Florian Birkmayer, MD, Author at Mad In America https://www.madinamerica.com/author/fbirkmayer/ Science, Psychiatry & Social Justice Fri, 29 Mar 2024 18:06:18 +0000 en-US hourly 1 https://wordpress.org/?v=6.5.3 Unbecoming https://www.madinamerica.com/2024/03/unbecoming/ https://www.madinamerica.com/2024/03/unbecoming/#comments Fri, 29 Mar 2024 18:06:18 +0000 https://www.madinamerica.com/?p=255360 If the wounded healer doesn't work on their wounds, they become the wounded wounder, keeping the client and themselves trapped in their roles.

The post Unbecoming appeared first on Mad In America.

]]>
There are books that change your life… drastically, whether you want to or not. I certainly had that experience and it made me question ‘everything.’ I was a holistic psychiatrist and wanted to offer the best services to my clients, but this book made me realize that in spite of, or because of my best intentions and efforts, I was keeping my clients trapped in the client role. And I was keeping myself trapped. In good conscience, I couldn’t continue to do this and I closed my practice, yet the insights and deeper understanding continue to be forced on me.

The book was The Alchemy of Healing by Edward Whitmont, MD, a Jungian analyst and a homeopath. The second half of this book was all about the healer and the healer’s wound.

healer shadow

It starts with an ‘interlude’ chapter called “Godfather Death,” which in brief is the story of a physician whose godfather is death and who becomes very successful by letting himself be guided by this godfather, who tells him when a patient can be saved and when they must die. One day, pressured by the desperate promises of the king, he tricks death to save the moribund princess. Death is angered and subsequently claims the life of the physician, explaining to him that there is a careful order to everything, including who must die, and that by tricking death, his life had to be taken instead of the princess’s to maintain this order. It was the physician’s arrogance that threatened to upset this order and he paid for it with his life.

Reading this book was terrifying and as its message sunk in, I flung it across the room. I read about how the provider unconsciously makes the client carry his own most unloveable part, and this is where the devotion to wanting to be the best provider comes from. The unconscious message is that the client must stay in the client role, and the provider in his role. I was reading about myself as a wounded healer and how unconscious I had been.

The term Wounded Healer was introduced by C. G. Jung in a late essay titled “Fundamental Questions of Psychotherapy,” where he states: “We could say, without too much exaggeration, that a good half of every treatment that probes at all deeply consists in the doctor’s examining himself, for only what he can put right in himself can he hope to put right in the patient. … it is his own hurt that gives the measure of his power to heal. This, and nothing else, is the meaning of the Greek myth of the wounded physician.”

Through reading Whitmont’s book, I realized I hadn’t ‘examined myself’ and hadn’t put something right in myself, and thus I couldn’t hold the space for clients to put it right in themselves. To me there were unconscious aspects in myself I needed to examine and get clear about, to accept the reality of the unloveable part of myself that Whitmont mentions. But even more so, I realized that there were fundamental issues in the way I had learned to participate in and contribute to the mainstream behavioral health system.

In addition to committing to my own wounded healer’s journey, I didn’t think there was any way to continue working as a psychiatrist. Elsewhere I have written about my problems with diagnosis and prescribing medications and how this contributed to my decision to no longer be a psychiatrist. In addition to projecting unconscious parts of myself onto the clients, which kept the clients trapped, my diagnosing and prescribing medications, and even helping clients safely come off medications which became a focus of my private practice, were perpetuating the power structures of the behavioral health system. I just couldn’t continue working as a psychiatrist, because there was no way to not keep the clients and myself trapped.

Elsewhere in the writings of C. G. Jung I came across the statement: “If the wounded healer doesn’t work on their wounds, they become the wounded wounder.” To me, this made exploring my own woundedness as a healer imperative, because I didn’t want to become a wounded wounder, or, if I had become one, I wanted to stop. Wounded wounder to me means not just the obvious boundary violations of a healer, such as entering into a relationship with a client, which we all know about, or the dangers of compassion fatigue or burnout and the negative impact this has on the ‘delivery of care.’ Wounded wounder also means keeping the client and themselves trapped in their roles, even if they are not engaging in boundary violations, even if they are practicing exactly as they should. The power differential and the power of diagnosis and prescribing, really the entire system of behavioral health, wounds the client and the provider. It dehumanizes both and keeps them trapped in a mostly unconscious pattern.

