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DRAWING ONE: Intersubjectivity Overcomes Maladaptation 6/20/16
After twenty years of not being able to draw, the Patient, at the urging of the Doctor took up pencil, ink and marker. To the Patient's surprise, the intersubjective alliance that had been forged with the Doctor, allowed the Patient to access and share and draw memories, dreams and fantasies in the form of images and words.
The Patient is depicting real traumatic events, as-well-as recurring nightmares and compulsive fantasies. Some of these are recalled spontaneously during the act of drawing. Others have been revealed in session with the Doctor.
The most therapeutic component of this work, from which the entire drawing flows, is the overlapping brains and spine of the Patient and Doctor as depicted in the upper left corner. The two brains and fused spine represent to the Patient the shared conscious and subconscious relationship the Doctor and Patient share in the professional setting.
The work also depicts memories of surgery including a Masked Doctor, IV bag, incisions, dissection and an enema. Additionally, the Patient's relatives are included: a remote Father/brute, a Sexualized Mother. Biographical events and locations appear such as the Mother's car accident and the Patient's childhood bedroom window.
Finally, the Three Faces Of Dissociation and a young girl lost in time manifest in the lower right corner.
DRAWING TWO: Full Attention 10/31/15
Full Attention depicts a recurring fantasy that the Patient has compulsively participated in since she was approximately 9 years old to the present.
Two figures are embedded inside the Patient's brain like a tumor or an overriding thought process.
The figure on the left is at once the Patient's Father and a Nurse. As the Father/Nurse the figure is cold, cruel, remote and armored. Tubes travel from the Father to control the Patient and from the Nurse to harm the Patient.
The figure on the right is the Patient. She is entombed within a labial like cocoon and restrained. She cannot see, hear or speak. Her only contact with the world is sexual as indicated by exposed primary and secondary sexual characteristics. She depends solely on the Father for food, water, air. She has been immobilized and dominated to the point of total helplessness and hopelessness.
Helplessness and immobility is the only approved stance that is allowed the Patient by the Father and the only way for the Patient to remain safe. The Patient wishes she could avoid the Father's full attention but as much as she fears it she cannot.
The Nurse emerged as the Patient executed the drawing. The emergence of the Nurse was a shock to the Patient and caused upset.
The Patient has experienced periods of relief from the fantasy since completing the drawing and discussing it with the Doctor in session.
DRAWING THREE: Neglected 6/9/16
This drawing depicts a recurring nightmare that has persisted for decades. The Patient awakes in disgust.
Within the dream the Patient comes upon animals that she was supposed to take care of. To her horror the animals have been forgotten and neglected. She finds them trapped in dirty feces impacted cages and tanks without fresh food or water. Most of the animals are dead and decaying. A few cling to life. Some are injured.
The Patient desperately tries to clean the cages. She forces herself to touch the vile contents so that she can dispose of the dead and save the living. She has no idea why she forgot to take care of the animals. She can only surmise that she was unintentionally distracted or absent.
The Patient has discussed the nightmare with the Doctor in session. Based on mutual interpretation the Patient is aware that the trapped animals represent herself and her inability to remove herself from her family where she has been trapped, neglected, and staved for attention.
The closed eyes represent the Patient's dissociation from reality and her own feelings. She is distracted and absent to the degree that she neglects herself. The open eye represents the Patient's longing to remember and understand the nightmare so that it will stop recurring.
The multiple mouths on the face represent the Patient's inability or means to tell someone about the pain she is experiencing and get help before she dies like the animals.
DRAWING FOUR: Unintended Consequences 6/29/16
This drawing is based solely upon work with the Doctor in session. The Patient has discussed her unintended conception and medical conditions that were a result of her premature birth at seven months gestation in 1952.
The Patient's premature birth resulted in weak muscle tone exhibited as inwardly turned feet and outwardly turned eyes. Additionally, the Patient had a disfiguring vascular birthmark on her nose. Retinopathy of Prematurity was acquired from exposure to Oxygen in an incubator.
Despite medical admonitions to not conceive again after two previous miscarriages, the Mother engaged in unprotected sex. Subsequent methods to sustain this pregnancy resulted in the Patient being exposed to Diethylstibestrol or DES in utero.
The Patient has told the Doctor that she resents that at the earliest moment of her life the Mother was lazy and precipitated a cascade of medical and surgical interventions that began with use of radium to remove her birthmark before age one and continued with eye and cosmetic surgeries through age 35.
In the drawing the supposedly happy Baby wears a mask of anger, pain and humiliation depicted as a clown face due to her "clown nose" deformity. The anger surfaced consciously as the Patient drew and let herself remember.
The Patient continues to come to terms with her anger surrounding her Parent's cavalier actions and the future encounter with the Nurse and unintended psychological consequences of her conception.
