Wednesday, December 30, 2015

Moving Forward

Crystal greets me with a big smile as I open my waiting room door. A slender, 35 year old woman, dressed in casual black clothes, her hair pulled up in a bun, she looks like the yoga instructor she is.

“It’s been quite a week,” she begins. “We’re going into the New Year and, hopefully, I’m going into my new life.” She laughs. “Maybe that’s a bit dramatic. But I feel I’ve suddenly shed my old self. I was totally miserable when I left here last week. I couldn’t stop crying. I even canceled my classes. I know you’ve been saying it for years, but I never really got it, not really. But last week I really felt for me as that little girl, that little girl whose parents were so wrapped up in each other they didn’t even know I existed. It always felt so unfair. It was unfair. It’s not that they were struggling to make ends meet. It’s not that they couldn’t pay attention, they just couldn’t be bothered. And I kept hoping, hoping that I could make them be different. As a kid. As an adult. But I couldn’t. And I got angrier and angrier. And the angrier I got, the more I messed up my life. I was valedictorian of my high school class and I never even graduated from college. How sad is that? I guess I figured if they didn’t care, why should I?”

I’m pleased. This is one of those moments therapists wait a long time to experience. “Wow, Crystal. I’m impressed. It certainly sounds like something coalesced for you in a very different way last week.” 

“It’s what you said about mourning – not that you haven’t said that a million times before too. And you brought up that movie again, “Inside/Out.” So I watched it again. Especially that scene about the elephant. I sobbed my way through it and then I realized that letting go of the elephant as an imaginary friend was a metaphor for letting go of childhood, letting go of the past and that even though it’s very sad, there’s really no other choice if you want to move forward in your life. I can be mad at my parents forever. I can long for their love and attention, but it’s just never going happen. So I have to stop being a baby, let go and move on.”

“I was feeling so pleased for you, Crystal, but that last sentence raised a red flag for me. When you say ‘I have to stop being a baby,’ you’re now rejecting the hurt, vulnerable child in you just as your parents did.”

“Hmm,” she says thoughtfully. “What should I have said?”

“It’s not a question of what you should have said, but rather what you do feel for that child part of yourself.”

“I guess I don’t like her a lot. At least not this week. I want her gone.” She pauses. “You know, I don’t think I get how I could like that part of me and still move forward. I decided after my epiphany this week that I’m going to go back to college and then on to graduate school, although I don’t know if that would be in business or film or dance. I know, I’m covering the spectrum there.”

Although I wonder if Crystal is pushing herself into activity to get away from her internal sadness, I say, “That’s great, but you raise a very important issue when you say you’re not sure how to be kind to the sad, vulnerable part of yourself while going on with your life.” 
“I don’t.”

“Well, you sometimes talk about your neighbor’s little girl. Suppose one day you saw her crying because a friend of hers hurt her feelings or because someone pushed her and she fell. What would you do?”

“I guess I’d hold her and reassure her until she stopped crying and felt comfortable to go back to playing.”

I smile. “Well?” I say. 

Crystal smiles back at me. “I guess you’re saying I should treat myself like I’d treat her.” Pause. “You know, that’s not so easy. It’s like either I have to push myself forward and forget about the sadness or get stuck wallowing in it.” Another pause. “Well, I guess you don’t get rid of me yet. We still have work to do.”

I’m startled as I realize the meaning behind Crystal’s statement. “Crystal, allowing yourself to move forward, to do the things you want to do in your life, doesn’t mean you have to stop seeing me. There isn’t this strict demarcation between childhood and adulthood where adults don’t need love and caring and connection. You can go out into the world and see me for as long as you want or need.”

Crystal’s eyes fill with tears. “You’re amazing. I’m afraid I’ll never want to leave you.”

“That might be a fear of yours,” I say. “And we’ll deal with it.”    

Tuesday, December 15, 2015


Jennifer Holland sighs deeply as she settles into the chair. “Well, another holiday season is upon us and I’m alone.”

“I thought both your sons were coming with their families,” I say too quickly and concretely.

She sighs again. “It’s not the same.”

“You mean your husband Dave isn’t here?”

Her eyes fill with tears as she nods. “It’s been five years since he passed. Five years of being alone.” 

“I understand that no one can replace Dave, but that doesn’t mean you’re alone.” 

“It’s not the same,” she repeats.

I’m back in a familiar place with Jennifer. I do understand her feelings. As a widow myself, I know all too well that the holidays bring one’s sense of loss and loneliness to the foreground. But Jennifer’s inability to appreciate what she does have, to take in anything positive from anyone – including me – leaves me feeling angry and frustrated.

“I know it’s not the same, but I wonder how your sons would feel if they heard you discounting their love and caring.”     

