Tuesday, June 24, 2014

Black and White

“I was so depressed I didn’t go out of the house all weekend,” Liz says, her mouth pinched, her eyes downward, staring at her hands. 

“I’m so alone. No one cares about me. No one cares if I live or die.”

Rather than feeling compassion for my obviously unhappy patient, I’m aware of feeling immediately annoyed. There are reasons I could feel compassion. Liz’s husband Bob decided he wanted a divorce after almost 45 years of marriage, leaving her adrift at age 65, never having lived on her own, never having been involved with any man but her husband. Still, I feel annoyed. This tells me two things: one, I have a hard time with someone who remains stuck in the victim role because it’s a role I can’t tolerate myself and, two, underneath her depression, Liz is angry and is unconsciously communicating that anger to me.

I remain silent.

Liz continues. “Bobby went to see his father again this weekend. He was just there for Father’s Day. You’d think he could have stopped by.”

“So you’re angry that your son saw your husband again and not you.”

“I guess.”

“What do you mean, you guess?”

“I wouldn’t have called it anger, more like disappointment.”

“Can you feel both?”

“I suppose. I just don’t know why I don’t see more of him. He obviously has time for his father and for the girls he’s always chasing. I don’t see why he can’t squeeze a little time in for his mother. He’s all I have left in the world and I never see him.”

I consider and reject various responses: What about your daughter and her three children? What about your sisters? What about the friends you’ve been trying to develop? Although all these are all realities, they are irrelevant to Liz at this time. For the moment all that matters is that her son saw her husband instead of her.

“When was the last time you saw your son?” I ask although I fear that even that question veers too far from Liz’s feelings and her present state of mind. Still, her answer surprises me.

“He took me to dinner earlier last week.”

My unspoken response is, I thought you said you never see him, but I recognize the futility of going down that path. Instead I said, “I think you really are angry at Bobby, Liz, angry that he sees your husband despite how much Bob hurt you.”

“Well he did hurt me horribly. And he didn’t even leave for another woman. He left because he couldn’t stand me anymore. How do you think that makes me feel?”

“Of course it’s hurtful, Liz. Of course you feel lousy. But I wonder if you’re also feeling angry with me right now?”

“With you? Why should I be angry with you?”

“Perhaps because you don’t feel I’m being sufficiently understanding. Perhaps because when you get angry your anger gets bigger and bigger until it’s hard to find anything good or positive about anyone. It’s like you see the world in black and white with no shades of gray. It’s like when you’re angry at Bobby, you forget all the positive or caring or loving things he’s ever done. And then your anger keeps expanding until it encompasses everyone in your life and you’re left with only blackness, you’re left feeling all alone.”

“I definitely do feel all alone.”

“I know you do. But I wonder if you really are as alone as you feel or if it’s your anger that erases all goodness. It is possible – and I know this is very difficult for you – but it is possible to be angry with Bobby or with me or with anyone and still love them and care about them and know they care about you.”

“That’s really hard for me. I don’t even know that I’m angry until you point it out.”

“Well that’s a problem too. Instead of recognizing your anger, you tend to turn it on yourself and feel worthless and depressed. So, yes, first you have to recognize your anger as anger. And then we have to work on your being able to hold anger and more positive feelings at the same time.”

“So you’re not giving up on me?”

“Why would you think I’d be giving up on you?”

“I don’t know. Sometimes I think you’re impatient with me.”

“Maybe you’re right. Maybe sometimes I do feel impatient. But that would be a good example of my being able to feel something negative like impatience and still hold on to caring about you and being committed to our work together.”

“I understand. I just don’t know if I can do it.”

“That’s what we’re here for.”


Patrick Tomlinson said...

i found that useful - thanks

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

You're quite welcome. Thanks for your feedback.

Mirel Goldstein said...

Very nice, I would be happy to post something of yours as a guest blogger on my blog, if you'd like. I think we have some ideas about therapy in common!

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

Thanks, Mirel, that's a great idea. I've enjoyed your posts as well. We can trade guest blogger spots. Let's communicate more directly and figure out the logistics.

Anonymous said...

Hello, is it possible to e-mail you Linda Sherby? I have some questions you might be able to help me with. Thank you,

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

I would prefer that you identified yourself or perhaps left your email address, although I would want to be clear that I definitely do not offer therapeutic advice to anyone who is not one of my patients.


Linda, Passivity, entitlement, externalization, rigidity and lack of imaginative/playful persistent do you want to be? Has she ever thought about what made her husband so angry and why he prefers to spend time with his son and not her? Does she have no perspectives on the divorce rather than emphasizing her status as victim. With such a patient I might consider referral to someone with the patience of Job and the willingness to confront her gently with her embedded victim role. I presume she is a 'fictional character' or...perhaps that is my hope for you! Sid

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

Thanks for commenting directly on my blog, Sid.

Yes, she is a fictional patient, but I do see someone who has many/most of the characteristics you mention.

I suppose all of us are sometimes called upon to have the patience of Job.