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It’s hard to mingle in this line of work

On November 4th

There’s a paradox in clinical practice. I get to know people very well, but they can never be my friends. This bothered me at first, but it doesn’t so much any more. If there were any way of being friends, then the work we do together would become unbearable, and therefore impossible. It’s a sacrifice we mutually make to make it possible to do something useful. It’s a loss I’ve accepted.

The work entails the most personal conversations imaginable. I have to be emotionally present and available — when I’m not, the work goes all to hell very quickly. Even if I’m not telling about my life and my struggles, I am very much involved. It is hard to describe this without sounding sentimental or creepy. There is a discipline to it, which accounts for the long training required. There is an emphasis on not monkeying with the person’s autonomy, which is harder than it sounds: not trying to push or persuade them one way or another. Anna Freud spoke of being “equidistant” between the differing parts of a person. We don’t try to pick winners or root for one part or another to win in the struggle. Easier said than done.

I get to know these people in a privileged way. I do feel it’s a privilege. I am naturally curious, and I never tire of hearing how people make their way through life. The supply of creative solutions to the human condition is inexhaustible. Some of the deals and compromises people make are painful or tragic, which is what brings them to me.

I also get a side benefit of hearing about life from all sorts of occupations, cultures, and histories. I learn something amazing every day. I get such a kick out of this that I feel a little guilty.

Some people find the nature of our relationship hard to deal with. They emphasize that it’s “artificial” and therefore “not real” I agree with the first part, but not the second part. We are surrounded by relationships that are artificial: teachers, managers, customers, etc. What brings these relationships into being is that people are acting within roles. But within the artifice can come an actual human bond. We’re all just people, and we’re all in this together at some level. Here is where I think of Marianne Moore‘s description of poems as “Imaginary gardens with real toads in them”.

Once in a long while I get invited to weddings, graduations, etc. I try to treat these gently. It is a vulnerable thing to invite someone to cross a threshold into a different kind of relationship. I always turn the invitation down, although sometimes I am tempted to indulge. I remind myself, and the person, that I need to preserve the chance to be helpful to them. I want to get to the place where we can understand their wish that makes them invite me to be a different kind of person to them than I can be. Sometimes people are hurt or angry about this.

One way of explaining my refusal has helped me out. I say “It’s kind of hard for me to mingle”. This usually explains it.

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