An extraordinary psychiatrist, an extraordinary teacher has recently died. Charlie has not been active in the department for a couple of decades, but in the era in which I trained, the early 1980s, Charlie was a shy giant among giants. He slipped away from us without fanfare, and, despite his prominence as a teacher, always seemed unknowable, a quirky elusiveness keeping him apart, but for that, no less inspiring of love and awe. He was a psychiatrist unbeholden to the dogma of his time, beholden simply to the care and understanding of his patients, and to the nurturing of those who sought the same.
In the quaint ritual of supervision, I brought him my cleverest interpretations; he wondered why I was trying to do so much. I fashioned my responses to elicit his approval; approval or disapproval seemed the furthest thing from his mind. I tried to anticipate the patterns of his response, his method, but to no avail. He remained as obscure as a Zen master or an object of passion.
"Psychotherapy," he said, "is something that happens in the patient." I have spent years trying to understand that dictum.
Watching Charlie interview a patient was like listening to a great musician. Whether the melody was soaring or fractured, the harmony thunderous or threadbare, Charlie heard the inner voices, the deeper structure, and like a master contrapuntalist, drew out the patient in simple duet, finding the sublime in the ordinary.
A former luminary in our department, at the dawn of the neurobiology age, brashly declared that he didn't want our residents to become like Charlie Gardner. This scientist correctly identified the greatest opponent of a model of psychiatry the goal of which is to find the disease in the patient. Charlie, indeed, was the exemplum of a physician looking for the patient with the disease. But this leader did not understand that Charlie was the least dogmatic of our psychoanalytically trained clinical masters, the most receptive to new findings in child development, early mother child interactions, findings that we might now term developmental, cognitive, and social neuroscience.
Charlie was startlingly open to the realms of experience that occurred too early for complete symbolic encoding, or too traumatic or overwhelming for a fragile meaning-making system to domesticate. He was not afraid of the unbearable and the unspeakable, not offended by the sometimes ugly manifestations of too much pain or too great fear. He neither retreated nor attacked with the noble intention to cure. After all, psychotherapy is something that happens in the patient.
Charlie was much taken by John Gedo's formulations and syntheses of an analytic approach with then new developmental research. Gedo used the terms "pacification," "unification", and "optimal disillusionment" to describe processes within the "holding environment" of therapy that are required to assist the patients mired in the most archaic modes of psychological functioning. And to these seemingly simple emotional tasks: to be able to calm oneself, to feel at the center of one's experience, to be the author of one's own thoughts, and feelings, and actions, to be able to incorporate a reasonable set of standards and ideals for oneself without grandiosity or guilt, without bitterness or shame, Charlie subtly directed our attention.
Charlie did not leave behind a written legacy. Nor was he particularly good at explaining what he did – at least not to my satisfaction. He was a master craftsman, and those of us lucky enough to have been his apprentices have our versions of a mode of practice rich and regenerative, for our patients and ourselves. I like to think that I have grown through my own optimal disillusionment to the sweet understanding that supervision is something that happens in the one being supervised. The world, so much enriched by his life, now turns poorer by Dr. Gardner's death.
- Richard Kravitz, MD