Inside/Outside

Thursday, December 14, 2017

#MeToo

“I’m trying to decide whether I should join the hashtag MeToo movement and tell my story. All these courageous women are coming forward. Why shouldn’t I? I mean, I don’t have the same story. There was no famous actor or congressman, but still, I have a story.”
You most definitely have I story, I think to myself, remembering when Amber first started working with me many years ago, an almost mute thirty-five year old who held herself rigidly together, staring blankly into space. It took her over a year to tell me her story of sexual abuse by both her father and brother.
“And, after all, my brother is a pretty hot-shot business executive,” she continues.
“Is it that you’re concerned your story isn’t …” I hesitate. “…news worthy enough?” I ask, puzzled.
She pauses. “Maybe.” She pauses again. “You think that’s kind of crazy, don’t you?”
“I don’t know about crazy, Amber, but it confuses me. It’s definitely up to you whether or not you tell your story. I’d just want us to consider the consequences of your telling or not telling.  But what’s your fantasy here, that you expose your abusers and no one really cares? Is your wish that it be front page news?”
“I hadn’t thought of that but it’s a good question.” She sits in silence. “I’ve never told anyone except for that feeble attempt to tell my mother who obviously didn’t want to hear it so I immediately backed off. And you, of course. But even that took me a long time. I have considered confronting my brother.  Not my father,” she continues. “That would be way too scary. But I haven’t even said anything to my brother. What am I scared of? Having them deny it? I guess. Not having anything to do with me? That would be no great loss. But now I’m thinking of telling the world that my father and brother took turns raping me while the other one watched. It’s disgusting. I can’t even say it without feeling nauseous. How could I imagine telling the world?”
Although I have some thoughts about what might be underlying Amber’s conflict, I stay silent, waiting to see what she’ll come up with herself.  
“I would love to expose them to the world. I want the world to know how these seemingly normal upper-middle class men – boy in my brother’s case – can be brutal rapists. I was only 11 for God’s sake. And it went on and on until I finally got up the nerve to say ‘no’. And what would people say? That I could have said ‘no’ sooner? That I could have told my mother? Or somebody. I’ve certainly told myself those things often enough.”
“You say that it feels scary to confront your father, but it sounds like you find it less scary to imagine exposing him to the world.”
“I suppose I do. It feels more anonymous, like he can’t get to me. Standing in the same room with him and confronting him, I don’t know what he’d do. Scream his head off at me, for sure. Smack me across the face? Very likely. Kill me? I don’t know. Maybe.”
Feeling my anxiety rise, I say, “Amber, I don’t know whether your fear that your father might kill you is your fear as a child or your adult fear, but if the adult you is truly afraid that your father might kill you, I can’t imagine that your exposing him publically would decrease that risk.”
Amber’s eyes widen. “Now you’re scaring me.”
“I’m sorry, but when I said I thought we should consider the consequences of your speaking out, I wasn’t thinking about your placing yourself in physical harm.”
“But how do I know whether my fear is coming from my child self or my adult self?”
“I don’t know. We definitely need to talk about it more. And I should ask you if you’ve ever known your father to physically taken revenge on anyone.”
“I know I told you that he beat up my first boyfriend. I guess he didn’t want the competition. And that he sometimes beat up gay guys in bars. I know he has guns, but I’ve never known him to use them. Used to say it was for our protection. That’s a joke.”   
“Let’s step back a minute. Let’s for a moment ignore the possibility of your father retaliating and look at what you’d feel about publically telling your story.”
“Scared.” Pause. “Victorious. Like I finally got them back.” Pause. “But then I wonder what everyone else would think of me. Especially my fiancĂ©. I haven’t even had the nerve to tell him. I’m afraid he’ll think I’m garbage. Or that he’d treat my brother and father differently.” Pause. “When I hear myself say that I think I must be crazy. Why wouldn’t he treat them differently? And why do I care? You know, I think maybe I should work on telling the important people in my life before I decide if I’m going to come out publically.”

