Inside/Outside

Monday, February 26, 2024

Unrelenting Grief

“I just can’t get over this,” Scott says his head buried in his hands, a tall, dark-haired man who looks like he’s in his mid-thirties. “He was 98 years old. Did I expect him to live forever? I loved him so much. And he was always, always there for me. When he and my Grandma decided they couldn’t handle the Kansas farm anymore they moved right next door to us. Actually giving up the farm was pretty hard for me too. I guess I’ve always been a softie. My Dad made fun of me, called me a wuss, a ‘girl,’ too sensitive for my own good. He was always trying to toughen me up. But I loved that farm. It was my safe space. I spent summers there, got to be rid of my Dad and just be loved by my Gram and Gramps. I’m sorry, I’m just rambling all over the place”

“Not at all,” I say. “I can feel how much you’re grieving.” I am near tears myself, remembering the pain of losing first my grandmother and then, three years later, my grandfather. Remembering too, although my grandparents lived not on a farm but in a three room apartment in the Bronx, I knew what it was to have and lose a safe space. “You’re talking about loss. Most people have a terrible time with loss. Doesn’t mean you’re a wuss. Loss of the farm, loss of the days of feeling safe and protected, now the loss of your Grandpa. Is your Grandma still with you?”

“Yes, she’s only 90,” he says with a slight smile. “In my family that’s almost young. But the last month has been really hard on her,” he says sobbing. “I guess it’s been really hard on all of us, taking turns sitting by his bedside, holding his hand, first all those machines and tubes and God knows what else. Then, nothing. I don’t know which was worse, hoping for a miracle, or letting go of hope,” he says breaking down in gut-wrenching sobs. 

Several minutes pass.

“I can’t go on like this. It’s over a month. I have a wife, a precious daughter, a job. I can’t just keep crying.”

“A month isn’t a long time, but I understand you’re saying you’re feeling his death too intensely, like it’s entirely consuming you.”

“Exactly! And I keep asking the same thing my father did, ‘What’s wrong with me?’”   

“I suspect there’s nothing wrong with you, but perhaps we can try to understand the intensity of your feelings. Whose Dad was he, your mother or father’s?”

“My mother’s. I never really knew my father’s parents. They were very old and lived across the country so we almost never saw them. I don’t think I even went to their funerals – my Mom probably wouldn’t have wanted me to.”

“Because?”

“She was over protective like that, wouldn’t have wanted me to get too close to death.” Pause. “I had an older brother who died before I was born. I’m not sure my mother ever got over that loss. And she spent a lot of time making sure I wasn’t going to die like he did.”

“How did he die?”

“I guess he was a real dare-devil kid from the moment he was born. Putting things into electrical sockets when he was like two, riding his bike in traffic, climbing taller and taller trees. That’s how he died, fell out of a tree. My Mom was going to have none of that with me.” 

“Are you saying your Dad pushed you to be more like your brother and your Mom pushed you to be anything but?”

“I never thought about it that way, but that’s exactly right.”

“And your grandparents?”

“I was fine however I was.”

“Wow, that’s quite a contrast. Your grandparents loved and accepted you for just being you. You didn’t have to do or not do anything. That’s an amazing gift. No wonder your grief is so profound.”

Scott weeps. After a while he says, “But I have to stop crying. Why can’t I stop crying?”

“Because you’ve lost one of the two people who were most able to love you.”

Scott shakes his head. “I think there’s more.”

“I’m sure there is. None of our behavior is so simply explained. Do you have any thoughts?”

“I think I’m afraid. I’m afraid of my father. I’ve always been afraid of my father. My Grandpa kept me safe from my father. Now that he’s gone I don’t know if I’ll be safe. I don’t know if I can keep myself safe. And my Grandma’s too depleted. Anyway she wasn’t the one who kept me safe from my father. It was Gramps, Gramps,” Scott says sobbing. “I’m such a baby. I’m a 36 year old man, how can I be so afraid of my father?”

