Inside/Outside

Friday, July 16, 2021

Too Close

 

“I went out with Charles again last night,” Ashley begins. “You know the guy I met on Match who I’ve been out with a few times.”

“I remember,” I say, nodding at the computer screen. “You kind of liked him.”

“I guess, but he was a little too much last night.”

“Meaning?”


“I don’t know. Like he started telling me all about his childhood, which was pretty terrible. He was physically abused by his mother, like really bad. And he wanted to know all about me. I’m not sure I was ready for that.”

“What made you uncomfortable?”

“What if we don’t work out? Why should I tell him all about me? Does he really need to know that my mother died of cancer when I was four and that my father wanted nothing to do with me?”

“I’d say there would be no reason for him not to know.”

“I never understand why you feel I should be blabbing my whole life to anyone and everyone.”

“Well, if you’re not presenting who you are to people it’s kind of impossible to get close to them and it takes a lot of energy to be play acting through a large part of your life.”

“Aren’t you play acting? Isn’t being a therapist all play acting?”

“In what way?”

“You could be in terrible pain right now, physical or emotional, and you wouldn’t tell me about it, right?”

“That’s true. We do all have roles that we inhabit in our lives and…”

“See, I told you! So I’m no different than you or anyone else!”

“We all have roles that we inhabit. Being a therapist is one


role, just as being an attorney is another. And, no, in our professional roles we’re not telling everyone everything about us. You’re not going to be in front of a judge and say, “Your Honor I can’t try this case today because I had to put my dog down yesterday and I’m a total basket case. But yesterday, when you put your dog down – obviously I’m just using that as an example – would you have been able to call a friend and say I need to talk?”

“I don’t have a dog,” Ashley says matter-of-factly. “I don’t want a dog.” Pause. “Actually, dogs are kind of like that guy last night. They want too much. They’re always there, always begging. I guess you’ll say that’s my need to keep my distance.”

“Yes, I would. And there’s the question of why that distance feels so necessary for you.”

“It just popped in my head that we’re back in your office next week. I don’t like that idea either. This is much more convenient. I don’t have to drive to and from your office. I don’t have to waste time sitting in your waiting room. I just turn on my computer screen and here you are.”

“So I assume by bringing that up right now, you’re making the connection that returning to my office feels closer – literally and figuratively - than virtual therapy.”

“Right. And I’d prefer continuing just as we are.”

“So do you have any thoughts about what makes closeness so uncomfortable?”

“It’s messy. People are just so needy. They want so much. Just like a dog.”

“Are you needy, Ashley? Do you want so much?”

“Me? No way! I can take care of myself.”

“I think you learnt that early on. If there’s no one really there for you, you learn that you have to take care of yourself.”

“Right!”

“But there’s a problem with that, Ashley. When you were four years old you couldn’t take care of yourself. You were a helpless, dependent little girl who just lost the most important person in your life. That little girl is still inside you. She still wants and needs and longs for someone to care for her…”

“Ugh! That’s disgusting. I hope that’s not true. And if it is true I want her gone, poof! Like she never existed.”

“I wonder, Ashley, if that’s exactly the reason you didn’t like the man you saw last night and the reason you don’t want to return to in office visits and the reason you don’t want a dog, all of that brings you closer to that dependent, childhood part of yourself.”


“So what should I do about it?”

“Well, first we’ll resume in office visits and we’ll talk about how that feels for you. And when you’re with someone and feel the need to get away, maybe you can try to pay attention to what you’re really trying to get away from. I suspect it might be the needy part of yourself.”

“What if I just avoided people?”

“Well, what do you feel when you avoid people? What did you feel when we were locked down in the pandemic?”

“Lonely. Like something was missing.”

“I guess that’s your answer.”


Friday, June 11, 2021

On Vacation

“I’m sorry I’m late calling,” Mia begins. “Lots of little things came up just as I was supposed to call.” Pause. “Of course, I’m sure you don’t care, just gives you 10 more minutes to do whatever you do.”

