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.” 


Unknown said...

Openness and honesty from both sides in the so-called therapeutic relationship, which will undoubtedly be continued in the next "non-vacation" session.

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

You are no doubt correct, BklynDodgersFan. But I do hope it's more than a "so-called therapeutic relationship."

NormalWasNotMyGoal said...

Thanks for sharing this. It may have helped me get a little more understanding of my 'weird' feelings toward my therapist.

kitty literate said...

Is it possible that Terri's closing comment, if not altruistic, was also not ambivalent? She is identifying with your dog (a step on the road to empathy) and perhaps imagining being really cared for and hoping that if the dog gets better under your care, she will too.

I unequivocally hope your dog feels better!

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

Glad you found the blog helpful, "NormalWasNotMyGoal. I hope that you are able to share your "weird" feelings towards your therapist with him or her.

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

Thanks for your comment, kitty literate. That's what I meant by ambivalent - she is both identifying with my dog and wanting me to be the good enough mother who can fix both of them, as well as still being angry that my dog has more than she both has and had.

And I unequivocally know that you hope my dog feels better!

Unknown said...

I have got to learn so much from your posts. Terris's statement before she left speaks a lot. I can now relate to the concept of Transference and its use in therapy. I wonder how different it would be if she was guarded and not expressed her anger towards the situation or towards you.

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

Thanks so much, Arabhi. I'm glad that you learn from my posts and now have more of an understanding of transference.

As I said in the post, I think Terri's statement before she left was an ambivalent one. She may partially have hoped that my dog got better, but she may also have hoped that my dog got worse or even died. The statement could also be thought of as her way to make reparation for her anger and attacking statements.

And, yes, I think it is very important to give patients a space where they feel safe enough to express their anger.

Thanks again for your feedback.