I Hate You--Don't Leave Me - Jerold J. Kreisman [77]
At one point in therapy, Elaine focused on her relationship with her parents. After confronting them with the revelation of her father’s sexual abuse, she continued to feel frustrated with them. Both parents refused further discussion about the abuse and discouraged her from continuing in therapy. Elaine was puzzled by their behavior—sometimes they were very dependent and clinging; other times she felt infantilized, especially when they continually referred to her by her childhood nickname. Elaine requested family meetings, to which they reluctantly agreed.
During these meetings Elaine’s father gradually admitted that her accusations were true, though he continued to deny any direct recollection of his assaults. Her mother realized that in many ways she had been emotionally unavailable to her husband and children and recognized her own indirect responsibility for the abuse. Elaine learned for the first time that her father had also been sexually abused during his childhood. The therapy succeeded in releasing skeletons from the family closet and establishing better communication within the family. Elaine and her parents began for the first time speaking to each other as adults.
Artistic and Expressive Therapies
Individual, group, and family therapies require patients to express their thoughts and feelings with words, but the borderline patient is often somewhat handicapped in this area, more likely to exhibit inner concerns through actions rather than verbalization. Expressive therapies utilize art, music, literature, physical movement, and drama to encourage communication in nontraditional ways.
In art therapy, patients are encouraged to create drawings, paintings, collages, self-portraits, clay sculpture, dolls, and so on that express inner feelings. Patients may be presented with a book of blank pages, in which they are invited to draw representations of a variety of experiences, such as inner secrets, closeness, or hidden fears. Music therapy uses melodies and lyrics to stimulate feelings that may otherwise be inaccessible. Music often unlocks emotions and promotes meditation in a calm environment. Body movement and dance use physical exertion to express emotions. In another type of expressive therapy called psychodrama, patients and the “therapist-director” act out a patient’s specific problems. Bibliotherapy is another therapy technique in which patients read and discuss literature, short stories, plays, poetry, movies, and videos. Edward Albee’s Who’s Afraid of Virginia Woolf? is a popular play to read, and especially perform, because its emotional scenes provide a catharsis as patients recite lines of rage and disappointment that reflect problems in their own lives.
Irene’s chronic depression was related to sexual abuses that she had endured at an early age from her older brother and that she had only recently begun to remember. At twenty-five and living alone, she was flooded with recollections of these early encounters and eventually required hospitalization as her depression worsened. Because she felt overwhelmed by guilt and self-blame, she was unable to verbalize her memories to others or allow herself to experience the underlying anger.
During an expressive-therapy program that combined art and music, the therapists worked with Irene to help her become more aware of the fury that she was avoiding. She was encouraged to draw what her anger felt like while loud, pulsating rock music played in the background. Astonishing herself, she drew penises, to which she then added mutilated disfigurements. Initially fearful and embarrassed about these drawings, they soon made her aware and more accepting of her rage and obvious wish for retaliation.
As she discussed her emotional reactions to the drawings, she began to describe her past abuse and the