Silence.

“Aren’t you going to say anything?”

“Sounds like you’re angry at me,” I respond.


“Why? Because I’m late calling? Why should I be angry with you? Are you feeling guilty about something?”

“So I assume you’re feeling angry because I’m not going to be here for two weeks.”

Silence.

“It’s so stupid!” Mia says angrily. “I can’t believe you’d be dumb enough to actually go somewhere and risk getting Covid. Even I’m not ready to start traveling and I’m probably 50 years younger than you! I don’t really know how old you are, but you’re certainly not young!”

I realize Mia is goading me but, at least on this occasion, I don’t feel pulled into her provocation. “It sounds as though you’re feeling scared about losing me,” I say softly.

“So is that supposed to be the great interpretation that makes everything all right? That makes me understand, makes me less angry, makes me more accepting?”


“Why do you think you’re so angry, Mia?”

“I told you! You’re being stupid! And I can’t afford to have a stupid therapist! And not only that, you’ve been my therapist for years and I assume you’ve been secretly stupid the whole time. Maybe I’d be a lot further along if you were smarter.”

“Don’t you think it’s interesting, Mia, that you’re choosing to focus on my being ‘stupid’?”

“Why? Because my mother always told me I was stupid? One thing has nothing to do with the other. She’d accuse me of being stupid because she wanted to put me down. She was a bitch! And when my Dad was out of town there was no stopping her. She hated me and couldn’t stand for me to ever accomplish anything.”

“And you feel how about that Mia?”

“Don’t change the topic!”

Beginning to feel annoyed I say, “I’m not changing the topic. I’m trying to get underneath your anger, whether that’s your anger at me or at your mother. We know that anger is your first line of defense but that underneath you have lots of other feelings – fear, sadness, longing.”

“So I suppose now you want me to cry?”

“Mia, stop a moment. It’s not going to help you if you feel only pissed at me when I’m gone. You know …”

“You’re not going yet, right? I still have a couple of weeks, right?”

“That sounded almost like panic. Yes, you’re right, I’m not going for a couple of weeks.”

“So I still have time to change your mind.”

“Mia, you’re not going to change my mind. I’m going on vacation. I’ll be gone for two weeks. You know I’m fully vaccinated and I’ll be fine. Which doesn’t mean you can’t feel angry about my leaving, although I wouldn’t want you to worry that your anger could magically kill me. You can also feel scared and abandoned and alone. Sometimes you may even feel you won’t survive without me. But you will. You’re not a little girl any more. And even though it may feel like it, I’m not your Dad abandoning you to the uncontrollable rage of your mother.”

“Are you sure?” Mia asks, plaintively. “Right, here I go, just what you wanted, whining like a baby.”

“Mia, tell me what you’re feeling right now.”

“It’s just that I’ve gotten used to your always being here. It’s been a while since you’ve been away. It scares me. What if I need you? What if something terrible happens? What if my Dad dies? What if I’m sure you died?”

“So my being away increases your fear of something bad happening.”

“Yes.” Pause. “I can tell myself rationally that’s not the case, but that’s not how it feels.” Pause. “I guess it must be like when my Dad went away. Bad things did happen. Sometimes awful things.” Pause. “But my Mom can’t hurt me like that anymore, right?”

“Right.”

“’Cause I’m not a little girl, right?”

“Right.”


“And we still have time to work on this before you leave?”

“That’s right. And if you remember, Mia, I did tell you that I’ll be covering myself this time when I’m on vacation so if you have an emergency you can reach me.”

“That’s right! I totally forgot!” Pause. “You don’t usually do that.”

“No, I don’t usually, but I’m doing it for exactly the reason you mentioned. I’ve been here and available to all my patients for over 18 months - an unusual stretch for me - so I thought it might be hard for people to go cold turkey. I figured covering myself in an emergency is a sort of in between step.”

