by Frank Tallis
Even though psychotherapy can be a challenging occupation and many patients don’t get better, there is always a possibility, however slim, that treatment will be successful. A woman with agoraphobia might be persuaded to leave her house or a man with obsessive-compulsive disorder might learn to resist his compulsions. But death is irreversible. As a psychotherapist undertaking bereavement counselling you can only ever tinker at the edges. Talking to a psychotherapist doesn’t bring back the dead.
Mavis was difficult to engage with. When she answered questions she tended to favour monosyllables. Even so, I tried to keep things going. I kept prompting her, sometimes with words, sometimes with expressions or gestures, until our exchanges achieved a kind of rhythm, enough momentum to carry us forward.
She had left school without gaining any qualifications and married young. Her husband, George, had been a postman. Two years after they were married, their son Terry was born. Mavis had been a housewife all her life and had never been tempted to get a job outside the house. When Terry left school he worked in a factory. Eventually he became a foreman. He was now in his forties and still lived at home. I asked Mavis if her son was in a relationship.
‘No—he’s not much of a ladies’ man.’
‘Oh?’
‘He likes his money.’
‘I’m sorry?’
‘He doesn’t want to share it with anyone.’
‘Does he share any of it with you?’ Ageing mothers make excellent and very cheap housekeepers.
She answered loyally: ‘He pays his way.’
I wasn’t convinced. ‘Has he ever had a girlfriend?’
‘When he was younger, but he hasn’t for a while now.’ Terry didn’t sound like a very generous-spirited man. He was more interested in cars than people. ‘Always outside, he is: fixing his Mini up. It’s his hobby—customising.’
I wanted to know more about George.
‘He was never a talker. He’d come home, have his dinner and then we’d watch the telly.’
‘What sort of things did you do together?’
‘Do?’
‘Yes… when you were together.’
‘Well, we didn’t go out much, if that’s what you mean.’ She appeared to be surprised by my question, as though the idea of doing things together as a couple was unheard of—foreign or suspicious. ‘Sometimes we’d do a bit of shopping on Saturdays. We’d go down to the market. But not often—there was no need. I did the shopping in the week.’
I asked her about their social life.
‘George didn’t have many friends. He’d go for a drink once in a while—but that was it really.’
‘What about you?’
‘Me?’ She shook her head. ‘I had my husband…’
Mavis was lonely. She thought about George every day—all the time, in fact. His absence had opened a chasm in her being, a frigid void. She missed him and she missed him terribly. Yet, when Mavis spoke about George, it was difficult to understand what she was missing exactly. I didn’t get any sense of their life together; there were no fond reminiscences or anecdotes. And there was something very odd about how Mavis talked about their son. Children cheat death. Our expressions and mannerisms survive in our children. If a father dies, a mother might still find solace in the reproduction of his smile on her son’s face. Yet, Mavis talked about Terry as if he were a lodger.
Ostensibly, Mavis was coping, doing the same things she’d always done: the housework, the cooking, Terry’s washing and ironing. But she was functioning like an automaton. I asked her if she was still able to get pleasure from anything. ‘Food,’ she replied. ‘I still treat myself now and again. Sponge fingers, evaporated milk—fruit cocktail.’
Undertaking psychotherapy with older patients, particularly those who have not been fortunate enough to receive an extended education, can be testing. They often find it difficult to express their feelings—having always been told not to. They can be inflexible and unable to grasp abstract ideas. Mavis was hard to help for all these reasons. But in addition, I sensed there was something else, something important that I hadn’t identified.
While discussing her loneliness, I asked Mavis what she missed most about George. I had chosen to ask a direct question in order to elicit a direct answer.
She looked at me through the smudged lenses of her spectacles and replied without hesitation, ‘The sex.’
I have to admit, I wasn’t expecting that.
We think of sex as a drive, powered by hormones; however, sexual motivation is much more complex and subtle. Hormones are only part of the explanation. Although there is an association between levels of testosterone and desire, it is possible to have high levels of the former and little or no desire. Similarly, removal of the testes—where most of the testosterone in the male body is produced—does not always lead to loss of sexual interest.
We are motivated to have sex when certain circuits in the brain become active in response to sexual thoughts, images or external stimuli that we find arousing. These circuits are sensitised by hormones and signals that are transmitted from the genitals.
Contemporary psychologists explain sexual desire within a framework called incentive motivation theory. We are not pushed towards sexual objects by a drive; rather we are pulled towards them. We are attracted by incentives. The value of sexual incentives is determined by the outcome of our past sexual experiences. Pleasurable outcomes will raise the value of incentives, whereas unsatisfactory outcomes will lower them.
Many people enjoy sex when they are old. But desire dwindles with age—even more so over the course of a fifty-year marriage. Our bodies change and as a consequence so do our needs and appetites. The psychologist Robert Sternberg has suggested that love, when it meets the standard of our cultural ideal, is composed of three elements: intimacy (or closeness), passion (which is mostly sexual) and commitment. Sternberg calls this ‘consummate love’. These three elements are not always present or equally represented and they can be combined in different ways to produce less enduring or satisfying forms of love. For example, passion alone, without intimacy and commitment, produces a highly unstable ‘infatuation’, whereas intimacy and commitment, without passion, produce ‘companionate love’, which has the character of an affectionate, long-term friendship.
