fortsättning om terapi

Det finns ett par symtom som berättar att tomhetskänslan inte är en död tomhet. Det är rädslan och desperationen. Tomheten lever alltså. Den ligger kanske där som en övergiven galosch i strandkanten och skvalpar och väntar på sin ägare. Så kan man se det. Så finns det hopp. Det är det första man ska försöka ge som psykolog till den som söker hjälp. Det ”ser” hopplöst ut men att man vet själv att det alltid finns hopp. Det gör man på olika sätt. Risken är att man blir så ångestladdad som terapeut att man blir för ivrig att visa att patienten ”har fel”. Patienten ( jag föredrar det begreppet eftersom det betyder ”den som har tålamod” och det är nåt bra…inte alls nedvärderande på något sätt ) har rätt…sin subjektiva rätt att uppleva det hopplösa i sin situation. Därför må den upplevelse bekräftas att ”ja så är det nu…att du upplever ditt liv som meningslöst och hopplöst”.

Man ska inte tveka att ställa frågor om tankar på självmord. Många har kommit så långt i sin känsla av förlamning att de redan upplever sitt liv som dött. Men därunder kan vaga tankar om suicid leva och frodas därför att ingen nånsin törs fråga om dem. Att bara träffa någon som inte verkar drabbad eller själv förlamad av rädsla för döden kan vara rent befriande och ge en första liten liten öppning om att allt kommer att kunna talas om och sättas ord på. Och det är till syvende och sist orden som kan befria.

Att visa på detta är att ge hopp. Att man ska till slut kunna tala sig ur den döda vinkeln.

Antalet människor som får en tillräckligt bra utbildning och egen-analys/-terapi för att handskas med tomhetsdepressioner och bristen på livskänsla, sjunker är jag rädd. Det beror på flera ting. Bl a att alla är vi barn av vår tid och många av de nya utexaminerade hjälparna har själv problem av liknande slag…hur osannolikt man än vill det är. En annan orsak till att tyngdpunkten i en terapi i dag, med KBT-tekniken, har förflyttats från hjärtat till hjärnan, från känslan till intellektet, från en fråga om att passa sina terapi-tider till en fråga om hur fort det ska gå.

När Barbro Sandin startade upp psykos-psykoterapierna i Säter och Ludvika på -80-talet handlade kritiken inte i första hand om tidsperspektivet utan huruvida det övh var möjligt och önskvärt att se psykosen som behandlingsbar. För mycket gammal psykiatri-prestige verkade stå på spel och i stället för att välkomna det nya och optimistiska sökte man på flera olika sätt sätta käppar i hjulet för henne och hennes medarbetare.

Vi vet att de hade fel. Psykosen går att förstå och det ”konstiga språket” ( psykotiska ) är meningsfullt. Hallucinationer är inga hjärnspöken utan ett medel för att slippa dö av ensamhet.

En dylik terapi tar tid…visst. Men den inger hopp om fortsatt liv. Den ger oss nya kunskaper om mänsklig utveckling och skörhet.

På samma sätt är det i dag med ”den nya kategorin” patienter som inte ens har hallucinationer som vänner. De har i stället hankat sig fram genom att ta tag i det yttre. Jag brukar kalla dem intellektuella autister. Aspergare säger vissa. Jag är ännu osäker på om jag talar om Asperger när jag talar om dessa nya tomma människor. Det kan vara så. Tills vidare är det inget problem.

Många Aspergare har en väldig mamma i bakgrunden…en styrande kraft som väl inte egentligen kan sägas finnas i bakgrunden utan tvärtom om många gånger fungerar som styrande. Subjektet längtar efter hennes ömma sidor utan kommenderingar om vad subjektet ska och inte ska göra och säga. Därför är patienten medveten om hennes farlighet. Men att separera är förenat med skuld och evigt fördömande i en nattsvart ensamhet. Att balansera detta omänskliga företag är det som gör att man ofta utvecklar en extrem förmåga ( skill ), för att känna sig kapabel och självständig. Mamman blir tyvärr snabbt avundsjuk på den och blåser upp den ytterliggare till att hon minsann har ett sånt fantastiskt barn. När andra är närvarande. Hennes sanna känslor, avundsjukan, blir barnet ensamt förunnat att ta del av…Det känns omöjligt att både vara tillsammans och vara utan.

Jag talar mer om människor som inte ens har möjligheten att utveckla speciella förmågor som balanserar det tomma. Det är en öken. Att bara tänka på andra människor är förenat med stor ansträngning. Det går inte att vara tillsammans. Det är uteslutet. Man vet att det kommer att skita sig. Man går in i sin sitt eget lilla kryphål och står ut med hjälp av arbete. Man skulle ju i o f sig kunna se denna arbetsinsats som just Aspergarens ”förmåga”. De skiljer sig åt, verkligen. Aspergarens specialitet har svårt att hitta ut på den öppna marknaden…många gånger pga dess ”bisarra” natur, t ex att kunna tidtabellen utantill eller att rabbla geografiska namn.

Tomhetsmänniskan gör sig ju inte ”obekväm” på det sättet genom att ”kunna irritera med sina konstigheter” . Tomhetsmänniskan ser helt ”normal” ut. Är ”funktionsduglig”. Mycket.

Det är på vägen hem från arbetet som hon förvandlas om hon törs det. Om hon inte tar allt med sig hem och fortsätter vara duktig. Inte för andras skull. Absolut inte. Inte medvetet för någon annans skull. Antagligen omedvetet.

Men fr a gör hon det för att inte behöva ta livet av sig eller en taxi till psyk-akuten. Men det sistnämnda är nära på omöjligt eftersom hon inte vet vad hon skulle ”klaga på”. Ensamheten är ju självvald. Tror hon. Hon är helt övertygad om det. Jag har annan uppfattning i saken.

Jag menar att ”ensamhetsproduktionen” är satt i system.

Återkommer.

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35 kommentarer till fortsättning om terapi

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