From The Therapist's Couch

A man in his mid-thirties has come to therapy for a few months. Then, there is a sudden change in what seems problematic. Initially, he sought help because of "writer's block". A recently married scriptwriter, he sold his bachelor pad and now writes from the top floor of his marital home. He hadn't bargained for the impact that moving from solitude to shared living would have on his work. A foggy mental paralysis besets him when he sits down to write, and it is churning him into a flat spin of neurotic worry.

At the outset, our work was focused on uncovering the reasons for this. It materialised that he has always needed to be alone to be creative. He is almost obsessively needy of eliminating distractions and unplugging phones before starting to work. He'd been anxious about sacrificing his solitary base, but his wife was reassuring and he quashed these niggles.

It transpired that there was a very good reason why he needed to keep his creative core under lock and key. The only son of acontrolling mother, he soon learnt that by mirroring what his mother needed, he secured her affection. But at a cost: "My mother had a way of scrutinising whatever I was doing and rolling me out of my shape and into hers."

He recalled an occasion when he was 10, and writing a poem. He loved writing, the feel of words. He remembers how his mother crushed both his pleasure and confidence by saying she would "help him make it better by ending every line with a rhyme". Because he loved her, he couldn't say no; because he couldn't say no, he couldn't be creatively alive in her presence. Hence the hiding - and the "writer's block".

One day, he announced that his wife said he had to tell me about his moodiness. This hadn't figured in our dialogues. He often had the slightly strained over-cheeriness of the too compliant, but I'd never "seen" the shadow side of this. When I asked him, he looked cornered. "She interrupts my work all the time. Or that's what it feels like. It's always sweetly done, cups of coffee and so on. I've tried to say I mustn't have interruptions, but it's so difficult. She doesn't understand. I've really tried not to let it get to me, but I end up fractious and withdrawn. It makes her cry. I do love her, but it's become something I can only really feel when she's out of the house."

I suggest that passive-aggressiveness is another way to describe this moodiness, and that maybe the cause is the same. His long habit of letting another's "shape" determine his own except when he is safely alone carries the shadow of suppressed rage. And every now and again this hidden fury lashes out.

So what can my patient do? The first and strongest tool is self-awareness. Recognising that he is transferring on to his wife a similar pattern of relating is a start. Instead of unconsciously repeating this habit, it must be challenged. Asserting what he feels, not muffling it, should knock the moods for six. Too much niceness is unlikely to get him anywhere other than another round of backhanded nastiness.

Elizabeth Meakins is a psychoanalytic psychotherapist in private practice. None of these clinical details refers to specific individual cases

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