31 JANUARY 2004, Page 24


I like to have a little nap in the afternoon, though I rarely have the opportunity to do so. I have reached the stage in life, though, when I rather regret waking up; I don't remember my dreams, exactly, hut! know that they are better and more entertaining than reality. To wake is to die a little.

I therefore had some slight sympathy with one of my patients last week, who had taken pills above and beyond the call of therapeutics in order to kill himself. He was a young man of not altogether prepossessing mien, and I asked him why he wanted to end it all.

'My head, doctor,' he said, 'it's full of thoughts all the time,' Full of thoughts? As compared with what? For some reason, an image of those polystyrene fragments that packers use to prevent damage to delicate objects in transit came to my mind's eye.

'When I start thinking, my head goes huge,' he added.

'What are you thinking about?' I asked. 'Fings in general.'

'What things?' 'Fings just aren't going right, they've all come at once, they're getting on top of me.'

I felt it was time for a leading question, otherwise we should be stuck for ever in the realms of philosophic abstraction.

`Do you have a girlfriend?' I asked.

'Yes, but she's doing mad fings. We need a break.'

'To get your head sorted?'

He looked at me with something like respect.

'Yes, that's right, how did you know?'

I modestly brushed aside the question of my psychological penetration, and asked him whether he had recently had an argument with his girlfriend and whether she had broken up with him.


'Are you jealous and possessive of her?' 'I don't stop her going out.'

'Have you ever been violent to her?' 'Not much, only a slap. She's never had to go to hospital or nothing.'

I moved on to the question of drugs. Did he take crack, cannabis?

'Only when they come around me. Not all the time.'

And how often do they come around you?' 'About three or four times a week.' I telephoned his girlfriend. I heard the television in the background, as well as several children, not all of them his. I asked her about him.

'It's an on-off relationship and we've just had a child,' she said. 'I think I need some space.'

`To get your head sorted?'


'Has he ever been violent towards you?'

'Yes.' She mentioned a number of occasions on which he had hit her: several times the number he had first thought of.

'Did you have an argument recently, just before he took the pills?'

'Yes, and he threatened to kill me.' 'Threatened to kill you?'

'Yes, but not kill as in kill.'

Kill as in what, then? Kill as in confer an inestimable benefit upon her? Kill as in offer her a box of chocolates?

'Why did he say he wanted to kill you?' 'He said I wasn't showing him enough love.'

I've always wondered what the Americans meant when they talked of Tough Love. Now I think I have some understanding. They don't mean love as in love — they mean love as in threatening to kill.