Martha Crawford, LCSW – Autotomy and Remembering

Jason deCaires Taylor
Jason deCaires Taylor

“Starfishes, which have hard spiny skeletons and five (or more) arms or limbs in a star-like arrangement, are also adept at autotomy when caught by predators.”

Some people live their whole lives in one zip code. They remain near and close to their family of origin, and their extended family. They find their earliest attachments to be hospitable, enduring, and nurturing. There are people who still have their best friends from kindergarten, from high school, from college and from twenty years ago.

These lives have, for the most part, offered a kind of narrative continuity, consistency, a sense of going-on-being, where the people who know them now, knew them then, and can watch and mirror what has changed, and what hasn’t.

These are lives that unfold progressively, epigenetically, perhaps each chapter moves forward with a tidy security – or perhaps with a suffocating, repetitious, entrapping or even boring continuation of themes and relationships carried over from the chapter before. The joys, challenges, losses, and unavoidable abject sufferings of life take place in a more or less, consistent, continuous context.

"Silent Evolution" by Jason deCaires Taylor
“Silent Evolution” by Jason deCaires Taylor

And there are others, different – not better or worse – who have great, insurmountable, or repetitive breaks in their narrative. Life stories that start over again, and sometimes again and again, with little or nothing remaining from one chapter to the next. Life itself has offered minimal constancy.

Survival has required that limbs must be shed in order to carry on.

These life narratives unfold like a collection of short stories, episodic, mini-narratives which carry their own arc. A turn of the page and a new story begins with a new setting, new characters and events that make little reference, and hold little knowledge of the story that preceded it.

I think of them as starfish.

So many come to this city to get away from someplace else, to escape relationships and connections to those who could or would not follow them in. They have fled small towns and provincial, tradition bound communities for the expensive freedom and anonymous diversity of urban life.

Others ran for their lives, their freedom, and their sanity from families or communities or countries that would have done them in, annihilated, abused, repressed, devoured or destroyed something sacred in them had they not escaped over the bridges and tunnels into the great, teeming cement labyrinth. Others came, what-the-hell-do-I-have-to-lose, from homes that collapsed out from under them. Everyone essential died. Or abandoned them. Families fragmented, degenerated and blown to bits, like dandelion seeds, scattered around the world, every man woman and child for themselves.

Maybe there are more in New York City than in other places.

Or, maybe, there have just been more in my office.

The leavings-behind and losses of emigration, adoption, coming-out, addiction, abuse and recovery, divorce, deaths and die-offs, abandonments, disasters, severed family relationships, the sudden eruption of mental illness in ourselves or those we depend on, wars, epidemics, all of these, and more can create fissures in time, in our sense of unfolding Self, cause us to shed skins, sever limbs, and to start life over again.

"Vicissitudes" by Jason deCaires Taylor
“Vicissitudes” by Jason deCaires Taylor

Any form of severance or cut off, letting go, of giving up, of going away from a relational environment that we have been profoundly attached to, or stuck on, involves leaving some aspect of ourselves behind.

Sometimes we must cut-off toxic environments and unrepentant abusive family members to preserve ourselves. Sometimes we develop inflamed, excruciating emotional “allergies” to people we have loved but can no longer be near. Sometimes we are cut-off or cast out, or a life-structure simply collapses or disappears out from under us with out our having any say in the matter.

Attachments to those around us take pieces of us with them whether they are lost voluntarily or involuntarily.

Like our evolutionary relatives, slugs, starfish, sea stars, lizards, spiders that leave bits of themselves behind when survival mandates it, we human beings, perhaps further along in the evolutionary chain, nevertheless rely on autotomic functions to preserve ourselves too.

Autotomy (not to be confused with autonomy, but sometimes utilized in service of preserving it) from the Greek auto = “self-” and tomy = “severing.”

In Awakening the Dreamer, Phillip M. Bromberg discusses Nobel prize-winning poet Wislawa Szymborska’s poem titled “Autotomy” which relies on the image of a sea creature called a holothurian as it splits itself in two – half dying, half alive, in order to grow again another day.

Bromberg uses a Latin phrase borrowed from the poem “Non Omnis Moriar” – “I shall not wholly die!” – as the reflexive motto of dissociation in the face of repetitive or traumatic loss:

Others may validly discuss such severances in terms of post traumatic dissociation, or attachment theory and disorder. I am less interested in diagnostics, pathology or prognosis, but more an experiential Winicottian construct: exploring the disruptions in the fragile sense of “going-on-being” through time, as a self that is at least partially recognizable and somewhat knowable to those around, and to oneself.

My grandmother-in-law, a holocaust survivor who by 102 had lost and reconstructed several lives, used her own language to describe people without such consistency:

“They are like ‘this’ in the world” she would say, showing us the back of her hand, a bent, arthritic index finger standing up as straight as it could, the other three fingers and thumb curled in a knotted ball in her tiny palm.

One finger standing alone, in a solitude which carries its own burden, but also still in historical and enfleshed connection to the other digits, now unreachable, cut off and out of sight.