Assuming that commitment holds steady, as years of married life accumulate there is usually a shift of emphasis, from passion to intimacy. Sex isn’t such an urgent necessity and relationships become more companionable and emotionally rewarding.
The first major reduction of passion occurs after three or four years of marriage and many relationships fail around this time; indeed this is when divorce statistics peak. The reason for this is probably evolutionary, three to four years being the optimal time to reproduce and ensure the survival of offspring in the ancestral environment.
When men settle and start a family, their levels of testosterone drop and will continue to drop unless a new relationship is formed. Although testosterone is often described as the male sex hormone, it is also associated with sexual activity in women, whose levels of testosterone follow much the same pattern as men with respect to marriage and procreation. Women also experience an additional loss of libido in later life which is linked to post-menopausal reductions in testosterone.
Sex is precious, because for most of us, it is time limited. Even if couples continue to have sex into their eighties, it can never be as vital as the sex they had when they were eighteen. Lack of stamina, blunted senses, failing health and low testosterone inevitably make the experience less physically intense. There must be few people who, languishing on their deathbed, wish they’d had less sex when they were young. Sex was at the heart of Mavis and George’s relationship. Indeed, it may have been the entirety of their relationship.
‘We used to do it all the time,’ Mavis confessed, clearly bemused by the improbable strength and longevity of her libido. Her voice didn’t soften when she said this. There wasn’t a hint of a smile. I wondered
whether her feelings about sex were complicated by guilt. Many women of her generation were taught to view recreational sex as morally suspect. My efforts to explore this possibility were promptly repelled with a typically concrete response. ‘No, I never felt guilty about it. Why should I? We were married.’
A marriage based almost entirely on sex shouldn’t last. It should begin to fail after a few years. Sternberg’s theory of love is known as the triangular theory, because ‘consummate love’ requires all three—intimacy, passion and commitment—to be equally balanced. Like a tripod, ‘consummate love’ stands on three legs. If you remove just one of these legs, it falls over.
Of course, a tripod can still stand—up to a point—if one of the three legs is shorter than the other two. This is precisely what happens when passion cools. Marriages become inherently less stable but the weight-bearing distribution of passion, intimacy and commitment is sufficient to prevent the tripod from toppling.
Why did Mavis and George’s relationship last? They didn’t talk very much and didn’t have common interests. They were committed, certainly, but Sternberg calls the combination of commitment and passion, in the absence of intimacy, ‘fatuous love’. It is without real substance and largely irrational. Why would anyone commit themselves to a person they didn’t really know? For commitment to be meaningful it must be preceded by amity. Moreover, fatuous love is always doomed because passion declines, leaving nothing but empty commitment. When this happens, couples only stay together out of a sense of duty—and not for very long.
None of this applied to Mavis and George. Their passion didn’t diminish as the decades passed and the sex was good enough to keep them committed to each other for fifty years. They didn’t need to talk.
Mavis still yearned for her husband’s touch, the feel of his body against hers, physical contact; and this yearning became so great that it was like a cry, a calling out—or something even more powerful—a summoning.
‘I can still feel him—you know, like he’s still around.’
It was an important disclosure. I wanted her to continue but detected signs of internal struggle. Neither prolonging the silence nor posing a question seemed right, so I reflected her last statement back.
‘You feel like he’s still around…’
Mavis nodded, ‘When I’m in bed.’ She paused and looked at me with a peculiar, concentrated expression. ‘One morning I woke up and I saw him—standing by the wardrobe. You know… a ghost.’
‘What did you do?’
‘“George,” I said. “George.” But he faded away.’
Do ghosts exist? Of course they do. There are simply too many reports of ghostly sightings to doubt their existence.
Two theories predominate. The first is that ghosts are spirits returning to the world after death and the second is that ghosts are a psychological phenomenon. Today, we tend to favour the latter. However, just because something is psychological doesn’t mean that it isn’t real. Your memories, for example, are every bit as real as a rock, a tree or the sun. Although a brain scientist might argue disparagingly that memories are a mere by-product of underlying biological processes, epiphenomena, this doesn’t make them any less real. They are simply real in a different way.
It’s often the case that fiction identifies subtle truths more readily than science. This is particularly true with respect to ghosts.
The first truly psychological ghost story was Henry James’s The Turn of the Screw, published in 1898. The plot is very simple. A governess becomes convinced that two ghosts (former employees of the house and lovers) are wielding a malign influence over the children in her care. She challenges their supernatural authority and a tragedy ensues.
What makes it psychological is the way the story is told. We can’t help but wonder if the ghosts are supernatural or imagined. We are tempted to engage in a little amateur psychoanalysis. Is there, perhaps, some connection between the ghosts and the prim governess’s repressed sexual feelings? In this respect, James prefigures Freud, who suggested that supernatural occurrences represent the return of the repressed. Ghosts are projections from the unconscious.
