Missed Sessions

 Jeremy, the prototype of a man who is tall, dark, and handsome, and just beginning to enter middle-age, begins his session by saying, “I won’t be here for the next three weeks. I’ll come back in December.” 

“Are you going out of town?” I ask, surprised. He hadn’t mentioned an upcoming vacation. And I don’t recall him making such an announcement in the two or so years we’ve worked together.

He squirms in his chair. “Umm, no. No, I just figured I could do with a little break.”

“Because?”

He crosses his legs, uncrosses them, then crosses them again. “It’s just beginning to be a bit too much.”

“What’s the ‘it?’”

“This,” he says, gesturing around my office.

“And what’s making it too much?”

“That,” he says brusquely, gesturing toward me with his chin.

“I’m too much.”

More squirming. “Not you exactly, just this, this questioning, probing, always searching for something more, something deeper.”

I try to think what might have occurred in our last few sessions that may have brought about Jeremy’s desire to flee. “Is there something that happened that made you feel I’m too overbearing, too intrusive?”

“I knew you’d say this was about my mother!” Jeremy says angrily.

Although I hadn’t been thinking about his mother, I remain silent, waiting to see what might develop.

“It’s not about my mother. I haven’t spoken to my mother in weeks. I decided to take a break from her too!” He pauses, taking in what he’s just said. “Shit!! I just agreed with you, didn’t I? This could come straight out of a Woody Allen movie!”

I smile. “And like in a Woody Allen movie, I’m going to continue digging. Is it that I’m feeling like your mother or have you experienced me as being more intrusive lately? Or did something happen with your mother?”

“I don’t want to. I don’t want to keep thinking and thinking and trying to figure things out. It’s enough already. I need a break!”

I feel frustrated and annoyed and find myself unable to stop. “Can you at least humor me and help me understand why this has come up right now?” As he is about to respond, I realize that I am indeed duplicating his relationship with his mother and say, “Wait! Let me pull back. First, I realize I am repeating exactly the relationship you have with your mother. I’m coming after you more and more. And the more I come after you the more you resist and the more you resist, the more I come after you. But, and maybe this is the piece you need to own. You’re the one who has put up an unbreakable wall. You’ve said ‘no matter what you say or do, I’m not telling you.’ You may have very good reasons for erecting that wall in the past, but now it feels more like a two-year-old who’s having a tantrum. Which doesn’t excuse my behavior of coming after you. I need to look at that myself and figure out why I couldn’t just pull back and let you tell me in your own time.”

“That’s a lot to take in.” Pause. “I do appreciate your saying that last part, that it’s not all me, that something got kicked up in you as well. It helps break the cycle you were referring to – chased after, run away; run away, get chased after.”

Long pause.

“I think I know what happened,” he continues. “I did have a
conversation with my mother. But before that I broke up with Charlene. I broke up with Charlene for exactly the reason we’re talking about. I told her I was going out with some friends and she asked where we were going. I wouldn’t tell her. We were only going out drinking, although Charlene did think I drank too much. Anyway, I wouldn’t tell her and she came up with more and more preposterous guesses – going to a strip club, hiring prostitutes, etc. It was ridiculous. The more she came at me, the more intransient I became until I finally said, ‘That’s it, we’re done!’ My mother called the next day and began right away bugging me about what had happened with Charlene and when was I going to settle down and give her grandchildren. I hung up on her.”

“So you were tired of all these pushy women, myself included.”

“Exactly!”

“I wonder if you’re so afraid of all these pushy women that you erect barriers to protect yourself or whether you erect those barriers so that women WILL come after you so that you can be ‘justified’ in rejecting them.”

“Why would I do that?”

“We’re almost out of time and you’ll need to tell me whether you’ll be here next week or not, but I think you might want to reject them so you never have to deal with the need for genuine connection that exists within you.”

“Wow! That’s a lot to digest”

“Yes, it is. And if you want to take some time to digest it, that’s fine and if you want to come in next week that’s also fine.”

“Can I think about it and call you?”

“Yes.” 

Risk Averse

 “I was talking to my friend Cindy last night,” Jenny begins. “She said she came across this quote from Eleanor Roosevelt ‘Do something every day that scares you.’ I was blown away. That’s just what we’ve been talking about, right?”

“Yes,” I agree nodding. “That’s a very profound quote.”

“But I thought you said you have to feel safe in order to take risks.”

“That’s also true. But if you wait until your last, last drop of fear and anxiety is gone you might stay stuck forever.”

“I know,” Jenny says dejectedly. “That’s why I’m here,”

“You’re 25 years old Jenny, I don’t think you can say you’re stuck forever.”

“I know. But we’ve been working for a while now and there are still so many things I’m terribly, terribly afraid of. Meeting new people is a total, complete trauma for me. I hate the first few weeks of school. There are so many new people, new faces, new expectations, new, new, new.” 

“And what is it that you’d say you’re afraid of?”

“That’s no secret. The wicked step-mother! What a cliché.”

