In a previous post I used sleep as an example of loss. One used to be able to sleep and so it's like sleep used to be there to embrace or take care of one and then left. If you ask the person to consider sleep as a person who used to be with them in the night and has since left, they can use their own vocabulary to express "you left me, I need you, I'm not the same since I left... etc."
This colleague told me that the patient came up with some adjectives, but that the patient never came up with anyone after making the other-statements. However, before getting into any of the many "resistances" a patient might have in this case (i.e. not trusting the therapist with the answer, a general inability to be spontaneous and allow surprises, etc.) I asked the therapist if he had got into the details of what didn't allow the patient to sleep. He said he hadn't asked!
I wrote this up for him about a patient who said he had problems sleeping, and who told me, only after I had asked, that it was his "damn dogs!"
I ask him why he has the "damn dogs" sleep with him and he says that sometimes they are good and he wants them in the bed with him. He talks about having the “comfort” of the dogs in bed to feeling like they are “too much.” Thinking about it, he feels a “mild annoyance” towards them and says “they are great, but selfish.” I enquire about this last remark and he says that everyone is selfish.
I ask him to think about the general relation to his dogs in the good phase and then the bad phase. He says he wants to give the dogs love and warmth and for them to feel part of the family. He says they are like his kids.
At first the dogs are “pure love” and then they want too much, they are pushy, and selfish assholes.
I ask him how the dogs might see him. He says, as a "protector, friend but then as a betraying asshole". They think he “doesn’t want them anymore” and that he “abandons” them
He uses the description he gave of the dogs as self-statements and they felt true. He talked about how he has wanted “too much” and felt others “didn’t love him as much as he loved them”
I asked him to also use the thoughts he had about how the dogs might think about him (“you are a protector, friend, etc.”) and he creates a list of people (2 girlfriends in his 20s and one male friend in high school)
He also generally related it to his father (“Dad was never around as much as I wanted him to be”. “There were fleeting moments we were together… and then he’s gone or I’d leave.”)
He says that the women had been “threatening with their presence” and gave the impression that if they didn’t get their way then they would leave.
He says at some point he changed and said he won’t be the one to chase after someone. He says he felt like a “sucker” and “fool.” He remembers feeling weak and embarrassed when they would make a scene in front of his friends.
Don't go straight for sleep and the abstract relation-- no matter how interesting it is that people can have relations to Time, Space, sleep, their bodies, etc. that reference oedipal (i.e. interpersonal) relations with people in their lives.
Stay close to the material your patient gives you.