I smile. “Sounds like an excellent idea.”

Thursday, November 16, 2017

Misery

Beth smiles wanly at me as I open the waiting room door. I anticipate a long, dreary session.
“I’m still miserable,” she says, sitting down, immediately confirming my worst fears. I do understand that Beth has good reason to be miserable. Her husband divorced her after 20 years of marriage, leaving her with two teenagers, three dogs and a six bedroom house. It’s a lot to deal with. And we’ve been dealing with her misery for almost two years.
“Of course I had another problem this week. The kitchen sink started leaking. I freaked out. I went running around to my neighbors to ask if they knew a plumber. Luckily one of them did.”
Knowing I am about to make a futile statement, I say, “So that’s something that worked out well.”
“Not really. It took me days to reach the plumber and then more days before he could come. And in the meantime the kids and I had to eat out which certainly doesn’t help my budget.” She sighs. “It’s all so complicated. I don’t know why life has to be so difficult.”
I wonder how many times I have said things such as, ‘life can be difficult and you’ve certainly had a difficult time, but life can bring lots of joy as well.’  I remain silent.
“Well …?” she says.
My stomach tightens. I feel as though she is commanding me to respond.
“What is it that you want from me right now?” I ask. I hear my choice of words, the tone of my voice and realize that Beth is making me feel as she feels – burdened, put upon, ineffectual, despairing. Ineffectual. That’s an interesting word to flit through my mind. Perhaps that’s what Beth feels. Now alone, she feels unable to competently contend with life.
“I need you to reassure me, to tell me that it will all work out okay.”
“Would you believe me?”
Beth opens her mouth to speak and then stops. After a pause she says, “Well if you said it, it might reassure me.”   
This time I don’t hear Beth’s words as a command to speak, but rather a wish that I take care of her. “I understand that you want reassurance, but you often hear that reassurance as empty words.”
“But I don’t know what to do. I have all these responsibilities. The kids. They’re certainly becoming more than a handful. How am I supposed to handle two teenagers by myself?” She takes a breath. “And what if I get sick? That’s all I’d need. How could I take care of all the things I need to take care of if I got sick? Who would take care of me?”
“I definitely hear how overwhelmed you feel, Beth. Like there are all these things that happen on a day to day basis and then there are all the things that might happen. How are you going to cope?”
“Exactly.”
“But I wonder, Beth, if it would be more helpful to you if you were able to see your own strength, if you were able to realize that you’re far more capable than you think you are.”
“But I’m not!”
“Do you really feel as though you’re not a competent, capable adult or are you afraid to let yourself know you’re a competent, capable adult?”
“They always said I wasn’t.”
“Who’s they?”
“My parents, my sisters, my husband. Even my children. They say I’m a wreck, that I can’t do anything right, that I’m always running around in circles. And I am. I’ve been doing that my whole life.”
“So what would it feel like to be competent?”
“How do I know? I’ve never felt it.”
“Would you like to?”
“Of course!”
“Beth, can you think about that a bit more? I wonder two things: If feeling competent feels so foreign to you that it would be like you’re becoming another person and that in itself would feel pretty scary. And two, you’re not sure you want to be all grown up before you find someone who’ll take care of you.”
“My husband said he’d take care of me. But he never did. He just nagged at me for what I didn’t do right. Even my parents. I was the fifth girl. They’d had enough by that time. I was kind of an add-on.”

“I understand, Beth, that it’s very difficult to give up on wanting the love and caretaking you never had, but there’s no way to get that kind of caretaking as an adult. It doesn’t mean you can’t be loved and cherished, but you can’t go back to being the child and, in the end, it does feel much better to have confidence in your ability to take care of your adult self.”  

