by Bev Thomas
She takes a breath.
‘So, what about all this baby stuff? How can I get it to her?’ she says and picks up her pen again. ‘The clothes are hardly worn; Boden, Monsoon, Baby Gap,’ she adds, as if this will prove the deciding factor.
I feel a heaviness as I sit back in my chair.
‘OK. So, tell me about your wanting to give these things to Samira.’
She stares back at me. ‘Well, she needs them. It’s simple, isn’t it? Something I can do to help. Something that will make a difference. Her family – the things that happened to her,’ and again, I can hear the emotion in her voice. ‘At least, she’ll have some clothes, toys, a bed for the baby.’
I hold up my hand.
‘What’s happening to you right now?’ I ask.
‘Me? What do you mean?’ she says defensively, like it’s a trick question.
‘You’re speaking very fast. Not taking a breath. How do you feel?’
‘What’s that got to do with anything?’
‘Tell me. How do you feel?’
She blinks back at me. ‘Well – I just want to help …’
‘And the feeling?’
It takes her a moment to answer.
‘Overwhelmed,’ she says, ‘I feel overwhelmed – and helpless.’
I nod. ‘So – perhaps,’ I offer, ‘the chance to give her these things and make a difference will make you feel less overwhelmed? Less helpless?’
‘Well – it’s something, isn’t it?’
‘Let’s assume the helplessness is coming from Samira. And you’re picking it up. It’s your job to use the feeling to help her with her feelings. Giving her the baby stuff might not help her feel any differently – but it might make you feel better.’
Stephanie looks shocked. ‘So, you’re saying this is about me?’
‘Not consciously,’ I shrug, ‘but in a way, yes. It’s a response to the helplessness. A way of distracting yourself from the awfulness of what she’s been through. Wouldn’t it be wonderful,’ I say, ‘if a bag of toys and clothes would help a woman who’s been raped and seen two members of her family murdered?’
I wait for a moment. ‘Do you see what I’m saying?’
Her eyes flash. ‘I’m not saying that a bag of clothes will make a difference.’
‘And if you did give the bag of clothes to Samira. What do you think you become to Samira?’
‘Helpful? Kind?’ she says with irritation.
‘That’s right. You will become her benefactor. And that will irrevocably alter the therapeutic relationship. It will stop you being able to deal with the difficult stuff. Transference isn’t always about good feelings.’
Stephanie sits tight in her chair.
‘Bad things have happened to Samira. Her experience is dark and murky. Like a lake. You can walk around it, point to things in the middle distance, imagine what might be lurking at the bottom. At some point, you’ll have to get into that dark water with her. To feel it as she does. And it will be awful.’
She stares back at me. Her hands are clenched in her lap.
I try a change of tack.
‘One of the papers I recommended – the one by Bion?’
She scribbles the reference down.
‘He worked with soldiers traumatised after the Second World War. I suggest you take another look at it,’ I say. ‘Containment in this context means bearing the feelings of traumatised patients. While part of the recovery is to get into the lake, it’s not enough. You have to help her get out again. Incorporate the bad stuff back into her life.’
Stephanie stares at me. A small ridge of tension across her forehead.
There’s a moment of silence.
‘This is all new to me,’ she says quietly, and as she lays her pen down, her hands collapse in a heap on her file. It’s a small gesture of defeat and I feel a surge of warmth towards her for the first time.
‘But I think I understand what you’re saying,’ she says, ‘that to work in this way – using this model – I need to stop trying to be some kind of fairy godmother.’
I smile.
I tell her about Freud. How he had a lot to say about the giving of gifts. ‘He wrote about the storms of transference that come from the simple exchange of an object.’
Presents change things, I tell her.
Together, we come up with an alternative. She’ll donate the items to Samira’s local children’s centre, then alert the care coordinator, so Samira can buy them with her allowance. I tell her I understand her desire to save and rescue. ‘Giving her things would be helpful and kind,’ I say carefully, ‘but it’s not your job.’
