Emma settles into the chair across from me, takes a deep breath and speaks quietly, slowly, deliberately. She’s telling me about her week. Her son is excited about his softball team, her daughter is anxious about her upcoming school play, her husband is away on a business trip. “That makes it easier,” she says.
“It makes what easier?” I ask.
“His being gone. I know it’s terrible to feel like that and I know it’s not his fault, but it’s easier.”
“But what’s the ‘it’ that’s easier?”
There is a long, profound silence. Emma sits motionless. Although I’ve only seen Emma for a couple of months, I’ve become familiar with her stillness.
“I’m trying to decide whether I should take the children out to dinner tonight,” she finally says.
I’ve also become familiar with Emma’s tendency to avoid answering questions and to switch topics, often to something banal, almost as though there was nothing we had been discussing.
“What just happened now, Emma?” I ask. “How did you get from it being easier when your husband’s gone to taking the kids out to dinner?”
“If I’m going to take the kids out to dinner, tonight would be a good night. Before he gets home.”
Yes, I think, but she still hasn’t addressed what makes it easier when he’s gone. I consider pushing, but find myself reluctant to do so.
Another profound silence ensues.
“Do you ever take vacations?” she asks suddenly.
“Yes, I do. Why do you ask? Do you feel anxious about my being gone?”
Another long silence. “No,” she says with a nervous laugh. “It would be easier. I wouldn’t have to think of what to say.”
“So it’s easier when your husband is gone and it would be easier when I’m gone.”
“Speaking is obviously very difficult for you, Emma. What happens when you sit in your silence? What are you thinking? What do you feel?”
Emma’s silence, her non-responsiveness, her tendency to talk about apparently inane topics. None of it makes me angry. Sometimes bored, sometimes frustrated, but generally I hold myself still along with her. It’s like feeling frozen. Emma has told me a little about her background. She was the only child of a religious family who lived in the rural Midwest. Her father was extremely depressed, often unable to get himself to work for weeks at a time. Her mother was an angry, embittered woman who reached for the belt for any minor infraction.
“Emma, what about as a child? Was it difficult for you to speak then too?”
Another nervous laugh. And silence.
After a while I ask, “Can you say what you’ve been thinking during the last couple of minutes that you’ve been silent?”
After a while she responds, “They’re images.”
“Can you tell me what some of the images are?” I say gently.
“Cornfields. Sunflowers. My mother. It’s cold.”
I flash on a patient I saw years ago who, as a child, was punished by being left naked in the storm cellar. I wonder if Emma was similarly abused.
“Can you tell me about your mother, Emma?”
“She was mean. She hated me. She said I was the devil’s child, that she needed to beat the devil out of me.”
“What kinds of things did she beat you for?”
“Everything. Not getting up at exactly 6AM. Tracking mud in the house. Talking when she had one of her headaches. She always said her headaches were my fault. She never had headaches before I was born. That’s what she said.”
“You were terrified of her.”
“Did you ever feel angry with her?”
“You can feel angry with someone even if you don’t express it,” I say.
“She gets bigger.”
“I’m sorry?” I say, confused.
“The image. It gets bigger.”
“You’re saying that if you feel angry at your mother you see her image getting bigger?”
“And you feel more frightened.”
She nods again.
“Is that what happens when you talk to me, Emma? Does the image of your mother get bigger, like you’re not supposed to be telling me things?”
“You know, Emma, you can always tell me to stop, that you’ve had enough. I’ll always respect your wishes. The last thing I want to do is be another abuser.”
Silence. Then she says, “Maybe if it would be better if we didn’t go out to eat. It’s a school night. The children need to do homework.”
Although she can’t say it directly, Emma has clearly told me she’s had enough.