When I was doing research for my book, I ran across a report of a weight loss device that seemed absurd at the time — the AspireAssist. At that time, the inventor of the Segway was applying for approval for a device he calls AspireAssist which is medical device with a tube which is surgically implanted in the stomach and is attached to a skin-port which is equipped with a valve which is attached to a battery operated pump which sucks a portion of your stomach contents out of your gut and mechanically vomits them into your toilet. About 30% of what has been eaten is removed. In short it is medically induced bulimia. In a thin or normal weight person, induced vomiting after eating is considered an eating disorder, purging which is a part of anorexia and bulimia, and seen as a health hazard and psychiatric disorder. In a fat person, a device that does this is seen as treatment.
I actually thought that the FDA would recognize this device for what it is, but I was wrong. Last week, with much ballyhoo, AspireAssist actually received FDA approval. Look at how the New York Times headlined their piece on it: FDA Approves Stomach-Draining Obesity Treatment — makes me want to shout ARE YOU KIDDING?
Someone I know is studying end of life care. She made me familiar with what is called “the surprise question” — a question put to a patient’s medical team asking if they would be surprised if the patient were dead in 6 months or a year. The answer can help guide treatment to meet the realistic expectations for the patient’s outcome. Because modern medicine is oriented toward treatment and more treatment until no further options remain, all too infrequently patients with little hope of recovery are submitted to considerable painful and experience a lot of suffering because of the notion that the fight must go on. Palliative care, on the other hand, is willing to acknowledge that sometimes what we need is comfort care not aggressive treatment. The surprise question opens the way to contemplate when is the time for palliative care.
Well, i have been intrigued by the power of this question ever since learning of it. And it occurs to me that a variant of it might be of use if applied to the care of fat patients. Bear with me here.
The tulips there are in a vase next to where I am sitting. When e first moved into this house 11 years ago, there were a few tulips at the bottom of a yard - red ones and yellow ones. I have no idea when they were planted. I assume years before we moved here. We’ve never done anything with them. Some years there would be more flowers than others. Then came this year. The wind seems to have been blowing seeds from those few tulips around where they were planted. It takes several years for tulips grown from seed to produce flowers and this seems to be the year for ours. Red ones, yellow ones, and a pretty yellow and red-orange one like those you see here. Four to six years from seed to flower.
Which brings me to why I have not been posting. Six years ago, Kevin Smith was removed from a Southwest Airlines plane because he was deemed too fat for one seat — he was too fat to fly. For some reason this incident moved me to start writing about fat, the way fat people are treated, and eventually to look at the war on obesity through a Jungian lens. I wrote and wrote and wrote. For 5 years. Through revision after revision. Along the way I learned a great deal about myself, opened my own complexes further. The writing became a significant part of my analysis. Then I came to the place where it was done, or done enough because it is entirely possible to keep revising a book forever. I took a deep breath and submitted a proposal to a publisher.
Eventually every therapist will make a mistake -- forget something important, be late, forget to return a call -- something. It will happen because it must, because we are human and part of the therapeutic process is learning to accept both one's own and the other's humanness. Some patients will stubbornly hold on to demands for perfection and not forgive even the most minor slips. As the therapist, I have to be willing to stay with it and apologize for the mistake and listen to the patient's hurt and anger while also trying to help them see that life has gone on, that the relationship is not over and that there is room for forgiveness. It helps that I remember my own feelings when I discovered my analyst was not perfect. It's never easy to be caught in one's own errors and lapses, though with practice, over the years, it does get less anxiety provoking to listen to and deal with a patient's anger and disappointment.
As a therapist, it is important that I not act out any hurt or anger caused by the patient. This means that the patient can say what happened and that the effect was that she were hurt or inconvenienced or whatever. And that there will not be retaliation. I have to sit on my own all-too human urges to defend myself, not always an easy task.
I found myself getting irritated a couple of times recently about casually dismissive remarks I have heard about therapy and therapists. That therapy is just good listening and if friends could learn good listening skills, then therapy wouldn't be necessary. That and the usual fantasy about therapists getting rich off people's suffering.
Listening empathically can and does provide catharsis and catharsis is an element of therapy. But it is only an element, not the whole thing.
The inferior and even the worthless belongs to me as my shadow and give me substance and mass. How can I be substantial without casting a shadow? I must have a dark side too if I am to be whole; and by becoming conscious of my shadow I remember once more that I am a human being like any other. At any rate, if this rediscovery of my own wholeness remains private, it will only restore the earlier condition from which the neurosis, i.e., the split-off complex, sprang. Privacy prolongs my isolation and the damage is only partially mended. But through confession I throw myself into the arms of humanity again, freed at last from the burden of moral exile. The goal ... is not merely the intellectual recognition of the facts with the head, but their confirmation by the heart and the actual release of suppressed emotion (Jung, CW 16, p134)
When I enter a session with a patient I endeavor to do so without memory or desire -- which is to say that any day as I meet with my patient, I put away thoughts about this blog, about my husband's latest project, about other patients, and about our last session with each other and I prepare to meet her in the moment and without an agenda. I wait for her to begin and allow her to set the agenda for our time together. I follow the thread of her concerns and as I do so, bits and pieces of the other times we have met come to mind. I hear more of her themes and as we go along I am relating them to themes I have heard from others and what I know about such themes. I am aware of issues in her life that have led to her personality being structured as it is -- this is a clinical piece where I touch into my database of experience with people who have similar histories and who have had the constellation of issues in their lives that she has has and what I know from more theoretical material, mythology and even fairy tales. I challenge a bit here, ask a question there, offer a suggestion, share a personal experience. I watch as we do our dance of speaking and listening and I see when an interpretive arrow hits the mark and when it misses.
