How hidden meanings may lead to understanding your problems

In the consulting room, conversation with a new patient often starts with the current situation. This is never as simple as it might seem at the first meeting. However, gradually the empty spaces of ignorance in the minds of both analyst and analysand are delicately half-shaded in. The result is hardly ever a clear black and white picture and does not remain fixed. This is not painting by numbers; rather, it is closer to the delicate lines of Chinese brushwork, fluid and implicit rather than explicit in meaning. I will try to demonstrate what I mean with a few verbal brushstrokes:

A woman, ‘Rita’, in her twenties and unemployed, describes life in the family home. ‘My father and brother have the best beds; my mother only has a “put-you-up” bed.’ After some more talk about beds, I comment, ‘There seems to be a lot of talk about beds’. Rita glares at me and replies, ‘You think this is all about sex don’t you, I don’t think that’s revelant.’ ‘Revelant?’ I query.

This is a classic example of the capacity of unconscious thoughts to reveal themselves in spite of the attempts to keep them under wraps. Research into the reasons for Rita’s lack of work, obsessional misery and resentment of all the members of her family, differently expressed towards each of them, is now under way. This research does not measure Rita’s brain activity, is not particularly interested in the details of her obsessional behaviour in relation to checking whether the gas burners on her cooker are turned off before she leaves her flat, or indeed in comparing how she was feeling last week with how she is feeling now or indeed how she might feel next week.

Here is another example:

A successful teacher ‘Bernie’ discusses the many compromises she has to make in her life; compromises at work, in her home life and above all with her highly problematic sister. Eventually I ask, ‘So what does the word “compromise” mean to you?’ Bernie grins at me and says, ‘Of course I know what the word means, but so far as I’m concerned, it means I’ve lost the argument!’

At this point we can both start reviewing together the multiple meanings of the word ‘compromise’ and its effects in her life. Research into the complex array of meanings, hints, allusions, comparisons with other events in her life where ‘compromise’ has occurred, has now commenced.

Both of these examples are taken from work with clients where attention to the minutiae of the words they used led to further investigation of the problems which brought them to my consulting room in the first place. For reasons of both space and confidentiality it is not necessary to spell out their problems in detail and I have used old examples. In the first case there were problems relating to possible sexual abuse; the latter was never clearly established. However, the patient completed a training course, left home and found a job which she liked in another country. Later she wrote to tell me that she had met a man whom she was going to marry.

The woman in the second example came to see me about panic attacks that she had started to experience while teaching—a problem which if it had got worse would have resulted in her having to give up her job. After some months of analysis, it became clear that in fact her relationship with her sister was the cause of many of her problems. The panic attacks ceased of their own accord six months into the therapy.

Both these examples illustrate the slippery nature of meaning. The neologism ‘revelant’ is of course a conflation of the words, ‘relevant’ and ‘revealing’. ‘Compromise’ is not a simple word in the hands of someone who has experienced oppression dressed up as compromise by her sister. In both cases there is an element of compression which serves to reveal the full range of meanings and to conceal them at one and the same time. Thus, Bernie’s understanding of the word ‘compromise’ is a different kind of compression from Rita’s. Rita reveals the fact that her thoughts do indeed have a sexual connotation even if it is disavowed. In Bernie’s case, there is a whole series of meanings to be uncovered which apply to her and her alone. Assumptions that we have a shared understanding of the meaning of any word that seems important to our clients turn out, not exactly to be completely untrue, but clearly far less than the whole truth. Similarly, we cannot assume that there can be a ‘one size fits all’ approach to the question of what our clients are talking about—or even what they think they are talking about.

These examples both turn on a particular use of language that is picked up in the consulting room. Yet of course, idiosyncratic use of language is an everyday feature of ordinary life. It is simply something that is not normally remarked upon except within the consulting room where it may help both client and therapist to understand the hidden conflicts in life which cause so much pain.