“I guess you really do care,” Mia says with a catch in her throat. “Thank you.”

“My pleasure.”

 

Friday, May 7, 2021

A Dream

 “I’m so glad I’m talking with you today,” Rose stays, starting immediately. “I had this awful dream last night and it’s haunting me. The specifics are kind of vague at this point, but the feeling it left me with is very clear - horror. And it was like a horror movie or something out of a scary sci-fi movie, neither of which I ever watch. So it was like this force, not sure what the force was – people, aliens, I don’t know. I don’t know that I ever saw any particular thing or person, I guess that’s why I call it a force - that was going around and doing something to people so that they looked like their whole body had been burned and like instantly turned to ash and dissolved. Ugh! It makes me shudder just to think about it. And I guess I was going around trying to avoid this thing, but also to warn people, people I knew and cared about, that they were in danger. I think I had a better idea when I first woke up who some of those people were, but now I’d just be making it up. I keep shaking my head wanting that image of people dissolving into ash to go away.” She takes a breath. “So what do you think?”


“I can certainly understand how disturbing a dream it was,” I say, impressed with how Rose has managed to convey her horror so well over the telephone. “What are your thoughts?”

“I don’t know. I was watching this TV show that had a cancer patient in it last night and it struck me how he seemed to be being eaten up from the inside out.”

Silence.

“I just keep feeling the horror.”

“Where does that feeling take you?”

“The horror? I guess the horror of the pandemic, of how many people have died. Oh! I guess that could be the force, the unseen virus, killing all these millions of people.” Pause. “But I wonder why I’d have the dream now. Things do seem to be getting better, at least for us. I’m vaccinated, most of the people I love and care about are vaccinated. Why now?”

“You said you thought there were specific people you were trying to save. Even if you have to make it up, who do you think some or one of those people were?”

“My mother comes to mind. She’s been dead for over 10 years now. She had a long life, almost 100 and she was pretty good until the last few years. She was ready to go. That made it easier for me, although it was still hard losing her. Painful, but not horrifying.”

Silence.

“What are you thinking about?”

“First I was thinking about this article I read about how deaths to overdose have skyrocketed during the past year. That feels like another force taking over people, especially young people. But then I ended up


someplace entirely different. I was thinking of the horror of growing up in my house, of my parents screaming and screaming at each other, of us cowering in the corner waiting for my father to start beating up on my mother or turning on one of us. He was definitely a force to be reckoned with, although he was a specific person, a tangible force, not a sci-fi character.”

“Maybe that made him even more scary. You couldn’t just turn off the TV.”

“That would explain why I was trying to save my mother. I was always trying to save my mother and feeling awful that I couldn’t.” Pause. “But still, I don’t know why I’d be dreaming about this now. This is an old story. Why now?”

Silence.

“Any thoughts about people being turned to ash and dissolving?”

“Cremation. Lots of cremations during the pandemic.” Pause. “The Holocaust. That was certainly a force of evil. Hitler, the gas chambers. But it doesn’t seem to be about that either. It felt more contemporary, like right now.”

“All right. Right now, what’s horrifying you, scaring you, threatening you?”

“Aging. I turn 65 next month. I know that’s not old these days, but I worry about aging, about who will take care of me if I’m ill or incapacitated in some way. And I suppose death itself feels frightening, the unknown, the aloneness. Death is a pretty scary, menacing figure. You think that’s what the dream’s about?”


“It’s certainly possible. And it’s also possible that it’s about all the things you’ve talked about today.”

“I suppose.”

“What are you feeling now?”

“Definitely not as horrified. Talking about it made it less scary. I feel more removed from it, like it’s something to look at and to figure out.”


Friday, April 9, 2021

Endless Despair

 “I don’t understand,” Amber wails over the phone. “I was doing fine. I had a good day. I took my dog for a long walk. And then with one phone call I’m a wreck. I can’t stop crying. I feel as though I want to beat my head against the wall,” she says sobbing.

