Tuesday, July 21, 2015


“I didn’t want to come today,” Penny says quietly. “I knew I’d have to tell you what I did and I’m not sure I want to. I’m not sure I can.”

Penny’s anxiety is palpable and mine rises along with hers. It’s difficult when patients introduce a topic this way. I always think of something dreadful – she attempted suicide, she started cutting herself, she killed her daughter. I remain silent.

Penny sits looking downward, her dark, straight hair partially covering her face. She makes no attempt to wipe away the tears that fall down her cheeks.

“I beat up Jennifer,” she finally says in a whisper.

Even though my internal list of dreadful possibilities did include Penny having killed her child, I didn’t really expect to hear that Penny had done anything violent, not this petite, delicate woman who sits across from me. And what does she mean by ‘beat up’?  

“I swore I’d never be like that,” she continues. “I swore I’d never be like my mother. I waited years to have a child because I was so afraid of being like her. And then I am. I’m just like her, just as out of control crazy,” says Penny between sobs.

Penny’s mother was an enraged woman with an explosive temper who beat Penny and her sister with straps and belts and anything else at her disposal. Did Penny indeed lose control like her mother? No longer able to contain my own anxiety, I say, “Can you tell me what happened, Penny.”
“Bill and I came home earlier than we expected and there was my 15 year old daughter on the couch making out with this… this boy I’ve told her to keep away from. He’s one of those bad boys. I bet he never even finishes high school. I just snapped. I started screaming and screaming. Bill told him to leave, Jennifer started to give her father an argument and I just went over and slapped her across the face. Twice. She looked at me shocked. I stopped. I couldn’t believe what I did. I couldn’t believe I was just like my mother.”

I can feel myself breath again. Although Penny was briefly out of control her behavior was a far cry from her mother’s. In fact, I can remember a time in a somewhat similar situation when I was about Penny’s age when my mother slapped me for the first and only time of my life. It didn’t scare me. Just made me mad, even though I knew I’d been out of line. But Penny is now frightened of herself, beating up on herself not with a belt, but with self-recrimination and guilt.

“I can’t even look at Jennifer without bursting into tears. And yet I’m still mad at her. She knew she shouldn’t bring that boy into the house. I don’t want her near him anyplace let alone in my home. But I shouldn’t have snapped like that. Bill tells me I’m being too hard on myself, but he doesn’t understand.”

Remembering my own musings before Penny told me what actually happened, I ask, “Is it what you did that’s bothering you so much or what you felt?”

“What do you mean?”

“Well, if we just look at what happened: You come home and find Jennifer with a boy you don’t approve of. You get angry and yell and slap her twice across the face. The facts themselves aren’t so terrible. Maybe that’s what Bill means when he says you’re being too hard on yourself. 
But the question might be, what did you feel? Did you feel so out-of-control with rage that you might even have wanted to kill Jennifer? And even if you consciously didn’t feel that, was it the extent of your rage that frightened you so much, made you feel like your mother.”

“I didn’t want to kill her!”  Pause. “At least I don’t think so. But I’ve never been so angry in my life.”

“You know, Penny, you present as this gentle, almost meek, little person who would never want to hurt a fly, who could never, ever feel angry at anyone. And maybe that’s the problem. You’ve been so intent on not being like your mother, in keeping any possible similarity to your mother buried far, far away that when that anger was unleashed it burst out like a volcano.”

“That makes sense. But I don’t know what to do with that.”

“Well, it’s too intellectual right now. But I suspect we’re going to need to spend more time looking back at your childhood and finding the anger you needed to keep buried back then, anger that’s still buried and looking for a way to get out.”


Anonymous said...

I have recently been reading your back blog entries after discovering your site. I have really enjoyed getting to see the "other side" and it gives me some perspective on how realistic the thoughts I assume my therapist has had while working with me.

One thing I noticed though, in your writing, is that a couple of times you've been worried a client has done something you call horrible - including intentional self harm and attempting suicide. These are topics that don't otherwise show up in your vignettes, which kind of surprises me. I thought they were more common. Perhaps that is due to a skewed sample though, from having spent significant time in acute care settings. Are these subjects not part of your usual cases and is that intentional? Or are you avoiding writing about them for a different reason?


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

Thanks for your comment, Anonymous. I'm glad that you discovered my blog and that you find my posts helpful.

Since you are new to my blogs, you probably don't know that the vignettes are fictionalized - at least partially. The "patients" come out of my imagination, although I try as much as possible to present myself as the therapist I am - including the thoughts, feelings and responses - I believe I would have to these fictionalized patients. The reason I chose to used fictional patients is that there was no way I could write so many blogs about actual patients and maintain patient confidentiality.

Having said all that, it is interesting to me that I do not often write about patients who cut or are in other ways self harming. For probably the first half of my career, I saw a lot of patients who were either suicidal risks or burned or cut themselves and who would call me frequently at home in some sort of emergency. But as I have gotten older, I have chosen to limit my practice to patients who require less emergency attention. So although I just told you that the patients are fictional - which they are - perhaps I'm unconsciously choosing to write about patients who are more like the patients I see currently. But perhaps you've given me an idea for a new blog. I don't promise, but maybe I'll write about a patient such as the one you describe.

Again, thanks for your interest and your comment.