Those “like this” in the world carry stigma in our culture, just for surviving their losses.

Kohut might talk about the loss of “self-objects”: people who help us to see and feel ourselves and give us a contextual, reliable, accurate sense of our selves, through time, across developmental stages. When specific “self-objects” are lost, shattered or eliminated, access to specific internal representations of ourselves are lost as well.

How full, how complete, how round, and how thread-bare can our memories be when there is no one there to participate in the act of remembering with us?

After grad school, I worked in a long-term day treatment for adults with severe and persistent mental illness, and was shocked by how little the treatment team knew, (or had bothered to find out) about the histories of the clients we served. Most lived in mental health residences. Many had lived their entire lives in state institutions like Willowbrook until Geraldo Rivera stormed the gates. Few had any involved family members. Many of the clients were unable to articulate anything understandable about their lives, scrambled thought process and daily dream-time disrupting any ability to sort historical memory fragments from the archetypal images produced by hallucinations, internal stimuli, delusions, and projections.

Their charts and psychosocial histories were barren: family history “Client says he has a sister, no longer in contact” or “Unknown”. Some clients had been served by the same agency for over ten, fifteen even twenty years, with their treatment providers passing through and being replaced every three or four years. Not only were their historical narratives lost, but when each new clinician updated the “expired” paperwork, huge chunks of their recent, therapeutic histories would be lost too.

I found myself writing voluminous progress notes and enormous histories in longhand fountain pen, stapling stacks of extra pages into the standardized forms. I would hunt down every piece of data I could find on their behalf pulling old charts from the archives, requesting ancient medical records from hospitals. I would find clues, ten-year-old phone numbers, a mention of an aunt with an unusual name who may be more easily located by 411. I spent hours and hours when the whole building was emptied, making phone calls, pouring through records, finding pieces of the past to help the clients I was serving remember who they are. When I could find something they were thrilled – “I remember her!!” or “Yes! That was the phone number of my old counselor – he was nice” or even “That was where the bad things first happened…” a piece of themselves, a lost bit re-collected, re-contexutalized.

One (fictionalized) small, smelly client with poor hygiene wore many coats, and had been mute at the agency and at his residence for over five years. His peers called him “The Smell” as he never spoke a word or made a sound. He came to my office to draw pictures with me regularly, to play Winnicott’s squiggle game together. One day, after many months, he wrote out a phone number.

Which I called.

The woman on the other end was a relative who hadn’t heard from him in years. I told her he was silent and we knew nothing about him. “Oh, he gets like that when he smokes crack” she said instantly. “He’ll talk his damn head of when he isn’t getting high.”

He met my request for a urine test with a drawing of a big, piss-yellow dragon guarding a castle in the distance – an initial refusal – which eventually led to a nod, a signed consent, pee in a cup, detox, and several years ahead of amazing art work, joyful, loud effusive wise cracking and talking his damn head off.


It was even annoying sometimes, but in a good way.

Their subsequent regeneration, however, can be particularly dramatic. As long as the shed limb is not devoured by the predator and still contains a section of the central body disc of the starfish that shed it, this limb has the ability to regenerate into a complete starfish.” (Karl P. N. Shuker)

I knew, and know, that those big fat long-hand documents I had written would only live in their charts for a time, that they would end up culled, archived, updated by other clinicians who would understandably and wisely, leave the office at the end of the work day. In five or eight years time much of the detective work, and re-assembly would be forgotten by the institution and maybe the clients too. If, and when clients lost gains we had made together, if “The Smell” ever fell silent again, there may be no remaining documentation of what we had regenerated. And I would not be able to stay there long-term and help him, or any of them, remember.

But I do still remember.

And I will remember for the rest of my life. Ridiculously perhaps, on some mystical, non-sensical plane, I believe it matters that I do. Clients I haven’t seen or heard from for decades do come back, call, leave messages, send notes, or check in to be sure that I am still able to remember them.

Being re-membered, over the course of our lives, lets us experience ourselves as whole.

We need to be in relationships that re-member us in order to re-member ourselves. Therapists are people who have committed themselves to re-membering.

Ideally, therapists commit to remember, long after the appointments have stopped. This therapeutic promise outlasts the treatment. Maybe even for our whole lifetimes, or as long as our capacities permit.

There are healthy and broken people living lives of constancy.

There are well and wounded people living through intermittence and discontinuity. Any one can be dis-membered.

Yet, even if only one limb remains, if even a piece of the central body remains, we can re-establish cohesion, wholeness.

The therapist has a special function in relationship to people living in the throes of discontinuity. It is this: To create a continuous environment, that exists over time, and may need to endure over a lifetime, that allows the core, the central body, to identify itself again, to resume its task of re-generation, to find its inherent capacity for “going on being.”

The therapeutic relationship becomes the seat of consistency, the embodiment of abidingness – continuing on, persisting, enduring in order to honor and assemble the tales of all the lost bits and pieces as they emerge.

To regenerate, we re-member, together, over time.

Martha Crawford, LCSW

First published on Martha’s blog, What A Shrink Thinks, on July 20, 2012. 





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