Talking Time

When I was in the ambivalent early stages of my love affair with Proust, wondering whether it was worth the commitment, well-meaning friends would advise that ʻlifeʼs too shortʼ. A year later and the relationship has deepened. I approach the last volume with intoxicating curiosity and fear that the end is in sight. Holding it, I see that this volume also contains ʻA Guide to Proustʼ. It feels like being given a map after reaching the summit, and my feelings are a mixture of if only Iʼd had this all along, and thank goodness I didnʼt. I didnʼt always know where we were going, the narrator and I.

There is not a lot of space in our world for long processes of uncertain outcome. The infamous length of Proustʼs labyrinthine sentences is an injunction to slow down, reading the prose an act of discipline in itself. Feeling harried in train stations, wet, anxious, and misanthropic, I have asked myself to consider how Proust would describe the scene, and noticing the high arch of the tunnels, the rain drops blurring on the windows of the carriages, or the space breathing above the heads of the multitude, I myself have breathed more deeply. The god is in the detail and the accumulation; the sense of increasing knowledge and understanding, amassed gradually, reiteratively, and over a substantial amount of time.

I have not been reading Proust alone – it has been a shared venture with a companion, a commitment not only to the novel but also to each other. We meet every 300 pages or so to share our thoughts, feeling attuned when the same corners are turned to mark a passage that strikes a particular chord. This commitment to an endeavour that takes time, is gradual, stalls and goes forward, relapses and frustrates, but is done in part alongside an other bearing witness: a commitment requisite to psychoanalysis as much as to reading Proust. Perhaps it is no surprise that when I have not been engaged in the latter, I have been embedded in the former – both lying on the couch five days a week, and practicing psychoanalytic psychotherapy daily with children and adolescents as a trainee psychotherapist in the NHS. Perhaps I have a fascination with things that take a long time. 

Proust seems to have had no knowledge of Freud, although the languages of psychoanalysis and literary modernism were emerging concurrently, and a retrospective comparison shows strikingly similar lines of thought. The critic Jacqueline Rose goes so far as to say that there is no point made by Freud that isn’t made also by Proust with greater depth and complexity. Like Freud, Proust understood how the accumulation of experience, external and internal, gradually forms our sense of self. He understood how memories can be unconsciously stored, returning to us with the smell of a tisane or the rustle of a ballgown. ʻItʼs all there,ʼ they might both have said. In reality, Proust puts it far more beautifully:

Each past day has remained deposited in us, as in a vast library where, even of the oldest books, there is a copy which doubtless nobody will ever ask to see. And yet should this day from the past, traversing the translucency of the intervening epochs, rise to the surface and spread itself inside us until it covers us entirely, then for a moment names resume their former meaning, people their former aspect, we ourselves our state of mind at the time.

What contemporary psychoanalytic thinking has added to this image is that the books begin to be written when the protagonist is sleeping in utero.

I once read an article in a magazine about the widely debated concept of women ʻhaving it allʼ. It was written by an executive who was doing just that apparently – bringing up small children and travelling a great deal on business. She claimed the first few years of their lives were the ideal time to be away – after all, the children wouldnʼt remember. Being around later would be so much more important. I have never met a child therapist who is interested in criticising parents – it was the psychoanalyst and psychiatrist D.W. Winnicott who coined the crucial concept of ʻgood-enoughʼ parenting, and it’s not the motherʼs decision to work, or to be away, that I take issue with; these are difficult decisions taken by most parents at one stage or another. My frustration is with the belief that what happens in the early years somehow doesnʼt matter: if we canʼt remember what happens in the first three years of life, then what difference can they really make? 

When people assume that what happens in the early years somehow is of little consequence to the developing personality, they are mixing up two very different types of memory: the conscious autobiographical memories that cannot form until the brain is developed enough (at around three years of age) and the procedural memories that Proust evokes, alongside the more conscious evocations of the narratorʼs childhood. These procedural memories are how we learn, and how we build our sense of self and the world around us. They include skills like learning to crawl and holding a spoon, and also lay down in the unconscious our internal working models of relationships. These crucial memories are built up in the early years. 

