A Welcoming Heart:
Remembering James Gooch, MD
Jeffrey Eaton, MA, FIPA
Early in my psychoanalytic training I was referred a very difficult child case. The child had significant complex infantile trauma and was acutely psychotic. I had already consulted with two other child analysts before seeking Jim’s help. After listening to me describe the intimidating details of case Jim said “Well, Jeff, I don’t know what is possible, but, I’m willing to help you find out”.
Jim supervised the child’s four times a week analysis for several years. She improved greatly. I learned a tremendous amount. But, it was Jim’s attitude of openness to experience that is probably the single most important thing I learned from him.
I visited Jim many times in LA, but most of our supervision took place over the phone. I remember in the early days of the case I just mentioned I would present detailed sessions to Jim and I could hear him sobbing on the other end of the line. At first, this troubled me. After some time I realized that Jim was allowing himself to really imagine the child’s experience. He could become so immersed in the details of the child’s experience that he was registering real pain that I realized later she was trying to communicate.
Though far away, and having never met her, Jim was more in touch with my patient’s experience than I was. He made it clear to me that my job was to help this little girl find words for her experience. But not just any words would do. Jim certainly eschewed the jargon of psychoanalysis when talking with patients. He made me appreciate that my words must come from trying to comprehend her from the inside out, not from some distant place. One day he said to me, “Jeff, it’s not enough to understand. You have to feel it in your heart”.
Jim was a keen observer and a deep listener. He embodied Bion’s emphasis on curiosity and a willingness to get to know. He asked questions and his voice was deeply expressive. He would often lean into a conversation. He had a good sense of humor and a wide smile.
Everyone who knew him knew that Jim liked to tell stories. Jim told stories in an old fashioned way, to illustrate a point, even to teach a moral. I remember many, but I will recount to just a few.
Jim loved and admired his grandfather. As a boy he would walk with his grandfather around the farm in Kentucky. He learned from watching his grandfather. His grandfather would point to things and ask questions about them. For example, Jim and his grandfather might pause by a tangle of tree roots growing in the side of the hill. “Look at that” his grandfather would say. “What kinds of conditions do you think produced something like that?” It was a real question, meant to be puzzled over and wrestled with. The important thing wasn’t knowing the answer, but directing attention to something in order to see what might be discovered or revealed.
Jim often told me that this was Bion’s attitude too. One of the most important things you could do was to learn how to look. Looking gives rise to questions. Questions arise from the details of the circumstances and from what you select to give attention to. From questions you develop ideas and you create hypotheses. It is from your lived experience in the world (or the session) that you deepen your understanding.
Clinically, Jim was very interested in what people could be aware of. He emphasized how important it is to embody experience. Feelings are not in your mind, they are in your body. Jim would say that I should try to get a feel for the texture of a patient’s experience. He’d evoke his grandfather’s hands. He’d talk about how his grandfather would pick up a handful of soil and test it with his fingers, smell it with his nose, and study it with his eyes. By combining all these senses you register a fuller sense of the object you seek to study. Psychic reality, of course, is immaterial. However, as Meltzer taught, it can be treated concretely. Jim had a sense of this paradox and of how deeply our intuition is connected to it.
Jim listened to experience. He would wonder what a patient is aware of at the level of sensation, image, idea, or anxiety. Only by building up the data of the patient’s experience can you then make deeper inferences. Jim admired Meltzer and had his own version of muscular psychoanalysis. He built on the work of Bion and Meltzer in important ways.
Jim was deeply influenced by his analysis with Bion. He often said that Bion made psychoanalysis alive again after he had suffered a period of disillusionment after his first training.
I remember expressing my frustration struggling with a feeling that there was one right way to do analysis. Jim told me a story of a patient that he took to Bion for supervision. The patient was not communicating. Bion wondered why. Jim did not know. Bion felt that both patient and analyst were somehow trapped in a stalemate. Bion said to Jim, “If the patient needs to stand on his head in the corner of the room in order to communicate, then that is what you must let him do”.
Once I was lamenting an intricate Kleinian formulation that seemed too far fetched. I could not see what the “evidence” for it might be. Jim was great in trying to show me what he thought and why. But this time Jim said, “We need to be humble, Jeff. We are already so far out on the edge of an epistemological limb”.
Another time he told me a story about how Bion interpreted to him. Bion said to Jim “I tell this to you not because I know it to be true, but because it may be of some use to you and it may help to you think about your experience from another angle”.
Jim and I had so many valuable discussions. I know what I will remember most is how intimate our conversations were. I felt Jim was not just teaching me about psychoanalysis, he was sharing his own mind, heart, and values. His generosity will stay with me because it changed me. Jim helped me to discover and get in touch with my own listening heart by sharing his. I will remember not just what he taught, but how he taught me.