This paper is based on a lecture given at a conference held in October 2024 to celebrate the 30 years of operation of the Family Therapy Unit of the Attica Psychiatric Hospital, and a farewell to the founders of the Unit.
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Translation in English_: Constantinos Apothikianakis, psychologist_
I would like to thank the director, Nikos Marketos, and all my colleagues, Ioanna, Kia, Georgia, Ioanna, Ersi, Katerina, and Maria for inviting me to participate in the 30th anniversary celebration of FTU (FamilyTherapyUnit).
When I first received this invitation, it was obvious to me that I would accept it. It felt as if I was invited to a celebration by my parental family — a celebration that, among other things, aimed to honor the "parents", the founders of the Unit Katia and Fotis. But what could I possibly say? How do you talk about your "parental home", the professional/therapeutic home? How can you talk about what you experienced for 28 years in a way that is meaningful, not only to you, but also to the people with whom you share this narrative? I decided, therefore, to speak about a very significant part of my inheritance — something I experienced, witnessed and learned during my time at the Unit, first as a trainee and later as a therapist and employee: the values of psychotherapy.
Ogden, in his book "This Art of Psychoanalysis", states that a person seeks out an analyst (or therapist) because he is experiencing mental pain, often without being aware of it or in touch with it and needs another person – an expert who is more familiar with this kind of emotional experience - to help him connect with it, process it, and move forward by integrating it into his life.
Similarly, Jeremy Holmes, in his book "The Values of Psychotherapy", writes that "psychotherapy means taking a person seriously. It sees a person all of a piece, a product of her own biography. This understanding, if all goes well, brings relief. It enables the patient to make sense of experiences that were previously incomprehensible, and this in turn enhances the patient’s feelings of autonomy and self-esteem”. He then raises a series of questions regarding the framework of psychotherapy:
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Is psychotherapy worth taking seriously?
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Does psychotherapy work?
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Is psychotherapy a luxury?
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Should it be available to the less affluent?
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Who should be responsible for paying for psychotherapy?
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Should the state fund psychotherapy?
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What is the role of psychotherapy in society?
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Are the benefits of psychotherapy reserved only for those who can afford and are willing to pay for it, or is it something that citizens of a society have the right to access as a public service?
And on the other hand, the question arises: What principles and values govern the process of psychotherapy?
Referring to the framework of the Family Therapy Unit (FTU), Katia Charalabaki, in her book "Family Therapy Unit of the Attica Psychiatric Hospital: 25 Years — What Remains, What Has Changed", discusses values and states:
· We do not accept “under-the-table payments”.
· We do not grant favors.
· The trainees we select do not have "connections in high places".
· Every September – before the start of the academic year – we received a multitude of phone calls from hospital directors, colleagues, friends, acquaintances, and even ministries with propositions (that bordered on orders): “Accept so and so to your training course”. We had found a standardised response: “Don’t even tell me their name or they will be automatically disqualified”.
· We do not know the word "nepotism". If you walk into certain academic institutions and whisper the word "nepotism", the building might collapse on you. Our own children refused — also because they were never asked — to inherit our positions.
· We reject commercialization.
· We remain outside any form of advertising, striving to preserve authenticity, sincerity, humility, genuine care for our patients, and human values.
"Does this mean we are saints, holy, perfect or sacred? Of course not. We simply walked together in a collective effort to uphold certain principles".
Ogden identifies the most fundamental value of therapy as the therapist’s ability to be genuinely human in a way that honors human dignity at every moment. Additionally, he emphasizes the importance of both therapist and patient facing the truth together and being honest with themselves when confronted with emotionally distressing experiences. This is an extremely challenging and demanding task for both, as they strive to put the patient’s emotional experience into words, creating the potential for a new experience to emerge. Another core value in psychotherapy is the therapist’s responsibility to respond to what the patient seeks and needs - to help them live life differently: in a way that is less painful, less lonely, less empty, less destructive. This requires the therapist to be fully present during therapy, often containing and metabolizing the patient’s unprocessed and unformulated emotions.
Moreover, psychotherapy necessitates that both therapist and patient think and express themselves genuinely, as real individuals, using language that serves communication rather than obfuscation, understanding rather than confusion - language that expresses the individual’s emotional experience rather than distort the truth. Finally, the therapist must be able to tolerate uncertainty - not to claim to know the TRUTH, not even to fully know himself - so as to remain open to discovering himself alongside the patient in a journey that is anything but easy. Because, as Ogden states, by not knowing, the therapist can imagine, allowing for a new articulation of the patient’s dilemma.
I would like to share with you the experience of a treatment at the Family Therapy Unit, as I believe it illustrates the significance of the principles discussed earlier.
I first met Lena when she was 38 years old. She had been referred to me by Katia. Lena had initially sought help from the Unit along with her husband for family therapy, following the recommendation of the Community Mental Health Center, where they had been referred for support regarding their eldest daughter, who was 16 at the time, and engaging in self-harm. The family also had a younger daughter, aged 13. After a few sessions, the father decided he did not want to continue, so the mother was referred to me for individual therapy.
