Wednesday, April 26, 2017

An Emotional Storm

“Bill broke up with me Saturday night,” says 28 year old Chelsea in her Monday session, looking as though she may not have slept or bathed since then.
“I’m so sorry…” I begin.
“You didn’t call me back. I called and called and called.”
“I’m sorry, Chelsea, but when I called on Sunday I explained I was at a very long play, didn’t check my phone and got home way too late to call. Did you get my message?”
“It was too late,” Chelsea says, rolling up the left hand sleeve of her blouse.
Always a bit queasy, I resist the urge to look away, her left arm filled with red gashes from what I assume are self-inflicted cuts from a razor blade. “Oh, Chelsea,” I say, “It’s been years since you felt the need to cut yourself. I guess you were mad at both Bill and me.”
“You abandoned me. I couldn’t stand the pain.”
“What made the pain so unbearable?”
“What?” she asks, becoming angry. “That’s a stupid question. The two most important people in my life abandon me and you ask what made the pain so unbearable?”
“You’re definitely angry with me.”
“But why did you need to turn the anger on yourself, why cut yourself, why not be angry at me, at Bill?”
“What was I supposed to do, go to your house and kill your dog?”
“Was that a fantasy you had on Saturday night?” I ask, hoping I sound calmer than I feel internally.  
“What if it was?”
“You know, Chelsea, it’s always all right to have whatever fantasy you have, as long as it stays a fantasy.”
“Hah! Scared you, didn’t I?”
“It’s a scary fantasy, but the pleasure you took in scaring me indicates just how angry you are at me. I guess what you’re saying is that you felt afraid you couldn’t contain your rage, so had to turn in on yourself.”
“I wanted to kill you! I wanted to kill Bill. I did start swinging at him, but he just pushed me away and told me that’s why he had to get away from me and literally ran out the door.”
“I am sorry, Chelsea. I know you loved Bill and really wanted this relationship to work out.”
“Why don’t they? Why don’t any of my relationships work out?” Chelsea says, starting to cry.
Although we have dealt with the responses to those questions many times over the years – because you’re demanding and needy, because one moment you love the person and the next you hate him, because you can’t tolerate even brief separations without feeling enraged or terrified or both  - I also know this is not the time to revisit them.
“When I didn’t call you back on Saturday, what did you think? Why did you think I didn’t call? And what did you think when I called on Sunday?”
“I felt you were just like Bill. That you didn’t care about me, that you were sick of me just like him, that you wanted to be rid of me.”
“I understand that’s what you felt, Chelsea, but I was asking something a little different. I was asking what you thought. If you thought there might have been a reason I didn’t call you back that might have had nothing to do with you, like maybe I lost my phone or forgot it.”
“But you didn’t. You chose not to call me back.”
“So it would have felt better for you if I’d called after midnight?”
“It would have felt better, but it still would have been too late.”
Only Chelsea’s feelings exist for her at this moment. “You’re caught up in so many painful feelings, Chelsea - hurt, loss, rage, abandonment – that from this place it’s impossible for you to step outside your feelings and try to reflect on them. So maybe it would be better if we focused on helping you not to turn all those feelings on yourself and hurt yourself. Can we do that?”
“I kinda liked doing it, it was like going back to an old friend.”
“I’m sorry to hear that. So are you saying that you think you’re going to start cutting again?”
Chelsea smirks. “That made you angry, didn’t it?”
“You know, I wasn’t aware of feeling angry, but you’ve always been incredibly sensitive and now that you mention it, perhaps that’s true.”
“And that’s one thing I’ve always appreciated about you, your honesty and your willingness to own your own shit.”
“Thank you. So maybe from there we can work on repairing our relationship and move forward.”
“Maybe,” Chelsea says with considerable hesitation.
“I understand. Right now repair feels difficult.”

“Yes, it does.”

