Wednesday, October 29, 2014

Unspoken Loss

“I never expected to be in a therapist’s office,” Darlene says, pulling at her fingers, glancing anxiously around the room. “I like all your windows. It makes your space feel larger, but still cozy.” She laughs self-consciously. “I’m an interior designer. Space matters to me. I’m sorry, I’m just rambling. I guess it’s hard to begin.”

“Take your time,” I say reassuringly. “It’s hard to open up to someone you’ve never met before.”

“It’s hard to open up to anyone. I’m 37 years old and except for my husband and my best friend I never talk to anyone about my sister. Or her death. That’s how I got to you. My friend sent me your blog about your husband’s death and I looked on your website and saw that you wrote a book about it and I thought, wow, here’s someone who can talk about her loss, maybe she can help me talk about mine.” 

Darlene is talking rapidly now, as if in a rush to discharge years of pent up words. “I was seven when she died in a car accident. She was 16, the golden girl. Literally. She had beautiful long blond hair. And she was very smart, in her senior year of high school, with her pick of all the best colleges. Even her name was special – Lily, like the flower. Me, I kind of faded into the background – skinny, brown curly hair, a bit of a tomboy back then, okay in school but nothing exceptional. I was the tag along little sister, kind of a pest. 

“Then she got killed. Of course my parents were devastated. Everyone was. I know now that my mother became majorly depressed, but then all I knew was that she vanished into her bedroom. I would hear her crying. I’d want to go in and comfort her but the door was always locked. Sometime I’d curl up on the floor outside the room and just wait for her to come out. My father threw himself into his work. He’d tell me not to bother my mother, not to upset her any more than she was already upset.”

I’m aware of the sadness I feel for Darlene as the lost, frightened child. I’m also aware of Darlene’s envious feelings towards her sister and wonder how that has affected her mourning.

She continues. “I don’t know how long it was before things became normal again. Except they weren’t normal. All the pictures of Lily disappeared. And no one could mention her name again. I never really understood how Lily died. I mean I knew she died in a car accident, but I don’t know who was driving or who was at fault or any of the particulars. I still don’t know. No one talks about her. It’s as though she had never existed. It’s weird.”

I shudder internally. I can’t imagine a more unhelpful way to mourn. And I can’t imagine the message Darlene received about death and mourning when a child goes from being loved and adored to being vanished and unspoken. There’s so much that Darlene needs to work on. 

“How did you feel about Lily’s death?” I ask.

“Scared. I couldn’t understand how someone could be here one day and gone the next. It was frightening. I still feel that way. Death scares me. It’s one of the reasons I keep putting off having a child. My husband really wants children. But I worry. How would I cope if the child died?”

Darlene has stated her conscious concern about having a child. I wonder about possible unconscious reasons such as fear that her negative thoughts magically killed Lily and might similarly kill a child or that a child would become a competitor for her husband’s affection just as Lily was for her parent’s. But these are just speculations on my part and very far from where Darlene is at the moment.

She continues. “I still miss Lily. And I imagine losing a child would be way worse. Can I ask you something?”


“Is there something wrong with me that I still miss Lily after 30 years, that I still want to talk about her?”

Sadness fills me as I think about my two October losses - my husband now dead for seven years and my grandmother for 44. I carry them with me always, aware of the richness they brought to my life.

“Absolutely not,” I say. “Your parents never gave you or themselves the chance to mourn Lily, to tell stories about her, to remember her so that you could take Lily inside yourself so that it wouldn’t feel as though she had never existed. Taking the person who’s died inside us is a way to bring ourselves comfort, as well as a way to keep that person alive in the only way possible.”

Darlene’s eyes fill with tears. “You will work with me, won’t you?” she asks plaintively.

“It will be my privilege.”   

Tuesday, October 14, 2014


In honor of this day, my late husband George’s birthday, the following is a small excerpt from the book I wrote to memorialize George and our relationship, Love and Loss in Life and in Treatment, which was published by Routledge in 2013:

In August of 2008, ten months after George’s death, I hear the following message on my answering machine:  “I’m Molly Callahan. I need to see someone. I lost my husband, Mitch, six months ago and I’m having a hard time.” Her soft but determined voice wavers towards the end. She leaves her number. I sit staring out my window at the darkening sky, shades from light gray to black, trees whipping wildly in the wind, all warnings of the storm headed our way. I think about this woman I have not met. The timbre of her voice suggests that she’s young, certainly younger than me.

The question now is: Am I ready? Am I ready to hear another widow’s pain? Will I be able to put aside my own grief to work effectively with hers? Or perhaps I should ask if I could use my own grief to hear hers more deeply, communicating on an unconscious, as well as a conscious level. I decide that I’m up to the task and that is how Molly becomes my patient.

Molly is a striking, curvaceous, dark-haired forty-two year old woman, with big, sad eyes. She immediately plunges into her story.

“I lost, Mitch, my husband, in February. I can’t believe it’s been six months,” she says, shaking her head. “I miss him so much. We had such a great relationship. He was my best friend. He would have been 47 on October 14.” Her voice is strong, determined, as if she is willing herself to tell her story without breaking down.