“Can you tell me what happened during the phone call?”

“Nothing! I mean nothing that would lead me to feel awful. I don’t understand. Why doesn’t it stop? Why do I always, always feel so awful?”


Having seen Amber for several years, I realize nothing I say at this point is likely to be of help. Still, I reply, “You don’t always feel awful. You were just telling me you were having a really good day.”

“But it always comes back! Why does it always come back?”

“Part of the problem for you is that when you feel awful, the feeling takes you over completely and you can’t remember that you felt really good yesterday or the day before.”

“But why does it always come back?”

“What’s the ‘it’ that always comes back?”

“The bad feelings. They always come back.”

“You know, that’s a really good question. Why do your bad feelings always come back? Like today, you said you didn’t think the phone call should have triggered your bad feelings, but it did. And perhaps I should ask what specifically you mean by bad feelings.”

“Sad feelings. Depression. Feeling everything’s pointless.”

“Okay. So why do your sad, depressed feelings always come back?”

“I don’t know!”

“Well, what did happen on the phone call?”

“My boss told me I did a really good job on the marketing project. She had a few minor corrections, but basically complimented me on a job well done.”

“And you felt how about that?”

“While I was on the phone with her I felt good, pleased. But then, I don’t know. It just washed over me and I felt like shit.”

“What washed over you?”

“Despair. Like what does it matter anyway. It’s just a stupid marketing job, for some stupid liquor company that’s just going to turn people into alcoholics.”


“Whose voice is that, Amber?”

“It’s mine.”

“Yes, but isn’t it also someone else’s voice? You’ve certainly told me that your mother was always critical of you, always telling you what a failure you were, how you couldn’t do anything right.”

She sighs. “Yup. That’s my mother.”

“So when you were talking to your boss you could take in your her voice, you could take in the compliment. But when you got off the phone, your mother’s voice returned with a vengeance.”

“I guess so.” Pause. “But why?”

“What are your thoughts?”

“I certainly heard her voice a lot longer. It’s louder, telling me how stupid I was and that I’d never amount to anything. And she still does. Why did I go into marketing? Why couldn’t at least have been a teacher? Why aren’t I married? Why am I such a bad daughter, etc., etc.”

“Yes, her voice is louder. And I also wonder if you’re invested in staying attached to your mother’s negative voice.”

“Why?”

“If you move away from your mother’s voice, maybe it’s like moving away from her, leaving her behind. And she is, after all, the only mother you ever had.”

Amber starts sobbing. “I can’t leave her. I can’t. I’d feel way too guilty.”

“Plus, if you take in more positive voices and leave your mother behind, you’d also have to mourn never having the mother you wanted or deserved, not as a child and not as an adult.”

Amber continues sobbing. “I can’t! I can’t! You can’t make me! Oh my God, I’m being swallowed up by those bad feelings again!”

“No, Amber, I can’t make you. I neither could nor would force you to do anything. But I think you can see how terrifying the thought is for you, the thought of moving away from your mother, of mourning who she isn’t and wasn’t.”

More sobbing. “But maybe she’s right. Maybe I am bad and stupid and incompetent, maybe that’s why she couldn’t be nice to me.”


Softly I say, “I understand that it feels safer to take the badness inside you, to take it away from your mother, so that as long as it’s inside you you can hold onto the hope that if only you were different she would treat you differently, would love you more.”

“Wouldn’t she?”

“Only you can answer that, Amber, but from what you’ve said, it sounds as though your mother was rejecting of you from the moment you were born, for her own reasons, stemming from her own problems, but extraordinarily destructive and painful for you.”

“I can’t. I just can’t.”

“I understand. You can only do what you can do. And we’ll keep working, working at a pace that you can tolerate, that isn’t unbearable to you.”


Friday, March 12, 2021

From Father to Son

 “My son’s home on Spring break,” Craig says, looking forlorn.

I wait.

“I know I should be happy, glad to see him. He’s a good kid, getting great grades in college, actually thinking about becoming a psychologist,” he says with a wry smile.