“Except your step-mother was a little more wicked than most.”

Jenny seems to fade away and soon starts visibly shaking.

“Jenny, where are you? Can you come back?”

“I’m here. I didn’t dissociate. At least I don’t think I did. I knew I was here with you in your office.” Pause. “But perhaps part of me was back there, back in that basement,” she says starting to cry. “Why, why did she hate me so much? What did I do that was so terrible?”

“Jenny…”

“I know. You’re going to say I didn’t do anything. That she hated me because I took my Dad away from her, because she couldn’t have him every minute of his life. But maybe that means I was too demanding, wanted too much!” she adds sobbing.

“Is that how it feels, how it felt?”

“Yes, that I was just a greedy child who would suck her father dry unless Darlene stepped in to protect him! After all, I had killed my mother, why wouldn’t I kill him?!”

“Do you feel you killed your mother?”

“Of course!” Pause. “No, no I didn’t kill my mother, she died of cancer!”

“Jenny, it sounds like the rational you knows that you didn’t kill your mother, but perhaps there is a piece of you that feels you did.”

“She died so soon after I was born, before I was one. I don’t remember her at all,” she says sobbing. “Is that killing her? Not remembering her?” Pause. “Maybe I infected her when I was inside her. Maybe there was something so bad about me I contaminated her.” 

Although the rational me, yearns to counter Jenny’s assessment of her culpability, I wait to see what more primitive material Jenny may unearth. 

“Darlene would always tell me I was a bad seed, destined to do nothing but hurt and destroy. I fought her, screaming, yelling, thrashing, but she only hurt me more, left me starving in the freezing cold basement. It gets cold in Vermont in the winter. But, truthfully, I believed her. I believed I was a bad, bad person. I had killed my mother. She gave up her life for me. Even neighbors said that. ‘Your mother loved you so much. She gave up her life for you.’ She gave up her life for me and I was so, so angry with her. If she was going to have me, she should have stayed with me!! If she was going to leave me she should never have had me!” Jenny says, sobbing.

I want to go her and hold her and tell her nothing was her fault and that everything will be all right. Instead, I sit calmly in my chair. 

“I never said that out loud before,” Jenny says between sobs. “It feels good to say it out loud.”

“What feels good about saying it out loud?”

“I’m not sure. Sort of like I can examine it in the light of day.”

“And what do you see when you examine it in the light of day, in the light of an adult day?”

“Yes, that’s it. Saying it out loud brought it into the present, into me as an adult – sort of. It’s like a child fantasy that I’ve carried around my whole life and in the light of day – in the adult light – it doesn’t feel as real or as powerful.”

“It’s time for us to stop for today, Jenny, but you’ve done amazing work here today. I hope you’re able to be proud of yourself.”

Yes, yes I am,” she says smiling for the first time. “Thank you.”

“Thank you,” I say.

Mother

 “My mother is driving me absolutely crazy,” Jenny begins. “I know that’s an old story, but it’s getting worse. I’m trying to get ready for my 50th birthday party and she can literally call me a dozen times a day. She’ll ask me how she can help me with the party and if I give her anything to do she keeps calling with one question after another. ‘Is it okay if I invite my sister? What about my neighbor? Are you having kids come? What about kids under 12? Under 5?’ And those are all separate calls. It’s driving me nuts! I’ve asked that she text me these questions but she just won’t do that. I’m at my wits end.”

“What’s your guess as to why she’s calling so often?” I ask. “Is she having some anxiety about you turning 50?”

“I never thought about that, but maybe. If I’m turning 50 she has to be getting older too. She’s always dreaded aging. But I don’t know, it also just feels like it’s what she’s always done, pretended to be helpless so I would take care of her, which has obviously gotten worse since my father died. I’m tired of being her caretaker. I have enough of my own headaches, my daughter floundering, my husband dissatisfied at work. It’s too much. But my mother is always the one who throws me over the edge. I guess that’s because I see her as so narcissistic and self-involved, never really seeing me or wanting to know what I want.”

“That’s obviously been true throughout your life.”

“Definitely! That’s why it’s so maddening. Even these questions about my party. It’s she who wants to invite her sister – and of course I’m inviting my aunt. She wants to invite her neighbor and it’s she who probably doesn’t want kids at my party.” Pause. “I’m sick of talking about her. I feel I can’t ever get her out of my head. Now she even calls about questions about her money, about her checkbook, about whether she deposited her social security check, which is of course on direct deposit. I guess she’s getting more and more infantile, wanting more and more for me to take care of her.”

Alarm bells go off in my mind. “How old is your mother?”

“Seventy-six.”

“I don’t mean to be an alarmist, but is it possible your mother is beginning to have cognitive problems?”

At least a minute passes as Jenny sits staring at me as though in shock, a deer caught in the headlights. Then she bursts into tears. “I’m terrible! I’m a terrible person, a terrible daughter. My first thought when you said that was, oh no, now I’m really going to have to take care of her! Isn’t that awful?”