The psychological ghost story is extremely powerful, even to modern readers, because it does not depend on credulity for its effect. We are not asked to believe in disembodied, vengeful spirits, but in the self-evident truth of the human mind. Thus, the ghosts are real—as real as our memories and our forbidden wishes.
Mavis’s forbidden wish was all too apparent. She wanted sex with her husband and her unconscious wasn’t recognising death as an obstacle.
It transpired that Mavis had encountered George’s ghost more than once. Over a period of several weeks, she became more comfortable discussing the subject and she revealed that she had seen George four or five times in her bedroom and twice in public.
‘I was sitting in the park and I saw him standing under a tree.’
‘Did he look… real?’
‘Yes, just like he did when he was alive. He was wearing his mac.’
‘What did you do?’
‘I was getting my things together, getting ready to go over and talk to him, but when I looked up he’d gone.’
Apparitions of this kind tend to be elusive: a blink, a small head movement or a subtle change of light—like the sun appearing from behind a cloud—can easily dispel a ghost.
‘Where else have you seen George?’ I asked.
‘On the high street, but I lost him in the crowd.’
I was inclined to count this latter sighting as a case of mistaken identity. ‘Okay…’ I nodded. ‘Okay.’
Hallucinations are defined as perceptions that arise in the absence of external stimuli. The most common forms of hallucination are auditory and visual, but equivalents occur across all sensory modalities. For hundreds of years, hallucinations were regarded as a cardinal symptom of madness, a reliable marker of abnormality. But this isn’t correct and probably never has been.
What we think of as objective reality is a kind of compromise, the result of external stimuli impinging on the senses followed by interpretations. Eyes have blind spots and change position every second, peripheral vision is extremely poor and the image that arrives on the retina is small and indistinct. We should see a foggy, shaking world with dissolving edges and parts missing. But instead, our picture of the world is complete, stable, panoramic and sharply defined. This is because a great deal of unconscious editing has taken place before visual information enters awareness. The brain fills in gaps, compensates for movement and makes educated guesses. This editing process is biased by our expectations, motivations and desires. A new mother, for example, will constantly misinterpret background noise as her baby crying. Even when there is no noise at all she will still experience the occasional false alarm. She will cock her head to one side and say, ‘Did you hear that?’
The cognitive psychologist Roger Shepard has said that perception is ‘externally guided hallucination’ and hallucination is ‘internally simulated perception’. In other words, reality isn’t entirely authentic and hallucinations aren’t complete fabrications.
Approximately 5 per cent of adults hallucinate and never seek medical help. They just accept that they are hallucinating and carry on as normal. Moreover, a third of Americans claim to have seen angels. This may sound like an exaggerated figure, but actually it is entirely consistent with the fact that roughly a third of children have imaginary friends.
The type of hallucination that Mavis reported is extremely common and has been given a precise name—PBHE or Post Bereavement Hallucinatory Experience. Some studies have found that as many as 80 per cent of bereaved individuals report PBHEs. This suggests that these experiences are a normal rather than an abnormal phenomenon. If you are predeceased by your partner, you will probably see them again before your own demise.
People don’t talk about their PBHEs very much. Perhaps this is because the experience of seeing one’s wife or husband after they’ve died is so strange and deeply per
sonal that it’s hard to know where to begin. How does one broach such a topic? Or perhaps it’s simply that people worry about attracting a psychiatric diagnosis.
When my mother was dying in her hospital bed, she was no longer lucid. When she opened her eyes, nothing registered. The only sound she made was an intermittent—‘Ow, ow, ow’—as if someone were prodding her repeatedly with a pointed stick. It was distressing to watch and she continued a whole night and into the early hours of the morning. She didn’t appear to be in great pain, but she did look extremely annoyed.
My mother’s best friend was sitting next to me. ‘She knew what to expect.’ Resting a solicitous hand on my arm, the friend continued. ‘She’s had plenty of time to prepare herself.’
‘I don’t think any of us are ready to die,’ I replied. ‘Not really.’
‘No,’ my mother’s friend insisted. ‘She was. Because of your dad…’
My father had died a decade earlier.
‘I’m sorry?’
‘She could feel his presence. And it got stronger and stronger. “It’s so strong”—she used to say. “Sometimes I can feel him in the house and I call out his name. Other times it’s just like he’s sitting beside me.” She knew. It was like he’d come to get her.’
Over a period of ten years my mother hadn’t said a word to me about my father’s spectral visitations. I can only assume that this was because I didn’t share her religious convictions. By the time the friend had disclosed my mother’s secret, my mother had already spoken her last words. She never spoke again, and the following afternoon she passed away. I’m still curious.
‘Do you think it’s him—really?’
Mavis’s spectacles had slipped and she pushed them back up her nose. ‘Yes.’
‘What do you think it means? George returning…’
‘I don’t know. Maybe he’s missing me too.’
