Transcending Shame and Sorrow
There are times when clinical work alone does not provide enough to rescue us from the shame and sorrow it can engender. I need to be transported to a plane where time stands still. At least for me, writing provides one avenue for this transformation. On this level clinical moments that, in themselves, may have been fraught with pain can initiate contemplation that doesn’t have to obey time limitations or any other requirements. I can allow myself to get lost and roam around in my thoughts, much as I love to get lost in a city that is new to me. Of course, in theory I could experience this transformation within sessions, and not just in writing about them, and in actuality this does sometimes happen. But when I am doing clinical work, I can’t stray endlessly. Also, in my writing, for example, the patient who leaves me becomes an instance of a phenomenon rather than John Jones, who felt he wasn’t getting enough to make it worthwhile to stay in treatment with Sandra Buechler. At least for me, writing most easily brings me to a higher level of abstraction. This reminds me of something Levenson (1982) wrote about supervision. He said that clarity is easier to achieve in supervision than in clinical work, because in supervision we deal with a class of patients rather than one person in all his or her (sometimes confusing) particularity. Furthermore, I would say that both writing and supervision have in common the absence of the moment-by-moment press of a live transference-countertransference exchange. This limits them in some ways but also removes them from some of the painful immediacy of acute shame and sorrow.