Tuesday, April 11, 2017

Seeking Protection and Connection

I smile at my new patient, Eileen, as I greet her in the waiting room, extending my hand in introduction. She doesn’t return my smile, but does warily shake my hand. Settling herself stiffly in the chair across from me, she looks slowly around the room.
Oh oh, I think, seems like a pretty disturbed woman, at best distanced and removed, perhaps paranoid, maybe a trauma survivor.  
“I like your office,” she says. “All the windows. Feels free, like floating in space.”
“Thank you,” I say, not sure how to take her comment. An attempt to relate to me? A fear of being confined? A desire for freedom? Hopefully not a wish to jump.
A few moments pass in silence.
“What brings you here?” I ask in traditional therapist mode.
“I have no friends.”
“Can you say more?” I ask, while thinking that her demeanor would certainly make having friends difficult.
“I’m 36 years old. I live alone. I work at home. I’m an IT person, a computer geek.” She shrugs. “There’s no one in my life.”
“Sounds sad.”
“I guess.”
“How do you feel about not having friends?”
“It doesn’t seem normal. People are supposed to have friends.”
“Eileen, what made you decide to come into therapy right now?”
“I found you online. You had a kind face. I liked your website.”
“Like maybe you hoped I’d be your friend?”
“Eileen, can you tell me a little about your background, your childhood, your family.”
“It was messed up. My parents divorced when I was two. They’re both alcoholics, drug addicts, both with so many different partners I lost count. And a ridiculous number of so-called siblings. I’d go from one household to the other. Sometimes there would be six, eight of us in a small apartment. I hated it. Felt like I couldn’t breathe. I just wanted everyone to leave me alone. And basically they did.”
“So you learned to put up a wall that said ‘stay away.’”
“Yeah, that’s a good way to put it,” she says nodding. I have the sense she’s pleased by my understanding, although there’s no obvious change in her demeanor.
“Have any idea what’s behind that wall?”  
“What do you mean?”
“Well, when you construct a wall, there’s usually something behind it, something you’re wanting to protect, perhaps something that feels vulnerable or scared.”
“I don’t do vulnerable or scared.”
“So it feels pretty scary to be vulnerable or scared,” I say smiling compassionately. I find myself liking Eileen, feeling sad for the deprived, needy child who must exist behind what feels like an impenetrable barrier.
“I didn’t say that,” she says, stiffening.
“Sorry,” I say, backing off. This is going to be slow, slow going. I need to be careful not to push to glimpse behind that wall too quickly. Her defenses are there for many reasons. They need to be respected, not ripped away.
“You said earlier that there’s no one in your life. Do you see your parents?”
“Not if I can help it. Maybe once or twice a year. Christmas time, Easter. Maybe not.” She shrugs. Doesn’t much matter to me.”
“Was there anyone in your life who did matter to you when you were a child?”
“Like who?”
“A grandparent, a teacher.”
“A math teacher in middle school. She thought I was more than a dumb oaf. She encouraged me. Maybe she was like my friend, except she was my teacher so she couldn’t be my friend. But she’s the one who helped me make something of myself. I don’t know where I’d be if it weren’t for her. Probably just like my parents. Except without the drugs. I’ve never touched drugs in my life. Swore I never would and I haven’t.”
“That’s pretty amazing determination, Eileen, given where you came from and what you’ve been through.”
“Mrs. H – that’s the teacher – she’d say things like that.”
“And when she or I say things like that, you feel a sense of warmth, of being understood and appreciated.”
She looks down. “Yeah, I guess that’s right.” She pauses. “So are you going to help me learn how to make friends?”
“Yes, Eileen, I am. But we have a lot of work to do before finding friends becomes our focus. First we have to help you find you. We have to find the person behind your wall and that’s going to take time. You’ve been hiding from that person for a long time and a sledge hammer isn’t going to work here. And I suspect it’s going to be painful and scary for you. I’ll be here with you and hopefully that will make it easier, but I’m sure there are times it will be tough going.”
“I’ve been through tough before.”

“Yes, I’m sure you have.”