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Psychotherapist on picking up the pieces

Immersed in other people’s lives and the witness to much life and death, one psychotherapist tells THEO PANAYIDES the most important thing we must do is relate

Some are born profile-worthy, some achieve profile-worthiness, and some have profile-worthiness thrust upon them. ‘I know a guy who’d make a great profile,’ raved a mutual friend – and it only takes a few moments in Achilleas Koukkides’ company to see what the friend had in mind. We all have those people we think of as ‘characters’, those who stand out as being lively, or dynamic, or just somehow memorable – and Achilleas is one of those characters. As he cheerfully puts it: “I’m a party person!”.

It almost wouldn’t matter what he does for a living, though in fact it matters deeply. I sit on a garish red sofa in an office decorated with Tintin posters, random-looking phrases scrawled on the walls (“You can’t relate to people without paying a price”) and rotary-dial phones piled in a corner. The décor is eccentric; his moustache is also eccentric, one of those twirly numbers favoured by Hercule Poirot. He’s 46, with curly black hair and extremely alert brown eyes; I’m used to people breaking eye contact during an interview (one can only be observed by a nodding, attentive stranger for so long), but the brown eyes return my gaze effortlessly. It’s no surprise, because looking at people is part of his job; looking and listening, taking in their stories and offering his knowhow – as well as his candid, impetuous energy – in return.

Achilleas is a clinical psychologist turned psychotherapist. For the past few years he’s been in private practice, seeing clients in this very office where he “spends more hours than I do at home”. Before that, for about two decades, he worked as a therapist for sick people (‘clinical’ from the Greek ‘klini’ meaning ‘bed’, hence patients confined to their beds) – initially HIV patients, during his studies in France, then cancer patients for about 15 years, 10 of those in Cyprus. “I would go back anytime, but I’m restraining myself from going back,” he recalls of his time at Arodafnousa and the Nicosia Oncology Centre. “It fit my personality completely. Completely!”

It seems a bizarre thing to say, given how intense and intimate the work was – “because I lived with them, OK? I dedicated most of my time to it, when I was doing it”. Doctors have it relatively easy, insofar as they can fall back on talking therapies and medical terms – but the psychologist has to deal with the nitty-gritty, the mortal fears of patients and their loved ones. “Diagnosis. How to present it to people, how to explain to the family, how to deal with the children,” he recalls, listing his duties. “How to help them get out of their denial, or their anger or depression – how to pick up their pieces and put them back together, in a completely new life… And then the different losses throughout the process. I mean, from the hair, to the lifestyle, to the party [which they’re unable to go to], to the graduation of the child, to going to the cinema, to the body they had. And then the grief at the end. Even if they were cured, there was a grief,” all those feelings they’d placed “under the carpet” and were now ready to deal with. Achilleas pauses, then adds counter-intuitively: “It was magical for me”.

He’s not being callous, quite the reverse. The magic came in the intensity, the “honest conversations” with no time for lies and hypocrisy. “Everyone thinks that working with dying people is like you go into a grave in the morning and come out at night. It’s exactly the opposite! There’s so much life to it… And time becomes precious. Every minute you live there, you feel it.” Then there was the emotional rollercoaster of life on the wards, “this beautiful controlled manic depression of one moment you’re crying with them, feeling like it’s all over, and the next moment you’re in bliss because – I don’t know, the kid next door finished therapy or something”. Many people wouldn’t fancy such extreme emotional swings, I point out. “I adored it. I don’t know if I could do it again today, every day, but I adored it.”

Is he quite an extreme person in general?

It depends, he hedges briefly – “but yes, I like things that have energy and magic. I wouldn’t sit on my sofa and watch TV. I mean, that would be like my nightmare.”

Actually he doesn’t even own a TV, his interests being rather more vigorous. He likes walking, sports, pilates. He used to play squash, and hopes to resume soon. “Good wine, good food, good conversation,” he enumerates, nodding happily (he’s a party person!); he’s a drinker and a smoker, and loves to do both. He’s never married, but was always in relationships (this period now is the first time in his life when he’s single, by choice). Acting was a big obsession in his youth, and he’d like to get back to it; Achilleas was a star of his high-school drama society, indeed it’s what turned him from a bullied boy into a popular one. (I assume, as with everything else, that he liked the intensity of acting, and the intimacy.) Above all, “I write every day,” filling diaries with stories, random thoughts, even a play. He keeps these creative endeavours to himself, though he’s recently – in the past few months – launched a blog at efpraxia.com, where he shares some of his writing (“mostly stories of cancer patients, at the moment”). What about the play? Has he been writing it for long? He shakes his head: “No, everything I write is written very quickly. I’m – not a very patient man”.

Reading through his blog offers more information. As with all good psychoanalysis – though he doesn’t really strike me as a Freudian – many of the answers are to be found in his childhood. One (very touching) story harks back to the time when Achilleas was eight years old, finding echoes of his life in an eight-year-old French boy named Oliver whose grandpa, much later, was one of his patients. Achilleas’ own grandfather died of cancer when the boy was eight years old – a defining event because “I was more attached to him than anybody else in the family”, even his dad. (The father-son relationship seems to have been rather fraught; in the story, listing details of his childhood, Achilleas recalls “the fear of [hearing] my father’s voice”.) He talks of this in our interview – but reading the story fleshes out how profoundly the boy was affected, how he took his grandfather’s pyjamas and slept in them well into his teen years, how he later smashed his grandfather’s record collection with a rock in an act of impulsive rage.

