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?”
“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 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.
Very interesting. It strikes me that therapists take on a lot when it comes to breaking through our outer hard shells to the defensive, vulnerable, wounded younger selves - even before healing can begin to happen... Annie
I couldn't agree with you more, Annie.
Thanks for the comment.
Thanks for sharing! I believe the saying is true, "There is a fine line between genius and psychopath." Great blog and insight!
Have a great day,
Thanks, Lisa. I'm glad that you enjoyed my blog.
I must say, however, that I didn't see the patient as either a genius or a psychopath. He was definitely difficult and challenging, but my sense was that came from a fear of being attacked, or feeling too needy or vulnerable, and probably both.
IT appears to me that your reaction was very muted, As the space between you was verbally controlled by him there was , for me , a sense that you did not respond to what he was saying or doing . He was reversing poles and getting you to ask questions . The true response was the urge to laugh. I might have said to his first question "How am I supposed to know ? If I was in a cognitive mode... Or whoever asks the questions controls the dialogue..........Or as I told a patient recently "You must be very smart to know what to say that is immediately annoying " For me when a male patients begins with a " probe" he is generally impotent or trying to locate what he can " project " onto /into me. The female patient I referred to above ..... was a supreme J U D G E as she was judged.
Hi, Bennett. I appreciate your comment.
I agree that this man needed to use his aggression to cover feelings of inadequacy, vulnerability and neediness. I also thought that your comment to your patient, "You must be very smart to know what to say that is immediately annoying," would have been an excellent response to this man.
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