In my meetings with parents and carers, I have come up with all sorts of analogies and metaphors to make sense of the very real difference these beginnings make – burning the onions affects the sauce, the foundations affect the solidity of the house built upon them, and so forth. Excitingly for psychotherapists, neuroscience is now confirming what we have always believed. At birth, the human brain contains an overabundance of brain cells, but with few connections between them. A massive process of ʻpruningʼ occurs in the postnatal period, a ʻuse it or lose itʼ development where unused cells simply die off. A formed connection remains wired for life, although as recent studies have suggested, new pathways and wiring can occur later in life, as a result of the brainʼs plasticity. In terms of child development, these early wirings mean that experience will be filtered through pathways formed in our earliest days. Our brains are ʻexperience dependentʼ and gradually we form standard ways of experiencing the world. Psychological links are made and synaptic links are formed. 

A child who has been exposed to trauma, abuse or neglect in the first months of life might have come to expect adults to be violent and aggressive, and may respond to a perceived threat with hyper-vigilance or self-protective aggression. These responses are hard-wired in the brain, and it is part of the psychotherapeutic process to offer a new space for a new kind of experience. For children who have not been protected from predators, forging new relationships (with foster carers, teachers or therapists) can be like trying to build castles on shifting sand. However, although old neural pathways cannot be erased, new ones may tentatively be added. In the consulting room the child that responds to the sound of footsteps outside by freezing, stopping play and running from the room, gradually starts to form new links, to think that the footsteps could be those of another clinician or child, not of a potential attacker. But ‘unlearning’ a working model of a relationship is very difficult, not always manageable, and simply can’t happen in the course of just a few sessions. We try to encourage the growth of early reactions and processes: it is delicate nurturing.

Some more brain science: the amygdala is part of the reptilian brain – ancient in evolutionary terms. Small and almond-shaped, it responds in microseconds to threat and fear, part of our primordial need to respond immediately to danger. In children and infants who have been subjected to trauma, the amygdala is set constantly on hyper-alert. This means higher levels of the stress hormones cortisol and adrenaline, a raised heart rate and higher blood pressure. These physiological differences, in conjunction with the psychological, can produce the hyper-vigilant and restless behaviours in traumatised children so frequently diagnosed as ADHD. 

In a traumatised brain, the sensory thalamus, perceiving an emotional stimulus, sends a message down the ‘super-fast route’ straight to the amygdala, producing an emotional response of the fight/flight variety – a primitive fear response. For example I might ask a child to stop climbing on the window sill for her own safety, and she hits me: my setting of a boundary is perceived as a ‘telling off’ and experience suggests a beating will follow. The amygdala responds, the child hits out and the surge of adrenaline and cortisol is palpable in the room. However in other children and healthy adults there is a longer route available whereby the experience can be filtered through the sensory cortex allowing for cognitive processes to take place.

But thinking, as Proust shows us, takes time. In his hero Marcelʼs case, thinking about his lover Albertine and whether or not she is faithful is a painful, conflicting and all-consuming activity that fills almost an entire volume and many months of the narratorʼs life. On a neurological level, thinking in the evaluative sense takes time, and requires a longer route through the brain. Therapy, and good parenting, can encourage these longer processes – the therapist makes the links for the child (‘you are frightened that I’m cross and so hit me to protect yourself but in fact I am making sure that you do not hurt yourself’) and over time, many weeks, the child may begin to make these links for herself. One of the most rewarding things to hear is when a child reflects back on her behaviour (‘remember when I used to run out into the road or kick you?’) knowing that she has new responses at her disposal.

When I tell people I work with children ranging from babies to adolescents of 18 or 19, I often meet a shocked reaction of ʻwhy would a four year old need therapyʼ? Itʼs understandable, particularly given the Woody Allen cliché of middle-aged white and well-off neurotics seeking to understand themselves after making a mess of various aspects of their lives. This is also important and necessary work for the psychotherapist. But work with children can often be of a different nature – referred by GPs, teachers or social services, the children we see have often had such difficult, traumatic and abusive early experiences that their neurology, their self-esteem and behavioural symptoms tell the same story. 

Psychotherapy can do many things. It can make the unconscious conscious. It can analyse the defences against anxiety and promote healthier defences over the pathological. It can help children build a narrative of their past experience, putting words to chaos and trauma. It can facilitate emotional growth in areas where development is stunted or regressed. It can offer an alternative version of a relationship with an adult who can contain and reflect on painful feelings and experience, rather than project them, undigested, back into the child. It can build new procedural memories and offer the mind a different response route to anxiety or fear – no longer always the short cut straight to the amygdala, but sometimes the longer way, through the cortex where emotion can be evaluated. 

Proust and psychoanalysis are daily reminders in my life that the long way round can take us somewhere more interesting, more helpful, more hopeful.