Twinkle Twinkle...

Dr. Catharine Bailey

Presented at the APAS Conference on “Memories, Mourning and Re-imaging the Future” Oct 2023

I would like thank the scientific committee for giving me this opportunity to talk to you today about my life as a psychoanalyst. As with all things psychoanalytic and in line with the theme of our conference on ‘Memory, Mourning and Re-imagining the Future,’ many of life’s memories and present experiences weave together to where I find myself today.

First I would like to talk about diamonds

My father was a religious man and this ‘diamond’ as he called it, sustained him through all the death and horror that surrounded him as a soldier in WW2. He gifted that diamond to his children. Another diamond and for me the most precious diamond that our parents gave us was their love. It is this diamond that still shines strongly in my heart even though my parents both left life a few years ago.

There was another diamond that my father possessed in the form of creative energy that is a passion for art and design. He was an architect after all, and he passed this diamond onto us. He used to remind me about this diamond saying, ‘Don’t forget your art, Catharine.’

My mother passed to me the love for reading, after all she was a primary school teacher and taught me to read and write. As a child I traipsed around the world with my family and it was hard to know where I felt at home. This lack of belonging has been a theme in my life.

Second I would like to talk about stars

Recently I read a book titled ‘The First Astronomers. How indigenous Elders read the Stars,’ authored by Dwayne Hamacher, Associate Professor of Cultural Astronomy in the School of Physics, University of Melbourne in collaboration with First Nations Elders from Australia and around the world.[1]

This book draws on the latest knowledge of modern astronomy and ancient indigenous knowledge of the cosmos. Knowledge of our planet and the stars began with First Nations peoples all over the world, observing the land and oceans where they lived, and the night sky overhead. Cosmic events have been encoded in dream - time stories, art, dance and songs for millennia. For example, the position of stars in the night sky thousands of years ago were different from where they are today. These changes were tracked by Indigenous people long before astronomers made the same discoveries retrospectively in modern times. Indigenous people immersed themselves in understanding the places they called home.

In other words, Hamacher is saying that there are many ways to observe, measure, navigate and record natural events and phenomena both broadly and finely focused, both traditionally and using state of the art equipment.

So why am I talking about diamonds and stars and telescopes?

Down here on planet Earth, Psychoanalysis is an example of both a science and an art. Psychoanalysis is relatively new and can trace its roots from Freud, but also historically from diverse knowledges and traditions that include ancient and modern philosophy, science, literature, poetry, medicine, the arts and more. Psychoanalysis is about story-telling, curiosity, listening and observing natural human phenomena in inner and outer landscapes, finding meaning and gaining knowledge and wisdom in the field of the unconscious using both broad and narrow lenses.

Psychiatry is a new science that evolved from historical and traditional practices including psychoanalysis. Long before I began my specialist training in 1996, psychiatry had effectively abandoned its broad roots, and had become enthralled with the mega star of pharmaceuticals and a narrow scientific/biological approach to mental illness. Perhaps this change was linked to the rise in popularity of ‘behaviouralism’ and ‘cognitive psychology’ in mid 20th century, as a reaction to Freuds ‘models of the mind.’ These neurosciences were concerned with empirical evidence and the functionality of the brain, rather than a mind or psyche that is concerned with feelings, ideas, emotions and beliefs [2]. Entities that couldn’t be measured empirically were banished to a ‘black box.’

By the time I qualified as a child psychiatrist, CBT was enshrined as the treatment of choice, and long-term psychotherapies were side-lined and are still actively discouraged today.

This reductionist approach has meant that psychiatry has significantly narrowed its focus thus depleting itself of its rich broad origins. Hopefully this is will change.

Hamacher tells us that the new science of astronomy has been enriched by listening to the wisdom of Indigenous astronomers; so too can it be true for the knowledge and skills that psychoanalysis can bring to psychiatry.

Returning now to my story. I was accepted at aged 17 years into medicine, but at that time I also wanted to pursue art. Rather strangely the clear thought in my head that finally propelled me into the scientific world was ‘Do medicine because if you do art you will go mad.’ Psychotic was the actual word. I did feel confused and adrift at that time and believed that I needed something solid to hold onto and the glaring light of external reality to guide me.

Long story short my relationship with medicine was indeed very real and brutal.

Many a time it felt like I was living in a war zone, bearing witness to the immense pain and suffering of others. Unlike my father, I had no religious diamond to guide me and felt far away from a place in my mind that I could call home.

I survived but not without significant scars. There were times that I wanted to walk away from medicine altogether, but what sustained me through those hard times (apart from sheer stubbornness and pride) was my curiosity about the human mind and body.