“They can’t understand. I know they lost their father, but they have their own families, their own lives.”

Feeling my anger rise, I wonder if I am feeling not only my own anger, but Jennifer’s as well. “Are you angry that your sons have their own lives, that they’re not here with you?”

“I’d prefer they were here. But boys don’t stay with their mothers. I have friends who are widows whose daughters live nearby. I get jealous whenever they bring up spending time with them. But me, I’m alone.”

“You just said you have friends,” I say, immediately aware that I am fruitlessly attempting to change Jennifer’s mind. 

“Yes. But they’re just friends.”

I try to get beyond my frustration and my wish for Jennifer to be different and say, “Do you hear yourself reject anything positive you might receive from anyone: friends, your sons, me?”

“But it doesn’t feel positive.”

Stymied again.

“What would be positive?” I ask.

“Having Dave back,” she says, crying.

From most patients, I would experience such a statement with great empathy. With Jennifer, I feel only anger. “I’m sure that’s true,” I say, trying to conceal my anger, “But you can’t have Dave back.”

“I hate when you say that!”

“Do you hate me?”

“No, I could never hate you. You’re trying to help me.”

“Are you saying you feel that you’re not allowed to hate me because I’m trying to help you?”

She nods.

“But you might hate me even if you feel you shouldn’t.”

“You’re confusing me. Besides, I don’t know why we’re talking about this. I want to know how to be less alone.”

I’m ready to scream. I try to step back and understand what’s going on between us. What I feel is that Jennifer is determined to spit me out. Well, I think, maybe that’s a starting place.

“Jennifer,” I say, “I know that your life has been unbearably sad and painful since Dave’s death, but my experience of the immediate right here and now, of this session right at this moment, is that you reject anything I offer that might help you to feel less alone, like you’re spitting me out.”

“But you haven’t said anything to make me feel less alone.”

“If you’re saying I haven’t said anything that’s going to bring Dave back, that’s true. If you’re saying you’re unwilling to take in anything that might make you feel better unless it’s bringing Dave back, I’d say you’re holding out for the impossible. And if you are saying you’re going to reject anything that isn’t going to bring Dave back, I’d say that’s what we need to work on.” Am I being too harsh, I wonder? Is my frustration turning into hostility?

“I don’t know what you want from me,” Jennifer says plaintively. 

Yes, I’m being too aggressive but Jennifer’s passivity and sense of entitlement is difficult for me to handle. I try to soften my tone. “Can you say what you’d like from me, Jennifer? Or what you think you might be able to do to help yourself to feel better.”

“I don’t know,” she laments. “I thought you were supposed to tell me that.”

“It’s so, so hard for you, Jennifer, to take in positives, to feel good about your sons coming, to feel pleased to have friends.”

“It’s not enough.”

“I understand they’re not Dave. But maybe you won’t be able to begin to take in the positives in your life until you’re able to accept that regardless of how much you might want it, Dave can’t come back.”

“I hate when you say that.”

“I know. It’s a reality you don’t want to accept.”

Friday, December 4, 2015



Mrs. Jackson sits across from me looking all of her 80 years. Speaking slowly and softly, I strain to hear her. “I know it’s ridiculous. My parents have been dead for years. I’ve had my own family, my own life and yet I can’t get past what they did to me. Or what they didn’t do, would probably be more accurate. I was invisible to them. They couldn’t have cared less about me. There were days I went hungry because they couldn’t be bothered to feed me. But my brother, he always got fed. The crown prince.”

“You sound angry,” I say.

“Oh yes,” she replies in barely a whisper, “I’m angry. But what I am supposed to do about it?”

“Do you always speak that softly when you’re angry?”

She smiles. “My husband always tells me I go around whispering.”

“Any idea why you speak so quietly?” I ask, thinking it’s both a way to keep herself invisible, as well as a way to force others to pay close attention to her.

She shrugs. After a pause she says, “I know it’s not unusual for parents to prefer the boy, I sometimes felt that with my own children, but it wasn’t only that. My mother would walk by me like I wasn’t in the room. She didn’t help me understand how to dress appropriately, how to make friends, couldn’t care less if I got myself to school. I did go to school. I couldn’t pay attention very well, but at least that was a time I didn’t have to deal with my mother’s rejection.”

Although I’m aware that Mrs. Jackson has ignored my question, possibly repeating the experience of being ignored herself, I opt for empathy at the moment rather than confrontation. “I’m sure being constantly ignored was extremely painful, but do you have any thoughts about why you decided to come into therapy at this particular moment.”

“I’ve been in and out of therapy my whole life. It never works. I try, but it never works.”

“What do you mean it never works?”