In the last few minutes I ask her if there is anything else she has noticed about the work with Samira. I tell her how my supervisor always focuses on how things start. ‘“It’s all in the beginning,” is what he says.’
Stephanie looks surprised to hear I have a supervisor.
‘Everyone needs supervision,’ I explain. ‘The unconscious is not available to us. Things are hidden. We can’t see what’s right in front of us.’
I press her. ‘Anything significant about the referral letter? How she started the work?’
Stephanie looks hesitant.
‘She was late,’ she remembers. ‘She couldn’t find the building. Then because she’d forgotten the referral letter, she didn’t know where we were in the hospital. Front reception rang round. Eventually got hold of Paula.’
There’s a beat.
‘So,’ I say quietly, holding my hands out, palms up, ‘she was lost.’
As she’s packing away her files, she asks about the blog.
‘Who’s Matt Johnson?’
‘He was a patient of mine. A few years back. He was nineteen years old, a student at Kent University on an exchange visit to Seattle.’
I pause for a moment, remembering.
‘There was a gunman on his campus.’
Stephanie sits very still, holding the rucksack on her lap.
‘Matt was with his best friend. They were hiding under a desk in one of the classrooms when the gunman came in. He knelt down and pointed a gun at him. Then, for no apparent reason, he swung the gun to the left, and shot his best friend instead, then he calmly got up and moved on. Matt was physically unhurt, but left utterly traumatised. The usual PTSD symptoms, but he was crippled by appalling survivor guilt. He was in a catatonic state when he arrived back in the UK.’
Stephanie shakes her head, stunned.
I think back to that first sight of him, the horror of seeing a six foot young man, pale and mute, curled up like a foetus on a psychiatric ward.
‘What happened?’ Stephanie asks quietly.
‘I saw him for a year. In hospital at first, then at home. Eventually, he was able to come to see me here.’
I smile.
‘That was some years ago. As I said, he’s a junior doctor now. Works in Emergency Care.’
‘What did you do?’
I think for a moment as I recall those hours spent watching him slowly uncurl.
‘The dark lake,’ I say simply. ‘We got in. We eventually got out. His catatonic state was a way of splitting it all off. All his feelings were gone. We had to retrieve them, so he could come to life again. He remembered every detail; the weave of the wool on the man’s balaclava, the smell of his breath, the small flecks of brown in his eyes. It was all there. Every single awful moment of it. The sessions offered him a contained place, so he could see that, in spite of such a devastating experience, the world was, in general, a good place. A place that was safe, ordered and predictable. A place that he could choose to live in again.’
‘That’s incredible,’ she says in awe, ‘– to do that kind of work. I can’t imagine.’
‘I had been working for twenty years by then. Here in this very unit,’ I say. ‘And anyway,’ I shake my head, ‘if anyone was incredible – it was him. He was wise and courageous. An inspiration. His blog is about trauma. He writes about his experience of being a pat
ient, about what we do here, our model of treatment, but he also writes about being a doctor in Emergency Care, linking back his life now to how things were before.’
Stephanie looks pale. ‘All these stories—’ she tails off, ‘they’re so dreadful.’
I nod. ‘It’s a difficult placement. People come here with very painful life experiences. It can skew your view of the world – leave you feeling these things are normal, everyday occurrences.’
I encourage her to look at Matt Johnson’s blog. ‘It’s very good. And helpful to remember our success stories – good outcomes, in among so many complex cases. People do leave us,’ I say. ‘They do get better.’
*
I have time to go out for some lunch. It’s a relief to leave the hospital. The canteen is on the fourth floor and I already spend too many journeys in the lift squashed next to post-operative patients. Starched white sheets over bodies immobilised by anaesthesia; eyes closed, heads lolling and mouths agape. It’s not always good for the appetite.
As I walk to the café across the road, I realise Matt Johnson then wasn’t much older than Tom would be now. Then, almost immediately, my thoughts are drawn to Dan; his panic attack, the cuts, his sudden change of mood, and the way I ended up giving him exactly what he wanted. It’s a struggle to order these thoughts, like having all the right ingredients in front of me, but not being able to turn them into a meal.