DRAWING FIVE: I Remember 6/30/16
The Patient remembers: "I remember the hospital. I remember the operating room. I remember the eye doctor and the Head Nurse. I remember surgical instruments and hospital gowns, metallic sounds, bright lights, cold air, bad smells. And to my surprise I remember the feel of the retractor on my right eye, eye patches, bandages and breathing tubes in my mouth. I remember pain. I remember dissociating to blunt fear and bodily sensation. In the moment of remembering and during the act of drawing I am there again, I dissociate."
The Patient has come to understand the "rules" of dissociation and PTSD. What she does not yet understand is how pain, restraint and fear in a medical setting can cause the manifestation of her persistent, intrusive and unwelcome fantasies of pain, restraint and fear.
The Patient needs the intervention of the Doctor. The Doctor has knowledge and brings understanding. In the drawing the Doctor stands in the Patient's brain holding books. The Patient is represented by five figures all in various forms of discomfort.
The Patient dissociated as she drew but was comforted by the presence of the Doctor in the drawing and the implied stance of attention, explanation and diagnosis. The Patient dissociates when viewing or writing about this drawing.
DRAWING SIX: No Map. 7/3/16
Here are the Lazy Mother and the Indifferent Father. The Mother is asleep and unavailable to her child. The Mother has not prevented a pregnancy because she was lazy. The Father looks away from his wife and child. He does not know how to be a husband and would prefer to not be a Father.
The Patient is depicted as a fetus. The fetus carries the genetic characteristics of the Nervous/Weak Mother. The fetus will grow up in the presence of the Cold Abusive Father. This is the beginning of the Patient's journey through life.
The Patient is also depicted as a teenager in the 1960s wearing denim jeans and work shirt. The Patient looks back in time toward her Grandparents' home and to her childhood home which were lost.
The Patient is trying to understand and overcome the sad circumstances that brought her to Long Island. The Patient wants to rise above her genetics and family circumstances, to be more than the sum of those parts. But she has no map.
Unbeknownst to the Patient, her journey to Long Island will bring her to the Doctor.
DRAWING SEVEN: Recurring Nightmares 7/16/16
It is nighttime and the Patient is sleeping in the moonlight in her childhood bedroom. The Patient is enduring recurring nightmares that began when she was very young. The nightmares made it frightening to fall asleep.
The Patient could not explain to the Mother why she fought to stay awake. When the Mother sat with The Patient at bedtime the Father would get angry. He wanted the Mother's full attention.
The nightmares include cars driving on telephone pole wires, atom bombs exploding against the horizon, telephones that will not work, toilets with no privacy, hallways that lead to nowhere, staircases that turn into slides, endless downtown sidewalks, New York City parking lots and subways. Dreams of being in school or hospital and searching storefront windows complete the list.
The nightmares would come every night and the Patient would wake up afraid and not ready to report to school or work.
In the upper left hand corner the Patient is drawn sitting in the Doctor's office. She is older and light shines on her. She has begun to become "enlightened" about her psychological predicament.
DRAWING EIGHT: Good Old Dad 7/21/16
The Father/Brute has risen up to fill the World. Nothing exists beyond his angry face and rage-filled words. The Patient and the Mother are frozen in fear. No one can help. Time stops. The Patient goes away.
This is the Father at home, undisguised. The Father exhibits his essential nature. He is angry, loud, strong, and male. He reeks of cigarettes. The Patient cannot ignore or escape the Father. There is no help.
The drawing contains an actual verbal outburst. This time the Father has gone to far. He has been unusually cruel to the Patient, too cutting. The Mother speaks up. She cuts off the tirade. The Patient feels the Earth change. Day-to-day nothing is different. Not for a very very long time.
DRAWING NINE: "3" (title) 7/25/16
The patient sits in a doctors office. Bright light shines on her from three lamps. The Patient has come to the doctor because she feels sick. She needs to be sick so she can stay home from school. But the Patient is not physically ill. She is emotionally and mentally ill. No amount of physical examination/light will illuminate her "problem".
The Patient is very familiar with doctors' offices. However, she has never been diagnosed correctly. To quote the drawing, "No one can see there are three of me."
The Patient is represented as three superimposed dissociated seated figures. Her naked body can be seen and represents her somatic symptoms. Her emotional pain is represented by one red heart.
DRAWING TEN: "Die" Press 7/25/16
The Father is represented as a large metallic mechanism designed to pound and press other materials until they are hammered into another shape.
The mechanism is relentless. It will continue to pound and press until an object is deformed, bent until it's intrinsic structure fails.
The Patient has been pushed to the far left side of the drawing by the mechanism. She gradually deforms, then disappears.
This is how the Patient felt when she lived with the Father. She is still trying to repair herself.