Rolands Bortaščenoks (Latvia). When Suffering Is The Meaning

A year after the end of four years of therapy (140 appointments) with a client, whom I shall call Anna, I received a message from her asking for a meeting. One year has passed, and I see a confident, accurate woman of over forty, dressed in a business suit, with a luminous smile and beautiful, kind eyes. In less than a second, I remembered our first meeting five years ago, when I was alarmed to see an emaciated, pale woman of over forty who left the impression of a scared, tired and exhausted child.

Anna wanted to meet me because during that year certain changes occurred in her life, at which we could not arrive before the end of our work together. Anna wanted to share her joy and satisfaction from her current life. Her marriage was over; she has peacefully divorced her husband, they have maintained respect towards each other, while their children accepted the divorce with understanding and even with relief. Anna expected that the world would fall apart after the divorce and that she would never feel joy and peace again, but reality proved otherwise.

The beginning of our work together with Anna was completely different. The reason for her turning to me were difficulties in her relations with her husband and fear that their family would dissolve. Anna’s initial motivation was based on fear. At the beginning of psychotherapy, Anna expected that, with my help, she would be able to understand what was happening in her family and would be able to become a better wife and mother. Anna’s main aim then was to find means and ways to preserve the family (marriage).

Anna’s goals changed during psychotherapy. Her initial goal became to raise her self-esteem, to set new boundaries in her relations with her husband and with others and to understand what scared her so much in the idea of divorce. Towards the middle of the process, her goal became transformed. Anna wanted my help to understand her feelings about her past experience, characterized by soreness and anger towards her husband, and to forgive him and herself. Towards the last third of our work together, another goal appeared – to accept her choice not to divorce and to share responsibility for the hardships of family life between her husband and herself.

Our shared interest in Anna’s existential world was directed towards three areas of her difficulties, which we identified and designated together as the key ones: her sense of inferiority, absence of sexual attraction and masochistic pattern of relations.

Sense of inferiority. Anna could not pinpoint the time when the sense emerged; she remembered that she felt inferior, unconfident and uncouth all her life. She remembered how she was afraid of her parents being ashamed of her and studied with excellent marks, although her parents treated it as being self-evident. Her sense of inferiority intensified when she became adolescent and observed how the bodies of other girls were acquiring more feminine shapes, and her own body remained childish for a long time. Her parents and elder brother made all the important decisions for her. The experience of relations with prominent people in childhood and during her early years at school, coupled with hyper-care caused the development of a neurotic sense of guilt and fear of choice and responsibility.

Absence of sexual attraction. Anna could not remember ever feeling sexual attraction. I believed that the idealized image of an emotionally inaccessible father facilitated her slow sexual development. During sexual relations with her spouse, she never experienced orgasm. She took pregnancy with the joy of becoming a mother and with relief for having a reason to give up sexual relations, which she viewed rather as her duty. After three years of marriage, she was abandoned by her first husband, who created another relationship. In a couple of years, Anna married for the second time. She confessed to her husband several times that she did not feel orgasm. On the husband’s initiative, she turned to a sexologist, underwent a course of treatment, but with no changes. Her relations with her husband were tense. The husband’s sexual harassment and his threats to take a lover caused her to feel constant anxiety and the sense of losing control of her life.

Masochistic manifestations appeared already in her early years at school, when the client experienced lack of attention, approval and received unfair punishment. When she could not defend herself, her parents punished her for the actions she did not do or for her failures in studies. She accepted and suffered the punishment in silence. Anna liked suffering, because she knew that suffering would be followed by a reward (recognition, pride, surprise, pride for her achievements and, simultaneously, the sense of being immersed in a ‘sweet fog’). When she married for the first time and the relations between the spouses began to deteriorate, she concealed for a long time how she really lived, and then began to tell her parents about her hardships. The parents supported her, calmed her down, encouraged to suffer a little, and she thought she was a heroine, she would endure it all and they would live happily, that she would win the struggle for her family, and the other would bow their heads in recognition of her achievements and say: ‘yes, you made it… yes, you are a hero, you saved your family!’ During the second marriage, the masochistic pattern of behaviour continued and reached its summit. In her relations, the client demonstrated subordination, naivety, childishness and self-sacrifice.

At the initial stage, our work together was directed towards revelation, acceptance and awareness of her feelings of anger, guilt and shame. I think Anna was helped by the fact that I was the first man to treat her seriously, with respect, understanding and acceptance.

Gradually, Anna came to trust me and believe that I really respected her and believed that she herself could make sense of her difficulties and arrive at a satisfying solution. It helped her to gradually discover for herself the reality and the subjective perception of life.

During the following process of psychotherapy, we gave much time to exploring Anna’s investment in the destructiveness of family relations, how she creates the dynamics of dependent relations herself. Gradually, Anna developed a vague awareness of her responsibility and cost for the choice she had made – by choosing to remain in the relations that, for her, were destructive, she rejected the opportunity to create relations that would be acceptable, fulfilling and close to her.

At the initial stage, I became for Anna an authority father figure. It was clear that the client needed an accepting, loving and strong father, next to whom she could feel protected. I consciously accepted this role, which at the initial stage helped us to progress in different directions of the client’s existential world. My sincerity of acceptance allowed the client to open up in her authenticity. In the course of her psychological coming of age, Anna was becoming a true partner in the exploration of her existential world, and I began to lose my ‘expertness’ in her eyes. Gradually, the client got better at recognizing her feelings and taking them for herself.

I could not progress in solving the problem of sexual attraction, but I succeeded in integrating this phenomenon as a given at the current stage of her life, in strengthening the feminine aspect in the client’s identity and in getting rid of the frigidity stigma. I think I could not achieve it due to the positive translation of me as the father. I could not progress considerably in reworking the masochistic pattern; it was evident when at the end of our shared work I realized that her masochistic readiness to sacrifice her own interests to remain in relations with me became an impediment in our further work.

For a long time in psychotherapy (two and a half years) the transfer in which the client viewed me as the ‘final saviour’ was helping us when we were working on raising her self-esteem, on the issues of female identity and on personal borders. Later, her masochistic readiness to sacrifice herself lead our work to a dead end, from which we began to find a way only when we began to set the terms of ending psychotherapy, i.e., introducing the aspect of finality of psychotherapy. The client began to realize that her life, her family are not eternal, that time is inevitable, that either she makes her choice or someone else will make a choice, just as I did in offering to end psychotherapy. The client made her choice, deciding to stay with her marriage due to a number of practical reasons, which seemed sufficiently important for her. A choice does not always mean a choice between good and bad; sometimes it is the only choice, when a person renounces to use the freedom of choice. The client accepted the limitations that at the given stage of her life seemed unsurmountable for her.

On taking leave, I had the sense that the client was satisfied with what she had achieved and had accepted her limitations. And I was satisfied with the work I have done.

As our meeting in a year’s time proved, the process of psychotherapy had a legacy, and changes in Anna’s life continued and were supported by the shared experience of our relations.