“But you’re not happy.”


He shakes his head. “And I hate myself for it!” Pause. “You know, I told you my father was an ass, always criticizing me, always telling me all the things I’d done wrong. He was the perfect one, I was the incompetent fool. Made me the anxious, insecure mess you see now.” Pause. “It’s not that I’m like that with my son Daniel. I’d kill myself if I was like that. I swore to myself I’d never be like that with my kids and I haven’t been. It’s more what I feel inside. And I’m so ashamed, how could I be such an awful person? It’s not like that with Britany, my daughter. We have a great relationship, so easy to spend time with, so easy to talk to.”

“So what is it that you feel about your son?” I ask.

“Jealous. Jesus, I hate that about me, what an awful thing to feel about your own son.”

“Beating yourself up for your feelings isn’t helpful to you. Or to your son for that matter. It would be better if we could understand your feelings. What do you feel jealous about?”

“It’s so embarrassing, but I’m jealous about everything. I’m jealous of his relationship with my wife. I’m jealous about his ease in the world. I’m jealous he has all these friends. I’m jealous that he already has a sense of purpose. I’m jealous, I’m jealous and I’m sick of myself.”

“It sounds like you’re saying you’re jealous of Daniel because he’s had a much easier time in himself and in the world than you had.”

“And what kind of father is that?! Fathers are supposed to want more for their children, want their kids to do better than them. And me, I’m a despicable jealous fool!”

“You certainly still carry your father’s critical voice with you inside your head, condemning yourself for who you are and what you feel.”

“But I should condemn myself. How else could I feel?”

“Well, you might feel compassion for yourself and, again, try to understand where your feelings come from.”

“It’s not only how I feel, it’s how I act! It’s not that I’m critical of Daniel but I’m – I’m not sure what to say – I’m distant, reserved and I worry how he interprets my coolness.”

“Do you think your father felt jealous of you?”

“What?! No. I told you, he thought I was an incompetent jerk.”

“But maybe he needed you to be a, quote, ‘incompetent jerk.’ Maybe he needed you to be less than him so he kept you down by being critical and demeaning. I don’t mean he knew all that consciously, but unconsciously he might have experienced you as a dangerous competitor.”

“I don’t know what to say to that. It’s like turning my world on its


head.” Pause. “And what would that mean in relation to Daniel?”

“Well first, as I said, you carry your father’s critical voice with you in your head. That critical voice certainly gets turned against you, but it sounds like you’ve also been afraid you’d turn it against Daniel and rather than do that, you’ve withdrawn from him.”

“Wow, that makes sense. I’m not sure what I do with it, but it makes sense.” Pause. “What about Barb, my wife?”

“What are your thoughts?”

“Barb always doted on Daniel. Britany was our first born, but I thought Barb always favored Daniel. I don’t know why, maybe because he was a boy and she lost her father shortly before Daniel was born. I guess I was jealous then, jealous of their bond and I worried that she was indulging the boy. Wow! I do sound like my father when I say that. My father was always telling my mother she was spoiling me, but unlike Barb my mother would immediately stop however she was being to me and side with my father.”

“So you lost your mother to your father. Are you saying you feel as though you lose Barb to your son?”


“I don’t know. Maybe. Especially since we’ve gotten older, you know, as the passion dims.” Pause. “I feel as though my heads spinning.”

“We have dealt with a lot today. Some of it might make sense intellectually, some not, but there are certainly a lot of feelings to work through on an emotional level. For sure, your relationship with your father has affected your being a father and that’s pretty much true for everyone.”

“So I’m not a freak?”

“That’s you father’s voice again, Craig. And, no, you’re definitely not a freak.”  


