A Guest

There’s a small community hospital in Murray, Kentucky, where I went to school to get my master’s degree in psychology. As a second year student we were seeing clients in the counseling center, and one day when one of my clients didn’t show up for her appointment, I discovered that she had been admitted to the hospital for “exhaustion.” She had refused to eat for several days, and although pop singer Karen Carpenter had yet to succumb to anorexia and the general public was barely aware, the medical establishment—even in rural Kentucky, knew well of its danger and feared for my client’s life.

By truculently opposing all those well-intended folks who tried to get her to eat, my client had entered what pilots call the “region of reverse command,” in which airplanes do the opposite of what you tell them to do. I was about to join her there.

I decided to visit my client in the hospital.   Just outside her door, a nurse took me aside and said, “Please do what you can to get her to eat.   Her parents are on their way, and she hasn’t eaten in days.   We’re all really worried about her.”

Just a day or two before that I attended a lecture given by J. Thomas Muehleman, a young psychologist who may in fact be the only one of my professors from those days who is still alive (and still, I am told, residing in Murray). The particular lecture was on a topic called “paradoxical intention,” and in it he outlined the behavioral approach to the use of paradox as a psychotherapeutic tool.

Fortuitously, within five or 10 minutes after my arrival, lunch was delivered on its plastic tray, and was placed on the wheeled table next to her bed; the nurse slid the table over the side of the bed and my young, frail client looked down at it disgustedly.   From my vantage point, the ugly slab of meatloaf couldn’t have been a better choice of food.   She took one look at it and shoved the table to the side.

I proceeded with the cocky insouciance of the 22-year-old graduate student that I was:  “I don’t blame you,” I said.   “It looks…. just horrible.”   She looked at me quizzically, half-expecting me to follow everyone else’s suit and push her to eat.   “I can’t believe they would try to get you to eat that.   It looks… well, you know, it looks like a piece of shit.”

My client gazed at me angrily.   I went on.   “And can you imagine how they handle food in the kitchen? It’s probably made somewhere down in the basement.   Dirty, disgusting.   It could’ve fallen on the floor and they wouldn’t care, they’d just pick it right up and put it back on the plate…”

That was enough for her. She pulled the table back over the bed, grabbed her fork, forcefully stabbed the meatloaf and shoved it into her mouth.   As she wolfed it down she continued to stare at me with fiery eyes.   Although she was angry with me, I could see that while she was rejecting me she was nurturing herself, and that was what was important.  Before we could talk further we were interrupted by a nurse politely asking me to leave the room because my client’s concerned parents had arrived.

I admit that I was thrilled that my intervention could somehow, magically, accomplish what others couldn’t.   Psychotherapy and life rarely work that way, and a whiff of potency can be intoxicating to a young clinician, so thus began a lifelong interest in the landscape of paradox.

What began simply in my mind as a technical move, like moving a rook in position to threaten the queen– over time grew into a deeper understanding of how the game of chess is played.   Rather than simply a method of “joining with the resistance,” as some have described it, paradoxical thinking became a path to more deeply understanding how we all build shelters in which to hide our demons and modulate our interactions with the dangerous world around us.   The walls of that shelter sometimes consist of our strident adherence to our positions, however problematic or self-destructive they become.   Sometimes we can’t break down those walls by confronting them directly, because that only makes them more necessary and strengthens them.  But by surrounding those walls with love, compassion, and eventually understanding, those walls begin to crumble.

I like to think of paradox as a way of inviting a discomfiting guest into Rumi’s guest house.   The guest is those demons, those ugly, sturdy walls we construct to keep us invulnerable, the shameful and destructive behaviors that we repeat even though they trip us up and trap us.

This being human is a guest house.
Every morning a new arrival.

A joy, a depression, a meanness,
some momentary awareness comes
As an unexpected visitor.

Welcome and entertain them all!
Even if they’re a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still treat each guest honorably.
He may be clearing you out
for some new delight.

The dark thought, the shame, the malice,
meet them at the door laughing,
and invite them in.

Be grateful for whoever comes,
because each has been sent
as a guide from beyond.

In the region of reverse command, the way out of danger is to do the very opposite of what you instinctively are wont to do.   When you are sinking, sometimes you need to reduce power and point the nose down in order to find the energy needed to climb.   My client, way back in the 1970’s, was suffering.   I don’t doubt that the food that appeared before her symbolized the nurturance that she found so utterly “distasteful,” and that those who benevolently pushed her to eat stood in firm opposition to her need to reject that nurturance.  I don’t believe for a moment, nor did I back then, that this single intervention was all that was needed to resolve those underlying conflicts. Yet, by honoring her protest and welcoming the dark thought, the shame and malice, she was able to make a foothold into the path of letting go of her protest and nurturing herself.

3 thoughts on “A Guest

  1. Fantastic! That is a great and true story! I am going to send it to our granddaughter who is a new RN. She has worked at Aurora Vista Del Mar hospital in Ventura since July and has already been promoted to being in charge of a difficult unit. She loves that job! thank you for your wonderful thoughts on so many important subjects!

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