Tuesday, December 2, 2014

Welcome Home

Thea, a woman in her mid-thirties, with porcelain skin, curly red hair and deep blue eyes, glares at me from across the room, her brows knitted, her arms folded tightly across her chest. We have been sitting in silence since she entered my office and threw herself into the chair. Only a few minutes have elapsed, but the time hangs heavily in the room. 

Concerned that we fall into a power struggle of who speaks first, I decide to break the silence. “You’re obviously having lots of feelings, Thea. Can you talk about what’s going on for you?”

“Why should I?” she retorts.

“Well, that is usually what we do here. You tell me what you’re thinking and feeling and we try to better understand you.”

“Don’t be a smart ass! You know goddamn well what I mean.”

Thea is correct. I do know what she means. She is a therapist herself and someone I have seen in treatment for several years. “OK,” I say. “So this is our first session back since I returned from vacation and you’re clearly angry with me. But that doesn’t help me understand if this break in our schedule was particularly difficult for you and if so, why.”    

“I ran into Cathy in the grocery store. She knows that I see you – and obviously knew you were away - but why she found it necessary to tell me that you were presenting a paper I have no idea.”

Cathy is a colleague who did in fact know that I presented a paper during part of my time away, although I too have no idea why she needed to give Thea that information. However, she did, and it is now our job to understand the feelings churning inside Thea. Although I’m always eager to treat other therapists, they do present their own unique set of difficulties, particularly in a small therapeutic community where you don’t always know who knows whom. 

“So what did it mean to you that I presented a paper?” I ask.

“You could have told me!” Thea replies, her voice still sharp and raised. “It was embarrassing that Cathy knew more about you than I did.”

I keep my face impassive, although I’m immediately puzzled. Certainly Thea knows that Cathy would know more about me than Thea herself. I say nothing, hoping that Thea will continue her self-exploration.

“What?” she says. “You’re not going to say anything?”

This whole session feels like a land mine. If I stay silent, Thea might well experience me as withholding and provocative, much as I am experiencing her. If I confront her on what seems an extremely unlikely reason for her anger, she could experience me as both challenging and negating. If I guess at what I think might be going on here, I am doing her work for her.

Perhaps the most productive course is to follow Thea’s direction. “I thought you might say more about what was embarrassing about Cathy knowing I was giving a paper while you didn’t.”

“Isn’t it obvious?”

“Thea, I know that you’re angry with me and I’m not trying to be dense here, but you’ll need to say more before I can understand what it meant for you not to know I was presenting a paper. You also didn’t know where I was going in my absence, if Cathy told you that would you have been equally angry?”   

“She did tell me. And, no, I didn’t care about that. Oh!” Thea’s pale skin turns scarlet.

I think of how difficult Thea has made this session. I think about her being many years my junior in terms of professional experience. I think about her highly successful older sister, Emily. I have a sense of what’s going on here, but realize how important it is for me not to be the wise, all-knowing therapist.

“Now I really am embarrassed,” Thea says, dropping her eyes, her anger fading. “I’m mad that you got to give a paper and I didn’t, just like with Emily, who got to read her reports in school and get into the best universities and snare the best academic job in the country. I’m sorry. I was behaving like a brat.”

“You have nothing to apologize for. You had feelings. You brought them here and you figured them out. I’d say you did just what you needed to do.”

“But it’s not right if I put my feelings about Emily onto you. And I’m sure I put them on other people too.”

“Perhaps what you’re saying is that we still need to work on your feelings about Emily, as well as feeling competent and capable and good about yourself.”


Pamela Atkinson said...

Great recounting of the dynamic - I was gripped reading it, really!

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

Thanks so much for your comment, Pamela; for your appreciating the dynamics of the treatment, as well as my writing.

Anonymous said...

I'm a therapist in training, and really appreciated this example. Thank you -- you have helped me too.

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

I'm thrilled to be of help to anyone who identifies themselves as "loving psychoanalysis."

Allison Cassidy said...

Excellent work Linda and such valuable sharing

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

Thanks so much, Allison. I appreciate your feedback.