Goose bumps appear on my arms, as I keep my face impassive. How is this possible? What are the chances that the deceased husband of the first widow I see after George’s death would share his birth date?

“He died of a heart attack. He wasn’t feeling well that day. In fact he hadn’t been feeling well for several days, but he continued working. He was a construction supervisor.”

Is this some sort of a cosmic joke, I wonder? [George was a construction contractor I met 30 years earlier when I hired him to remodel my small home on a lake outside of Ann Arbor, Michigan.]

Molly continues. “He didn’t take good care of himself. There was a lot of heart disease in his family and the last time he saw his doctor – maybe two years before – he was supposed to get all these follow-up tests, but of course he never did. But that Saturday he seemed to be feeling especially lousy. I offered to take him to the hospital, but he wouldn’t hear of it. I was supposed to go shopping with my best friend and he told me to go. I said I’d stay, but he said, no, I should go, that he’d be fine. 

“When I got home he was slumped over on the floor in the living room. I don’t even know if he was still alive then. I called 911 and they came over and started working on him and then they took him to the hospital and they wouldn’t let me go back there and then they came out and told me he was gone,” she says in a rush to get her words out. And then, much more slowly, more quietly, she adds, “Then they let me go back. He was cold, so cold.”

[I feel as though] I’m back in the hospice room staring down at George’s body. He isn’t cold. I’m glad. I wouldn’t want him to be cold. I wouldn’t want my last experience of him to be cold. Not cold. Warm. Warm, like always.     

Tuesday, October 7, 2014

Ten Sessions

“This is our ninth session,” says Penny, a petite, anxious 29 year old, adjusting the pillow behind her back as she settles into the chair across from me. 

“And that means…?” I ask.

“We only have one session after today.”

Startled, I ask, “Why is that?”

“That’s all the insurance company allows.”

“I’m confused, Penny. I thought I explained to you that I’m not on any insurance panels and that you decided to see me anyway.”

“For 10 sessions,” she says, squirming in her seat. “That’s what my husband said I could do because you were so highly recommended. He said I could see you for the same 10 sessions the insurance company allowed and if you were as good as they said you should be able to help me in the same amount of time.”

Thoughts swirl through my head: I’m not on insurance panels because I don’t believe therapy can work in 10 sessions; you were sexually abused by a brother-in-law as a child, have to force yourself to endure sex and want to be “cured” in 10 sessions; you’re a scared, passive woman with three small children at home and have no one in your life to talk to other than me; I wanted to see you at least twice a week and we compromised on once, but I’m not a miracle worker.

I settle on a far more mundane response. “How would you feel about us ending after ten sessions?”

“That’s what my husband said I could do.”

“I understand, but how do you feel?”

“I don’t want to. Talking about all that childhood stuff, I don’t know, it’s brought it all back up. Now I really can’t stand to have my husband touch me. He’s not happy about that either.”

“Have you told your husband how you feel?”

She shakes her head, morosely.

“Can you?”

“It won’t make any difference.”

Penny’s passivity is difficult for me, but I know that’s always been her way of being in the world, the obedient little girl who did what adults told her – including her brother-in-law – and now the obedient adult who follows her husband’s dictates. I’m in a bind. I don’t want to become another person who tells Penny what to do, but I also can’t help her if she doesn’t stay in treatment.  

“What are your options, Penny?”

“I guess I’ll just have to stop after next week.”

“You wouldn’t consider talking to your husband about what you want? After all, he must also want you to become more comfortable with sex,” I say, aware that I am coaching her.

“Do you think that’s possible?” she asks, more brightly.

“It would certainly be my hope, but I know we can’t accomplish that overnight.”

“Would you talk to him?” she asks, plaintively.

Oops, I think, I should have seen that coming. “Penny, why do you think my talking to your husband would have more weight than your talking to him?”

She shrugs. “I don’t know. It just would.”

“But maybe it's important for us to understand why you feel he'd listen to me more than to you.”

“I just know he would.”

“Let me ask this, how are you and I different?”

“What?” she says, giggling, “In every way. You’re smart, educated, a doctor. You know what you’re talking about. There’s nothing about us that’s the same.”

“It’s impressive how much you put yourself down, Penny, how little you think about yourself, how you so easily give up your power. If you think so little of you, I understand that it would be difficult to present what you want in a convincing manner to your husband or anyone else.”

“So you’ll talk to him?”

I groan inwardly. “Is the answer for me to talk to your husband or for you to feel better about yourself and to be able to stand up for what you want?”

“But we’re running out of time,” she says.

“You definitely have a point,” I say, glad to be able to support her statement. “It would be difficult for us to sufficiently help you feel better about yourself in one remaining session.”

“So you’ll talk to him?”

I remain reluctant to step into the role of the authority who might save the day – assuming, of course, that her husband would listen to me which is clearly uncertain.  Instead I say, “How about this idea, Penny? How about if you ask your husband to come in to a session with you and you can tell him how your feel and I can be here to support you?”

“What if he won’t come?”

“I guess we won’t know until you ask.”