This is my last column for you. I am shocked and delighted that I’ve been allowed to carry on for almost two years, saying such controversial and true things as: the oedipal complex is real and all of us have one; psychodynamic psychotherapy is an effective and vital mental health treatment and we must fight for it in the NHS; and Midnight Run is the best film of all time. It has been a joy and an honour, and, now we are here, I’ve been thinking about the significance of endings.
Because they are significant. Sometimes, having no time left can make it possible to feel and say what was impossible before. They can invite an intimacy and truthfulness and grief that some find overwhelming. It’s not unusual for patients to talk of dropping out, or to skip the final session – to call it a waste of time, to want to leave the room before the end.
But the ending is one of the most crucial experiences of good psychotherapy; an opportunity to suffer the loss and to mourn. A chance to feel the disappointment and rage of wishes not granted and needs met and unmet. To put into words the true feelings of abandonment and gratitude and not knowing and despair that come with the ending of something that has been important, that we want to hold on to. When we have been struggling with these feelings since infancy, spending our adulthood unconsciously killing them off with addictions or repeating them in dissatisfying relationship dynamics or scrolling them away, a therapy ending offers different possibilities. When you skip the end, you rob yourself. I know all this – but I also understand that wish to leave the room.
My father died when my daughter was nine weeks old. I’ve been wondering if I would write a column about this, but I’ve always shied away from doing so. Now, perhaps because it is my last, I’m ready.
My psychoanalyst spoke the reality that everyone could see apart from me, because I couldn’t bear to turn towards it
In hospital, when we knew he didn’t have long, my dad told me that he was sorry for wasting everyone’s time. It was an electric moment for me. I said we mustn’t waste this time. That what I had learned through writing my book, about growing up over the course of a lifetime, was that this very last chapter of his might well be one of the most meaningful. That we were extremely fortunate to have this time and that he needed to think about how he wanted to use it, the conversations he needed to have.
The reason we were able to have this talk, the reason I was able to be by his bedside, was because of something my psychoanalyst said. I didn’t want to go to the hospital. I just wanted to be at home with my baby, feeding, changing nappies, napping. I didn’t want to leave the house – never mind for a ward where infants were not allowed. But my psychoanalyst spoke the reality that everyone could see apart from me, because I couldn’t bear to turn towards it: “Your father is dying.” It was unbearable until it was said, and it was what I needed to hear to get in the room.
After that, it was possible, somehow, for my dad’s bed to be wheeled out of the ward, where babies were not allowed, into the courtyard, where I could take my newborn to be with her grandfather. She wailed, he sang to her. He made his last phone calls. I fed her on a bench next to his bed. The sun shone and the air was cool and fresh, dappled shadow on his blankets. We didn’t say much; it was a different kind of conversation. This memory is painful and beautiful and it is one of my most treasured moments with my dad. It was a gift.
We were lucky; my dad had a good death. He had moved to a hospice and I was standing by his bed with my daughter and my mother and our rabbi. As the rabbi spoke her soft prayers, the familiar Hebrew words seemed to calm my father’s harsh breathing to a gentle, easy rhythm, and to lull my girl to sleep in my arms. I knew that death was near, and fear blew into my mind: “Is it going to harm my child, to be so close to death so early in her life? Should I leave the room?”
In response, I felt a deep emotional understanding that I think had grown inside me through years of desperately running from my feelings, followed by years spent recognising this in psychoanalysis. The understanding was: no, it won’t harm her or me, this is happening to all of us, now, and we need to stay in the room. I knew this was going to be a peaceful death, an important moment in our lives, and that being present might shape her in profound ways that we would never know. I didn’t need to protect her from this ending or the feelings that came with it – it would all become a part of her – and of me.
Staying in that room helped me to realise that as difficult a start to motherhood as this has been, it is mine. My ending – and my beginning. This is what I needed to write in my final column, and I’m only able to do so because I know my time is limited and I want to say what matters most. Don’t leave the room. That is why I keep fighting for sustained psychodynamic psychotherapy in the NHS. Because I know it can help us to stay in the room, whether that room is a psychotherapy consulting room, or your mind, or your own life.
This series was called How to build a better life, but I think what I have been writing about, which is also what I’ve been learning as a patient in psychoanalysis, and as a psychotherapist to patients, and through losing my dad and becoming a mother and through writing for you, is not so much how to build a better life. It’s about how to truly come alive in the life we’re in, so that our time will not be wasted.
Moya Sarner is an NHS psychotherapist and the author of When I Grow Up – Conversations With Adults in Search of Adulthood
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