by Ruth Wade
But he couldn’t abandon her now out of fear. Out of not wanting the responsibility. His interference with the asylum’s laissez-faire approach to treatment had already altered her; had made her withdrawal less complete. He had no way of knowing at this stage whether the chink in her defensive armour he had opened would warp into a gaping hole she’d be unable to plug with anything except despair. Only by continuing was there a chance he could forestall the need of ever having to find out.
He took his pad and pen from his briefcase and began roughing out a diagram of the interactions between the human conscious and subconscious: the workings of the mind. Every now and then he glanced out of the window before scribbling down another word. He kept at it until they plunged into the netherworld of Balcombe tunnel on the other side of Haywards Heath. He rubbed his sore eyes and waited until they were in the daylight again before studying what he had come up with. He underlined the key concepts: repression; conflict; dissociation; rationalisation; self-perception; adaptation. The order within the pattern sprang out. It took him down a different line as neatly as the throwing of the points’ switch would on the track.
Olive’s problem had been that she had never been able to reconcile and live with the conflicts her life threw up; she was always raw and in pain and every day was a constant reminder of her failure to adapt to who she was. Edith, on the other hand, could well be suffering from the opposite problem. What if she was actually unaware that there was any conflict? Could anyone’s repression be so great? He was beginning to think so. If he accepted that the conscious and subconscious were actually fighting for control then it wasn’t too much of a leap to imagine that one was gagging – starving – the other into submission: as good a definition as any of catatonia. And if such an extreme form of repression and splitting was what was going on in Edith Potter’s mind, then the danger of pushing her faster and further than she wanted to go was negligible compared with that of doing nothing. He had to pull her back from where she had already been allowed to remain for too long or she would, indeed, destroy herself. Without his intervention, she would continue the internal battle until withdrawal no longer became a defensive position of choice, but one of necessity. She would spend the rest of her days in a permanent coma.
CHAPTER TWENTY-THREE
Stephen made the train journey in reverse on the following Sunday. In the intervening week he’d managed a couple of snatched telephone conversations with a harassed, but increasingly intrigued, Dr Johns. The asylum director had reported an astonishing improvement in Edith Potter’s condition and had begun to institute a programme of cold baths in addition to the electric shock therapy. There had been more than a note of pride in his voice when he’d announced that she had begun talking. Stephen let him believe that any progress was down to physical intervention, although he remained convinced it was his clandestine hypnosis that had been the key.
He brushed away the last remaining cobwebs of a late night on emergency call at the clinic, and let himself into Edith’s room.
‘The good doctor tells me you’re speaking to us at last. He says you complained about the state of the electrotherapy room. Bravo. They say that nature, time, and patience are the three great physicians but I’m all in favour of a little spunk from the patient myself. A blood-rousing altercation never did anyone any harm – but you’d better not tell anyone I told you that; it’s not quite a textbook thing for a psychoanalyst to say.’
He sat down and settled into the familiar routine of pulling his papers from his briefcase and sifting through them in an exaggeratedly slow way in order to give Edith time to get used to his presence. He stole glances at her but not once did her gaze waver from a spot on the ceiling above the door. He wondered if this was the trade-off her conflicted personality had decided upon: a loosening in control over speech in exchange for no eye contact. He fished out Jung’s Association Method from his other papers and put it on the bedside cabinet before stuffing all his other notes back in the briefcase.
‘How would you feel about conducting a simple word game? Nothing too strenuous, but I do believe it would help us get to the bottom of your condition.’
His proposal received a timid nod. Edith Potter may have been talking but she wasn’t giving anything away. He picked up his pen again and intoned the introductory sentence as Jung had written it: ‘I will read you one hundred words and I want you to answer as quickly as possible with the first word that occurs to your mind.’
He cleared his throat and began.
‘Head ...’
‘Neck.’
The sound was faint but distinct: she would co-operate.
‘Green ...’
There was a longer pause. Stephen wondered if this was going to be the first indicator. He counted the seconds of silence.
‘Skirt.’
‘Lamp ...’
‘Burn.’
Her voice had quavered a little. He made a note of it.
‘To sing ...’
‘Canary.’
‘Dead ...’
‘Canary.’
That was hardly a surprise.
Stephen read through the next fifteen words slowly and clearly, giving Edith at least ten seconds to respond before he started to count the length of the pauses and annotate his notes.
‘White ... ’
‘Paper.’
‘Tree ...’
‘Paper.’
‘Book ...’
‘Filthy lies.’
Stephen continued with the rest of the test. When it was over he had a page full of notes and a slightly clearer idea of what he was working with. It was extremely promising. He slid the results back into his briefcase and allowed himself a self-congratulatory smile. He probably should leave it there but he was too excited to stop; she would be tired with the strain of having to think after so many months of silence but when this was all over she would have long years in which to rest.
