help. He has a relaxed and self-effacing style. He showed me how to adapt my “inferior function.” The inferior function, according to the Swiss analyst Von Franz, behaves “after the manner of a fool hero, the divine fool, or the idiot hero. He represents the despised part of the personality, the ridiculous and unadapted part, but also that part which builds the connection with the unconscious, and therefore holds the secret key to the unconscious totality of the person.”

In my case, this meant developing my backhand. He asked me to hold the racquet loosely. I experienced an ecstatic state, a moment of conscious spontaneity. Later, he addressed my serve. He asked me to forget my world of words and bounce the ball three times, and touch it to the racquet. This simple act of concrete grounding, allowed me to hit the ball powerfully. What a chance meeting. Australia is at the opposite end of the world; my backhand and serve are the vulnerability in my game. Suddenly, everything is turned on it’s head and I feel, for a moment, a complete player. Then it begins to rain and reality seeps back in. Still, allowing my inner idiot some freedom has opened up a whole new dimension in my game. Rather than defending from my weak backhand, I am now hitting freely, even attacking! I can’t wait to play my hitting partner when he comes back with his Australian tan!

My motto this year is to be more Keys! Loosen up, relax. Hamid the coach says slow down. Don’t rush. Loosen the death grip on the racquet. The looseness is what gives the body power. Sure Sinner is a winner. But Keys is the underdog who played out of her skin! No point in pretending to be somebody else. No point in choking, or holding back. Don’t waste your time and money! Swing and follow through. Put your whole body into it. In the end the best therapists don’t follow a rigid and dogmatic rule book. They don’t clench. They have some give, some fluency. Move those feet.

The patients who get the most from their work don’t try and mimic somebody else. They bring both their superior and inferior sides, light and shade, left and right. Coach Hamid says keep your feel on the ground. So, next time you’re on the tennis court, or in the therapy room, loosen up, give yourself time, take help from the divine fool, and hit it out of the park!

Reading:

Psyche and Sports, Ed. Murray Stein and John Hollwitz

Psychoanalytical Perspectives on Intense Involvements in Sports, Ed. Irwin Hirsch

I have clients who could be referred to as Homo Globalis, or the New Cosmopolitans (Stenger). Thank zoom! The global psychotherapy client can now dial in from Silicon Valley, or Zurich or Singapore. They are part of an English speaking professional elite, well educated, and widely travelled, yet beset with psychological difficulties.  They feel that what they do is somehow inadequate.  Their frame of reference is no longer local, but extends to Mars and back!

As the sociologist Zygmunt Batman (2013) writes

“We live in a world of communication, everyone gets information about everyone else.  There is universal comparison and you don’t just compare yourself with the people next doors, you compare yourself with people all over the world and what is being presented  as the decent, proper, and dignified life.  It is the crime of humiliation.”

Carlo Stenger writes in a 2011 edition of Psychology Today:

“Homo Globalis is faced with a difficult predicament. A new class has evolved at the border of the upper and the upper-middle classes, which led Secretary of Labor and now professor of public policy at the University of California at Berkeley Robert Reich to speak of the “New Rich-Rich Gap.” He writes:

“A new group is emerging at the very top. They’re CEOs and CFOs of global corporations, and partners and executives in global investment banks, law firms and consultancies. Unlike most national symbolic analysts, these global symbolic analysts conduct almost all their work in English, and share with one another an increasingly similar cosmopolitan culture.

Most global symbolic analysts have been educated at the same elite institutions — America’s Ivy League universities, Oxford, Cambridge, the London School of Economics or the University of California, Berkeley. They work in similar environments — in glass-and-steel office towers in the world’s largest cities, in jet planes and international-meeting resorts. And they feel as comfortable in New York, London or Geneva as they do in Hong Kong, Shanghai or Sydney. When they’re not working — and they tend to work very hard — they live comfortably, and enjoy golf and first-class hotels. Their income and wealth far surpass those of national symbolic analysts.” (Robert Reich, The New Rich-Rich Gap. American Prospect, December 12, 2005.)