Jung At Heart is now 9 years old! I never thought when I first started posting in February of 2007 that nine years later I would still be doing this, albeit less often than in the early years. But here I am. I still have things I want to say and I am working on an exciting new project too.
Alert readers will notice I have made some changes here. Three years ago, I deactivated my other blog, TheFatChronicles, because I wanted to integrate that kind of content into this blog as symbolic of embracing those issues as part of who and what I am. In this three years I have worked on and now finished the manuscript for what I hope will be my book. And as that book is centered on issues surrounding fat, it seems this is an important time to separate out that blog again. You can find it by clicking on the link in my link list which is in the sidebar of every page here.
Eight years ago during the campaign season, i took a look at some of the issues around sexism that were coming to the fore and I related some of it to the negative other complex, because after all, I am a Jungian and I like to look at how archetypal themes and issues wind heir way through our lives. Here we are again with the same issues, updated to a new intensity so it seems worthwhile to revisit them. Today a dive into Jungian theory and the mother complex.
The mother complex is a potentially active component of everyone's psyche, informed first of all by experience of the personal mother, then by significant contact with other women and by collective assumptions. The constellation of a mother complex has differing effects according to whether it appears in a son or a daughter.(The Jung Lexicon)
It isn't possible to escape the influence of mother in the development of any and all of us.
Jung tells us of several forms the mother complex can take in a woman --
The exaggeration of the feminine side means an intensification of all female instincts, above all the maternal instinct. The negative aspect is seen in the woman whose only goal is childbirth. To her the husband is . . . first and foremost the instrument of procreation, and she regards him merely as an object to be looked after, along with children, poor relations, cats, dogs, and household furniture.(Jung, CW 9i., par. 167.)
and in another variation, what Jung calls the feminine instinct is inhibited or wiped out --
Internationalpsychoanalysis.net posted the link to this video last week. Do take a look as it is one of the best looks at what it is to be a patient in depth psychotherapy.
A Tweet about this article caught my eye before the holidays: Millennials and the false allure of online psychotherapy. Just the term “online psychotherapy” can mean anything from Skype or FaceTime sessions to email. Not all therapists are comfortable with or accepting of therapy except when done face to face in the consulting room. So I am used to seeing articles here and there decrying therapy which occurs via telephone or Skype. And that is what I expected to read about in this article. To a degree, that is indeed what I found.
After describing factors that seem to make millennials “the most stressed out group in the country”, there is this brief bit:
With Talkspace, for just $25 per week, clients can purchase “Unlimited Messaging Therapy” that allows them to text with a therapist whenever emotional problems arise. The Web site for the app states, “just like texting with a close friend, you can now message your therapist every day, for an entire week, writing as many times as you want.” Initial sessions for In Your Corner cost as little as $25 dollars for “instant expert support when you need it.” That might include online therapy, written coaching plans and stress-reduction techniques from a meditation instructor.
I had only recently heard of these quick response options from my son, who is just starting out in private practice and considering what he might offer. When he asked my opinion, I asked him if he really wanted to work with anyone on that kind of uncommitted catch as catch can sort of basis, because in my mind, it is not therapy but more like a stop at a first aid station for a band-aid now and again. He tried to make a case for it, thinking maybe some people would want to convert over to more regular scheduled therapy. I told him that when therapy starts with such a haphazard frame and very little commitment, it doesn’t seem likely to change because in accepting it, the therapist is colluding with the patient in his or her belief that a quick fix, an encouraging word as needed is sufficient to actually deal with ongoing issues and problems.
The new year always brings a rush of ads, news pieces, magazine articles on dieting, the assumption being that we will have been gluttonous over the holidays and now feel shame which will motivate us to correct the error of our ways — or should that be “weighs”? This year, of course is no exception.
In 2015 Oprah Winfrey bought 10% of Weight Watchers for $40 million. And because she likely expects her investment to yield healthy returns, it lends additional weight to her perennial quest to find a body she can love.
So Oprah opens 2016 with a long commercial about what she claims all fat women feel — that is her dissatisfaction with her body — and says that she wants this year to be the year of her “best body”. And it was this phrase that caught my attention.
What is one’s “best body” anyway? Recently I saw a series of photos of ballerinas’ feet — like this:
The dancer’s body looks so ethereal, so lovely — is that her best body? But look at the price her feet must pay to be able to present that graceful line that so defines classical ballet.