We are both simplicity and complexity, fragile yet resilient, a natural ecosystem made up of many exquisitely tuned parts. Each part when well, acts in harmony with the whole, rather like a symphony or a primary forest.

The stars that did shine amongst the many cataclysmic events in my tumultuous relationship with medicine, were the thousands of patients that I encountered along the way. Many of their names and stories are forgotten, but I am grateful for all that they taught me, and how they shone a guiding light on my inner world. It is through them and my curiosity about their minds and unique stories, that I began to find my way towards psychoanalysis.

After many wanderings I found myself no longer living under the northern hemisphere star constellation but under the southern cross in Australia, married with children and working part time as a GP. One day a group of GP’s whom I worked for at the time, were critical of my work stating that I ‘spent too much time talking to my patient’s.’

That comment felt incongruous with my belief about who I was as a doctor. I mean when did the rules change? And where was I when they did?

Thinking naively that I would be able to spend more time listening to patients’ stories, I applied to train as a psychiatrist. But towards the end of my adult psychiatry training, and just before being accepted into the child psychiatry fellowship program, a supervisor told me that I ‘spent too much time talking to the patients instead of establishing within the first 5 minutes whether they were suicidal or not.’

Those criticisms [amongst others] from my colleagues, as harsh as they felt at the time, were an important guiding principle that I had to attend to, in order to ultimately change course. Soon I was relieved to find my way out of the hospital system and into private practice as a child and adolescent psychiatrist.

As a mother and a child and adolescent psychiatrist, my own children and countless young patients, taught me many valuable lessons including ‘how to go with the flow’ a kind of ‘Chaos Theory.’ These experiences assisted me to eventually gain an understanding of my adult psychoanalytic patients, that is to tolerate uncertainty without immediately grasping for solutions or answers.

I found out later that the poet John Keats [3] called this negative capability.

Along the way several bright shooting stars, in the forms of Neville and Joan Symington, Shahid Najeeb, Maurice Whelan, Ken Israelstam, John Boots, Mark Howard, Louise Gyler and several other psychoanalysts, appeared on the horizon. I had first noticed this cluster of unusual celestial bodies during my years as a GP when I attended several public/outreach seminars in Sydney facilitated at that time by SIP [The Sydney Institute for Psychoanalysis], and my curiosity about the unconscious grew. I also began to attend psychoanalytic conferences and read books by Freud, Winnicott and Neville Symington.

Thus began my journey into the psychoanalytic training.

Once I was accepted into the training, I felt I had found a home star - if you still wish to continue with the astronomy metaphors. Despite significant challenges involved in the training, I threw myself into the deeply immersive experience and was strongly attached to my small family of sibling candidates. I felt that I had arrived at a village, a place I could call home, at least for a while.

On another note, my personal analysis was a voyage of re-discovery, re-igniting my love for all things to do with art. I recall dragging into my sessions some ghastly paintings that looked like chaotic in-decipherable tangles. I was curious about their meaning, and perhaps by showing them to my analyst, I was expressing how lost and adrift I had been feeling for years. Slowly the pain and confusion diminished and, another star that had previously been hidden inside the chaotic tangles emerged from my unconscious.

This star is called Poetry, the star of words and symbolic expression.

Using a different metaphor, Poetry appeared like an exotic flower growing out of the fertile swamp of primitive artistic representation. Both these gifts, poetry and art are now part of my dreams, my stories, my consolation, and along with my family and friends, add meaning to my life. I also felt deeply understood by my analyst. Thank you.

Maurice Whelan one of my supervisors once said ‘So much of ourselves is unknown or outside our awareness and yet it exists. In other words, the unconscious exists and our psychic world is capable of being understood. What this requires is at least one relationship.’

What was necessary to equip me as an analyst, was the re-emergence and re-experiencing of the creative and destructive unsymbolised primitive aspects of myself and their transformation first, into artistic representation and second, into symbolic expression.

It was the re-discovery of these forms or objects in my unconscious that assisted me in turn to listen closely to the unconscious and emerging states in my patients.

Finding an internal home continues to sustain me despite so much grief in recent years.

During COVID I was devastated to lose M. a member of my candidate family, as well as two of my psychoanalytic parents; Neville my progress advisor, and Joan who supervised my first training case among others. They were part of my professional life for many years.

Their deaths impacted my life greatly, and echoed the passing of my parents who both died just prior to COVID, rendering me adrift again.

Coincidentally I finished my personal analysis a month before my mother died.