“I can’t let go, I can’t forget about how they treated me, despite what the therapists say.”

“And what do the therapists say?”

“They say I should forget about it. And I agree. But I can’t.”

“I don’t think the problem is that you can’t forget how they treated you, but rather that you can’t move beyond the feelings you had as a child. The pain of their rejection feels as though it happened yesterday as opposed to 70 plus years ago.”

“You’re absolutely right. I can’t get beyond the feelings.”

“Can you imagine what it would be like not to have those feelings?” I ask.

Mrs. Jackson mumbles a response.

“I’m sorry” I say, “I didn’t hear you.”

“Free,” she whispers, looking down at the floor.

“You sound so tentative. I wonder if it feels scary to imagine yourself as free.”

“Why would it be scary?”

“Well, for one thing, it’s very foreign to you. Being free means putting yourself out there, speaking up, feeling you’re valuable and worthwhile. You’ve spent your life making yourself as invisible as you were to your parents.”

“That’s true. But I’m 80 years old. I’m 80 years old and I still feel like a child.”

“It’s really hard to change a lifetime of how you feel about yourself, how you are in the world. Perhaps you hope that if you make yourself invisible enough, your parents will finally love you.”

“But my parents have been dead for years.”

“Yes, but we all walk around with parents in our heads and those parents never die. We still try to get those parents to love us, to notice us, to approve of us. To get beyond the hurt and angry feelings you carry inside you, you have to mourn those parents in your head. You have to come to a place where you know and feel that you can never, ever get the love and attention and caring you needed and deserved as a child, regardless of how invisible you make yourself.”

There’s another inaudible reply.

“I’m sorry, I didn’t hear you,” I say. “I don’t have the greatest hearing, but I suspect it’s not only my hearing that’s the problem.”

“I said I’d try.”

“Do you want to try for you or are you trying to please me?”

She chuckles. “Perhaps a little of both.”

“It will be important for us to pay attention to who you’re trying to please – me, the parents in your head, or yourself. Hopefully you can get to a place where you’re doing what you want to be doing for you.”    

Tuesday, November 17, 2015

Life and Death

Naomi looks weary and haggard. She looks as if she has spent countless nights in a hospital besides her 85 year old mother with stage IV ovarian cancer which is indeed the case.

“I had to come in and see you today. I had to steal an hour for myself. I’m not even sure the last time I took a shower. Good thing the girls are self-sufficient. Although my husband’s been great. No complaints there.” Pause. “But now there’s my brother. I don’t know if he thinks he’s the knight in shining armor, but he’s decided he’s going to save our mother. By prayer.  As long as I don’t ‘kill her’ in the meantime. Does he actually think I don’t want her to live? I’ve spent years of my life trying to keep her alive; years trying to make sure she had the best quality of life. But she’s dying. She doesn’t even know who we are any more. It’s enough. It’s enough already.”

Internally I flinch at my patient’s words: “It’s enough already.”  Those were the same words my late husband spoke when he decided that he had tried everything possible to halt the progression of his cancer and that he was ready to let go. I would, of course, respect his wishes, but the finality of the words took my breath away. Steeped in remembering, I struggle to bring myself back to Naomi’s current reality.

“Your mother never made her final wishes known?” I ask.

“No, she didn’t. Every time I tried to bring it up, she’d change the subject. She couldn’t tolerate dealing with the reality of her own death. Well, you know how my mother was, never wanting to deal with reality, her head always in the sand.”

“So now you and your brother disagree about what to do.”

“That’s putting it mildly.”

“And you’re angry.”

“Yes, I am. I’m almost too tired to be angry, but I am. I’m not sure when he got so high and mighty religious and it’s not like I’m talking about killing Mom, just withdrawing treatment and allowing her to go peacefully. You’d think his God would welcome that.”    
Did you and your brother ever see eye to eye?”

“As children we were very close. I was like his second mother. But then he moved away and I stayed put and I gave my parents grandchildren which he never did. I guess that made me the favored child.”

“So maybe he’s fighting for favored child status now?”

“A bit late, isn’t it?”

“Perhaps not psychologically.”

“Yeah, I know what you mean. So you think I should be more understanding of my brother?”

I flash on an incident that occurred when my beloved grandfather died and the samovar that had always been promised to me was taken by my uncle, the less-favored child. “Being more understanding doesn’t mean you’ll be any more comfortable with what your brother is doing. I guess I’m concerned that this battle with your brother is going to divert you from grieving for your mother.”

“That’s true. Right now I’m more involved with feeling angry with my brother than dealing with my mother’s death. And it’s only a question of time before she dies, regardless of what we do or don’t do.”

“So how do you feel about her death?”

