Tuesday, April 15, 2014

The Caretaker

“My grandfather died last week,” Melinda says as she settles herself into the chair.

“Oh, I’m so sorry. I know how important he was to you.”

“Yes, it’s hard. I know he was 95 and failing, but I loved him so much. He was always there for me. And I always knew he loved me.”

As she talks, childhood images of my own grandfather pass through my mind: his joy at baking my birthday cakes; our walking for what seemed like miles to find my wished-for record, “I’m a Lonely Little Petunia in an Onion Patch;” his traveling roundtrip by subway almost every weekend to pick me up in Brooklyn and bring me back to my grandparent’s apartment in the Bronx; the twinkle in his blue, blue eyes whenever he saw me. He’s been dead for over 40 years, but he lives with me still.

“His funeral was Sunday. My sisters came in which was good, but there just aren’t many people left. He used to have so many friends, but they’re all gone. And my uncles have been dead for years. Some of my friends came, but having so few people made it feel even sadder, emptier. My parents, of course, and Ron and the kids, but when we got home everyone left.”

“Everyone left?” I ask surprised. 

“Yeah. The kids wanted to go be with their friends and my sisters are staying at my parents and Ron went to play basketball.”   

“How did you feel about Ron leaving, about being alone?”

“That’s just how Ron is. He can’t sit with his feelings. He loved Pop too and he can’t just sit around and be with his feelings. He has to keep moving. He has ADHD. I get it.”

“But how did you feel about his leaving?” I persist. I “get it” too, but having known profound loss myself, I cannot imagine being without kind, loving people after the death of a loved one.  Am I being overly sensitive? Am I imposing my experience and values onto my patient? Regardless, I feel angry with Ron and wonder if I am feeling Melinda’s anger as well as my own.

“That’s Ron. Would I have preferred if he was able to cuddle with me on the couch? Sure. But if he sat there playing with his phone, that would have driven me crazy. Better that he not be there. It’s like a month or so ago when Haley had her appendectomy, and he couldn’t sit in the waiting room. I told him to go.”

I remember Melinda and I discussing that incident and my being equally incredulous – and angry - that a parent wouldn’t have needed to be present during a daughter’s surgery. There again I found it hard to believe my patient’s apparent equanimity. 

Now I think about my anger and say, “Melinda, do you notice that when I ask you how you feel, you tell me how you understand why Ron is doing whatever he may be doing. I think it’s great that you’re able to be compassionate towards your husband, but that doesn’t tell us what you’re feeling.”

She sits thoughtfully. “That’s what I always do, isn’t it? I focus on Ron or the kids or whoever else, rather than on me. I always thought it was because I was such a caretaker, but maybe I’m just avoiding what I feel.”

“And what do you feel?”

“Sad. I feel sad. Here I just lost Pop and my own husband can’t even be there for me.”

“Sounds like there’s some anger there as well.”

“Yes, there is. But mostly it’s sadness. We’ve talked about this before. I’m the third girl, the unwanted child, everyone too busy for me, except for Pop - and Grandma. And then I pick a man who’s there and not there. I mean I know Ron loves me and he’s there for me sort of, but he has his own problems, and that limits what he can give me.”

“You’re starting to move back towards focusing on Ron. What happens if you stay with your own feelings?”

Her eyes tear. “It’s way too painful,” she says quietly.

“You’re carrying around lots of pain, from the past as well as the present. I know it hurts, but it is important that we look at it and that you try to stay focused on you. Otherwise you’re treating yourself the same way you’ve been treated, not giving yourself and your feelings enough importance.”

“Wow! That’s true. What I feel matters. I’ll work on it.”  


Emanuel said...

Avoidance coping, emotional detachment by intellectual assertiveness; conscious denial, etc. There are many names and definitions to explain Melinda's situation. She is encapsulating her feelings to save and maintain the unity of the family. There is great value in what she is doing. Cracking the shell may lead to an explosion. She is very fragile. I would not confront her resistance but lead her to her own conclusions to keep the family unit. Melinda is dealing with a husband who is emotional dysfunctional and surely he can not behave differently.

Linda Sherby PH.D., ABPP said...

Hi Emanuel. Thanks for writing.

I agree that Melinda is coping the best she can with the dysfunction in her family. However, I also believe that being "the caretaker" enables her to avoid the sadness which she has carried with her way before her current family ever existed.

Being with her in a real and compassionate way while she deals with whatever feelings she has - both past and present - would be the approach I would take with her.

Again, thanks for your comment.