Donald Kalshed, a Jungian analyst, has written about trauma and the soul, an archetypal perspective about defensive structures in the psyche that help a child survive but later prevent truly becoming authentic. In an interview with Daniela Sieff, he states that if a child’s life is sufficiently traumatic to require a lot of dissociation to survive, the narrative coherence of the child’s inner sense of meaning is destroyed.

Growing up in Germany and Austria in the 1970s, I now realize I was mostly dissociated, which was a reaction to personal traumas, including a crazy birth story and emotional neglect due to unresolved maternal grief, but it was also due to the implicit messages from prior generations, in what has been termed transgenerational perpetrator trauma. My grandparents’ generation were very evasive about their roles in Nazi Germany and the implicit message was “don’t even ask.” Daniel Bar-On, a sociologist who extensively researched transgenerational perpetrator trauma related to the Holocaust, called this the “double wall of silence,” in which the older generations don’t talk about what happened and send the implicit message to not even ask.

I’m just beginning to understand how this impacted me. One consequence is that because of the implicit messages to not even ask, and yet perceiving without knowing that a lot of things didn’t make sense, I have always struggled with narrative, with making meaning. I think this search for the hidden meaning, the shadow aspect of stories, what the unconscious knows and how this invisibly shapes us also drove me into psychiatry, even if I couldn’t have told you that at the time. Suffering and trauma were disruptions in meaning-making, in narrative, and without knowing it, if I could help clients rediscover meaning, then maybe I could figure out a meaning in my path that I just couldn’t see.

Another transgenerational impact was the message that I was part of a special, privileged family. My paternal grandfather, who was a firebrand Nazi, after the war repositioned himself as a famous neurologist and denied his Nazi past, even claiming to be a victim. The full extent of his devotion to the Nazi cause only was revealed after he died in 1998. Like many other families with Nazis in Austria and Germany, the post-war pervasive message to family members was that we were a special, privileged family. This was an attempt to disguise and to obscure. The hidden message, that I absorbed without knowing, was that you had to take on a special role, such as being a doctor, because being your authentic self was dangerous.

I never rebelled. I never questioned my grandparents or asked “What did you do in the war?” Even the decision to go to medical school was due to a subtle yet pervasive pressure from my father, who had become an MD, which I suspect was also due to subtle pressure from my paternal grandfather.

I thought I knew why I wanted to become a psychiatrist. It had a promise of being holistic, as I told myself I could treat everything from the molecule to the community. I was also motivated because I suspected that physical illnesses had their origin in psychological issues. I could even speculate that it had something to do with my upbringing.

But not until recently, years after I stopped being a psychiatrist, did I realize that I had taken on the hidden message that I had to hide behind a role. While there were many aspects of being a psychiatrist that I enjoyed, I often felt like an impostor even when I was an assistant professor in an academic department of psychiatry. I also never got into the social roles of being a physician. I never went to gatherings of the local medical association. I felt I didn’t belong. Unconsciously, my soul knew that this role wasn’t my authentic self and rebelled against me trying to fit in and act the part. I’m thankful for the persistence of my soul, even if I couldn’t hear it for so many years.

In discussing the physician role recently with an older friend who is also a psychiatrist, he called this attachment to the role ‘the prison of privilege’ and I really like that term. It does feel like I had lived in an unconscious prison. I jokingly said that I’m an ex-psychiatrist, which is like being an ex-con… There’s nothing ‘ex’ about it. It continues to influence me.

Along with the messages that I needed to hide in a role, i.e. ‘psychiatrist’, that to be authentic was dangerous, an inner critic developed inside me. “How dare you write about this? It is unbecoming of you and your role,” I can hear it saying right now. This inner voice would question and undermine me when an authentic impulse came from my soul. This inner critic would also push me towards the inauthentic role, appealing to a sense of responsibility and vague promises of other rewards for playing or fulfilling the demands of this role.

