The Impossibility of Knowing: Dilemmas of a Psychotherapist
Brett Kahr came to hear my paper on Absence (Chapter 8) given at the London Centre for Psychotherapy in June 2009 and, following this, encouraged me to think about producing a book, based on the many papers I have written and published over the years. He made the first contact with Oliver Rathbone on my behalf, and so smoothed the path through to Karnac Books, who generously offered to publish.
I then had to choose from my published papers as to which would most easily integrate into a book and find a title that would encompass the papers and my thinking and work as a Psychotherapist. The first title that I reached was The Human Touch and then I found that Michael Frayn had written a book with just such a title. Later, I recalled a letter from a grateful patient which read “thank you for teaching me that the answer is that there are no answers”. This quickly developed into the current title – The Impossibility of Knowing: Dilemmas of a Psychotherapist.
The book divides into 3 sections:
- the first addresses patients with certain types of psychopathology;
- the second is focused on the themes of love, hate and the erotic in psychoanalytic work;
- the third section is entitled ‘Challenges to the Frame’ and spells out some more extreme difficulties that can occur in the work – both through enactments during sessions and work with a patient who was largely absent;
The final short chapter, entitled ‘Dilemmas of a Psychotherapist’, lists some amusing, yet difficult, anecdotes of incidents occurring during the therapeutic session.
I was excited about the encouragement I received from Brett, Karnac Books, friends, colleagues and family in writing this book. I had previously admired those of my colleagues who wrote books whilst I only wrote papers! Now both seemed to be possible. My excitement, however, was somewhat tempered by the hard work and difficulties in editing the previously published papers and particularly in cross referencing the various chapters of the book.
I think that the book could be helpful to those who are training in counselling and psychotherapy – not only because it portrays the psychotherapist as someone who is always learning and struggling herself – but also because of the many clinical examples it offers in every chapter. It may well be of interest to those who have some knowledge of psychoanalytic theory so that they would not be struggling too hard with the theoretical aspects of each chapter. In so far as its capacity to change aspects of the profession are concerned, I think perhaps my main contribution has been to open up issues of erotic transference and counter-transference – particularly in those chapters on seduction and betrayal and on enactments.
I am well aware that my teaching in these areas seems to have been rather unique to many post-curricular trainees who have not addressed these issues during their basic training.
The book was completed with the support of colleagues, family and friends and in particular my husband, David, who has been so generous with his comments and encouragement.
A final word regarding the book cover: I had thought about ‘knowing’ and knowledge’ and about fountains of knowledge and began to search for an appropriate image for a fountain but found nothing suitable. I then spotted the painting by my daughter, Charlotte, entitled In the Deep – a gorgeous deep blue/black sea, which gradually lightens and depicts a strong ray of sunlight on the surface. This I thought could reflect a piece of valuable insight or indeed a ‘eureka’ moment. It seemed to fit beautifully with the title I had chosen.
My background was in social work and I completed my training with the London Centre for Psychotherapy in 1982. I gradually switched from medical social work (which included counselling in a General Practice surgery and abortion counselling in a hospital) to full time psychotherapy. Early on in my career I was invited to supervise at Westminster Pastoral Foundation for trainees completing a qualifying course in psychodynamic counselling. Andrew Samuels, a former supervisor, was instrumental here in making an introduction to WPF on my behalf. I think that this opportunity to supervise proved to be one of the principle formative influences on my development as a psychoanalytical psychotherapist. In supervision, one learns from one’s supervisees – just as Patrick Casement writes of learning from the patients – and this learning, coupled with work in the consulting room, is so fruitful for insight, patience, understanding and development. Supervision continues to be as much of a stimulating pleasure today – 25 years on – as it was in the mid-80’s.
Another area that I have thoroughly enjoyed in my work has been in working with couples. As a much younger social worker I started joint work with a Consultant Psychiatrist in a Sex Therapy Clinic. I attended many weekend workshops run by the Association of Sexual and Marital Therapists and thus learned much of what I know and practise from both formal and informal experience. I think this background has helped me to deal more easily with erotic difficulties in the work.
I am currently leading workshops and giving papers at various psychotherapy and counselling organisations around the UK – mainly on issues of love, hate and the erotic and on seduction and betrayal. I hope to write more in the future but at present I do not ‘know’ where the inspiration will come from. Up until the present, all my writing has been inspired by what happens in the consulting room (and occasionally what happens in supervision) – which leads me on to enquire, read and then, finally, to write.
Jackie Gerrard, author of The Impossibility of Knowing: Dilemmas of a Psychotherapist (Karnac Books, 2011)
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