“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.
“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.”