“I guess that is the question, Scott. What went on between you and your father when you were little that made you so afraid of him? We already know that he was very critical of what he saw as your ‘weakness.’ But perhaps there was more. Our time is up for today, but perhaps we can continue with this next time.” 


Saturday, January 13, 2024

Not Again

As Cynthia sits scowling from the chair diagonally across from me, I remember why I was both surprised and less than thrilled to have her call and ask to return to treatment.

After several minutes of us staring at each other I say, “What prompted your wanting to return to therapy with me?”

“The New Year,” she says curtly, as if that provides an adequate explanation.

“And…?” I ask, prodding.

“What the fuck! You know people make resolutions about what they’re going to do to improve their lives. As if January 1 was the magic date.”

“That would imply there were things in your life you wanted to improve.”

“Of course! You know anyone who doesn’t want to improve their life!”

“This all feels very familiar Cynthia. You say you want to improve your life, you asked to come back into therapy with me, yet you’re immediately attacking everything I say.”

“What? You can’t take somebody challenging you?”

“Okay,” I say, hoping I’m hiding my desire to strangle her. “Let’s look at that last comment: You can’t take somebody challenging you. What impelled you to make that particular statement?”

“What? How should I know. It seemed like a good response to your dumb ass comment.”

Silently counting to 10, I reflect on how uncomfortable it is to be angry and to have to contain it. “Okay,” I say. “We already know you’re angry. And we know you have good reason to be angry. But would I be making a wild guess to say that perhaps one of the ways you’d like to make your life better is to be less angry?”

She shrugs.

We again sit in silence, but this silence feels a bit more comfortable, not as raw, not as challenging.

She mumbles something.

“I’m sorry,” I say, “I didn’t hear you.”

“It’s not a good way to make friends,” she says, barely over a whisper.

“True. In fact I think that sometimes you use your anger to keep people away.”

“Why would I want to do that?” she asks, the edge back in her voice.

“I wasn’t criticizing you when I said you use your anger to keep people away. I was making a comment that, if correct, might help you to think about when and why you try to keep people away and when you you’d like a person to be closer.”

“I never know,” Cynthia says, again barely above a whisper. “I do want more people in my life. But when they come at me, I don’t know, I just can’t take it.”

“Interesting choice of words, Cynthia – when they come at me – like when your parents came at you to punish you, beat you, hurt you.”

She nods, dropping her head. “Yeah.” Pause. “People aren’t safe.”

“Some people are safe.”

“You can always get them mad.”

“I guess you’re saying YOU can always get them mad by prodding and poking and challenging. Or by running away.”

“Who says I run away?!”

“There’s that edge again, Cynthia. I say you run away. If you didn’t run away you’d have more people in your life. You’d be less lonely.”

“I never said I was lonely!”

“You didn’t imply it?” I ask gently.

She shrugs. Pause. “I guess.” Pause. “I don’t want people getting too close. I could get hurt.”

“I understand that, but I wonder if you’re also saying it feels really scary to want people, to need them. Like it feels really scary to need me, to say you want to be here, that you need to be here.”

“Go fu…” Pause. “I was just going to tell you to go fuck yourself, but then that seemed like exactly what you were saying, that I use my anger to keep people away and maybe it’s because I don’t want to need any of those fucking people who are just going to hurt me again and again.”

“I’m impressed, Cynthia, that you were able to catch that yourself, reflect on it and keep yourself from giving an automatic angry response.”

“Yeah. I guess that was pretty good.”

I smile. “I’m glad you were able to take in a positive comment about yourself and accept it.”

“I guess.”

“Now don’t get too enthusiastic,” I say teasingly.

“I… I’m glad I came back.”     

“Thank you, Cynthia,” I say. “I’m really, really glad you came back too.”