I am a recent convert to the iconic TV show Curb Your Enthusiasm. I have loved every episode of series 12. I am feeling sad at the idea that this is the last series, especially as I am such a latecomer to this work of comic genius.
There are lots of therapy references and story lines in this series. A couple of the characters are regularly in AA including his girlfriend and best friend.

In one episode he even goes to couples therapy.

But the show has a great deal in common with psychotherapy. The actors only know the skeleton of the story, and trust their unconscious to come up with the material. The method of improvising is fancily termed retro-scripting.

It gives the story line and dialogue a particularly alive quality.

It is also very funny in my opinion

In the weekend papers I read that Larry is now a post normcore fashion icon. His look is apparently quiet luxury. Or Hollywood Communist according to the Guardian.

Maybe I am trying to unconsciously emulate him? I have a fluffy white therapy dog, and I sometimes wear a frown and a blue blazer.

Apparently his dad was in the textile business and passed on something to Larry. Larry says he has one interesting / good item in each outfit. A bit like a good therapy session. Too much dazzle can be showing off! Overkill. One good/ interesting thought is plenty!

The current Tik Tok craze about peeling oranges touches on the theme of how dependent you should be in your relationship. Should you be able to peel your own orange – gritty, resilient, strong, self-motivated – a true sharp citrus warrior! Or should you lie back and be peeled for, allowing the love of the other, to be fully expressed. Should you keep your barriers up, or let them down. Most of the time, at least in recent times, we are all expected to fend for ourselves. Neo-liberal ideas have pared back the “welfare state”, and we are all expected to peel our own orange. In this blog, I look at this idea of dependency versus independence in the psychoanalytical literature.

The Japanese psychoanalyst Takeo Doi wrote the non-fiction book The Anatomy of Dependence (甘えの構造 Amae no Kōzō) in the 1970s to explore the issue of dependency. He argued that the ideal relationship was that of parent / child, which obviously has heaps of dependency built-in; and that this type of relationship should serve as a prototype for all other relationships. Forget equality and being responsible for yourself! No, according to Doi, deep satisfaction comes from really depending on another, sometimes in what we might think of as childish ways.

Trying to get your partner to pick you up from the station when you could walk home, or a cup of tea in the morning, these are all extremely important things to aim for. Make them feel guilty, sulk, act helpless, do whatever it takes. Equally important is to indulge your partner’s desire to depend on you in this fashion. In this version of living we are creatures with our own unique desires and quirks; and we need someone to accommodate them, indulge them.

We don’t want to be using all our capacities all the time like some worker drone machine. Doi thought that “amae” was more prevalent in Japanese society; but perhaps it is just as prevalent in the West but is more hidden. Everyone is busy strutting about showing off their “independence” (until they get ill, or lose their job, their partner, or get struck down by some other blow). Perhaps people express their dependence in private, to their therapists? Exhausted by being resilient and independent, I wonder if therapists provide an arena where it is ok to bring this shadow material?

Let me give you some more examples. Your son is five years old, and he asks you to do up his laces. Fair enough, he needs your help. This is normal dependency, because the child lacks the capacity to do his own laces. Imagine that your son is eleven years old and she makes the same request. You can either respond by saying “do it yourself”, or you can indulge him and say, “of course, sit down, I’d love to help you with that.” This second approach embodies the spirit of “amae”: your son experiences the feeling of pleasurable dependence. He has the ability to tie his laces, but he would rather you did it.

Doi argues that children are always trying to get their parents to indulge them, through this type of dependency. Similarly, adults may seek to be indulged in this way, by their employer or spouse. Your partner comes home drunk and asks you to help them undress. You could say, “do it yourself. I am not responsible for your drunken state”; or you can carefully undress them and help them into their pyjamas.

