The Silent Patient

by Alex Michaelides

Once you name something, it stops you seeing the whole of it, or why it matters. You focus on the word, which is just the tiniest part, really, the tip of an iceberg.

“There’s nothing to say. I just get so stuck in my head sometimes. I feel like I’m wading through mud.”

It reminded me that there was a world outside this house: a world of vastness and unimaginable beauty; a world that, for now, remained out of my reach.

I didn’t know it then, but it was too late—I had internalized my father, introjected him, buried him deep in my unconscious. No matter how far I ran, I carried him with me wherever I went.

I didn’t want to die. Not yet; not when I hadn’t lived.

This gave me a kind of hope, however murky and ill defined. It propelled me at any rate to acknowledge that I couldn’t do this alone: I needed help.

Psychotherapy had quite literally saved my life. More important, it had transformed the quality of that life. The talking cure was central to who I became—in a profound sense, it defined me.

Tears collected in my eyes as I walked up the hill. I wasn’t crying for my mother—or myself—or even that poor homeless man. I was crying for all of us. There’s so much pain everywhere, and we just close our eyes to it. The truth is we’re all scared. We’re terrified of each other. I’m terrified of myself—and of my mother in me. Is her madness in my blood? Is it? Am I going to—

Like sex, clearly more fuss was made over marijuana than it merited. Then—a minute or so later—something happened. Something incredible. It was like being drenched in an enormous wave of well-being. I felt safe, relaxed, totally at ease, silly and unself-conscious.

I would get stoned just from the rustling of rolling papers and the anticipation of the warm, intoxicating high.

Someone who has never learned to contain himself is plagued by anxious feelings for the rest of his life, feelings that Bion aptly titled nameless dread.

Such a person endlessly seeks this unquenchable containment from external sources—he needs a drink or a joint to “take the edge off” this endless anxiety. Hence my addiction to marijuana.

Whatever marijuana did for me was still working, Ruth argued—until the day it would outlive its usefulness, when I would probably relinquish it with ease.

Between the two of us, I had the most to lose, that was obvious. Kathy would survive—she was fond of saying she was tough as nails. She’d pick herself up, dust herself off, and forget all about me. But I wouldn’t forget about her. How could I? Without Kathy, I’d return to that empty, solitary existence I had endured before.

I’d never meet anyone like her again, never have that same connection or experience that depth of feeling for another human being. She was the love of my life—she was my life—and I wasn’t ready to give her up. Not yet.

how your sense of self-worth would implode, and the pain would be too great, too huge to feel, so you’d swallow it, repress it, bury it. Over time you would lose contact with the origins of your trauma, dissociate the roots of its cause, and forget. But one day, all the hurt and anger would burst forth, like fire from a dragon’s belly—and you’d pick up a gun.

I didn’t have a plan, as such, just a vague, unformed idea of what I needed to accomplish. Rather like an inexperienced artist, I knew the result I wanted—without knowing quite how to achieve it.