Friday, December 8, 2023

Unexpected Fear

 “I’m so terribly nervous I can’t stand myself,” Kaleigh begins wringing her hands, jiggling her right foot. “I thought I was going to be so excited about going back to Chicago after my first semester at school. But I’m not! I’m suddenly terrified of flying. I was never afraid of flying before. Maybe it’s because of the Israeli-Palestinian war and I’m afraid of terrorism, like of my plane being shot down. I don’t know.”

“Are you afraid of your plane being shot down?” I ask.

“I don’t know. It sounds ridiculous. But there was 9/11. Of course I wasn’t even born then, but still… It feels like anything can happen.”

“Anything can happen, but it is interesting to wonder why you suddenly developed a fear you never had before. Do you feel especially frightened because you’re Jewish?”

“I asked myself that. I guess someone could bomb the plane because they thought there’d be lots of Jews on it, but it’s not like I think someone’s specifically coming to get me because I’m Jewish.”

“Any other thoughts come to mind?”

“I just had a flash of my older sister. She’s not supposed to be there this holiday… But what if she is? That would be pretty scary.” Pause. “Oh God! It would be so terrible if she’s there. She ruins everything. She ruined my whole childhood! She ruined my family,” Kaleigh says crying. Pause. “I’m pretty sure my father told her not to come. But that doesn’t mean she won’t. And then everything would be ruined! All there would be is screaming and more screaming and tantrums and threats!! I can’t stand it.” Pause. “Do you think that’s why I developed a fear of flying? Like maybe I really don’t want to go home. Like maybe I’m afraid of what’s waiting for me.”

“Have you asked your parents if she’ll be there.”

“No, I haven’t. I feel scared about that too. Scared there will be this big scene about my even asking.”

“Why?”

“My mother will immediately get mad at me for being so afraid of my sister. And she’ll be mad that I might bring up the abuse again. She’s never believed me about the sexual abuse. She knows my sister used to beat the shit out of me, but she always dismissed the sexual abuse as two kids just playing around,” Kaleigh says crying. “I don’t know what’s more painful, the abuse or my mother just dismissing it. No, that’s not true. The sexual abuse was way more painful. I haven’t even told you all of it.” 

“Maybe it would be helpful if you did,” I say gently.

“She used to take things, mostly sticks, sometimes a vase or whatever else she found around and put it inside me. A few times she even threatened to use a knife, but she never did.” Pause. “Usually she put it in… in my vagina, but sometimes she’d put it in the other place. That really hurt,” she says crying.

“That’s so awful Kaleigh. I’m so sorry you had to endure that, it sounds like torture. No wonder you’re scared to go home. And I’m so sorry your mother doesn’t believe you. What your sister did is certainly not just ‘playing doctor.’ What about your Dad?”

“I’m so glad you believe me! I was afraid you wouldn’t. Afraid you’d think I was just making it up.”

“Of course I believe you Kaleigh. I can’t imagine why you’d want to make up something like that.”

“I’m so ashamed of it. I even lied to my boyfriend and said I’d had sex with one guy before him. It was better than telling him about what my sister did to me!”

“Shame is a very common in sexual abuse victims, but that doesn’t mean you have anything to be ashamed of. You were the victim. She was bigger and stronger and abused you.”

“I know. But that’s not how I feel.”

“I understand. And we’ll have lots of time to deal with those feelings. I notice you didn’t say anything about your Dad.”

“I’m pretty sure he believes me, but he’s not about to argue with my mother. It was hard enough for him to tell my sister that she wasn’t welcome in their house anymore after she hit him and trashed the entire living room.”

“I am so sorry, Kaleigh. Are you sure you do want to go home? Or maybe there’s someplace you can go where you can feel safe if your sister is there?”

“I can’t imagine announcing that I’m leaving to stay with Brad or even with one of my girlfriends. That would create an uproar in itself.”

“I know we don’t have time to discuss this further today, but we do need to work on you’re not being so afraid of your fear that you’re willing to sacrifice yourself. Obviously you have good reason to be afraid, but you do need to first and foremost take care of yourself.”