For many people the second approach feels like a living hell. Remember all those books about co-dependency. Aren’t you simply enabling an alcoholic? Isn’t it pathological to try and get someone else to meet your needs in such a way? Isn’t it better to just look after your patch, your life and leave others to tend to theirs? Aren’t we supposed to be independent and resilient? Indulging your children/partner will lead to incapacitating them, stunting their growth and development. Well, yes, these are all valid points. Perhaps you need to give your partner a jolt, an ultimatum, and there is a better life without carrying their luggage.

But Doi convincingly argues that we all have a desire to depend on others and it’s better to notice it and give it some space. There are more or less painful ways to do this. The western myth of the self-made man / woman is just that, a fantasy. All of us are interdependent on others. Yet, perhaps we find our profound levels of dependency on others too much to bear, so we try and hide it. We act as if we can take care of ourselves, alone. We can diagnose ourselves over the Internet, and we can create our own treatment plans. Perhaps we can track things on an app? We can remove our need to depend on a living, breathing other.

Nowadays patients are sometimes called service users, or clients, or analysands. The term patient often evokes too much passivity and we like to think of ourselves as empowered active participants in our mental health. There is a great deal to be said for this, and of course, in therapy, you are doing most of the work. If you were passive, nothing would change. However, whether you see yourself as a patient or a client, you are depending on your therapist. Is that so bad? The experience of depending on another person can allow you to explore areas of your life that would be off-limits alone. Nowadays, dependency is devalued. If you go to your GP you have five minutes, and you don’t want to be a burden. You will have done some Internet research before your appointment. However, there used to be a tradition of psychotherapeutic doctors, such as Michael Balint, who would meet with his patients after the surgery closed. He would like to get know all about their families and lives. He believed that he could only understand their difficulties in the context of their entire lives. He would allow his patients to depend on him.

This is becoming more and more difficult in modern healthcare. We know that 1/3 of GP appointments are not for any specific biological problem, often termed as “medically unexplained symptoms”. But how can the doctor get to the heart of the matter if they only have six minutes to spend with the patient? It puts both the doctor and the patient in an very difficult position. Both parties have to stick to surface niceties, even if there are much deeper things going on.

Psychoanalyst Darian Leader and David Corfield (Why do People Get Ill?) did some research and found that people often go to the GP on the anniversary of a significant bereavement, such as the death of spouse or parent. It’s understandable the patient may not be feeling well, but it’s unlikely the doctor will have the space to find out the reason. Six minute consultations limit the ability of the patient to express their dependency on the doctor and really think about what it going on.

Our health and ill health are likely to evoke extremely powerful experience of dependency. Doctors, nurses, medical staff and psychotherapists seek to attend to such primitive anxieties and provide a container for them in the therapeutic relationship. In order to do this, they have to be “dependable”, and the patient / client has to be able to depend on them.

Perhaps those people who enter therapy are in fact more independent, through seeking help, than those people who think that they don’t depend on anyone else. Many people depend on substances and process to get through the day, but perhaps we are better off depending on other people? Some people depend on destructive relationships and need to find new relationships. People in recovery from addictions often demonstrate this when they attend 90 meetings in 90 days. Historically people in analysis might go 3,4 times a week to see their therapist. Addictions are often very lonely experiences, with a fantasy of not having to rely on another person. Therefore, when a person stops using, they may be faced with very high levels of dependency which are unbearable on their own. Therapy and groups provide a way to experience and vulnerability and support, to truly take the risky, yet enriching path of depending on others.
The Japanese psychoanalyst Takeo Doi wrote the non-fiction book The Anatomy of Dependence (甘えの構造 Amae no Kōzō) in the 1970s to explore the issue of dependency. He argued that the ideal relationship was that of parent / child, which obviously has heaps of dependency built-in; and that this type of relationship should serve as a prototype for all other relationships. Forget equality and being responsible for yourself! No, according to Doi, deep satisfaction comes from really depending on another, sometimes in what we might think of as childish ways.