The café has a fridge of ready-made sandwiches to take away. Seeing them all in their neat packaged rows reminds me of Carolyn and her project in the last year of primary school. Each class had a week to fundraise for their designated charity and all the children came up with different money-making ideas. Hers was a sandwich service that she took round to the offices behind the school at lunchtime. One of the teachers went with them, but it was Carolyn and her best friend Penny who made all the sandwiches in the morning before school. Great towers of egg and cress, tuna and cucumber, cheese and pickle. I can still remember her standing at the kitchen table. Her small earnest face, her look of concentration as she sliced the tomatoes and cut through the bread. ‘In triangles,’ she said, ‘it looks better, I think.’
Every morning, they worked for two hours, sold them at lunchtime, then came back after school to count their earnings. On the Thursday, Carolyn came back alone.
‘Where’s Penny?’ I asked.
There was a moment before she answered, and I could see she was trying to control the emotion on her face. ‘She didn’t want to come today. Wanted to help on Suzanne’s tombola instead,’ she said, her voice catching. ‘She said I was too bossy.’ Then it came, a small wobble of her chin, before her face collapsed in a big heaving sob. My heart ached. But by the time I got to her, it was over. Her sadness and disappointment had been folded neatly away, like one of her sandwich napkins. I pulled her to me. She yielded for a second. Then her shoulders became rigid, conditioned for self-sufficiency. As she resisted my hug, I let my arm drop away. She was ten years old. I should have held on tighter.
There’s a voice behind me. A man trying to reach into the fridge. I select a feta and salad sandwich and take it to the till.
Five
‘Clingy,’ was how one of the nursery workers described Tom. She stood in the doorway, hair in pigtails with a red-cheeked baby in her arms. ‘We’ve had this before,’ she said, ‘they always settle fine in the end. Don’t worry,’ and she reached over to pat my arm, ‘some children are just more clingy than others.’
I recoiled at the sound of the word. Even more so, because of her pronunciation; ‘clin-g-y,’ with a hard metallic ‘g’. I stared at the ribbons in her pigtails and her pink nail varnish. She looked about twelve. She went on to talk animatedly about ‘the module on attachment theory’ at college. I stared at her incredulously, as she told me all about Bowlby and transitional objects.
I smiled. ‘That sounds very interesting,’ I said tightly. ‘The thing is – while books can be really helpful, I’m his mother. And well – you really don’t know what it’s like until you’ve had your own child.’
I flashed her another smile; my tone was pointed and persecutory, but she was so pleased with herself, she failed to notice.
‘We do see it,’ she said, ‘from time to time. And really, the best thing we’ve found is to simply “drop and go”.’
‘Drop and go?’ I said.
‘Give him a kiss and cuddle. Then go. Don’t look back. Leave – with minimum fuss. You know, the way you do with Carolyn.’
‘Carolyn is different,’ I said. ‘Tom is upset. You’ve seen him, screaming when I try to hand him over. Carolyn isn’t.’
She nodded. ‘Drop and go,’ she repeated breezily. ‘We find the children settle much quicker. If you draw it out, it makes it worse.’
Her smile was knowing. Smug.
‘Carolyn. She’s a happy little thing,’ she said, ‘so independent-spirited. Knows exactly what she wants. We were joking the other day – she’ll be the next prime minister, the way she holds court over the sandwiches at teatime.’
‘I’m sure you’re right about Tom,’ I said briskly, ‘but I’d like to arrange to speak to Gillian.’
Gillian was the manager and I wanted to speak to someone who at least looked old enough to have had her own child.
‘Sure,’ she said, obviously irritated. ‘You know,’ she continued, shifting the baby over to her other hip, ‘I was just thinking, when Dad brought him last week – it was much easier. Perhaps Dad could bring him more regularly? See how that goes? Tom was so much less clingy with him. We all noticed the difference. Could Dad bring him?’
Dad. Dad. Dad. And that word again. Clingy? I wanted to reach across and slap the word out of her mouth.