Thursday, October 26, 2017

Anger: Expressed and Repressed (Part II)

“You know, I’ve been thinking,” Jacquelyn begins. “I’ve been thinking I should take a break from therapy for a while.”
Internally, I scream, ‘What!? I thought you said you were going to think about your anger?’ To Jacquelyn I say, “And why is that?”
“I don’t know. I’ve been doing this for over a year, seems like it’s time for a vacation.”
“Does your desire for a vacation seem connected to last week’s session when you realized you were angry at your mother for not protecting you as a child?” I ask.
“I didn’t say that.”
“Not exactly, but you did want the woman in the TV show who reminded you of your mother to be killed by the serial killer.”
“I didn’t say that either.”
Disappointed that Jacquelyn has moved so far away from her more open, insightful stance of last week, I ask, “What’s your sense of what’s going on between us right now?”
“Nothing special.”
Feeling increasingly exasperated, I ask, “Can you say what you think is going on between us even if it’s not anything special.”
“You’re mad at me. You’re mad at me because I want to stop therapy.”
“I am annoyed with you, Jacquelyn, because I felt so hopeful last week, hopeful that we’d made a breakthrough, that you experienced your anger at your mother and that although you were scared of the repercussions, you went away wanting to think about it.”
“It was too scary.”
“I do understand that, Jacquelyn,” I say, thinking that perhaps she’s put one toe back in the water.
“But why were you angry at me if you understood?”
Hmm, I think to myself, I wonder if Jacquelyn wanted me to feel angry so that I could feel what she feels – angry but thwarted in its expression. I decide to keep that thought to myself. “I can understand and still be angry. Anger is a feeling. We can’t control what we feel, although we can control what we say or what we do.”
“So you don’t feel scared when you feel angry?”
“No, I don’t feel scared when I feel angry. Except some times.”
“Like when?”
Although repeatedly answering a patient’s questions is unusual for me, I feel that in Jacquelyn’s case it is a helpful form of modeling, perhaps making her own anger less frightening. “Well, I guess like in that TV show you talked about last week, I’d probably be scared if I got angry at the serial killer because I’d be afraid if my anger showed he might immediately kill me.”
“That’s it!” Jacquelyn says staring at me, her eyes wide open. A second later she’s sobbing, pulling at her hair.
“It’s ok, Jacquelyn,” I say quietly. “There’s no serial killer here and your father is long dead.”
She continues crying, but seems calmer. Through her tears she haltingly says, “I never even knew I was afraid he’d kill me. Like he could read my mind. Like he’d know I hated him. I was always so scared, so scared, so scared,” she says cradling her body in her arms and rocking in the chair.
“I’m so sorry, Jacquelyn. I’m so sorry that you had to go through all that. You were only a powerless, dependent little girl. You were so scared.”
I can see Jacquelyn bristle. She stops crying and lifts her head. I went too far.
“I’m sorry, Jacquelyn,” I say, “I know it’s very hard for you to be aware of how powerless you were as a child. It makes you feel all the more frightened.  It’s more than you can bear.  
“Maybe it is time to take a break from therapy.”
I look at Jacquelyn tenderly. “No, it isn’t,” I say. “I know I went too far. You were back there being that little girl and I so terrified you that you had to come back to your adult self, had to go back into a defensive mode. Will you forgive me?”

She is again crying. “I don’t think in my entire life anyone asked me to forgive them. I used to dream about that. I used to dream that one day both my mother and father would take me aside and apologize for all the bad things they’d done to me. But of course that was ridiculous. Except it’s kind of like you made my dream come true, even though you didn’t do anything nearly as bad as they did.” Pause. “Yes, I’ll forgive you,” she says crossing both her hands on her lap and staring directly at me.