Trying to get your partner to pick you up from the station when you could walk home, or a cup of tea in the morning, these are all extremely important things to aim for. Make them feel guilty, sulk, act helpless, do whatever it takes. Equally important is to indulge your partner’s desire to depend on you in this fashion. In this version of living we are creatures with our own unique desires and quirks; and we need someone to accommodate them, indulge them.

We don’t want to be using all our capacities all the time like some worker drone machine. Doi thought that “amae” was more prevalent in Japanese society; but perhaps it is just as prevalent in the West but is more hidden. Everyone is busy strutting about showing off their “independence” (until they get ill, or lose their job, their partner, or get struck down by some other blow). Perhaps people express their dependence in private, to their therapists? Exhausted by being resilient and independent, I wonder if therapists provide an arena where it is ok to bring this shadow material?

Let me give you some more examples. Your son is five years old, and he asks you to do up his laces. Fair enough, he needs your help. This is normal dependency, because the child lacks the capacity to do his own laces. Imagine that your son is eleven years old and she makes the same request. You can either respond by saying “do it yourself”, or you can indulge him and say, “of course, sit down, I’d love to help you with that.” This second approach embodies the spirit of “amae”: your son experiences the feeling of pleasurable dependence. He has the ability to tie his laces, but he would rather you did it.

Doi argues that children are always trying to get their parents to indulge them, through this type of dependency. Similarly, adults may seek to be indulged in this way, by their employer or spouse. Your partner comes home drunk and asks you to help them undress. You could say, “do it yourself. I am not responsible for your drunken state”; or you can carefully undress them and help them into their pyjamas.

For many people the second approach feels like a living hell. Remember all those books about co-dependency. Aren’t you simply enabling an alcoholic? Isn’t it pathological to try and get someone else to meet your needs in such a way? Isn’t it better to just look after your patch, your life and leave others to tend to theirs? Aren’t we supposed to be independent and resilient? Indulging your children/partner will lead to incapacitating them, stunting their growth and development. Well, yes, these are all valid points. Perhaps you need to give your partner a jolt, an ultimatum, and there is a better life without carrying their luggage.

But Doi convincingly argues that we all have a desire to depend on others and it’s better to notice it and give it some space. There are more or less painful ways to do this. The western myth of the self-made man / woman is just that, a fantasy. All of us are interdependent on others. Yet, perhaps we find our profound levels of dependency on others too much to bear, so we try and hide it. We act as if we can take care of ourselves, alone. We can diagnose ourselves over the Internet, and we can create our own treatment plans. Perhaps we can track things on an app? We can remove our need to depend on a living, breathing other.

Nowadays patients are sometimes called service users, or clients, or analysands. The term patient often evokes too much passivity and we like to think of ourselves as empowered active participants in our mental health. There is a great deal to be said for this, and of course, in therapy, you are doing most of the work. If you were passive, nothing would change. However, whether you see yourself as a patient or a client, you are depending on your therapist. Is that so bad? The experience of depending on another person can allow you to explore areas of your life that would be off-limits alone. Nowadays, dependency is devalued. If you go to your GP you have five minutes, and you don’t want to be a burden. You will have done some Internet research before your appointment. However, there used to be a tradition of psychotherapeutic doctors, such as Michael Balint, who would meet with his patients after the surgery closed. He would like to get know all about their families and lives. He believed that he could only understand their difficulties in the context of their entire lives. He would allow his patients to depend on him.

This is becoming more and more difficult in modern healthcare. We know that 1/3 of GP appointments are not for any specific biological problem, often termed as “medically unexplained symptoms”. But how can the doctor get to the heart of the matter if they only have six minutes to spend with the patient? It puts both the doctor and the patient in an very difficult position. Both parties have to stick to surface niceties, even if there are much deeper things going on.

Psychoanalyst Darian Leader and David Corfield (Why do People Get Ill?) did some research and found that people often go to the GP on the anniversary of a significant bereavement, such as the death of spouse or parent. It’s understandable the patient may not be feeling well, but it’s unlikely the doctor will have the space to find out the reason. Six minute consultations limit the ability of the patient to express their dependency on the doctor and really think about what it going on.

