I’m beyond startled. I’ve seen 32 year old Beth in twice weekly therapy for over three years. She hadn’t said anything about wanting to terminate and I hadn’t picked up any clues in her material. Besides, we have a relationship and a relationship requires time to say good-bye. Termination is the part of therapy I like the least, feeling the pain of losing the connection with a person I have come to know intimately over an extended period of time. But I do know that all relationships end and that the process of leave-taking, although often painful, can be both rewarding and growth producing.
Beth has certainly made progress in her treatment. She no longer experiences sudden panic attacks nor feels overwhelmed by life’s small difficulties. However relationships continue to be a problem for her, as she vacillates between excessive clinginess and total indifference, a repetition of her experience with her mother. I’m now experiencing the indifference side of the equation and I don’t like it at all. I feel discounted, dismissed and discarded.
“Are you dismissing me, Beth, just as you felt dismissed by your mother?” I ask.
Beth rolls her eyes, crosses her arms and jiggles her leg. “Do you have to interpret everything?” she says, clearly exasperated. “It’s time, time for me to go. I’ve been here long enough. Besides, like I said, it’s the end of the year.”
Trying to keep my annoyance in check, I ask, “Have you been thinking about this for a while because if you have, I wonder why you hadn’t mentioned it?”
“No, not really. I just decided.”
“’Just’ meaning …?”
“I don’t know,” she says, tossing her head. “Sometime during the week.”
‘The week’ I think to myself. That’s right, because of the holidays I only saw Beth once last week and am scheduled to see her only once this week as well. She also spent Christmas with her family which is guaranteed to bring up issues. I decide to explore the family question first.
“Did something come up with your family at Christmas?” I ask.
“No,” she says casually, indifference oozing from every pore. “It was the usual zoo. My mother totally frazzled and expecting me to know what she wants me to do by reading her mind and not asking me a single thing about my own life. So what else is new? It was fine,” she adds, shrugging again, “Just one day in the year.”
So Beth felt dismissed by her mother and, in turn, is now dismissing me. But she also felt dismissed by me, because I treated Christmas like, “just one day,” rather than appreciating that she might have feelings about us not meeting. Beth needs to feel important without feeling intruded upon, not always an easy tightrope to walk. And she doesn’t like to be reminded of her need to rely on me, which makes the tightrope even more slippery.
“Several things occur to me,” I begin.
“I’m sure,” she says snidely, interrupting me.
“But maybe we should look at why you’re taking jabs as me today,” I say, putting aside what I planned to say.
“So let’s say you’re angry with me.”
“Why would I be angry with you?”
“Well, I know you knew we weren’t going to meet on Christmas or New Year’s, but I think I took that too much for granted without giving you the opportunity to talk about how you felt.”
“You think I can’t live without you for a day?”
“I didn’t say you couldn’t live without me, I said you might have feelings about us not meeting. And you might have felt dismissed by my not giving you the opportunity to talk about those feelings.”
“You sure you just don’t want to lose a patient?” she asks, with less of an edge to her tone.
“I don’t want to lose you, Beth. And whenever you do decide you want to end, I want us both to have the time to deal with saying good-bye.”
“OK. I’ll stay.”
I look at Beth quizzically. “Had you really planned to terminate today or did you want me to show you that I cared enough to talk you into staying?”
She purses her lips and taps them with her finger, looking almost child-like. “I had decided to terminate. But I guess down deep I wanted you to change my mind.”
“I’m glad you could see that, Beth. And I don’t think either one of us is ready to say good-bye.”