Wednesday, May 28, 2014

A Dog’s Life

For what seems like the twentieth time today, but is actually only the fourth I say, “I’m not going to be going on vacation, so we’ll be able to meet the next two weeks.”

“Oh,” Terri says, smiling. “That’s great for me. Feels like a gift. I’ve been feeling really scared about your leaving. Almost like I couldn’t make it without you.” Then her smile vanishes, her eyebrows knit. “Is everything all right? You’re not sick or something?”

For me, in situations that involve my life and directly impact my patients, full disclosure is the preferred response.

“I’m fine. I have a very sick dog and there’s no way I could leave her.”

Terri clenches her jaw. “You’re canceling your trip because of a dog?”

Terri’s anger brings me out of my self-preoccupation with my own feelings of sadness. I feel a flash of anger, surprised by her total lack of empathy. And then I remember. Of course, one of the many traumas of Terri’s childhood. My anger vanishes.

“Seems like you’re thinking about the time your parents went to Japan and left you with the babysitter when you were so sick and ended up in the hospital.”

“They didn’t give a shit about me. All they cared about was each other and having fun. I was like the third appendage no one wanted. They probably would have preferred if I died in that hospital. The aloneness. The total aloneness I felt. I think that’s what’s made it impossible for me to be all right being alone. Why I’m always with these losers. Just to be with someone.”

“That experience is the metaphor of your childhood – alone, isolated, scared, unloved.”

“You got it.”

“So, Terri, what does it mean for you that I’ve given up my trip to stay home with my dog?”

“It makes me mad.”

“I understood that, but could you say more about it?”

“A dog is getting more than I ever got. A dog’s got a better like than me.”

“So you feel angry with my dog, jealous. Do you also feel angry with me? After all, I’m staying home to take care of my dog. I wasn’t going to stay home to take care of you, so that might feel like I’m doing the same thing to you your parents did.”

“Yup! Same thing. I don’t get it, I don’t understand how people can get so attached to their dogs. They’re only dogs.”

A mixture of feelings flood me, sadness, anger, fear. I struggle to separate my concern about my dog, from my need to stay focused on my patient’s needs and issues. 

“There’s lots going on here, Terri, and I think it’s important that we look at all of it. First, you feel jealous of my dog and angry with me for behaving in a way that feels rejecting of you, like I’m choosing my dog over you.”

“Well you are, aren’t you?”

“The caring and concern I feel for my dog is different from the caring and concern I feel for you. That doesn’t negate my feelings about you, but I do understand that’s how it feels to you, so you can feel however you feel, including really angry. And maybe dealing with your anger at me can be helpful to you and to us.”

Terri sits impassively, staring off. I can’t read what she’s feeling.

“What’s going on Terri?”

“I wish you had been my mother. I bet you would have been the perfect mother. I bet you’re staying home for your dog means you would have stayed home for me too.” Silent tears trickle down Terri’s face.  

Sadness fills the room, both Terri’s and mine. But I don’t want to neglect her anger.   

“What happened to your anger?” I ask.

“I don’t know. I guess I can still feel angry when I think about your choosing your dog over me. But really, I had shitty parents. And you would have been a great parent. And it’s sad that you weren’t.”

“There are lots of feelings churning around for you and I think it will be important for us to stay attuned to all of them.”

“I hope your dog gets better,” she says as she heads for the door.

Although I suspect even this statement is not unambivalent, all I say is, “Thank you.” 

Tuesday, May 13, 2014

Breaking Up

“I’ve decided I’m going to break up with Tim,” Allison announces at the beginning of her Monday session.

“Really?” I say, obviously surprised. I see Allison three days a week. On Thursday there was no intimation of her breaking off the relationship. “I thought you and Tim were doing very well.”

“Wow! I finally got to shock you,” she says laughing, passing her fingers through her curly, brown hair. “Yeah, we were. But, I don’t know, I think he’s too boring for me.”

“Too boring,” I repeat. 

Allison is a 30 year old drug rep who came into therapy because she made repeatedly poor choices in men. We came to understand that Allison chose men who were similar to her grandiose and narcissistic father, a man who was always too busy and self-involved to attend to Allison. By choosing boyfriends who were like her father, she hoped to win in the present the love she couldn’t achieve in the past. Such a strategy never of course works, since choosing a narcissistic boyfriend will lead yet again to disappointment and pain.

“Yeah. I don’t know, the relationship is just too predictable, maybe too easy.”

“Too easy,” I say.

Allison laughs. “I’ve clearly thrown you for a loop. I love it!”

“So maybe our therapy sessions were also too boring and you’ve just spiced them up.”

“I never thought of that, but maybe,” Allison replies, still gleeful.

“Okay, so here are my questions: What’s wrong with easy? What makes easy uncomfortable? And what happened in the last four days?”

“It’s just not exciting. There’s no spontaneity. He’s always there – trusty, reliable Tim.”

“And you could say the same of me.”

“Yes, that’s true, you’re trusty and reliable, but I kind of like that from you.”

“Except you liked ‘throwing me for a loop.’”

“Yes. But that was like I kind of one upped you, like you know so much and sometimes it seems you can even read my mind and here I am able to surprise you. It makes me feel like I got you!”

Thoughts race through my mind. Allison feels she has just won a competition. With her father? More likely her mother. Allison and I have spent so much time dealing with her father, that her mother is a more shadowy figure to me. Still, my sense is that she too was fairly narcissistic and definitely intent on receiving as much of her husband’s meager supplies as possible. And there’s still the question of what changed in four days. Was the weekend break difficult for her? Was I too know-it-all in our last session?

“Did you have a hard time with our weekend break, Allison?” I ask.

“This has nothing to do with you! Why do you always want to make it about you?” she says angrily.

“I guess that makes me feel like your parents.”

“Now that you mention it, yes! I think you just wanted to deflate me because I surprised you.”

I consider Allison’s accusation. “I’m not consciously aware of competing with you or wanting to deflate you, but I am aware of being disappointed in your so easily discarding Tim and what seems like such a good relationship. Perhaps it made me feel you were discarding our work together and perhaps that made me want to reassert my presence.” 

“Wow! There’s a lot of stuff in there. You certainly think a lot about why you do what you do.”

“I try to. I think it’s very important that we try to understand as much as we can about ourselves and our motivations. Doesn’t mean we always succeed. We all have an unconscious – including me – and by definition the unconscious is unconscious.”

“I guess you’re saying I should try to understand why I want to break up with Tim.”

I nod. “Yes, I guess that’s what I’m saying.”

“He’s so much not my father. I know, I know, that’s a good thing. But it doesn’t always feel like such a good thing. It feels like I’m giving up so much.”

“You are. You’re giving up hope. You’re giving up the hope of ever getting the father you needed and deserved in both the past and the present and that’s very painful.”

“But you’re saying I should do it?”

“I’m not saying you should stay with Tim, but I am saying that until you mourn the father you never had and give up chasing him in the present, you’re going to face a lot of painful breakups in your life.”