TThis is my last column for you. I am shocked and glad that I was allowed to say such controversial and true things as: the oedipal complex is real and each of us has one; psychodynamic psychotherapy – this is effective and life-saving mental health treatment and we must fight for it in the NHS; And Midnight Run is the best movie of all time.. It was a joy and an honor, and now that we're here, it makes me think about the meaning of endings.
Because they are significant. Sometimes the lack of time allows you to feel and say what was previously impossible. They can bring intimacy, truthfulness and grief that some find unbearable. Patients often talk about quitting their studies or missing the last session, calling it a waste of time and a desire to leave the room before the end.
But the ending is one of the most important experiences in good psychotherapy; the opportunity to experience loss and grieve. A chance to feel the disappointment and rage of unfulfilled desires, satisfied and unmet needs. To put into words the true feelings of abandonment and gratitude, as well as the ignorance and despair that come with the end of something important that we want to hold on to. When we struggle with these feelings from infancy, through adulthood, unconsciously killing them through addictions or repeating them in unsatisfactory relationship dynamics or smoothing them over, the end of therapy offers different possibilities. By skipping the end, you are robbing yourself. I know all this – but I also understand the desire to leave the room.
My father died when my daughter was nine weeks old. I've been wondering if I should write a column about it, but I've always shied away from it. Now, perhaps because this is my last time, I'm ready.
At the hospital, when we found out he didn't have long to live, my father told me he was sorry he had wasted his time. It was an electric moment for me. I said we shouldn't waste this time. Having written my book about growing up throughout my life, I learned that this very last chapter of it may very well be one of the most significant. That we were very lucky to have this time and that he needed to think about how he wanted to use it, the conversations he needed to have.
The reason we were able to talk about this, the reason I was able to be at his bedside, was because of the words of my psychoanalyst. I didn't want to go to the hospital. I just wanted to be home with the baby, feeding, changing diapers, napping. I didn’t want to leave the house, let alone a ward where babies weren’t allowed. But my psychoanalyst spoke of a reality that everyone could see except me, because I could not turn to it: “Your father is dying.” It was unbearable until it was said, and it was exactly what I needed to hear to get into the room.
After that, I somehow managed to take my father’s crib out of the ward, where babies were not allowed, into the yard, where I could take the newborn to my grandfather. She cried, he sang to her. He made his last phone call. I fed her on the bench next to his bed. The sun was shining, the air was cool and fresh, shadows fell on its blankets. We didn't say much; that was a different conversation. This memory is painful and beautiful, and one of the most precious moments with my father. It was a gift.
We're lucky; my father had a good death. He moved into hospice care and I stood at his bedside with his daughter, mother and our rabbi. As the rabbi said her quiet prayers, the familiar words in Hebrew seemed to calm my father's harsh breathing, making it soft and light, and lull my baby girl to sleep in my arms. I knew that death was near, and fear rushed into my head: “Will it harm my child to be so close to death at such an early age? Should I leave the room?”
In response, I felt a deep emotional understanding that I believe had grown within me through years of desperate escape from my feelings, followed by years spent understanding it in psychoanalysis. The understanding was: no, it won’t hurt her or me, it’s happening to all of us now, and we need to stay in the room. I knew it would be a peaceful death, an important moment in our lives, and that presence could affect her in profound ways that we would never know. I didn't have to protect her from this ending or the feelings associated with it – it would all become a part of her – and me.
Being in that room helped me realize that no matter how difficult the beginning of motherhood may be, it is mine. My end is also my beginning. This is what I needed to write in my last column, and I can only do it because I know my time is limited and I want to say the most important thing. Don't leave the room. This is why I continue to fight for sustainable psychodynamic psychotherapy in the NHS. Because I know that it can help us stay in the room, whether that room is a therapy room, your mind, or your own life.
This episode was called How to build a better lifebut I think that what I have written about, and what I have learned as a psychoanalysis patient and as a psychotherapist for patients, having lost a father and becoming a mother, and writing for you, is not so much how to build a better life. It's about how to truly come alive in the life we live so that our time isn't wasted.
Moya Sarner is an NHS psychotherapist and author When I Grow Up – Conversations with Adults in Search of Adult Life
