“I don’t know what to do,” Cynthia says plaintively, pulling at her hair. “I saw Phyllis for so long and I was so devastated when she just left her practice. When she left me! I mean I knew she was really sick, that she was probably going to die. But you know, I’ve hardly been able to talk about anything else since I started seeing you. And then here she is, calling me on the phone, saying she’s better and wondering if I’d like to come back into treatment with her. What am I supposed to do?”
I’ve been seeing forty year old Cynthia for a little less than two months and, she’s right, she’s been able to talk about little else then her feeling of abandonment when her therapist became seriously ill and had to precipitously end her practice. Fear of abandonment has always plagued Cynthia, having it come to pass with her therapist of many years has left her anxious, angry and distraught.
“Do you have any sense of what you’d like to do, Cynthia?” I ask.
Cynthia fidgets in her chair. She looks warily at me, takes a deep breath and says, “I don’t see how I can talk with you about this.”
“Well, it’s like I have to decide between you and Phyllis.”
“You don’t have to take care of me, Cynthia. You need to figure out what’s best for you. I’d certainly understand if you decided to go back to seeing Phyllis. You’ve had years of a relationship with her. And I’d be happy to continue seeing you if that’s what you decide.”
“It still makes me uncomfortable. Like I’d hurt your feelings. But I’d hurt Phyllis’ feelings if I decide to stay with you. That feels really terrible.”
“Can you say what feels terrible about hurting each of us?”
“Phyllis almost died! I wouldn’t want to do anything more to hurt her.”
“I understand that, Cynthia, but you’ve been really angry with Phyllis and if you do decide to go back with her that’s one of the things you’re going to have to discuss.”
Cynthia shakes her head empathically. “I could never do that. I’d just have to pretend it was like before she left.”
“From what you’ve told me, Cynthia, Phyllis sounds like a good therapist. I’m sure she’d encourage you to talk about how you felt about both her leaving and her return.”
“I’d say I felt sad, but that I understood and that I was really glad she was back.”
“So you’re saying you’d go back into therapy with Phyllis and be dishonest?”
“What else could I do?” she wails.
I feel myself becoming annoyed by Cynthia’s passivity, clearly remembering how angry Cynthia has been with Phyllis these past months. She’s felt guilty about her anger, but angry nonetheless. “I wonder if being dishonest with Phyllis would be a way of expressing your anger at her, of pulling back from her just as she did from you.”
“So you think I should go back to Phyllis and tell her I wish she’d died?”
I feel myself flinch, aware of the rage that exists in Cynthia barely below the surface. “First, I didn’t say that you should go back to Phyllis. I said I’d be happy to continue seeing you. Second, I think you’re really, really angry and that you’re afraid your anger can be deadly. Whether you can go back to Phyllis and deal with her with your anger is something you’ll have to decide. But one way or another I don’t think you’re going to be able to avoid dealing with it.”
Suddenly a thought comes to me. “What did you tell Phyllis when you spoke with her on the phone?”
Cynthia hangs her head. “I told her I’d see her next Monday,” she mumbles, barely audible.
“So has this session been a charade, Cynthia? Had you already made up your mind and only pretended to be unsure?”
“I thought it would be less hurtful,” she says avoiding my eyes.
“I think, Cynthia, it will be very important for you to work on why you think deception is less hurtful than honesty, but in order to do that you’re going to need to be honest.”
“Are you mad at me?”
After talking about honesty I feel obliged to respond truthfully. “Yes, Cynthia, I’m mad at you for presenting a charade this session, rather than coming in and telling me what you decided and allowing us time to say good-bye.”
“I’m sorry,” she says quietly.
“I’m sorry too. But I want you to know that anger doesn’t have to be destructive and that I wish you the very best.”