‘There are just one or two other things I want to ask you before I go. I promise I’ll make this as brief as I can but I need to know if you can remember any physical symptoms in the weeks or months leading up to finding yourself in hospital. I’ll tell you why.’
He’d decided he would try out the beginnings of his diagnosis of her, on her. He still had no real idea how much she could comprehend but he was convinced that being spoken to – even if she didn’t understand what was being said – was the best way for her rational, conscious mind to know it was being championed.
‘I’m convinced your catatonic state is as a result of repression. Now there’s nothing new in that because we’ve known the connection from the neurasthenics in the military hospitals during the Great War – much of the work carried out by your father, in fact.’
A shudder rippled through Edith’s body but she didn’t shift her gaze from the spot over the door, or alter her expression. Stephen felt the beginnings of a current of resistance in the air between them. He thought to make a note of it in his observations and carried on.
‘Then there are Pierre Janet’s findings that the conflict between the repressing and the repressed forces produces mental and emotional exhaustion; however, I think your mind has taken that one stage further and moved into the physical realm as well.’
Edith’s eyes had closed. Her breathing was growing shallow. Stephen knew he might lose her if he pushed too hard; her mind was fighting him – as well as itself – in its efforts not to reveal what it wanted to keep so firmly hidden. He would have no choice but to leave the rest of his tentative conclusions until another time and finish his questioning before she cut him off completely.
‘Just tap your finger on the bedclothes if you’ve felt any of the following. Can you do that for me, Edith?’
A bony finger shivered in the air for a second and then fell back down to rest with the others on top of the blanket. Stephen focused all his attention on her scrawny hand.
‘Thank you. Remember, I’ll notice even the slightest of movements so you don’t ha
ve to worry about the effort involved.’ He hoped his reassurances were reaching her subconscious. ‘Any pains about the body, particularly the back?’
A long pause and then a shaky affirmation.
‘Weakness in the eyes?’
Nothing.
‘Headaches? These might’ve felt like there was a weight around your neck or a metal band tightening across your forehead. Is that something you recognise?’
She waggled her finger.
‘These next may be a little more difficult to identify but I want you to think hard. Any restlessness and difficulties in sleeping?’
No reaction.
‘An inability to concentrate?’
Again, nothing.
‘An overall feeling of malaise or depression?’
When there was still no reaction, Stephen began to wonder if she had fallen asleep. He decided that he would risk one last symptom and then leave.
‘An increase or diminution of the sex impulse?’
He felt like a schoolboy as he caught himself blushing.
‘No.’
The word had been forced out between tight lips with all the explosion of a gas grenade.
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Medical notes
EDITH POTTER Page 1
Some speech but limited communication. Where is she inside that body? Still no indications of why she is doing this. Much clearer picture of how – her repressed tendencies are cut off from the rest of her personality. Wholly subconscious. Obscures the conflict behind it. A very thorough approach to dissociation – to be expected from someone of her mental capacities. What, if anything triggered it? She could have been – and probably was – repressing for years so why the collapse when she did?
Word Association Test Results
- Unable to read much into length of time to answer. Catatonia too masking.
- Majority of responses fall into opposite or association categories. No surprises.
- Some definitions on luck; behaviour; to choose; pamphlet. Symptom of her scientific training or refusal to co-operate and follow the instructions given? Unclear.
- Predicate responses significant. Correlation between words expressing emotions and her emotional judgements. Indicates deep problems with feelings. Classic repression:
WORD ---------- RESPONSE
Despise --------- ‘too complicated to explain’
Ridicule --------- are the ones who are stupid’
Anxiety --------- worry; forget’
To Fear --------- fear itself’
Foolish --------- foolish. What’s foolish?’
Sad ----------- won’t cry’
Angry --------- ‘know what you want’ (laughter)
Most interesting but for which I am unable to draw a conclusion as to the significance:
women; pride; behaviour; child; lie; pure; false; to abuse; to prick
She REFUSED TO ANSWER.
Notes:
Supplements – too many words – symptom of negativism (catatonia) or reinforced object-libido (Freud)? More likely former; her persona and scientific background do not lend themselves to excess of enthusiasm but she does display an inner void or dissatisfaction.
Repetitions – sign of impeded adaptation to me and world around her. Could also be testing me. Display of assumed superiority?
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Medical notes
EDITH POTTER Page 2
Theories:
Dissociation terminates conflict but repression merely obscures the conflict from the consciousness. Repression is often a gradual process but dissociation is likely to be sudden.
Amnesia – most common form of dissociation. Does Edith have it? OR
Is she experiencing dissociation to such a degree that she is splitting?
