“I wasn’t sure I wanted to come today,” Patrick begins.
Having realized in our first session that Patrick can put me in an adversarial position, I say nothing.
“I mean, what is there to talk about? Angela and I are engaged and getting married. I know she loves me, even though she says she doesn’t.”
Unable to resist I say, “Didn’t you tell me at the end of our last session that once Angela agreed to marry you you got scared and weren’t sure if she didn’t love you or if you didn’t love her?”
“I said I got scared,” he says with an edge to his voice. “Of course I love her. And, as I said, I know deep down she loves me.”
Already feeling stymied, I change course. “Patrick, I’m not here to talk you out of marrying Angela. I’m here to help you figure out what it is you want; what it is you feel. My sense is you think you have to argue with me. Except we’re on the same side. So I wonder if what you’re doing is arguing with yourself.”
Patrick smiles. “Occupational hazard. I’m a lawyer.”
Realizing that Patrick’s style of interacting is a very effective way of keeping distance, I ask, “Patrick, who in your life have you been really close to?”
“Wow! That came out of left field. Well, I guess my Dad and my brother. I had a girlfriend in college, except she was never really interested in me. And Angela, of course.”
“Can you tell me about your relationship with your Dad and your brother?” I ask, aware that he’s described as “close” two women who didn’t or don’t love him.
“Well, John, my brother, was 10 years older than me, so I guess we didn’t have that much of a chance to be close. But I always knew he had my back. And my Dad, he was a rock, holding it all together after my mother died. He worked a lot, tried to do as much overtime as possible. But he’d make time to toss a football around with me.”
Feeling the absence of emotional connection in Patrick’s life, but not wanting to get into a battle of words, I proceed cautiously. “When you said you got scared when Angela agreed to marry you, can you say more specifically what you were scared of?”
“I don’t know. Marriage. It’s a big step.”
“That’s true,” I say nodding. “And what does marriage mean to you?”
“Well, it means being with the same person for the rest of your life. It means being responsible for that person and having to take care of her. It means “for better or for worse.” It means …” Patrick stops and swallows hard.
“What just happened there, Patrick?”
“I was about to say, it means there’s no way out. I didn’t like that I thought that. And thinking it scared me. But it’s not like that with Angela. I love being with her. We have lots of fun together.”
“Your brother has your back, your father was a rock who tossed a football around with you, and you have fun with Angela,” I summarize. “You have relationships with these people, but I don’t know if they’re emotionally close relationships. I think the idea of an emotionally close relationship really scares you.”
“Why should it?” Patrick asks.
“Well, both because it feels so foreign and what’s foreign is scary and also because a really close relationship might open up feelings inside you that you’ve kept buried for a very long time.”
“And you think that’s why I want to be with Angela? I thought it was because I was supposed to be trying to save her like I couldn’t save my mother.”
“The reasons we do whatever we do is always multi-determined, Patrick.”
“What other reasons?” Patrick asks, challengingly.
“I’ll answer that, Patrick, but first let me say that my sense is that your need to challenge and dispute is also a way of maintaining distance. You can’t be close to someone you’re always arguing with.”
“Makes sense. But you said you’d answer my question.”
“I think you also pick unavailable women to try to win in the present with women who are similar to the women you lost with in the past. Let me say, Patrick, that I’m concerned that we’ve covered so much ground today. It feels overwhelming so me, I can only imagine how it feels to you.”
“I’m okay. It’ll give me lots to think about.”
“And maybe if we can slow it down a bit, it will also give you lots of feel about.”
Thanks so much for sharing your great work. I really liked your questions to the patient and the way you managed his questions to you. I am not using interpretation as much these days because I don't find that patients grow as much from that as being heard and eventually coming to the thoughts on their own as the therapist asks the questions and remains attuned and present.
Thanks for your comment, Linda.
I agree that there were many more interpretations in this blog than would ever be fruitful in an actual treatment session. The problem is that I have to write a piece in 750 - 800 words that is engaging to an audience. In order to do that I have to rush the presented treatment along. As you said, it is always preferable for a patient to come to his or her insights on their own. I also believe that although insight can be very helpful, in the end, it is always the relationship that matters most.
Again, thanks for commenting.
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