Tuesday, October 3, 2017

Anger: Repressed and Expressed


Thirty year old Jacquelyn looks unusually pensive as she settles herself into the chair across from me.
“A weird thing happened this week. Kind of disturbing ,” she begins. “You know how I tell you that I always watch those gruesome  shows like Criminal Minds or CSI, but that I have to cover my eyes during the particularly gory scenes?” she says grimacing.
I nod.
“Well, one of those gory scenes came on, and instead of covering my eyes I felt sort of compelled to watch it. And I – this is kind of embarrassing. I, umm, I actually felt kind of excited and found myself rooting for the serial killer. I wanted to watch him kill that, that, umm, that woman.”
“What did you first think of, Jacquelyn, before you said ‘woman?’”
Jacquelyn lowers her head. “First I thought to say ‘bitch,’ then ‘sniveling baby,’ or ‘coward’ or ‘idiot.’ But they sounded too negative, so I settled on woman.” Pause. “You know, you’re always telling me that I have lots of anger, but that I keep it buried inside me.” Pause. “I didn’t feel angry, not even when I was wanting him to kill her.” Pause. “That doesn’t make sense when I say it out loud.”
Jacquelyn’s last comment is encouraging. Although I’m sure she’s at least of average intelligence, she tends to be quite concrete, has difficulty with self-reflection, and is often unable to take in what seems to me the most obvious of connections.
“Was it that you wanted this particular man to kill the woman or did you want this particular woman dead?” I ask.
“Do you think I’m terrible for thinking about this?”
“Not at all. You weren’t killing anyone, you were watching a TV show.”
“I guess,” she replies dubiously.
Silence.
“You want me to answer your question.”
“Yes.”
“I wanted this woman dead.”
“And can you say more about that? Why did you want her dead? Who did she remind you of?”  
“I don’t know.”
“Well, how about thinking about it now.”
Silence. Jacquelyn squirms in her chair.
“Can’t she just be a woman?”
“If you think about a woman, what woman comes to mind?”
“She wasn’t like my mother.”
“Does that mean your mother was the first woman you thought of?”
She nods, looking down.
“And what’s the similarity between your mother and this woman in the TV show?”
Still not looking at me she says, “They were both housewives.” Pause. “They had children.” Pause. “Umm. Umm. They couldn’t stand up to their husbands.”
Thinking to myself, ‘now we’re getting somewhere,’ I ask, “How did the woman in the TV show not stand up to her husband?”
She looks up. I suspected that it would be easier for her to talk about the TV character than her mother.
“There’s this scene at the breakfast table where her husband is screaming his head off at both her and the kids. You know he’d be cursing in real life but of course they can’t show that on TV. He goes off on the little girl when she spills a glass of milk, calling her an idiot and worthless. The little girl starts to cry and the woman tells her husband to calm down and that does it, now he’s really off the wall, screaming at the woman and even looking as if he might hit her. She cowers and turns back to washing the dishes while the father starts screaming at the girl to stop crying and when she doesn’t he slaps her across the face. The woman doesn’t do anything.”
“Does that sound familiar, Jacquelyn?”
Tears roll down her face. “I didn’t want to kill my mother. Oh my God, I hope not. I hope I didn’t wish her gone, because then I would have been left with him.” Pause. “We were both such cowards,” she says now sobbing.
“What do you mean?” I ask.
“Both of us. Neither of us could stand up to him.”
“Jacquelyn, you were a little girl. How were you going to stand up to him?”
She shakes her head and continues sobbing. “Cowards. We were cowards. We should have done something.”
“You’re angry at both yourself and your mother for not being able to fight back.”
“We were cowards.”
“You can’t accept your own vulnerability, Jacquelyn.”
“No! I can’t!”
“So you wanted to kill the woman in the TV show because of her ‘weakness,’ because of her vulnerability.
“I didn’t want to kill her, I wanted her dead.”
I think Jacquelyn has had enough for today and decide to back off.
“You’ve done a lot of good work today,” I say. “I wonder how you’re feeling.”
“Scared.”
“Scared of?”
“I’m not sure. Being slapped across the face like the girl in the TV show. That’s silly. I feel bad, like I did something wrong and I’m going to be punished.”
“I understand, Jacquelyn. You’ve gotten closer to your anger than you’ve ever been and I think that’s frightening you.”
“You think so?”
“Yes, I do.”

“Okay. I’ll try to think about that.”