Consider: as part of her disintegration, her sentiments are divided into two conflicting systems (conflict = repression = dissociation = catatonia). Each part would have its own memories and be distinct and discontinuous with the other part of the personality. Remember she said it was crowded in her head – did she mean literally?
Evidence? Not conclusive but the groups of words to which she gave predicate responses and those she refused to answer must have some – differing – connections. These connections – not just the words – are of significance to her.
What does she get from her catatonia, her flight into incapacity? There must be some purpose in it. She is trying (successfully) to hide something. Is this the meaning of the functional disorder or is there something deeper?
Jung – “The patient has a story that isn’t told and which no one knows of. It is the secret, the rock against which he is shattered.” Does not even Edith know her secret?
Sexual repression – too Freudian or accurate? Would she ever be able to tell me? Dare I ask again?
Whatever the cause, Edith is in deep conflict; incompatible motives compelling her towards incompatible goals. With someone like her, they would go unrecognised because of years of rationalisation to explain and excuse the stirrings of unease.
If I can expose the conflict and reduce the opportunities for rationalisation (under hypnosis) and get her to acknowledge it, then the need for repression might vanish.
Action:
Need to be able to conduct more sessions of deep hypnosis. There remain signs of resistance –toward me or a symptom of her inner conflict?
Consider discussing her case with her as a way of appealing to her scientific judgement and eliciting co-operation. From the test results, logic and reason still form a large part of her personality (but for how long?)
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CHAPTER TWENTY-FOUR
Stephen pulled for a third time on the rusty bell. Why were they taking so long to come and let him in? It had been a month since he’d been able to return to the asylum. The frustration had nearly driven him crazy. It was as if everything was conspiring against him. First, he had succumbed to the influenza that had been doing the rounds of the hospital and then, when he had returned to his duties in the clinic, he’d found his caseload increased because so many of the other doctors were off sick. But he was here now. And impatient to find out what progress, if any, his patient had been making in his absence.
*
A vase of early daffodils was on her beside cabinet. He wondered what kind soul had thought of that. Edith would be sure to have noticed the additional colour in her room; every stimulation of her senses at this time was helping towards making her more conscious of her environment.
‘You’re certainly looking brighter this morning. A bloom of colour on your cheeks.’
This wasn’t bedside flattery; she really did have a flush of liveliness about her that he hadn’t seen before.
‘I’m sorry I’ve neglected you for so long, but I see that they’re taking good care of you. How are you on the talking front? Do you feel like indulging me a little today?’
He dragged the chair over to her bedside and got himself comfortable in the usual manner.
‘Hasn’t anyone told you how irritating that is?’
Her voice was strong and clear but her face was turned, as before, to the ceiling. It was etched with lines but no emotion.
‘Why don’t you be the first? After all you’ve already had some practice with Dr Johns; come on, do me the honour of letting me be the next recipient of your astute criticism. I’m sure I could do with it.’
‘All that crossing and uncrossing your legs.’
This was far more than he’d hoped for. Not only was she talking voluntarily but she was expressing a reaction to his presence. She was acknowledging a feeling. And in addition, she was demonstrating she was capable of processing and evaluating information. Maybe his weeks away had been good for her after all; her mind had used the time to unlock and unbend a little.
‘Physician, heal thyself – that sort of thing?’
She grunted.
‘It’s a point well made, Edith. Maybe we should swap places – bearing in mind of course that doctors make the worse patients – but I’m willing to give it a go if you are.’
‘Swap places.’
‘Yes, we can do that in a moment but first I’d like us to discuss one or two of the more interesting aspects of your own case.’
‘Swap places.’
Stephen flicked a swift glance her way but Edith’s face was blank. He swallowed a tinge of apprehension and ploughed on with his plan of making her a partner in her own therapy: her willing compliance from this point on was critical.
‘I promise we will. But for now I want to ask your opinion on how I’m doing. I’m sure with all this rest and relaxation you’re getting you must’ve thought once or twice about my progress with you. Be as critical as you like, I can take it.’ He wiped his palms on his trousers.
Silence.
‘In that case, I’ll start with a few of my own views if I may. Let me say now that I’ll tell you the truth as I see it but to tell you everything would be misleading; however, I promise you it’s only my ill-formed and tentative conclusions I’ll leave out. What do you think of my proposition?’
Edith blinked once or twice rapidly but said nothing.
Stephen forced himself to breathe slowly and wait. He had to learn patience; he’d tried the chocolate and the jokes, and that was the only thing left according to what had been the late Dr Maudsley’s favourite proverb: the best physicians are Dr Diet, Dr Quiet, and Dr Merryman. He would hold his tongue for the entire session if he had to.
