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Picking up the Pieces, Two Accounts of a Psychoanalytic Journey, by Fayak Nakhla, M.D. and Grace Jackson, is a report of a psychoanalytic treatment from the perspective of both patient and analyst. It is an unusual treat for a clinician to hear both sides of the not quite same story.
Grace Jackson, a pseudonym, wrote of her analytic goal, in a diary kept during the first three and one half years of her 16 year treatment:
I was afraid to say anything in the doctor's office because what I said might not be the truth. I had come to New York to discover the truth: I was going to become myself. I wanted to be able to talk without worrying about what the other person might be thinking: but I wanted to be sure that what I said was really what I wanted to say. (1: 25-6)
She was silent for almost a year and a half. The analyst's notation of this period: “This silence in her weekly sessions was set against a blank, empty background; any exchanges we had were without spontaneity. Her body was noticeably still …”. (1: 21)
The analyst's experience of this time is familiar to us all. I found myself instantly engaged by the account of this treatment, experiencing the analyst's discomfort, frustration, loss of self esteem, and concern as he worried about how to deal with the lengthy impasse, trying desperately to find ways to fix it, yet continuing to sustain enough interest to “watch and wait”. Who of us hasn't had the experience of sitting with a silent patient, trying to understand, experiencing the silence as a resistance, or an assault on our own selfobject needs for responsiveness.
When she began to communicate verbally, all hell broke loose. Her blood literally flowed, and flowed, and flowed. Hospitalized several times, she cut herself repeatedly.
Following a consultation with Joyce McDougall, who wrote the foreword, Dr. Nakhla determined to write a book about this treatment, and indeed, write it in collaboration with his patient. An interesting parameter, the reader might say. It