Tuesday, September 20, 2016

The Opponent

I open my waiting room door to meet James Harrison for the first time. He rises, hand outstretched to shake mine. I’d guess he’s in his mid-forties. A good-looking man, tall, thin, seemingly comfortable in his own skin. We make the brief walk to my office and I gesture him to the sage chair across from mine.

“So,” he says, “Why should I be here?”

I inadvertently jerk my head back while, at the same time, stifling the urge to laugh. He’s certainly wasted no time throwing down the gauntlet. Still, it’s so startling, that I find it almost funny. Perhaps that’s a defensive reaction on my part.

I think about commenting on his provocativeness, but decide that would only escalate what is already a fencing match between us.  “Well, since I’ve never laid eyes on you before,” I respond, “I have no idea why you should be here. Perhaps it would be helpful if you told me.” Too hostile, I tell myself. It’s hard not to meet aggression with aggression.

“At least you didn’t go into that bullshit about everyone can benefit from therapy, it’s always good to understand yourself better, etc., etc.”

Do I need this? I think to myself. We haven’t even said hello and we’re already adversaries. Actually that’s not a bad interpretation. “Mr. Harrison, I wonder why we’re already adversaries. As far as I know you voluntarily came into my office. I’m not forcing you to be here. There must be some reason you’re seeking the help of a therapist.”

“Ah ha. So you’re the try the gentle approach type of therapist.”

I am definitely getting pissed. Which must be what he wants. “I suspect it’s important for you to keep relationships on an adversarial basis. Perhaps that’s why you’re seeking therapy. Perhaps you have difficulty getting along with people.”

“Perhaps,” he says grudgingly.


“OK. So now what?” he challenges.

I really do not need this. I want to tell this man that I don’t think we should work together, that I’m not the best person for him. Maybe that too would be a good interpretation. Or would it just be acting-out on my part?

“Why don’t you tell me a little about yourself?”

“Why would I want to do that if we’re not going to work together?”

“Have you decided that we’re not going to work together?” I ask.

“Have you?” is the rejoinder. 

“I don’t know,” I answer truthfully. “I do know that I’m not willing to spend every session fighting with you when I have no understanding of why you need to fight. And I’m also not prepared to convince you that you should be in therapy with me.”

“But you do think I should be in therapy?”

“Yes,” I reply definitively.


“Because you are clearly someone who needs to fight which means that you either have a lot of anger or need to keep people at a very far distance or both.”

“You see. You were able to tell me why I needed to be here.”

“And I suspect that you could have told me that yourself far more quickly.”

“But then I wouldn’t have known if you’re smart enough to handle me.”

“So I suppose I should assume that you’re going to be continually testing me?”


“Mr. Harrison…”


“James, I do know that how you are in the world, is how you are in here with me, but I want to again say that I think it is very unhelpful for us to be continually sparring and that one of my goals for you, is going to be to find the James Harrison behind your defensive posturing.”

“You don’t like me much, do you?”

“I would say that you insure that no one likes you much. But I would very much like to learn to like you. And I hope you’ll allow that to happen.”


I groan internally and wonder why I didn’t refuse to take him on as a patient. “Can you tell me what you’re feeling, James?”

“Satisfied. I think you’re the right person for me.”

“Can you say how you felt when I said I thought you insured that no one liked you, but that I’d like to learn to like you?”

“I told you, satisfied.”       

“Did you feel anything else? Hurt? Relieved? Angry?”

“No. Just satisfied. I accomplished what I wanted to accomplish.”

“So you feel satisfied with yourself. Do you have any feelings about me?”

A slow smile spreads across his face. “I’ll tell you what came to mind. That’s what I’m supposed to do, right?”

I nod.

“I feel you’re a worthy opponent.”

Perhaps, I think to myself, this treatment will be about whether a worthy opponent can become a stalwart ally. If so, it’s going to be a slow slog through.   

Tuesday, September 6, 2016


“I had a dream about all these disasters last night,” Jenny says. “It was frightening. There was one disaster after another. I mean I know there have been lots of disasters – floods, hurricanes, earthquakes, tornados – but it was strange for me to be dreaming of them. I don’t know if I was in the disaster or watching the disaster or helping at the disaster. It was weird.”

Jenny‘s a young medical student. I wonder if, at a surface level, she’s anxious about how she will handle her responsibilities as a physician. I remain silent, waiting to see where Jenny’s thoughts will take her.

“My mother called last night. She was complaining about my step-father for a change, about this step-father, just like she complained about all the others. I don’t know why she keeps marrying them, always sure this one will be her most perfect love. I think I’ve even lost count of what number she’s up to. Ugh. I don’t think I ever want to get married. Or not until I’m really, really sure. I guess I see her as a disaster. That’s sad to say about your own mother. I joke with my friends that she’s my negative role model. I want to be everything she’s not and not be anything she is. Sad.”

“Did you feel that way as a child?” I ask.

“Maybe not as a small child, but before I became a teen-ager for sure. Our house was a revolving door. At least she was smart enough not to have any more kids, except that there were always the so-called Dad’s kids who revolved through and then disappeared forever.”

“Was that hard? Forming an attachment to these father figures or siblings and then having them disappear?”

She shrugs. “I don’t know. Maybe. Or maybe I just learned to do my own thing, be involved with my schoolwork, with my friends. I liked being alone.”

Despite the matter-of-factness in Jenny’s tone, I find myself becoming sad. I wonder about her desire for aloneness as a defense against loss. And I think again about her dream, since disaster almost always involves loss.

“When did you last see your own Dad?”

“Who knows. He vanished a long time ago. Every so often he’ll make an appearance, but I certainly wouldn’t want to count on him.”

“I wonder if it’s possible for you not to feel sad about all these losses, Jenny?”

“I’m too busy.”

To avoid sadness, I think to myself. I ask, “What were the disaster survivors doing in your dream?”

“I was going to say they were doing what disaster survivors always do, dig through their houses looking for stuff, try to find things that are important to them. But I don’t think so. I don’t remember seeing people. It was like one of those apocalyptic novels. Maybe there were a few people, I don’t remember, but basically it was empty, barren.”

“Sounds really sad.”


“I just had a weird thought. I wonder if it wasn’t me in all those disasters, but you. Like I was the observer, but you were the one who was there. I wonder what that would mean,” she muses. “I could get it if you’re the one who’s trying to help in the disaster. But would that mean I’m the disaster? I don’t feel like a disaster. So am I trying to reduce you, to make you like me, so I don’t feel like so much of a disaster?” Pause. “I guess that’s possible.”

“Are you saying, Jenny, that it feels like a disaster to need people, to need help, to not want to be all alone in the world?”

“It is a disaster to need people. No one is ever there. You can’t count on anyone. Not your mother, not your father …” Her voice trails off.

“Were you going to say, ‘not your therapist’?”

“Yes,” Jenny says looking down. “I mean I know you’ve been there for me, but you’re only my therapist. Eventually this relationship will end. And then what? Then I’ll be alone. Again. Just like always.”

“It’s hard for you to imagine that even when we do end – which we certainly don’t have to do until you’re ready – that you will take me with you, as part of you, just as a part of you will remain with me.”

“I don’t know if I believe that,” she says. A moment letter, Jenny is crying. “And I’m not sure I even want to believe it,” she says between sobs. “What would that mean, that I would stay with you when my parents could discard me so easily?”

“It would mean that you are loveable and that it was your parent’s great loss that they weren’t able to cherish you as you needed and deserved to be cherished.”