I am Kent Ravenscroft, an adult and child psychoanalyst and psychiatrist from Washington, DC. It is fitting that I follow David Scharff and Justin Frank, since it was partly because of their coming to the Tavistock some 25 years before me that I decided to be a Visiting Scholar in 1993-94. Because of their experience here I felt the Tavistock must be something special. But it was more my own experience with Hyatt, and Gianna too, when they came as visiting conference chairs to our Washington IIORT and later IPI conferences that convinced me. Seeing Hyatt in clinical action around cases and hearing his papers moved me powerfully, creating a sense of awe and piquing my interest. Finally, I felt I had to go to Mecca myself.
My wife, Patti, and I arranged a sabbatical year, living and eating in Paris, and my commuting three days a week to London to feast intellectually on Tavistock wisdom. My wife developed Les Liaisons Delicieuses, her French gourmet culinary tour business, while I joined Gianna in her Eating Disorders Workshop, leading our two volume series, The Generosity of Acceptance: Eating Disorders in Children and Adolescence.
Having supervision with Hyatt was something I especially looked forward to. When I called him to set this up, he was surprisingly precise about giving me directions, except for claiming to have forgotten the name of one street. I thought I heard a little chuckle as he said this. When I followed his route I discovered the forgotten street was named ‘Ravenscroft’. Hyatt’s sense of humor was at work.
When we settled into his modest cluttered office, and I brought up the practicalities of his fee, the first thing he said to me was, “Kent, I don’t think there’s enough of a gradient here. With all your experience, I don’t think I should charge you anything. We should just meet and work together.” I was speechless. Here I was finally with the man I idolized, and he was saying we should work for free. I had to convince him to let me pay. It wasn’t until sitting here at his memorial that I finally realized what he was doing. He was dealing with my putting him up on a pedestal, detoxifying my idealizing projections so they wouldn’t interfere with our work and my learning. I recall one of Hyatt’s famous quotes, probably from Bion, about being “lauded (loaded) with praise and sunk without a trace”. In his intimate mutual way, he wanted me to remember the words of our supervision.
Before we got into our formal work he was particularly interested in hearing about my experience in Haiti as an undergraduate anthropologist living with a Voodoo priest for a year in 1961 studying spirit possession. He was intrigued by my looking at it as a form of culturally determined multiple personality caused partly by early childhood psychosocial trama, given his interest in things that fracture and encapsulate parts of one’s personality.
As we worked on my case, he had a wonderful way of making Klein and Bion intimately accessible in every day language, which emphasized functions of the mind and body in ways that could be spoken to the patient without throwing body parts at them. He also helped me get more comfortable with aggression, my own and my patient’s, helping me be more aware of the violence of the unconscious and its impact on mental functioning. Finally, he emphasized the importance of being intimately attuned and attentive to the patient, remaining in the here-and-now of the patient’s and my own experience. He urged me to get the details of the patient’s experience, saying, “The devil is in the details, Kent.”
My year with Hyatt was priceless, though I did pay my supervision fee. Subsequently, we Washingtonians were lucky to see a lot of Hyatt, and Gianna around child work.
And in recent years, Patti and I have seen Gianna in Paris, and were privileged to share moments when she talked of Hyatt, and her loyal lonely vigil losing her beloved Hyatt to Alzheimer’s. The progressive loss of a wonderful person and a beautiful mind is a very hard thing to bear, and she has done it with patience and grace.
Two months ago, I went to Haiti, and Hyatt went with me. After the devastating January earthquake there, I had the opportunity to serve in the relief effort with the International Medical Corp (IMC), going beyond Leogane, my old field site and the epicenter of the quake, to open five mental health clinics attached to IMC mobile medical clinics. I taught front line Haitian family practitioners to do psychiatric diagnosis and treatment.
At one of the mobile clinics, a Haitian doctor and I saw a 22-year-old girl who had trouble speaking because of a tight aching throat. “Feels like a knot in there,” she said. “I also feel dizzy, my heart beats real fast, and I have trouble keeping my eyes open.” Her aunt who brought her in added she wasn’t eating. Two other times in her life these symptoms had appeared, when failing premed exams, and again when failing social work exams. During the earthquake her favorite brother was crushed as their house caved in, bringing on the symptoms in waves, beginning the moment she realized he had to be dead. She couldn’t open her eyes for hours. When her other brother in Cap Haitian found out, he kept calling her and crying, but she couldn’t cry with him. As my translator Tessier heard this, he tapped me on the shoulder, “Dr. Kent, I knew her brother. He was one of my best students and became a close friend. I feel so sad hearing he died.” I noticed tears running down his cheeks.
“Tessier,” I said. “Tell her what you just told me.” When he did, she initially began to cry, but then her eyes scrunched shut and her voice tightened, sobs catching in her throat. “That aching lump has come back,” she said. I leaned over and whispered to the Haitian doctor I was supervising, saying, “Notice she just developed a globus hystericus right in front of our eyes, an anxiety-based laryngospasm. Some people think it’s a “stifled cry”. These symptoms are spillovers from intolerable arrested mourning, the pain of loss going into her body. She wants to close her eyes to the painful reality. When her normal waves of sadness hit her, her defenses, a conversion reaction, result in her symptoms.
But we’re still missing something that’s making it hard
for her to mourn.”
I was recalling Hyatt telling me, “The devil is in the details.
Get the immediate details.” So I said to the Haitian doctor, “Ask
her what was going on with her and her brother at the time of the earthquake.
When Dr. Guirlande asked, she found out that they had just had a terrible fight. “Mad enough to wish something bad would happen to him?” I said in my rusty Creole “How did you know?” she replied. “That’s why I ran out leaving him alone in the house, just as the earthquake struck. It should have been me.” “You feel horribly guilty, don’t you, every time you start to cry?” “It’s awful. I can’t stand it.” “Well,” I said, “The earthquake wasn’t your fault, nor your survival, and now that you’ve finally told us I think you’ll be able to cry for him when you need to. He would want you to, to be able to go on living, and not be so guilty and stuck.”
As terrible as the earthquake was, the violence of her anger toward he brother, with devastating unconscious elements, and her intolerable guilt were what buried her grieving alive. Having Hyatt with me in Haiti as my internal supervisor gave me the strength and courage to see what was going on and to say difficult things directly to her.
And I am sure Hyatt lives on inside each of us who knew him, giving us active internal guidance in our ongoing clinical and theoretical work. I am deeply indebted to Hyatt, and very grateful for all that he has taught me. I continue to miss him very much.