Our health and ill health are likely to evoke extremely powerful experience of dependency. Doctors, nurses, medical staff and psychotherapists seek to attend to such primitive anxieties and provide a container for them in the therapeutic relationship. In order to do this, they have to be “dependable”, and the patient / client has to be able to depend on them.

Perhaps those people who enter therapy are in fact more independent, through seeking help, than those people who think that they don’t depend on anyone else. Many people depend on substances and process to get through the day, but perhaps we are better off depending on other people? Some people depend on destructive relationships and need to find new relationships. People in recovery from addictions often demonstrate this when they attend 90 meetings in 90 days. Historically people in analysis might go 3,4 times a week to see their therapist. Addictions are often very lonely experiences, with a fantasy of not having to rely on another person. Therefore, when a person stops using, they may be faced with very high levels of dependency which are unbearable on their own. Therapy and groups provide a way to experience and vulnerability and support, to truly take the risky, yet enriching path of depending on others.

So, just like in the viral tik tok video, we really may need another to peel that orange for us, at least some of the time!

Mathew Perry’s tragic death at age 54, which is still under investigation, will have struck a chord with fans of his show, and also all those who have had encounters with addiction. He was found dead in his hot tub and whether or not he died from natural causes, his body was terribly affected by his encounters with addiction. I have visited many men and women in prison, who have been addicted to illicit drugs. Their orange case files, which seemed to weigh kilos, are a symbol of prison of addiction. Illicit drugs, and illicit activity to fund the drugs results in short term prison sentences, often for decades. But there appears to be no escape from this numbing psychic and literal prison. It is a circular route. The only exit appears to be death. On the margins the drugs of choice are heroin and crack cocaine. But alcoholism is wide spread in polite society. Drugs affect our psychic functioning. They heal inner splits. The make us whole. Jung argued that they are so powerful that only an overwhelming experience of the divine, or ego collapse at depth, could help overcome such addictions.

He wrote in his letters that SPIRIT was required to overcome SPIRIT (alcohol). He did not publicise his views for fear of being misunderstood, but historians now credit him for being one of the forces behind the creation of the 12 step movement. Rather than being obsessed in seeking wholeness through drugs and alcohol, or other processes, the twelve steps allows one to experience the sense of wholeness through contact with others, and through spiritual development.

Psychotherapy is a relatively weak medicine in my experience. It can certainly have transformative effects, but it usually falls short when faced with the tsunami of addiction. Both the therapist and the patient will be swept away. The obsession to achieve wholeness, through drugs, is extremely powerful. If life is a quest, then addiction is a dead end. Nowadays, young people have little in the way of initiation. Consumerism doesn’t offer them a real initiation, so it is often drugs that play that role. In London today, middle class teenagers will talk about taking ketamine, cross-fading. They will drink vodka neat. Surely, they are seeking some form of initiation. When the addictive part of the mind takes over, the other sections cannot function. The analyst David Schoen argues that it is a Tsunami, not a hot tub. Addiction has a malevolent aspect that is murderous. It can kill the psyche. It is not amenable to logic and reason. Yet, strangely. we might also say that many people who suffer from addictions, are seekers, mystics, who think there is more to the world than meets the eye. Surely, they are right. I am not arguing against intoxication. There is certainly a place for such things. But we need to find a route to wholeness, at least most of the time, that doesn’t destroy our psychic structures. This is easier said than done. It requires painstaking work, it requires sacrifice, and it requires a certain humility. None of these are dominant values in an extroverted and materialistic culture. We live in an age of narcissism, where we want straight white teeth, we want credit and merit for our achievements, and we want the world to bow down to our personal truth. We don’t care about experts, or partners, we want to live our best life. Of course, there is some merit in this and those who experience oppression should fight back. But there is a precarious element to modern culture. The ego is a vulnerable edifice to build life upon. As Jung said, I am just a clod of earth. There is a relief in keeping our feet on the ground, and striving for wholeness, one step at a time.