The death was a catalyst, leading directly to his adult profession (he remembers thinking, as a child, “that I wanted to be sitting on hospital beds, next to people who were very sick and were going to go; that was a fantasy I had as a child”) – albeit not immediately, since he studied Aeronautical Engineering in London at his father’s behest before dropping out and moving to Paris. The bond with his grandpa was intense (the old man had taken early retirement, and the two were inseparable) – though you also have to wonder, at the risk of playing psychologist to a psychologist, if it was simply a case of a naturally fiery, emotive personality experiencing the first big rupture in his young life, a rupture he’s unconsciously spent the decades since trying to control.

Note, for instance, that being a therapist isn’t quite the altruistic enterprise it may appear. “It is egocentric to be a psychotherapist, believe me. Oh yes it is!” notes Achilleas when I laud his obvious dedication. It gratifies feelings “of control, of knowing everything, of being the best friend, of being important, of knowing all the secrets”. His immersion in other people’s problems appears heroic (since he’s trying to help) but his intimacy may also act as a form of self-therapy, as if constantly re-living his own early grief without the actual trauma of personal loss. It’s no wonder that – despite his assertion that he’d go back in a heartbeat – he suffered “survivor’s guilt” after quitting the oncology beat, plagued by debilitating panic attacks whenever he tried to relax or do something fun. Once, on his way to the beach, he actually had to stop the car on the hard shoulder – “because I thought I was going to die” – and phone a friend to come get him.

Even now, in his private practice, he’s nothing like the old Woody Allen-ish cliché of the therapist listening absently while the patient lies on the couch. He’s interactive, “pushy” as he calls it; simply put, he makes it personal. (The cliché of the silent shrink actually comes from psychoanalysis, which is not the same as psychotherapy.) “I can get very – you know, filled with energy, and shout,” he admits. “Teenagers, I am extremely interactive with them. I will shake them, if they need it – or they will shake me!” Achilleas pauses, trying to summarise his philosophy: “It’s about relating”.

There it is, in a nutshell. It’s about his personality as well, of course – because he’s really not the type to just listen. He’s not, as he says, the most patient man (though of course it’s different at work). Is he impulsive, in general? “Yes, extremely.” Does he lose his temper? He pauses, sucking breath through his teeth: “As I get older, much less. But [even] when I lose my temper – I’m like a cat, it’s like five minutes of being crazy and then I’m back to normal”.

Would he rather be happy or rich?

“Happy, surely. I was never interested in being rich.”

Would he rather be happy or free?

“Free! Oh, yes!”

There’s a lot of life force in Achilleas. He’s open, noisy, uninhibited. His TEDx talk a few years ago was called ‘Fear of dying, or fear of living?’. His Master’s thesis studied ‘Desire for life’, trying to discern why some terminal patients develop a new lust for life upon being given a deadline, while others lose the will to live completely. (He himself would presumably fall in the first category.) As a frustrated teen – “a real teenager,” as he puts it – he wrote poetry, wished his parents dead to their faces, started a band, studied the Bible, wrote “poetic letters” to God. He can get incandescent with mock rage, as when thinking back to his time in London: “I hated England, I hate it up to now. I couldn’t stand a moment in England! I couldn’t stand their shoes, I couldn’t stand their smell, I couldn’t stand their food…” It’s unclear why English shoes are so awful, though I note Achilleas himself wearing quite an interesting pair of tattered, bright-orange sneakers. “Yes. I love interesting shoes.”

Obviously, this kind of person will be this kind of psychotherapist – one who gets involved with his patients, tries unorthodox routes (the random lines scrawled on the wall turn out to be the “beliefs” that hold them back, one belief per patient), isn’t afraid to push or challenge; it’s a vestige of his years in the oncology ward, leaving him with a healthy awareness that people’s limits aren’t always where they think they are. (Needless to say, he does it responsibly.) But it’s also, as he says, about “relating” – about reaching people on a human level, as befits a man who’s seen so much of life and death.

“I think there is a fear of relating in our time,” Achilleas tells me sadly, thinking of the many troubled souls – young and old – he sees in his work: the OCDs, the depressives, above all those suffering from the modern condition of what he calls “an absence of being”. It’s like with sex, he explains (I just knew we’d get to sex eventually), the way today’s youngsters often tend to measure their exploits by the porn they’ve been watching: “It’s like they’re not present in the act itself”. Absence eats away at all our lives, especially the kids’: “They feel there’s something lacking” – more so than the adults he meets who are often in denial, heading off to psychiatrists (as opposed to psychotherapists) who can offer “the magical solution of pills, which is today’s great mania… We live in the time of quick solutions,” he adds with a sigh. “Quick fixes in everything, actually. From sex, to communicating, to meeting people, to dumping people, to getting married and getting divorced. Everything.”

And what about him? What of Achilleas Koukkides’ own life, much of it lived so intensely, from childhood rupture to all those years of counselling the sorrowful and dying? The intensity may have been a touch too manic, looking back. “I feel like I probably slept 30 per cent of what I needed” during his years in the cancer ward – just because he felt that time was precious and “partied as much as I could”, in addition to working all hours.

He takes it easier now, takes the weekend off and goes abroad a few days each month, just “to digest” all the stories he’s heard. He’s writing more; the blog is a new development. Being single probably helps too. In the end, he’s not your typical psychotherapist, indeed he’s unconvinced that psychotherapy – with its lofty ideals of how people should behave – has all the answers: “I think we do a lot of bad as well”. Just relate, he advises; take the time, be present, make mistakes, don’t be afraid of “just being human”. In this stormy and impermanent life, Achilleas makes the case for just being ordinary. Maybe that’s why he stands out.

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