Saturday, November 11, 2023

Missed Sessions


 Jeremy, the prototype of a man who is tall, dark, and handsome, and just beginning to enter middle-age, begins his session by saying, “I won’t be here for the next three weeks. I’ll come back in December.” 

“Are you going out of town?” I ask, surprised. He hadn’t mentioned an upcoming vacation. And I don’t recall him making such an announcement in the two or so years we’ve worked together.

He squirms in his chair. “Umm, no. No, I just figured I could do with a little break.”

“Because?”

He crosses his legs, uncrosses them, then crosses them again. “It’s just beginning to be a bit too much.”

“What’s the ‘it?’”

“This,” he says, gesturing around my office.

“And what’s making it too much?”

“That,” he says brusquely, gesturing toward me with his chin.

“I’m too much.”

More squirming. “Not you exactly, just this, this questioning, probing, always searching for something more, something deeper.”

I try to think what might have occurred in our last few sessions that may have brought about Jeremy’s desire to flee. “Is there something that happened that made you feel I’m too overbearing, too intrusive?”

“I knew you’d say this was about my mother!” Jeremy says angrily.

Although I hadn’t been thinking about his mother, I remain silent, waiting to see what might develop.

“It’s not about my mother. I haven’t spoken to my mother in weeks. I decided to take a break from her too!” He pauses, taking in what he’s just said. “Shit!! I just agreed with you, didn’t I? This could come straight out of a Woody Allen movie!”

I smile. “And like in a Woody Allen movie, I’m going to continue digging. Is it that I’m feeling like your mother or have you experienced me as being more intrusive lately? Or did something happen with your mother?”

“I don’t want to. I don’t want to keep thinking and thinking and trying to figure things out. It’s enough already. I need a break!”

I feel frustrated and annoyed and find myself unable to stop. “Can you at least humor me and help me understand why this has come up right now?” As he is about to respond, I realize that I am indeed duplicating his relationship with his mother and say, “Wait! Let me pull back. First, I realize I am repeating exactly the relationship you have with your mother. I’m coming after you more and more. And the more I come after you the more you resist and the more you resist, the more I come after you. But, and maybe this is the piece you need to own. You’re the one who has put up an unbreakable wall. You’ve said ‘no matter what you say or do, I’m not telling you.’ You may have very good reasons for erecting that wall in the past, but now it feels more like a two-year-old who’s having a tantrum. Which doesn’t excuse my behavior of coming after you. I need to look at that myself and figure out why I couldn’t just pull back and let you tell me in your own time.”

“That’s a lot to take in.” Pause. “I do appreciate your saying that last part, that it’s not all me, that something got kicked up in you as well. It helps break the cycle you were referring to – chased after, run away; run away, get chased after.”

Long pause.

“I think I know what happened,” he continues. “I did have a
conversation with my mother. But before that I broke up with Charlene. I broke up with Charlene for exactly the reason we’re talking about. I told her I was going out with some friends and she asked where we were going. I wouldn’t tell her. We were only going out drinking, although Charlene did think I drank too much. Anyway, I wouldn’t tell her and she came up with more and more preposterous guesses – going to a strip club, hiring prostitutes, etc. It was ridiculous. The more she came at me, the more intransient I became until I finally said, ‘That’s it, we’re done!’ My mother called the next day and began right away bugging me about what had happened with Charlene and when was I going to settle down and give her grandchildren. I hung up on her.”

“So you were tired of all these pushy women, myself included.”

“Exactly!”

“I wonder if you’re so afraid of all these pushy women that you erect barriers to protect yourself or whether you erect those barriers so that women WILL come after you so that you can be ‘justified’ in rejecting them.”

“Why would I do that?”

“We’re almost out of time and you’ll need to tell me whether you’ll be here next week or not, but I think you might want to reject them so you never have to deal with the need for genuine connection that exists within you.”