I recently fulfilled an ambition to go skiing in the Italian Alps. In my enthusiasm I snuck off from my group in the first 10 minutes as I didn’t want to be stuck on the baby slopes doing what looked like really boring exercises. As a seasoned runner and cyclist I reckoned that skiing couldn’t be that difficult. You just sort of point yourself down the slope and go. Easy. No fevered pedalling, or lung busting leg action required. I’m sure I could do this asleep. Within 15 minutes of my first ever trip to a ski slope, I had ditched my instructor (sorry Massimo) and I found myself on a Red run. It looked steep, and everyone seemed to know what they were doing; everyone except me.

Now I was up there I couldn’t see anyway down except by skiing. I decided to give it a go. Reader, I got to the bottom. Was it pretty? No. Did I spend most of it crashing and lying forlornly in the snow trying to get my skis on and off? Yes. Did I lose any semblance of grace and dignity? I sure did. Still, I managed, through a series of “controlled” crashes, to get safely to the bottom. The next day, with my tail between my legs, I made the decision to join the group. Maybe, I grudgingly conceded, I did have something to learn. As a therapist maybe I should know better? Yes, sometimes you need a guide, especially on unfamiliar territory, to show you the way. Or to learn how to get from A to B more gracefully! Although I knew this intellectually, some over inflated part of me thought I could work it on my own. I’m sure you’ll be glad to know us therapists have our blind spots too! I had to get literally knocked down to the ground, repeatedly, in order to learn my lesson. As therapists we say this day in day out. Our patients come in and tell us the ego, the “I”, can master every situation. Yet, the “I” always bumps into more powerful forces – inner and outer – and usually gets a beating. The conscious mind generally gets too big for its boots. We usually need to listen to and enlist the unconscious to really grapple with the difficulties and risks of life.

Later in the day, after my lessons, when I was practicing on my own, I found myself in the wrong lift again. The wrong lift once I could explain away as an accident, but twice? This is what Freud might have called “repetition compulsion”, when we keep recreating a situation again and again, hoping that we can figure it out this time round. Usually, we don’t. And then we do it again. This process happens without our knowledge, driven by unconscious processes. I knew something wasn’t quite right when I got on this lift, I had a feeling in my stomach, but I couldn’t quite figure it out. I had a feeling of dread and was about to bail, but ended up getting on, overriding my instincts.

To confirm my worst fears the lift just kept going and going upwards. I felt a knot in my stomach. The guy next to me looked very intense. I had ended up on another Red Run. Not all Red Runs are the same. This Red Run was really Red! Skiers jumped of the lift and floated and flitted like birds, turning and twisting and darting straight down the slope. This time I knew I was out of my league. I took off my skis, and found a small valley to the side of the carefully groomed piste, and carefully slid myself back to the flatter slopes. Various skiers stopped by to check I was ok. I said, “I’m not injured, just embarrassed…” Half an hour later I was back on more comfortable ground and I was able to put my skiis back on. Although this was a humiliation to my ego, I had surrendered and accepted defeat. A lucky escape.

Interestingly, I had found myself attracted to the higher slopes. I had been drawn to areas where I didn’t have the skills for. I somehow managed to “accidentally” repeat this. The second time, humbled and a little frightened, I had chosen to make a safe descent. On the last day I took the ski lift (without skis) up to the glacier. I was only able to go part way as I had missed the final lift cut off time. I was secretly relieved. I really didn’t want to go any higher. For some reason I felt nervous about going up to 3000 metres, even though I wasn’t skiing. When I returned to the hotel I remember feeling a little nauseous and unwell. I knew the signs of mild altitude sickness, which I seem to suffer from. It’s a useful warning signal from the body, telling I needed to get down from the mountains. So, every day, I had become more and more cautious. The unforgiving terrain had educated me.