And this inner critic isn’t just within me, even though it was implanted by the secret transgenerational messages. The critic is also present in collective, societal rewards and reinforcements. I think that’s one layer of the ‘prison of privilege.’ I have only recently become aware of how pervasive that inner critic is, often disguised as an authentic part of myself. By being able to name it, I am able to examine my thoughts and feelings and ask if they are from my soul or my critic. This has been very helpful in connecting with my authentic soul and its impulses, but it continues to be a struggle, since the critic either hides or takes over.

Jungian analyst James Hollis has written (in The Middle Passage) about how we were unconsciously programmed by our family and culture: “Perhaps the first step […] is to acknowledge the partiality of the lens we were given by family and culture, and through which we have made our choices and suffered their consequences. […] The lens we received generated a conditional life, which represents not who we are but how we were conditioned to see life and make choices.”

He goes on to say: “The person continues to operate out of the old attitudes and strategies, but they are no longer effective. […] the person one has been is to be replaced by the person to be. […] the Middle Passage represents a summons from within to move from the provisional life to true adulthood, from the false self to authenticity.”

His term Middle Passage could refer to a mid-life crisis, and I was 45 when I closed my private practice, but my understanding of why I had to give up my ‘provisional life’ is only now becoming clearer, in hindsight, and continues to accumulate. I feel I’m in another mid-life crisis. I feel as if he was writing about me. I feel grief that I was unconsciously living inauthentically for so much of my life. I feel grief about, and want to acknowledge, the patients I may have unintentionally harmed while practicing unconsciously. That grief can be overwhelming, but then I remind myself how blessed I am to have become aware and able to separate myself from this inauthentic role now and not in twenty years. And it’s still a struggle. The inner critic still takes over more often than I’d like, which is never.

Shadow Work started with Jung’s idea and has recently taken on a life of its own in social media, and wider society, seemingly. The shadow is defined as that part of ourselves we can’t see and yet it’s there, like water to the fish. Shadow work means that we examine our Shadow, inspired by the idea that it’s the path to becoming more whole.

Jung also said that we become “enlightened” (his term for becoming more whole) “not by imagining figures of light, but by fearlessly confronting our shadow.” A common misconception is that the Shadow is the part of ourselves that’s somehow negative, or that we don’t like, a Mr. Hyde to the Dr. Jekyll that our ego, our story of ourselves, tells us we are. The inner critic I describe above certainly fits that notion. And yet the inner critic is reinforced by society. In a way, the story I’ve told myself of myself, my ego, is very much shaped by this shadow. The ego is a creation of the shadow. When we tell ourselves the story of ourselves, my simple definition of the ego, we are not aware that there’s many other unseen parts to ourselves.

Yet it is very important to remember that some great treasures are hiding in the shadow. As Marianne Williamson wrote, “Our deepest fear is not that we’re inadequate. Our deepest fear is that we’re powerful beyond measure.” To me that means that for most people, myself included, our greatest power is hiding in our shadow. We can’t see it. We’re even afraid of it. In doing shadow work, this is one of the benefits, to reveal our greatest power, become more whole, live life more fully, an evolving union within of the parts of ourselves we know and the parts of ourselves we don’t yet know. I see this in myself as I continue to un-become what I had been programmed to become, by family and society, and as I confront my shadow, it is challenging yet also rewarding.

As I have struggled to free myself, this has rippled out to others. That is the true healing gift of the Wounded Healer: By focusing on our own healing, what ripples out to others is the possibility that they are not stuck in their roles, be that healer or client, either… That they can heal and that I can heal. Healing means becoming whole, no longer ruled by the inauthentic roles, either physician or client, that we were stuck in by our family and culture while being unconscious. ‘Whole’ means to embrace the hidden parts of ourselves, that we have been unaware of, or that the critic has made us devalue. Our greatest gifts lie in embracing our shadow and unbecoming.

The post Unbecoming appeared first on Mad In America.

]]>
https://www.madinamerica.com/2024/03/unbecoming/feed/ 19