“Wow! That’s a lot to digest”

“Yes, it is. And if you want to take some time to digest it, that’s fine and if you want to come in next week that’s also fine.”

“Can I think about it and call you?”

“Yes.” 


Friday, October 13, 2023

Risk Averse

 “I was talking to my friend Cindy last night,” Jenny begins. “She said she came across this quote from Eleanor Roosevelt ‘Do something every day that scares you.’ I was blown away. That’s just what we’ve been talking about, right?”

“Yes,” I agree nodding. “That’s a very profound quote.”

“But I thought you said you have to feel safe in order to take risks.”

“That’s also true. But if you wait until your last, last drop of fear and anxiety is gone you might stay stuck forever.”

“I know,” Jenny says dejectedly. “That’s why I’m here,”

“You’re 25 years old Jenny, I don’t think you can say you’re stuck forever.”

“I know. But we’ve been working for a while now and there are still so many things I’m terribly, terribly afraid of. Meeting new people is a total, complete trauma for me. I hate the first few weeks of school. There are so many new people, new faces, new expectations, new, new, new.” 

“And what is it that you’d say you’re afraid of?”

“That’s no secret. The wicked step-mother! What a cliché.”

“Except your step-mother was a little more wicked than most.”

Jenny seems to fade away and soon starts visibly shaking.

“Jenny, where are you? Can you come back?”

“I’m here. I didn’t dissociate. At least I don’t think I did. I knew I was here with you in your office.” Pause. “But perhaps part of me was back there, back in that basement,” she says starting to cry. “Why, why did she hate me so much? What did I do that was so terrible?”

“Jenny…”

“I know. You’re going to say I didn’t do anything. That she hated me because I took my Dad away from her, because she couldn’t have him every minute of his life. But maybe that means I was too demanding, wanted too much!” she adds sobbing.

“Is that how it feels, how it felt?”

“Yes, that I was just a greedy child who would suck her father dry unless Darlene stepped in to protect him! After all, I had killed my mother, why wouldn’t I kill him?!”

“Do you feel you killed your mother?”

“Of course!” Pause. “No, no I didn’t kill my mother, she died of cancer!”

“Jenny, it sounds like the rational you knows that you didn’t kill your mother, but perhaps there is a piece of you that feels you did.”

“She died so soon after I was born, before I was one. I don’t remember her at all,” she says sobbing. “Is that killing her? Not remembering her?” Pause. “Maybe I infected her when I was inside her. Maybe there was something so bad about me I contaminated her.” 

Although the rational me, yearns to counter Jenny’s assessment of her culpability, I wait to see what more primitive material Jenny may unearth. 

“Darlene would always tell me I was a bad seed, destined to do nothing but hurt and destroy. I fought her, screaming, yelling, thrashing, but she only hurt me more, left me starving in the freezing cold basement. It gets cold in Vermont in the winter. But, truthfully, I believed her. I believed I was a bad, bad person. I had killed my mother. She gave up her life for me. Even neighbors said that. ‘Your mother loved you so much. She gave up her life for you.’ She gave up her life for me and I was so, so angry with her. If she was going to have me, she should have stayed with me!! If she was going to leave me she should never have had me!” Jenny says, sobbing.

I want to go her and hold her and tell her nothing was her fault and that everything will be all right. Instead, I sit calmly in my chair. 

“I never said that out loud before,” Jenny says between sobs. “It feels good to say it out loud.”

“What feels good about saying it out loud?”

“I’m not sure. Sort of like I can examine it in the light of day.”

“And what do you see when you examine it in the light of day, in the light of an adult day?”

“Yes, that’s it. Saying it out loud brought it into the present, into me as an adult – sort of. It’s like a child fantasy that I’ve carried around my whole life and in the light of day – in the adult light – it doesn’t feel as real or as powerful.”


“It’s time for us to stop for today, Jenny, but you’ve done amazing work here today. I hope you’re able to be proud of yourself.”

