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One Sunday morning over coffee, while flipping through the New York Times and daydreaming about what I'd say on this topic today, I got absorbed in an essay appearing in the feature “Modern Love.” There Rachel Jones (2012), in “A Child of Two Worlds,” recounts her pregnancy and giving birth in Djibouti, near Somalia in the Horn of Africa. After a nightmarish description—it was a medically “normal” birth, but it included screaming while her torn vagina was stitched up without anesthesia, and being scolded by the midwife—“Don't be such a weakling!”—Jones ends the piece: “She [the midwife] stood in the doorway, silhouetted by the hall light, and we smiled at each other. We had done what women throughout the centuries have done and would continue to do, what no divisions or rhetoric or wars could ever stop. We had brought life and beauty and love into the world.” The baby Lucy, delivered in Djibouti by a Somalian Muslim midwife to an American woman and her English-born husband, was given a middle name that means “gift from Allah.” The baby would have an American passport, and her birthday was September 11, a date that in her own country has gone down in infamy
As psychoanalysts, we are rarely as close as that midwife to hands-on life-and-death situations. To do our work well, we rely greatly on our mentalization capacities, our memories, our capacity to identify empathically with our patients, and resonate with all the emotional nuances of past treatments and our own lived lives, while being careful to keep listening to and learning about the “otherness” of the patient's world. Our job is often to help patients distinguish between taking action, and thinking thoughts about action. We dwell deeply in a world of imagination,