Still, our culture often makes us feel that we can do anything, and that we shouldn’t back down. In the last few days I read about a French woman and Polish man who ascended the very dangerous K2 mountain without oxygen. The Polish man died, and the French woman took her shoes off after hallucinations brought on by altitude sickness. She has been told by doctors that her hands and feet may have to be amputated due to frost bite. Even so, she said she would be back in the mountains, because, she said, “I need this.” The climber Beck Weathers, a very driven American doctor, said he used to climb to deal with a deep depression. The total dedication and obsession required to climb, combined with the physical exhaustion, seemed to cure him of his depression. 1/6 people who climb Everest don’t make it down alive. Nevertheless, he was a man possessed. It was only a near death experience, resulting in him losing his hands, that he gave up climbing and found himself finally reunited with his family. Many psychoanalysts say it’s very important to accept our limits. In a culture that pushes us to extremes, it is very important to accept our vulnerabilities. It’s a lesson Beck Weathers has taken to heart: he no longer climbs, but is happier than he has ever been.

On the penultimate day in the hotel I got talking to a man who was a very experienced skier who enjoyed going off-piste, outside the prepared ski areas. I was impressed, but on the last day he went missing with his 13-year-old daughter. We feared the worst. His last ski pass use had been at 10.30 am at 3000 metres at the top of a glacier. The one I had turned back from because I had missed the cut off time. He hadn’t been seen or heard from since. As night fell, the helicopters and search parties returned to base. No sign of him. No phone. No signal. No flares. Nothing at all. Everyone in the hotel was in total shock; no one could sleep. The next day he had still not been sighted. This was a tragedy. At 9.30 just as I was leaving, there was news they had been found. They had got lost off the top of the glacier. Even with all that experience. They had then walked non stop for 16 hours through the night in order to stay warm and stave off sleep. They eventually found shelter, and were picked up at 9.30.

It was an incredible ending to what could have been a terrible misadventure. I wondered, what is it about getting “high”? It’s easy enough to get up there, but it’s hard to get down. Marie Louise Von Franz, the Jungian analyst worked with a lot of such cases. In her book, the Puer Aeternus, she recalls the case of young men who had trained themselves to sleep on mountains without any camping gear. The idea being that they didn’t want anything to weigh them down, either kit wise or psychologically. But mountains are extremely dangerous. They cut us down to size. The top of Everest, with its thin, lifeless air, is known as the death zone. People get up mountains, but sometimes they don’t get down. On a very minute scale, I experienced this over-inflation. Oblivious to the people being carted off the slopes in ski ambulances, I ended up on slopes that were beyond my ability. Similarly, my fellow guest, despite his decades of experience, had become disoriented off-piste, and without any back up plan. He was able to draw on inner resources, but it was very risky. Luckily, we avoided injury or worse, but both felt somewhat chastised in our different ways.

The body’s physical and psychological warning systems, such as altitude sickness, have an important role to play. Even though you can get medicine to rid yourself of altitude sickness, perhaps that is not always so wise? Watching the winter Olympics it’s easy to get carried away. However, if you watch an interview with any of those athletes, you’ll find that they are riddled with injuries: metal rods run through bodies that are broken and battered, and they have spent months in hospitals and rehabs. Still, something keeps them going back. This knife-edge existence is extremely precarious. That is why the gods can live in Mount Olympus, but not humans. We can spend a few days at altitude, but then we need to come down to sea level. When we go up, we need to carry emergency supplies, whistles, flares, and plenty of humility, or we risk being thrown down the mountain.

Addictions work in a similar way. It is maybe easy to get “high”; it seems like you can live up there forever; but then one wrong step; or just bad luck, and you find yourself caught up in avalanche. Von Franz warned of the dangers of over-inflation. It is very depressing to have to face our limitations and vulnerability. The Puer Aeturnus, wants to deny these limits. This works for a while, and can even be very heroic. But in the end the hero usually meets a grisly end. A life with no challenge or risk is dry and dull. But when a person only feels a alive when dicing with danger, that is another matter. My initiation to mountain sports has given me plenty of food for thought. The deeper I got into the skiing, the more aware of my limits I became. To be honest, I was glad to get back to earth, and place one foot in front of the other. On a more serious note, my fellow hotel guest, Gary Raine, appeared in an article in the Sun, and seemed grateful to have survived a very harrowing ordeal. The headline says, “they were lucky to be alive.” Sometimes, although very unpleasant, altitude sickness can be a life saver!

