Psychotherapy and writing are both the same and polar opposites.

In psychotherapy, the object is to resolve conflict, to help a patient understand why he’s in the predicament he’s in and why he’s experiencing so much anguish.

In fiction, a writer’s task is to create conflict, to place his character in an impossible predicament, and then to find a way for him to resolve it.

Both therapy and writing have conflicts that need resolution. Often, the conflict resides in the past, in a place that is not readily accessible to the patient or to the fictional character. Both need to track the course of their lives backwards, to chase an elusive past that has come back to haunt them.

Chasing Backwards is not an easy task. The mind has defenses that tries to protect it from unpleasant feelings. Defenses like denial, projection, turning against the self, identification with the aggressor and repression (to name just a few), are roadblocks to remembering. Often, to remember is to experience pain, and who wants to suffer? The more traumatic the memory, the more powerful the defenses.

One example is losing a parent or loved one at an early age. A common remnant of this experience is the anniversary reaction. Often the adult who has experienced such a loss does not remember the loss, but instead experiences a sense of sadness, melancholy or anger on or near the time of year the loss occurred. He has repressed the memory, but it emerges as a symptom that seems to come from nowhere. Only after chasing the past, and tracking down the real cause of the symptom, does it become clear what is really going on.

Whether it’s resolving a conflict in psychotherapy or creating a conflict in a novel, understanding the nature of the human defense system is the key ingredient to doing it successfully.

Art Smukler MD is the author of Chasing Backwards, a psychological murder mystery.

GROWING THE ONION, by Art Smukler, author & psychiatrist

Listening to a person’s politically incorrect, unedited story, is often more exciting than reading a novel. And what if the story is so amazing that it changes your life?

When a 40-year-old man came to my office complaining of depression, anxiety, sleeplessness and helplessness, I thought he was just another nice guy who needed to be treated for a Major Depression. Boy was I wrong. He did have a Major Depression, but he wasn’t just another nice guy.

When he was five years old, his hip started to hurt. Eventually, he was diagnosed with Legg Perthes Disease, a congenital hip abnormality. The part that took away my breath was that the treatment was ONE YEAR OF HOSPITALIZATION AT COMPLETE BEDREST. Within weeks he was moved from his home in Philadelphia to The Children’s Seashore House of Atlantic City, sixty miles away. His parents had three other kids to raise and worked long hours to make ends meet. Understandably, it was a struggle for them to visit him one or two times a month. This little five-year-old had to survive all by himself!

Back in the fifties and sixties, it was commonplace for Philadelphia families to rent modest summer homes in south Jersey. Mom and the kids would stay there the whole summer and Dad would visit on the weekends. That’s what my family also did, and I distinctly remember seeing dozens of frightened little children in wheelchairs when I would walk on that exact beach.

My patient’s situation became my obsession. He didn’t remember much about the experience, but that didn’t stop me from filling in the blanks with my own story. What if things happened that caused him to have nightmares? What if his whole family was inexplicably killed and then the killers were after him? What if the only way he could save himself was to remember what happened back when he was five years old? What if the only person who could help him was his lab partner in medical school, a woman who wouldn’t even talk to him?

I know all about depression, repression and denial. I know about the early wounds that create depressed adults. And I clearly remembered a girl from medical school who perfectly fit the role I needed. Joe Belmont, a tough Italian street kid and Karen Levine, a beautiful, psychologically minded woman were born. Chasing Backwards, a psychological murder mystery was the result.

Psychiatrists and stories are like Superman and Lois Lane. One without the other creates a palpable void. What a treat to grow an onion instead of just peeling back the layers.

Skin Dance, a mystery, will be available soon.

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