Friday, February 12, 2021

Being Vaccinated

 “So I know I’m locked in the house like everyone else and hating it and ready to strangle my husband, but I really need to talk to you about my daughter. She’s driving me crazy,” Paula says, barely stopping for a breath. “She just doesn’t stop. ‘Mom, did you get the vaccine? Have you tried getting the vaccine? Have you signed up through the Department of Health? Did you try your local grocery store? What about Dad?’ She doesn’t stop. You have to tell me what to do.”

Paula, who I’ve only ‘seen’ for a few sessions via the telephone, is a seemingly headstrong, stubborn, opinionated 67 year old woman. “What should you do about…? I ask.

“About her of course! What should I do about my daughter constantly bugging me?”

“What have you done?”

“Nothing.”

“Nothing? But what do you say to your daughter when she asks you about being vaccinated?”

“I just put her off, you know, like saying ‘not yet’ or ‘it’s not in the area yet.’”

“Do you plan to get the vaccine?”

“Not if I can help it!”

“Because…?”


“I’m not into being a guinea pig! Who knows what the government is putting into those vaccines? How do we know they’re safe? They’re so new. Maybe they’re giving it to all us old folks first because they think we’re disposable. Who cares if some old people die! I didn’t trust Trump and I don’t trust Biden any more.”

Although I knew that Paula was distrustful of others, I hadn’t recognized the extent of her suspiciousness. I tread carefully. “So why haven’t you told that to your daughter?”

She scoffs. “My daughter’s a doctor. She’ll laugh at me and tell me I’m crazy.”

Although I find myself agreeing with my patient’s daughter, I stall for time by asking an inane question. “What does your husband think?”

“He doesn’t care. He’ll do whatever I say. We’re both healthy. I mean I know we’re both over 65, but we’re in good health. Why take any chances?”

“And yet you’re comfortable taking your chances with Covid?”

“Maybe.”

“I’m sorry. I’m not sure what you mean.”

“How do we know the whole thing isn’t a hoax? Maybe there is no Covid. Maybe it’s all just a big scam.”

“And what would be the purpose of this scam?”

“I don’t know. Maybe to try out these experimental drugs for some future disease, some other virus that strikes 25, 100 years from now. Who knows.”

I sit with my anxiety for a moment until what I hope is an


inspiration strikes me. “You know, Paula, since you’re so reluctant to share your reservations about the Covid vaccines with your daughter, I’m impressed that you feel comfortable telling me about them.”

Silence. The silence continues.

“Paula, are you there?”

“I’m here.”

“Okay. Good.”

Silence.

“I’m supposed to tell the truth here, right?”

“Yes. That’s definitely helpful.”


“Well I know this sounds terrible, but I can tell you because you don’t matter. My daughter matters to me. What she thinks of me matters to me. What you think of me doesn’t matter because you don’t matter to me. I pay you to give me a service. Beyond that you’re irrelevant. Does that sound terrible?”

“Well,” I say cautiously, “it’s definitely honest.” I pause, trying to gather my thoughts and think of an appropriate response. Speaking softly, I say, “I wonder what it means that I don’t matter to you, that you can so easily dismiss me as irrelevant. I wonder who in your life has made you feel you don’t matter. I wonder if you yourself feel you don’t matter. And I wonder if one of the reasons you’re so suspicious about the virus or the vaccines is that it’s hard to believe that anyone could feel you’re important enough to care about.”

“Are you saying I should care about you?” Paula responds, understandably not able to take in what was a long, complicated interpretation.

“Only you can answer that.”

“Well, I don’t know if I can or if I should care about you.”

“I understand. I think perhaps our first questions should be whether you’re able to care about you and whether you’ve felt cared about by important people in your life.”

“You mean like my parents?”

“Yes. As well as others.”

“I told myself I wasn’t going back, that I wasn’t going to dredge


all that stuff up.”

“Yet you chose to see me, a psychoanalyst, so perhaps part of you wants to dredge all that stuff up.”

“Nonsense!”

“But we’re meeting again next week, right?”

“I suppose,” Paula responds grudgingly.

“I’m glad to hear that. I’ll talk to you then.”