Lena was a pretty woman, who was overweight, always wore black and was unemployed. In our first session, she spoke about her mother-in-law and sister-in-law, her grievances against them, and her anger. I felt exhausted and bored. When I walked downstairs from the first floor to the ground level, (to the staff common room), I complained to Katia, saying: “What am I supposed to do with this woman? Why did you send her to me?” Katia replied, “Do whatever you can, support her in finding a job, help her stand on her own feet…” Her response turned out to be somewhat prophetic.
In our next session, as soon as she walked in, she said: “I want to tell you something I have never said before: My grandfather raped my mother at the beginning of her marriage to my father, and he later raped me from the age of 9 to 14”. She did not dwell on this further and continued narrating her story, speaking about how she met her husband and the difficulties she was facing with her daughter. This time, as I walked downstairs, I felt overwhelming nausea, my stomach churned, and I wanted to vomit. Downstairs, I shared my experience with Ioanna, who was there…
The therapy continued with biweekly sessions. Lena did not want more frequent sessions, and I followed her pace. As we progressed, (perhaps to reassure me?) she would tell me that she was feeling better, that she felt stronger... After the first few sessions, she mentioned that since she spoke about her rape, her daughter had stopped self-harming. As for herself, she also began visiting the doctor for check-ups and was taking care of her health. Her role within her family of origin was that of a caregiver, primarily for her mother, who suffered from a neurological condition - “to make sure that Mom was okay, because she would have crises”, as she put it.
A few months later, she mentioned during a session: “I’m really happy - I worked, I cleaned a house, and I gave my daughters some pocket money…” In that same session, she mentioned for the first time: “My mother doesn’t acknowledge me”.
Gradually, she started connecting with her anger - toward her mother, who sent her to the man who had also assaulted her, toward her grandmother, who allowed her grandfather to take her away from the grandmother’s bed where she was seeking refuge, toward her father, who did nothing to protect her even after he found out… During some sessions, she spoke intensely about anger, pain, guilt, and profound sadness. During others, she spoke about strength and liberation. At one point, she said, “My mother cannot love me... maybe I was still waiting for that”. Later, she mentioned, “I keep having dreams... that I lose my children in a park... a constant anxiety that is never resolved”. And in that same session, she wondered: “Could I be the result of a rape? Is that why my mother hated me?”
Two years later, her eldest daughter took her exams but did not succeed. However, she decided to enroll in a school for graphic design and comics. After the Christmas holidays that year, Lena arrived with a bouquet of tulips. She had managed to talk to her daughters and her husband about her past. She said: “It really helped me to talk to my children, so they can protect themselves and their future children, and so they can understand their mother…” After that, her daughter wrote her first fairy tale as part of a school assignment, and her younger daughter earned her Lower certificate in English. Speaking about her relationship with her daughters, Lena said, “My eldest has become more expressive, and I feel a deeper trust from her. My youngest is the little whirlwind. She used to struggle with history, but now she finds it very interesting. I told her, ‘You have a beautiful history yourself - your dad and I loved each other, and we brought you into the world”.
A little over three years after our first meeting, Lena asked to close this chapter. Referring to her parents, she said: “My mother did everything for money. They both tolerated me going to my grandfather for money. They don’t love me”. At the time, and even now, my thought was that perhaps this ending was premature; that there were still many things that could have been worked through in therapy. On the other hand, I felt - and still do - a deep respect and admiration for this woman, who had not only survived psychologically and did not fall ill, but also managed to fight and win her life and relationships with remarkable courage. She had every right to decide how far she wanted to go at this stage of her journey…
In our last session Lena says: "I placed myself in the hands of the specialist. It wasn’t hard for me to let go, I needed it. What was difficult was describing the situation, accepting things about my mom. When I remembered about my grandmother, it was really hard… I never imagined I would talk to my children about it - liberation… Our relationship is completely different now. I understand that they understand…
Up until last year, I would return from our sessions with a headache, I would crash and sleep…What happened marked my life, but I have shaped what comes next myself…
It’s not like closing a book and putting it aside. It’s like being able to open the book without crying all the time…
My daughter won a competition at her school, first among all participants… Her professor recommended her, and she started working… My youngest, like a kite soaring in the sky… My husband and I are doing well… This journey of the soul - the best thing after my children; coming here was the greatest gift I’ve given myself…"
This therapy took place within the Unit, in the public sector. And as we often emphasized, it was not free - it was state funded. The therapist was with Lena in the consulting room, but she was never alone. I never felt alone in this journey, which at times was very difficult for me as well. My team was always there for me - to listen, to support, to share…
For this journey, and for many others like it - not always with a happy ending - I feel deep love and gratitude: for the people who entrusted us with their psyche and made us companions on their journey. For the trainees who honored us with their trust and with whom we learned together. But above all, for those who, to me, were the Unit: For Athena. For Fotis, who, together with Katia, built this place and who was the first to welcome me as a young trainee with warmth and humanity, opening the door of the Unit to me. For you, my dear Katia, who took me by the hand and helped me grow - therapeutically and beyond. For Ioanna, Kia, Bianca, Eleni, Georgia, Ioanna, Katerina. For all the times when your gaze and your presence warmed my soul.
Thank you!