Families, in the broadest sense, are the crucible in which we are shaped. It’s not just the parents, but the grandparents, uncles, aunts, siblings, cousins, and family friends that influence us. This truth is captured in the multi-generational Succession saga.

Succession is rich with psychoanalytical material. What great case studies! What perfect clinical vignettes. Freud based many of his theories on research on upper class Viennese women. He worked with the individual. But in reality, we are all part of sprawling chaotic groups.

The family therapist John Byng Hall argued that we are all part of “family scripts.” He meant that family life really is like a play or TV drama. We sometimes even know what each family member is going to say before they say it. We all draw on a treasure trove of family myths. Some conscious and some unconscious. We may not have a coat of arms or board room but we can all imagine what our family motto might be.

We all play roles in relationship to these scripts. We may repeat and replicate them, or we may edit and rewrite them. Or we may seek out an entirely new script for ourselves.

The Roy family is a dynasty based on an amalgam of the Murdochs, Maxwells and the writers’ imagination. Every pathology, every shadow area, every narcissistic trait is dialled up to full intensity. Perhaps that is why it is a vivid canvas for us to project parts of ourselves onto. It helps to amplify our own imaginations.

All four children crave their parents’ love and attention. The family business is central to their identity. The siblings either try and inherit the business, or take it over, or fight against it in a dynamic and ever-shifting psychic landscape.

The ending of the whole series, seems like a good time to look back to Series 1 Episode 7 when the father, Logan Roy recruits a corporate therapist to conduct some family therapy.

At the beginning of the therapy he tells the therapist “everything I’ve ever done is for my children.” The children look at each other incredulously. The father then gets on his phone “to buy a TV company.” The very double speak and dissociation inherent in the emotional weather system of the family is constellated in that very moment.

The father has gathered his children together to ostensibly talk about their feelings and in that very moment he turns away to the more tantalising world of mega business deals. This is familiar emotional territory to his children. To his credit, the therapist challenges the father to keep the therapy on track. But it becomes crystal clear that the father has absolutely no interest in delving any deeper. The whole thing is a publicity stunt to bolster the standing of his company. It’s a media circus and the therapy ruse is simply good optics for the company’s stock market valuation.

The therapist suggests taking a break. But he is seduced by the family. Does he think he’s a friend or a therapeutic butler? Is he corrupted by the family’s power and glamour? He dives head first into their swimming pool and smashes his front teeth. He has to go to hospital and the therapy is aborted. He has underestimated the danger of working with this family. Under the benign surface there are hidden complexities. He has lost his analytic stance and ending up “losing face” as a result. In the end he is a comic distraction and a casualty from the power tussles in the family.

At various points the patriarch Logan Roy has promised each child they will be his true heir. They always, in their desire to be the chosen one, fall for it. But he leaves them hanging. This sibling rivalry means that their is always a tension between the children. They are allies. They understand each other. But they are also deadly competitors.

The siblings struggle in their own lives and struggle with intimacy. The eldest son, Connor, makes a tragic attempt to run for president. His girlfriend is an escort and he pays for her interest in him. Money secures love. Kendall is ravaged by addiction, and struggles in his relationship with his ex wife and children. Roman has complex sexual involvements with work colleagues that unravel. Shiv, the only daughter, remains emotionally distant in her on/off relationship with her husband.

Like all families they have their problems. The father, Logan Roy, has visible scar marks on his back. The children all exhibit less visible damage. But it is still there in their psyches. Like all of us they have to contend with their family legacy and unconsciously or consciously decide on what to take forward and what to leave behind.