Thursday, February 7, 2013


As the publication for my book Love and Loss in Life and in Treatment nears, patients are beginning to learn of its existence via the internet and various professional circles. And, just as occurred when I dealt with the illness and death of my husband, different patients respond differently, depending upon who they are as people. Some patients tell me they can’t wait to read the book and have little willingness to explore what the reading might mean for them. Some who have worked with me for a considerable period of time, are curious and believe that we will be able to work through whatever they discover.

Other patients are clear that they don’t want to read my book. One told me she was afraid it would tarnish the doctor/patient relationship. She didn’t want to read something about me that might result in her thinking less of me. Yet another said that she was afraid reading the book would put us more on a peer level and that she preferred to see me as the good mother who took care of her.

My greatest lesson so far, however, came from Phil, a patient who asked me if he was in my book. “No,” I replied immediately, not asking him first how he’d feel if he was in the book or not. I jumped right in, as if I were afraid he might accuse me of violating his confidentiality.

But, as I might have predicted, he was hurt, feeling that I had rejected him as insufficiently important, interesting or worthy.

Once Phil left, I thought about my reaction and brought it up in our next session.

“I’ve thought a lot about how quickly and matter-of-factly I answered your question about being in my book,” I say. “This is difficult for me to explain because I most definitely take responsibility for being so quick to respond and insensitive to your feelings. But I also think my response reflects how I tend to collude with you in your defensiveness, how you present in a clipped and almost indifferent manner, as if you had no feelings at all, when we both know that you’re extremely sensitive and easily hurt.”

He squirms in the chair, looking embarrassed. “That’s my defense,” he says. “I make a joke out of everything or pretend nothing matters.”

“That’s exactly right,” I say. “But it’s my job to point that out to you, not to respond in kind. So I apologize. I’m sorry that I was insensitive to your feelings.”

My apology makes Phil even more uncomfortable. He’s not accustomed to non-attacking, non-defensive responses.

And I have to remember – not for the first time – that Phil and I both had critical, attacking fathers. So, when Phil is confronting or provocative in our sessions, in other words, when he responds as his father did, my reaction can be self-protective, as it was on this occasion. Instead, I need to remain open to the scared, vulnerable child who exists in Phil as well as in myself.

Once again, I am again revealed to myself as I continue my work with patients.

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