Yes, yes I am,” she says smiling for the first time. “Thank you.”

“Thank you,” I say.


Friday, September 8, 2023

Mother

 “My mother is driving me absolutely crazy,” Jenny begins. “I know that’s an old story, but it’s getting worse. I’m trying to get ready for my 50th birthday party and she can literally call me a dozen times a day. She’ll ask me how she can help me with the party and if I give her anything to do she keeps calling with one question after another. ‘Is it okay if I invite my sister? What about my neighbor? Are you having kids come? What about kids under 12? Under 5?’ And those are all separate calls. It’s driving me nuts! I’ve asked that she text me these questions but she just won’t do that. I’m at my wits end.”

“What’s your guess as to why she’s calling so often?” I ask. “Is she having some anxiety about you turning 50?”

“I never thought about that, but maybe. If I’m turning 50 she has to be getting older too. She’s always dreaded aging. But I don’t know, it also just feels like it’s what she’s always done, pretended to be helpless so I would take care of her, which has obviously gotten worse since my father died. I’m tired of being her caretaker. I have enough of my own headaches, my daughter floundering, my husband dissatisfied at work. It’s too much. But my mother is always the one who throws me over the edge. I guess that’s because I see her as so narcissistic and self-involved, never really seeing me or wanting to know what I want.”

“That’s obviously been true throughout your life.”

“Definitely! That’s why it’s so maddening. Even these questions about my party. It’s she who wants to invite her sister – and of course I’m inviting my aunt. She wants to invite her neighbor and it’s she who probably doesn’t want kids at my party.” Pause. “I’m sick of talking about her. I feel I can’t ever get her out of my head. Now she even calls about questions about her money, about her checkbook, about whether she deposited her social security check, which is of course on direct deposit. I guess she’s getting more and more infantile, wanting more and more for me to take care of her.”

Alarm bells go off in my mind. “How old is your mother?”

“Seventy-six.”

“I don’t mean to be an alarmist, but is it possible your mother is beginning to have cognitive problems?”

At least a minute passes as Jenny sits staring at me as though in shock, a deer caught in the headlights. Then she bursts into tears. “I’m terrible! I’m a terrible person, a terrible daughter. My first thought when you said that was, oh no, now I’m really going to have to take care of her! Isn’t that awful?”

“No, it’s not awful of you. It’s an understandable first thought. You’ve spent your life taking care of someone who didn’t need to be taken care of and it would indeed be horribly ironic if that person does need caretaking at the end of her life. But we may be getting way ahead of ourselves. I don’t know if your mother is having cognitive problems.”

“It’s just that it makes too much sense for it not to be true. I mean I know we all – especially as we age - lose words occasionally or misplace things – but as soon as you suggested it about my mother I knew it was true. That bit about her social security check did throw me and there have been other things. She didn’t seem to know who the President is although she’s always stayed up on current events. And it wasn’t only that she didn’t know, she didn’t seem to care either. And when she called to ask if she could invite her sister, I got short with her and said, ‘Of course I’m going to invite Aunt Mary.’ The way she reacted, I wasn’t sure she really knew her sister was my aunt.” Jenny pauses and shakes her head. “This is so terrible. What an awful way to end a life! And I’ve been getting so pissed at her lately and I’m sure you’re right, she just can’t help it.”

“But your getting pissed at her makes sense. You’ve seen her constant calling, questioning as a continuation of her playing at being helpless to elicit your caretaking.”

“But it’s not! Or maybe sometimes it still is.”

“Yes, that’s possible.”

“This is going to be hard.”

“Yes, it is.”

“I think I’ll make an appointment with her neurologist. Maybe he’ll be able to tell me how bad she really is. And if anything can be done.”

“Sounds reasonable.”

“But they really can’t do anything, can they?”

“My understanding is, not much, but it never hurt to explore possibilities and get an idea of where she is at this point.”