HEALING BEFORE FORGIVENESS

I had the privilege the other day to see a patient who had been long abused by a very disturbed mother and father, raise herself up to become a 'big' person. She wanted to be a big person, who would do the right thing. The parents were old, sick and frail now, and she was in her prime. Relations with the parents had been strained and distant, but now they needed help. This lovely person feared her mother's rejection or cruel words. Her mother had been denigrating and critical to her, even to the point of severe beatings, all during her childhood. In therapy she realized her mother was seriously mentally disturbed, but it was hidden, as the mother was able to put her best foot forward in public.

This old couple's house was a shambles, stacks of old newspapers everywhere, pet stains on the drapes and carpet, the odor of rotting garbage. Her mother would not pay attention to, or look at the fact that the father's legs were terribly swollen and he was short of breath. He was afraid of doctors. Luckily, this lady's husband was observant and assertive and got an ambulance to take him to the hospital. The father's heart condition along with many other complications assures that he will not be able to return home. He needed to be transferred to a longterm nursing facility.

That left her mother home alone in the disorganized mess. Tolerating it with her husband was a 'folie a deux' (a craziness of two), but now alone, reality set in. What was to become of her? The younger daughter was busy with two young children and feared getting close to the mother, despite wanting to help her. It would have been better to have the house cleaned up and repaired, then sold, and the two could go to a retirement community with medical and nursing services available.

The trouble was that the daughter, after years of therapy, told her mother she would not put up with any more abuse or embarrassment. The mother called her a 'jerk' and hung up. The daughter called back and said she would never speak to her again.

Months went by and the daughter was concerned about her mother living alone, with her father in the nursing home. The old couple had been inseparable while constantly fighting. She wondered, remembering all the cruelty, why she should care. The thought came up of battered kids wanting to go home to momma and poppa, despite severe beatings, neglect and abuse. It must be instinctive. You get bonded to just certain people, who care for you for better and worse from infancy on.

The primitive instinct to care for mother was still there, but the noble desire for honor and respect, wanting to help the parents in their hour of need, enabled this young woman to call her mother and ask how she was. She was bracing herself for a cutting remark, but instead she got an unexpected welcome and some important personal acknowledgments. It seems the period of time they were not in touch enabled both of them to get a perspective on their painful conflict. And to grow.

When the phone call was over and they had decided to meet at the bedside of the father, the lady sobbed and sobbed. She cried with relief at her mother being rational and not cruel. She cried for the years of missed happiness, not being in a loving family. She cried for all her pain and fright, depression and anger. She cried for the psychological distance she maintained, self-protectively, from all her loved ones, including her husband and children.

But this outpouring of emotion was the signal of a liberation from childhood pain and defense mechanisms. She was going to do the right thing, in spite of everything, she was going to be mature and strong and big, like a real adult.

Psychotherapy helped her reconnect with the fragments of herself. Fragmented, she was weak and confused; integrated, she was strong and clear. Getting it together, getting connected, being one person in the here and now is the goal of longterm, intensive psychodynamic psychotherapy. This, in simple words, is 'healing'.

I have observed that when there is healing, there is automatic forgiveness. One cannot forgive the feeling, based in fact, of being irremediably damaged. Self-help books often preach forgiveness, but I have seen my patients try and try to forgive, and be unable, but when the healing occurs, when it is clear they are no longer permanently damaged, they can be big people and even empathize with the problems of the parents.

It is a beautiful thing to experience this emergence from being dominated by childhood trauma to being free and competent adults. It is very like a rebirth.

Dr. Bloom is Clinical Associate Professor of Psychiatry, Wayne State University School of Medicine. He is a Diplomate of the American Board of Psychiatry and Neurology and Life Fellow of the American Psychiatric Association. He is a member of the American Academy of Psychoanalysis and corresponding editor of their quarterly journal, Academy Forum. He welcomes comments and questions at his e-mail address: vbloom@comcast.net.