“Sad. But it’s time. And I have no regrets. I’ve been a good daughter. There’s no unfinished business between Mom and me. Hmm. I wonder if that’s what’s missing between her and my brother. I wonder if he still has unfinished business.”

“That’s a good insight, Naomi.”    

“But I’m not sure he knows it. And I have no idea how I’d talk to him about it.” Pause. “But you know what I said about it only being a matter of time until she dies anyway. Maybe I should listen to myself. Maybe it doesn’t matter all that much what we do. Death will do what’s it’s going to do, regardless.”

“I’m impressed, Naomi. That’s certainly taking yourself out of the fight with your brother.”

“The only problem will be if she lingers too long and suffers.”

“Yes, that would be a problem.”

“But maybe I can just wait and see what happens and try to opt out of fighting with my brother.”

“Sounds like a good plan.”

Tuesday, November 10, 2015

I Lied

A tall, too-thin, young blonde woman looks up at me with beseeching eyes when I open my waiting room door. She does not return my smile. Slowly, tentatively she walks to my office and waits until I gesture for her to sit, which she does almost reluctantly, teetering at the edge of the chair.

Oh, oh, I think to myself. This young woman is in trouble and probably means trouble for me as well.

She looks down at the floor, pulling at her fingers. Anxiety fills the room.

“Bethany,” I begin, planning to ask what has brought her to therapy.

At the sound of her name, she flinches.

“That’s not my name,” she says, practically whispering.

For a moment I’m confused. Did I misremember the name she gave me on the phone?

“I lied,” she says.

“You lied about your name?” I ask, surprised. In all the years I’ve been doing therapy, I don’t think anyone has lied about her name.

She nods, still looking down at the floor.

I wait.

“My name’s Belinda,” she says.

Belinda I think to myself, an unusual name. Tall, thin, blonde. The pieces fall into place. “You’re Chelsea’s friend,” I say.

“You have to see me,” she says raising her head, her eyes now boring into mine. “I’ve seen lots of therapists over the years. I knew you wouldn’t see me if I told you I was Chelsea’s friend, so I lied. I planned to lie for a while, until we had a relationship going, but I was too afraid. I didn’t think I could pull it off.”

I’m swimming in conflicting thoughts and feelings, and suspect that my confusion mirrors Bethany’s – I mean Belinda’s. Why is Belinda so determined to see me? What does it mean about her 
relationship to Chelsea? Why did she choose subterfuge and then immediately abandon it?

“Why don’t you say something?” she asks.

“I guess because I’m feeling confused and uncertain what to say or do, much as I imagine you often feel yourself.”

Belinda’s face lights up. “Yes! That’s exactly how I feel. I knew you’d be the only one who could understand me.”

Immediate idealization always followed by falling off the pedestal. But it can never get that far. I need to extricate myself from this situation as soon as possible for, as Belinda correctly surmised, I cannot treat both Chelsea and Belinda. They are good friends, both disturbed young women with eating disorders. They’re also extremely competitive with each other. I can just imagine the jostling that would occur as each tried to win my favor. Way too complicated for me to ever consider.

“I assume, Belinda, that Chelsea doesn’t know you came to see me,” I say.

“You’re not going to see me,” Belinda says, tearing up.

“No, Belinda, I’m not going to see you, but I would like for us to understand why it was so important that you see Chelsea’s therapist. There are many good therapists I could refer you to, why did you want it to be me?”

“It has to be you!”


“Because of how much you’ve helped Chelsea.”

“That could be one reason you want to see me. Might there be others?”

Silent tears pour down Belinda’s cheeks. In the next second she’s beating her fist into her thigh, her face contorted with rage.

“Stop it!” I say. “Stop it and tell me what you’re feeling.”

“I always, always lose. I hate myself! I hate myself! I’m never good enough!”

“Belinda, I know almost nothing about you, but I do know that today you set yourself up to lose. You knew coming in that I wouldn’t see you when I’m already treating one of your best friends.”

“We could keep it a secret,” she says interrupting.

“You know I’m not going keep a secret from a patient. You wouldn’t want your therapist to keep a secret from you. Is there something that happened between you and Chelsea that made you suddenly decide you wanted to be my patient?”

She shakes her head no.

“Is there something that happened in your life?”

“My sister got engaged.”

“So you felt that your sister won over you and you thought maybe you could win over Chelsea.”

She nods. “But of course I couldn’t. I always lose.”

“But again, Chelsea, with me, you set yourself up to lose and I think that’s something important for you to understand. Can I give you the name and phone number of a therapist I think you’d work well with?”

“I don’t know.”

“Well, why don’t I give it to you and hopefully you’ll think about it and give her a call.”