You have no idea, is what I wanted to say. You’re just a kid. Clueless. What mother wouldn’t be distressed by the sobs of her child? At having to prise his small fingers from my hair, from my coat, from a curled position around my thumb? I dug my hands deeper in my pockets, my fists tight as buds.
‘Do you know Jennifer?’ she offered. ‘She used to have terrible trouble leaving Sam, then she followed our suggestions and he was fine. Settled just like that,’ and she clicked her fingers so loudly, the child in her arms startled with surprise. ‘Maybe you should have a chat with her. Might help?’
I had no desire to speak to Jennifer. I knew exactly who Jennifer was. She was one of the ‘Lycra Mums’. The ones that had high-powered careers into their thirties, before they gave up work to have children. Jennifer’s husband had a job ‘in the City’ – and while she didn’t need childcare for her work, she brought Sam to nursery to ensure he got time to socialise and spend time with other kids. ‘It’s healthy for him,’ is what she said. What she didn’t talk about so readily was her desire for ‘me-time’. I’d overheard her use that term at pick-up, as she described her timetable of Pilates and yoga and training for her half marathon. Every aspect of Jennifer’s life seemed project-managed; her social diary, her house, and her children, were all on a meticulous schedule. I’d see her sometimes with a group in the mornings, striding along, pushing buggies with such determined efficiency, all ready to ‘drop and go’ – like they were handing over a bag of shopping.
I did arrange a meeting with Gillian. But by the time we met, there had been several more mornings of distress. Tom’s followed by mine. I’d felt the eyes on me as I cradled him on my lap. Pitying looks from some of the mothers, as they waved cheerily to their offspring while I sat wiping away his tears, calming him down from near hysteria when I so much as tried to put him on the play mat. I’d heard the ‘shushing’ that the nursery girls had taken to doing in response to the noise we were making. Even though we were tucked unobtrusively in the corner, they moved exaggeratedly around us, as if Tom and I were an articulated lorry restricting vehicular access.
So, when Gillian and I met to ‘discuss the situation’, it was obvious that things had shifted. I’d already been cast in the role of the over-involved mother. The tearful e
motional mother who was unable to separate, who couldn’t let go. Gillian listened as I spoke, her head cocked to one side. ‘It is difficult, Ruth,’ she said, but I could see what was coming. More ‘drop and go’.
‘Really, it’s what we’ve seen to work.’
‘The thing is,’ I said, ‘I know my child. I don’t think that would work with him. I just don’t think he’s ready.’
She nodded kindly, then leant forwards and reached for my arm. ‘Perhaps the time isn’t right,’ she murmured. ‘Perhaps it’s you that’s not quite ready. We say to all our mothers that they must do what’s right for them. It’s an individual thing. But obviously, we’ll need a plan soon.’ Her hand was hot on my arm and I fought the urge to shake it off.
‘We have thirty children here, and if we had all thirty parents doing different things. Wow,’ she said, shooting her fingers in the air like small fireworks, ‘it would be chaos. We need a routine.’
‘The difficulties’ – how she referred to my emotional outburst and his screaming – ‘are becoming disruptive to the other children.’
David suggested waiting until the end of term. ‘See if he settles? Or I can move work things around and take him more often?’ I didn’t even reply. I didn’t want to acknowledge what I saw as an implicit criticism. My mind was made up. I began the nanny search that weekend, interviewed six potentials and paid over the odds for one who could start in a week’s time. In any event, a month later, David was offered a locum teaching job in Oxford, so he was away from London three nights a week. It was a relief to have the nanny.
Tom was much happier in his own house, with all his things. And Carolyn – well, she seemed fine too. In retrospect, I’m ashamed to say that I didn’t think much about her. Whether she would miss the nursery, the friends she’d made. It simply didn’t occur to me. Besides, we couldn’t afford to do both.
*
Whatever Carolyn would say now, and she’s certainly had plenty to say on the matter, I didn’t favour Tom over her. I simply saw that they had different needs and that he needed me more, and in a very different way.