Thursday, September 14, 2017

Chaos

“Welcome back,” I say to Ed, smiling. He attempts a smile in return, walks into my office, sits down in the chair across from me, and sighs. A smart, sensitive, psychologically minded twenty year old college student, Ed has had difficulties for much of his life – anxiety, compulsivity, facial tics, self-flagellation - but seemed markedly improved before returning to his home in New York City for the summer.
Shaking his head from side to side, he says, “It was too soon. I shouldn’t have gone home. And I shouldn’t have participated in that anti-Trump demonstration. Too much, way too much.” I watch Ed’s eye begin to twitch. He raises his right hand, then catches himself, makes a fist and puts his hand down. “As you can see, it’s back,” he says contemptuously.
“I’m sorry, Ed. I really am. Did you really feel so angry with you that you wanted to hit yourself?”
“Yes. I wanted to beat the shit out of myself,” he says clenching his jaw. “I’m sorry. I know you’ve worked so hard to help me stop that.”
“You don’t have to apologize, Ed. I’m just sorry you’re in so much pain.”
“I’m weak. I’m a sniveling baby. I can’t do anything to help myself.”
“That certainly sounds like the voice of your father.”
“Yeah, so what else is new? I thought I could take him on. I thought I was ready. How stupid of me. And joining that demonstration was terrible.” Ed’s eyes widen. I can feel the fear seeping from him. He fidgets, crossing his legs from side to side. “There were so many people, angry people. And they should be angry. We have an insane bully in the White House. North Korea, Venezuela, racists, Nazis! It’s insane. It scares me. But all the anger scares me too. It reverberates in my head. I can’t turn it off. I feel like I’m crazy too.” Ed digs his nails into both fists. He looks down at those fists as though they’re an alien part of him. He starts to beat his thighs.
I want to go and hold his hands to subdue him, to reassure him, to prevent him from hurting himself. Instead, I softly say, “Ed, Ed please look at me. I’m here. We’ll get through this. You’re with me now. You’re not in that demonstration, you’re not with your parents.”
Ed looks at me, first as though he doesn’t see me and then with dawning recognition. Tears roll down his face. He buries his head in his hands. “I don’t want to be crazy. I don’t want to be crazy,” he mumbles through his hands.
“You’re not crazy, Ed. You’ve been traumatized, actually re-traumatized, and it will take us a while to work it through. Can you talk about some of the things that happened with your parents or does that feel like too much for today?”
He lifts his head and smiles at me. “Well, that never happened. No one was ever sensitive to my feelings. It’s amazing what a difference just a little understanding and caring makes. How many times have I said I wish you were my mother?”
“Except there’s usually a second part to that statement.”
“Yeah, I’m afraid that not even you could stand up to my father and I wouldn’t want to find that out. And then you say you couldn’t promise me that you’d be able to stand up to my father but you certainly hope you’d try.”
“I also say that your father’s rage is not the only rage you’re afraid of, that you’re afraid of your own rage as well.”
He nods.
“I wonder if that’s what happened in the anti-Trump demonstration. You were…”
Ed interrupts me. “I did think that my father is a lot like Trump. A bombastic bully who’s thin skinned and easily narcissistically wounded.”
“So you mean you’d be afraid of going up against Trump, just like you’re afraid of going up against your father?”
“Yes.”
“That makes a lot of sense.”
“But you were you going to say something when I interrupted you.”
“Oh, yes. About your anger. I was wondering if in the demonstration you saw all these people who seemed comfortable with their anger and that that scared you, made you afraid that your anger might get out of hand, especially since, as you just said, Trump reminds you of your father.”
“You know, I’ve never quite gotten that bit about my anger, but somehow it makes sense in the context of that demonstration. There were all these people yelling their heads off, shouting terrible things about Trump. I wanted to join in, to become a part of the crowd. But instead I drew in and had all this noise going on in my head.” Pause. “Thank you. I feel much better.”
“My pleasure. See you Thursday.”

