My psychiatrist likes to remind me that no treatment is risk-free, including talk therapy. She can be rather snotty like that, but that's another story.Another story still was told on a website, that has now been taken down as far as I can tell, so I'm relying on my less than perfect recall here. The story was that of a woman, whom I'll call Jane, who was referred to an eminent psychiatrist, whom I'll call Dr X, after experiencing some difficulty sleeping. Dr X provided psychoanalytically-oriented psychotherapy, and by Jane's account, chose to ignore her presenting problems and instead focus exclusively and obsessively on the developing transference. In particular, Jane accused Dr X of deliberately fostering her dependence on him by forcing the transference - putting it to her that she had sexual fantasies about him, encouraging her to talk about them, assuring her it was appropriate, and so forth. This, according to Jane, had the effect of producing such sexual thoughts and feelings where none had existed before, culminating in her own obsession with Dr X and the therapy, and driving her to the brink of an emotional breakdown. Jane did not, however, allege that any sexual contact had actually taken place.Such was the gist of Jane's complaint to her state medical board. Predictably, it did not find in her favour - Dr X received a slap over the wrist for not adequately documenting his sessions with Jane, but no further action was taken. (Psychiatrists, take note... take notes, preferably accurate ones. If you even suspect you are within a fifty metre radius of one of them darn borderlines, whip out that pen and paper and note down the fruits of their futile efforts to seduce you.) This sent Jane into a frenzy of righteous indignation, enough for her to decide to make her complaints public, setting up a website onto which she uploaded copies of her email and other correspondence with Dr X's lawyers, and otherwise exhibiting the kind of behaviour that tends to prompt reactions like hard luck, but isn't it time to move on or, more crudely, just get a fucking life.Some psychiatrists will do their best to force the transference, which is both pointless and inappropriate. At the more benign end of the spectrum, you have shrinks who do a big song and dance just before they go on holiday, in grandiose anticipation of you doing likewise while they are away. Any arguments or other unpleasant moments that might occur in the periods immediately before and after the shrink's time off are are automatically and relentlessly interpreted as expressions of the patient's resentment of the shrink having a life of his or her own. Then you have the shrinks who will quite openly suggest that you want to sleep with them, and who will do their best to cajole you into believing it. These guys will really fuck you in the head, insisting that you're fucking them in your head until you're fucked in the head. They may justify their behaviour to themselves and others by reference to some theoretical underpinning - the it's just part of your treatment excuse - but it is nevertheless clearly predatory, narcissistic and self-serving. By Jane's account, this is what Dr X was doing. It seems likely that at the very least he mismanaged the transference, and when the situation became too intense and he had to refer her to someone else, she was left feeling blamed for the unfolding of a dynamic that she had not even anticipated, hence her subsequent outrage.But let's not talk about sex for a moment, and just talk about talking, and the risks that go with just talking. For confession or disclosure can be so much more intimate than sex. When you tell somebody something you can't take it back once you’ve done it, like you can with a part of your body, leaving the other person with nothing more concrete than the memory of some diffuse physical sensations that do not vary too much from one encounter to the other. Confession is specific, and the range of conclusions that the confidante may draw about the confessor extend well beyond that allowed by the usual insulting sobriquets.You are always bound to your confessor; even if he abandons you, or disbelieves you, the larva of confidence he once inspired grows into a tapeworm that eats away at your insides until your outsides cave in and what is hidden has prolapsed for all to see. Or the binding might be, in essence, an intersection: you become Siamese twins. You share his heart, liver, lungs, kidney; he shares you with the footpath, you’re a piece of gum stuck to the bottom of his shoe. Only he will survive the separation, which is why you know, deep down, that some things must never be revealed. On pain of death. Confession is, in a sense, losing one’s marbles; like a kid on the first day of school you don’t know that you’re supposed to exchange them, not just give them away. Or else they roll into drains, cats-eyes following their namesakes, iridescent meteors meeting their liquid selves in puddles of petrol; galaxies disguising themselves as birds’ eggs, clownfish masquerading as candy, blue jays as lost to you as NASA’s Big Blue Marble. You barely have time to grasp the entropy of the spheres, the distortion of your narrative, as a sharp shooter is catapulted into your forehead. Confession becomes indiscriminate, indistinguishable from small talk. Needless to say, friendships dry up, as do invitations to parties, as the marbles are picked over by filthy hands and the tapeworm eats through your brief career as a risky raconteur and leaves you wallowing in a state of total self-absorption.Jane's story resonates with me tonight, her unshakeable belief in her own rectitude providing a stark contrast to my intuition that no one in the world could truly understand what happened to me when I was 'in the system'. I believe that if I try to describe it to a friend or professional or anyone, the feeling I will be left with is that they just don't get it; that they'll be waiting for some further violent denouement; that they will think that all I have endured is, as Maureen Dowd once put it, the "ordinary brutality" of love and life. I still have access to all the old feelings, rising and turning like seals in that hypnopompic state between dreaming and waking, but not the words that could adequately convey them, or the precipitating incidents; the original sins.At first, there was just guilt, shame and more guilt, what ifs and why nots. It wasn't until I was 21 that I began to perceive, in the face of crippling agoraphobia, some (very ersatz) nobility in what I did, and some months later, I found myself in a dim bordello-style boardroom, discussing "some stuff that happened" with a sombre lawyer and a gung-ho social worker who had every free set of steak knives out, urging me to sue, sue, sue. The lawyer went through the options - civil action, conciliation, mediation, and warned me that I'd be dealing not with individuals but with institutions, with deep pockets and a legal policy of offense rather than defense. He also pointed out that any civil proceedings would possibly attract the attention of the tabloids and all their ilk. He was just doing his job, and no doubt his advice was sound. But the contrast between his demeanour and that of the rabid social worker was disconcerting, and at some point I said, "This is stupid, nothing really happened, let's just forget it." I was still shuttling between the extremes of experiencing a strange kind of gratitude towards one of the people involved, and even a (very hypothetical) yearning to see him again, and the understanding that something very inappropriate and damaging had taken place. Later, when I got a letter from the lawyer saying "Thank you for your courage in telling of your experiences", I felt like he was making fun of me.It's so easy to be rational about these things on paper. The mediation of keyboard and chewed fingernails, coupled with the aesthetic impulse, leave bottles drunk dry and thrown only at the bin. Time destroys all things, as the paedophile butcher says at the beginning of Irreversible, but for the things that it leaves covered in ash and waiting to be excavated, I need a drink to destroy time. It renders everything fragmented, devoid of context. Psychiatrists want to know where I’ve come from, friends and intimates want to know where I’m going, and I don’t know how to make them understand that history has stopped, that all that’s left is an interminable present, and the only way to break time up, to prevent the accumulation of the crust of dead experience, is via the bottle. (Source: Off-Label)

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