Lotus from Mud
by Judith Day, MFT

Emily, age fifty-eight, lives in the rain this winter, homeless for the fifth year. She started therapy with me recently after being violently attacked by a stranger. As assaults often do, this one set off repercussions from previous trauma -- severe abuse and neglect in her childhood. So we work to heal the trauma of the crime and also the past wounds that the more recent assault has torn open. And as if distant and recent traumas are not enough, Emily lives in the rain. And she's not getting any younger.

It's sometimes said that people who have survival needs -- food, shelter -- cannot benefit from psychotherapy because those material needs must be met before they can pay attention to less tangible problems. But some people, like Emily, need therapy (hers is paid for by the Victims of Crime Program) to cope emotionally with the overwhelming material difficulties of her life.

Emotional healing, in fact, sometimes has to occur first, to strengthen a person's ability to obtain basic food and shelter. Tony, who used to be homeless, is a Vietnam veteran disturbed by traumas from the war and by earlier traumas inflicted in his childhood by a pedophile neighbor. He suffers from severe, recurrent depression, post-traumatic stress disorder, and social phobia, and he was living in the rain because it felt safer than being around people. But eventually he allowed someone to help him obtain social services including MediCal, which pays for psychiatric care, medication, and therapy. These stabilized his judgment and helped him trust people a little more. Eventually he gave up the rain in favor of a group home (food, shelter) and a day treatment program.

Emily and Tony have suffered massive life traumas. In spite of this, both of them worked and lived normal lives in the past. Both raised children, and not too badly. But as they aged, old habits of ignoring their emotional problems caught up with them and they found themselves failing to function as well. Some of their material problems might have been avoided or handled better if they had tended their emotional wounds earlier. Instead, losses of jobs, homes, social support, and physical health snowballed into massive stress that they were never prepared to handle emotionally. Hearing their stories, I wondered how many of us could.

The lotus is a flower of exquisite delicate beauty that shows itself only after rising on a long wavy stem to the surface of a pond, coming out of mud at the bottom. Working with these two clients I see that no matter how hard people's lives are, they can move towards the light and blossom. In therapy Emily and Tony receive guidance and support in navigating their inner lives: the thoughts, feelings, body sensations that are the world of their experience. In this work they connect deeply to the trust, kindness, and peace of mind and heart within themselves that is the source of emotional healing. And in relating to a therapist they are also becoming more comfortable and skilled in relationship with other people. They are living more happily.

Tony, for example, comes up my stairway, taking time to catch his breath because of emphysema and continued smoking. He begins talking about fear of some people in his day program and his reluctance to attend because of them. The fear is immediately present as he tells about it, and we pay careful attention to it. I invite him to breathe into it, breathe with it. Then I point out that he's sitting on his hands, and we explore this and find out that he would like to strike out; actually, he says he would like to destroy somebody. This discovery panics him, and his shoulders and chest collapse inward. I note this somatic response, emphasizing that I am not judgmental but only curious and interested, and careful not to imply he should change anything. Plenty of people all his life have told Tony what he should do, and a precious aspect of our relationship is that I am not another one.

At times I wonder: by being so accepting, am I helping him grow or just letting him stay stuck? The question helps me be alert so that whenever I hear him expressing a wish to be free of his old fear habits, I quickly affirm his wish. Differentiating his desire to change from any demand that he should change is important work. Instead of reacting (either submissively or with resistance) to expectation from others or from his own inner judge, Tony is learning to take full responsibility for his own change. He is connecting deeply to his will.

Connecting to a deep positive force that is truly his own is the exact opposite of depression. It is expression, an energetic creative impulse. In spite of a lifetime of trauma and resultant unskillful emotional and behavioral habits, Tony has never lost his sense of humor and the ability to be delighted by life. Although he is terrified of social interaction on one hand, in our meetings it is clear he is enormously capable of giving and receiving in pleasurable relationship. And he is interested in what we are doing.

We work with assertiveness. How can he be with people and take his place? Long before he is able to speak assertively, he decides to find out how to walk without tiptoeing. Practicing this in his group home, he perceives himself as very loud and it scares him, but he starts to enjoy it. He walks taller.

Eye contact is next. He chooses some safe people and works on this, with a few words: Hi, how's it going? He is terrified, and with every step into functioning in the world we spend a lot of time tending the intense feelings that are the fallout: shame, self-hatred, fear and more fear -- of being bad, of hurting someone, of getting hurt, of not being good enough. Any risk in outer behavior is accompanied by overwhelming feelings. So if he wants to act more effectively in society, he must learn to tolerate his inner experience. We work with this every session -- simple, kind awareness, acknowledgment, allowing. Supported in this way, Tony's tenuous choice to be part of the world is growing.

Emily is more socially functional than Tony. She appears comfortable and assertive and isn't intensely fearful of the world even though it has hurt her very badly, both in her childhood and recently. She has lived on the street for several years, and knows how. Sometimes she stays for a few weeks with a sister in another city. All might be well if she weren't haunted.

We call it that. Memories of childhood traumas invade her daily life, in the form of flashbacks, visions, nightmares, voices. Over the years she learned to avoid this by keeping extremely busy, when she worked and had a family, and by overeating. The kids grew up; she suffered a few breakdowns and hospitalizations and lost her job and the ability to have a job. Several years ago she found that living on the street became the simplest option. She still found ways to keep busy, with volunteer jobs and an active street social life. But then she was attacked and she "lost it", as she says.

Therapy with Emily is a delicate balance between allowing the haunting to take place in a safe way, and learning how to shut it off so she isn't overwhelmed. The second task is the easier one. Since she has a long-standing coping habit of being busy to keep her demons at bay, we use that. Every day she takes a trip, choosing her destination the night before and finding out what bus and walking routes are needed, plotting it on a map, gathering supplies and the proper clothing for the journey. The next day she makes the trip, always bringing a book to read on the bus and usually ending up talking a lot with people she meets along the way. The destination itself is more or less nothing, a junction of two streets, perhaps. It's the getting there that matters -- relaxing, being alert and present to her experience, and enjoying the trip. She eagerly uses these forays not only to avoid her inner monsters but also as joyful, healing exercises in mindful living and somatic experiencing.

Allowing the haunting to occur, in the safety of therapy, is our other task. This is slow, careful, and somewhat scary work. It's scary for me because I want to be sure she doesn't open up more than she can handle, and scary for her because she has always been afraid of these very difficult inner feelings, images, and thoughts. Mindful attention and cognitive understanding are our tools, and instead of fighting a losing battle to shut out the memories Emily is gaining ground in tolerating and integrating them. They are, after all, a genuine part of who she is.

Emily and Tony engage deeply in the work of self-healing despite desperate, marginal circumstances. Tony has found his way out of homelessness. In the long run, therapy may strengthen them both enough to have better material lives. I want Emily to settle down in a trailer near her sister and get a part-time job in retail. I want Tony to move into his own apartment and start playing guitar again, maybe get a part-time job. But Emily is as homeless as ever and Tony doesn't look like he'll be joining the workforce again anytime soon. I don't know where they're going; for me, working with them has been strong training in how uncontrollable life is. But seeing how they've grown in self-respect and trust, creating meaning and joy in daily life, I can't complain. Their futures, like mine, are impossible to know.

Judith Day, MFT (www.judithday.com) is a Lomi Somatics Practitioner and a licensed Marriage and Family Therapist. She practices in Santa Rosa and Napa.

top of page