Posted by Dr. Vollmer on January 21, 2014
Bertha Pappenheim, known as “Anna O.” by Freud, said the process of “chimney sweeping” or describing the memory of a disturbing event, led to a relief, emerging as a curative effect of anxiety. Anna O, a famous “case” had paralyses and speech dysfunctions which resolved after she was encouraged to talk to a person with curiosity and a willingness to follow her lead. http://en.wikipedia.org/wiki/Anna_O.
Mara, fifty-five, comes to mind. Her father just passed away and now she presents with extreme bouts of diarrhea, which she has never experienced before. Her diet has not changed and she has not traveled in the last six months, making a parasite an unlikely explanation. Her primary care doctor told her to wait a few days to determine if it is self-limited. Mara believes it is stress-related, although she denies feeling anxiety or sadness with the loss of her father. She insists, rather, that she is relieved, both that he is out of his suffering, and that she does not have to worry about him, as she did in the past. “Maybe your bowels are telling you something different,” I say, curious to understand why she has this particular symptom which appears to be unrelated to her mental state. “Maybe,” she agrees. “I think the stress of my dad, and dealing with my half-brother, his son from a previous marriage, has just been too much for me,” Mara says, as if she is amazed at her own thoughts. “Roony, my half-brother, acts like he is the only one who is grieving, like he is not my father too,” Mara says, with a tone of anger, which she seems surprised to hear, as she reflects. “I know I sound angry, but I did not know I felt angry until I started to talk about Roony,” Mara continues, explaining her own self-discovery as she begins to articulate her experience. “I wish I had a sibling where we could help each other, rather than feel like we have two different fathers, as Roony and I feel.” Mara says, implying that her chimney sweeping relates to her challenging childhood of having a half-brother who occasionally spent time with her. “Siblings, full or half, or adopted, sometimes can connect over the death of a parent, and sometimes the wedge just widens as they are unable to be respectful of the other’s experience,” I say, highlighting that it is not just the complicated nature of half-siblings, but the more layered issue of sharing an external experience, but not being able to share an internal one. As Mara and I “chimney sweep” together, I suspect her gastrointestinal instability will calm down, and her feelings will be more conscious, more linear.