Mourning includes not only the passing of my biological parents and Joan, Neville and my candidate sibling, but also the loss of several other relatives, colleagues and friends who have passed away since 2017. The fallout from these losses continues to shape me.

I have also been left with a deeper existential question.

How does one ultimately accept death in whatever form it takes?

I don’t believe I have the answer yet.

I do know that being present in the living moment is one of the most difficult experiences. It is both bitter, sweet, terrifying yet longed for.

So how do we begin to feel comfortable in our own skin?

I believe that the paradox is to try to be; to be alive in the here and now experiencing our true self. This self may be found within life, but also within the transformational landscape of a personal analysis. Psychoanalysis is both a place and a relationship where we can begin to dream and hope, develop the capacity to tolerate uncertainty and an acceptance of loss.

Author Katherine Rundle in her book titled ‘Super-Infinite,’ about the life of the poet John Donne, tells us that he believed that ‘humans are at once a catastrophe and a miracle’. Indeed we are! We are the sum of all our parts and it seems we can’t have one without the other. In other words we can’t have love without hate, joy without grief, hope without despair, life without death. Hopefully joy will return soon.

In the last part of my presentation, I wish to return to the beginning where I was discussing the importance of passing on wisdom and knowledge.

The Sydney psychoanalytic outreach programs such as PPC, SGSC and public lectures are wonderful ways of demystifying and sharing our knowledge with curious health clinicians.

It is possible to bring together the reductionist model of a medical speciality such as psychiatry or neurology and the knowledge and skills of psychoanalysis, in order for each to work harmoniously when viewing an analytic object, one enriching the other.

In much the same way the modern science of astronomy is broadened and enhanced by the ancient indigenous knowledges of the cosmos and vica versa

These ideas are reflected in passing on accumulated knowledge and wisdom by the ‘Elders’ [so to speak] to candidates in the Society’s training program.

Being taught by the Elders or members of the Society in person was a vital experience for me as a candidate. This in turn lead to my involvement in teaching in the outreach programs, and eventually to teaching new candidates. These experiences felt like a natural maturational process.

Recently there has been a concern that fewer local members are available to teach and join committees. There are many reasons for this including a large number of analysts retiring.

In addition, changes in the training program partly due to the pandemic, that include placing seminars online, has understandably upset candidates and some members, and diluted the in-room group experience. On a positive note Sydney has introduced Weekend Intensives ie weekend clinical seminars where all candidates have a chance to meet in person each term and reflect on the group process. This is in addition to candidates meeting in person at Interstate weekends to present clinical cases. Sydney has also begun accepting remote candidates into the training program.

Out-sourcing the teaching of theory to overseas analysts has added a wealth of new material. However this initiative could be balanced with supporting local and inter-state members to teach both theoretical and clinical seminars. In turn this will enhance the group experience for both teachers and candidates, and promote a sense of belonging whilst keeping pace with new ideas internationally. Combining new and old knowledge, skills and experiences, will enable us to evolve rather than involute, thus enriching collegial relationships and revitalise our Society and its unique culture.

On summing up my presentation, my parents at my beginning gave me the most powerful diamond called love, and a collection of other diamonds and gifts to see me through life. Key people in my life, including my family and close friends are my compass and point me towards the stars that I follow, as I re-imagine my future.

My patients whether adults or children taught me what it means to suffer immensely and yet remain profoundly human. You still glitter in my mind like stars in the Milky Way.

Finally, I am beginning to understand why, at the start of my relationship with medicine, I was afraid that I would go mad if I pursued the path of art instead of science. It seems clear that I had to go on a long, difficult and convoluted journey in order to re-discover an authentic creative internal world, where I can live harmoniously with all the parts of myself. This required not only all the stars and diamonds in my collection but to have faith in myself, and find a way to embrace life and death in its many forms.

To be truly human is both a miracle and a catastrophe, and my own madness or psychosis, if that is what it is, feels just fine now. It is where I find myself today.

Oh! and to those colleagues who criticised me in the past for spending too much time talking to my patients. Thank you. However, you were wrong ………I was listening to my patients’ stories and observing their night skies……

References

1. Hamacher D. with Elders and Knowledge holders‘The First Astronomers. How Indigenous Elders read the Stars.’ Published by Allen and Unwin. 2022

2. Sohms M. ‘The hidden Spring. A Journey to the Source of Consciousness.’ Profile Books Ltd London 2021

3. Keats J. ‘Selected Poems and Letters.’ Collins Classics. [Ode to the Nightingale]

4. Rundle K. ‘Super-Infinite: The transformations of John Donne’. 2022 published by Faber