“Thanks again.”

Monday, August 21, 2017

The Consultation

Rebecca Whitman rises from the waiting room chair extending her hand to greet me. She is dressed in a pale lavender suit and matching high heeled shoes which are surprisingly flattering with her flowing dyed red hair. I wonder at her age. Mid-forties? Hard to know how much plastic surgery she’s had.
“This is a consultation, right?” she begins immediately . “I’ve had lots of them. You get to decide if you want to work with me and – never to be forgotten - I get to decide if I want to work with you. So what do you want to know?”
Feeling as though she has just thrown out her opening salvo, I say, “That’s quite a beginning.”
She sighs. “I believe in getting to the point. Why waste time. It is my money after all.”
“Do you want to be here, Ms. Whitman?” I ask, noticing that I have automatically called her by her last name.
“Why do you ask?”
“Well, we’ve never met before and yet it feels to me that you’re already angry with me. That doesn’t make much sense unless you’re angry at being here.”
“I’m always angry. I’m angry at being here. I’m angry that I have to pay you to listen to me. I’m angry that I’ve seen I don’t know how many therapists. I’m angry they’ve either thrown me out or been completely incompetent or both. I’m angry that even though I’m one of the best real estate agents in the area, I eventually get shown the door. No biggie, I’m good enough I always find another agency. I’m angry that I’ve had three failed marriages and heaven knows how many other relationships that failed. Any questions?”
I feel torn. A part of me wants to join all the others who have gone before me and stop this consultation immediately.  But another part, perhaps the grandiose part, wants to give it a shot. I do know if I’m going to try, I want to do something other than taking her anger on directly.
“What would you be feeling if you weren’t feeling all that anger?” I ask.
She laughs. “I’ve heard that one many times before. You think a simple question is going to have me dissolve into tears. You’re going to have to do better than that.”
So much for not taking her anger on directly. “Do you like being angry? Do you like losing jobs and relationships and therapists? And why are you here? What do you want to accomplish?”
“Better,” she says.
I feel myself getting angry at her constant evaluation of me. I keep silent.  
The silence persists.
“I guess you want me to answer your questions.” Pause. “Ok, Ok, I’ll answer the questions. Sometimes I like being angry and sometimes I don’t. And, no, of course I don’t like losing job or relationships.” Pause. “I’m not sure why I’m here. I guess I’m hoping someone doesn’t throw me out.”
Her last statement sounds so sad that I find myself fighting back tears.
“Someone I can have respect for, that is,” she adds with her typical bravado.
My sadness shuts down immediately. Rebecca Whitman has told me a lot about her defensive need for anger.
“If I ask you who was the most significant person in your life who threw you out, who would you say?”
She shrugs, “My mother.”
“Ok, Rebecca, so I do think you’re afraid if you let down your anger you’d be left with lots and lots of tears, tears of loss, abandonment, worthlessness and, of course, rage.”
“Think you’re smart, huh?”
“Rebecca this isn’t a contest. I’m not here to beat you in a competition. I’m on your side. And I know you can’t simply put away your defensive angry. It’s been a part of you for a long time. But hopefully if you come to trust me, you can let it down little by little and together we can deal with the pain underneath.”
“Ok smarty-pants, guess why my mother threw me out.”
“There’s no way I could guess that, but I’d appreciate your telling me.”
“Because I told her my step-father – step-father number three, by the way – was doing it to me.”
“Oh, Rebecca, I’m so sorry.”
“Yeah? Yeah? What the fuck good is your pity going to do for me? I was eleven years old. Eleven years old for God’s sake!”
“That’s more than reason enough to be angry. But you must also feel sorry for you as that eleven year old child.”
“I don’t believe in a pity party!”
“Compassion for a child is not a pity party.”
“So are you going to work with me?”
“Yes, Rebecca, I’m going to work with you. I’m not going to throw you out.”

“Ok,” Rebecca says as she sprints towards the door.