“No, it’s not awful of you. It’s an understandable first thought. You’ve spent your life taking care of someone who didn’t need to be taken care of and it would indeed be horribly ironic if that person does need caretaking at the end of her life. But we may be getting way ahead of ourselves. I don’t know if your mother is having cognitive problems.”

“It’s just that it makes too much sense for it not to be true. I mean I know we all – especially as we age - lose words occasionally or misplace things – but as soon as you suggested it about my mother I knew it was true. That bit about her social security check did throw me and there have been other things. She didn’t seem to know who the President is although she’s always stayed up on current events. And it wasn’t only that she didn’t know, she didn’t seem to care either. And when she called to ask if she could invite her sister, I got short with her and said, ‘Of course I’m going to invite Aunt Mary.’ The way she reacted, I wasn’t sure she really knew her sister was my aunt.” Jenny pauses and shakes her head. “This is so terrible. What an awful way to end a life! And I’ve been getting so pissed at her lately and I’m sure you’re right, she just can’t help it.”

“But your getting pissed at her makes sense. You’ve seen her constant calling, questioning as a continuation of her playing at being helpless to elicit your caretaking.”

“But it’s not! Or maybe sometimes it still is.”

“Yes, that’s possible.”

“This is going to be hard.”

“Yes, it is.”

“I think I’ll make an appointment with her neurologist. Maybe he’ll be able to tell me how bad she really is. And if anything can be done.”

“Sounds reasonable.”

“But they really can’t do anything, can they?”

“My understanding is, not much, but it never hurt to explore possibilities and get an idea of where she is at this point.”

Pretending

 “I did it!” Charlotte says, gleefully.

“Congratulations,” I say enthusiastically, “And welcome back.”

“I’m not talking about going by myself to Italy.”

“Oh! What did you mean?” 

“I did go by myself to Italy. It was hard. And all you’ve heard about Italian men, don’t believe a word of it. No one gave me a second glance. Oh course, why look at a middle-aged woman when you have all these gorgeous young, half-dressed I might add, girls running around. But seriously, don’t you remember what we talked about our last session?”

“I thought I did but… Oh, Charlotte, you really didn’t…”

She smiles broadly nodding at me.

“You pretended you were sick,” I state matter-of-factly.

“Correct! You see, not even you can remember me unless I do something daring, outrageous.”

“Of course I remember you. I didn’t remember that you were considering presenting yourself as someone who was ill, but I remember …”

“It doesn’t matter. I figured out how to get the attention I wanted. The more outrageous I made the story the more attention I got. It’s amazing how solicitous flight attendants can be when you tell them you’re dying of cancer or that you just had a chemo treatment.”

“And is that whose attention you wanted?”  

“Anyone is better than no one, but no, that’s not whose attention I wanted. But it was fun trying out different stories and seeing what provoked the most sympathy or what made people the most uncomfortable.”

“What did make people the most uncomfortable?”

“If they thought I was going to throw up all over them. That was a good one, especially on a plane with the person sitting next to me.”

“Sounds like you took a lot of pleasure making people uncomfortable.”

“Yes, I did. Felt like I was getting back at all the people who’ve made me uncomfortable, people who look at me like I’m ugly or don’t look at me at all, as if I don’t exist.

“What do you feel as you tell me all this?”

“First word that came to me? Triumphant!”

“And since you’ve been home?”

“It’s back to the same boring life. Biller in an ophthalmologist’s office. Real exciting. A great place to not be seen.” Pause. “But I am thinking about bringing my little pretense back home. Maybe in grocery stores or gas stations – I can go someplace I don’t usually shop. I’ve even considered taking it to work. Who’s to say I couldn’t start telling my co-workers I haven’t been feeling well, that I’ve gone to the doctor, that I have some kind of cancer, etc., etc.”

“Charlotte, when you first started talking today I felt annoyed with you, annoyed for the people you were duping and angry that you felt you had to stoop to subterfuge to get people to pay attention to you. But as you’ve kept talking, I find myself feeling sadder and sadder. And I suspect you also feel both angry and sad. You’re such a bright, insightful person. You could do so much more with your life.”

“Except that I’m ugly.”

“I know you feel ugly, and this is something you and I constantly disagree about, but you don’t have to be the most beautiful woman in the room to have friends, to have lovers, to have a job that fulfills you.”

“You mean billing doesn’t fulfill me?” she asks sarcastically.

I sigh. “I know your mother didn’t value you. I know you feel your older sisters were prettier and smarter than you. And given all that, it is still possible to have a meaningful life.” Pause. “You’ve always talked about writing. You certainly demonstrated that you can be creative with your storytelling about yourself. Put the stories down on paper instead of acting them out.” Pause. “I’m sorry. I’m preaching. I know I can’t decide your life for you.”  

“I’m 55 years old. Don’t you think it’s too late for me? How do I change now?”

“You went to Italy.”

“And my most fun was spinning a death fantasy about myself.”

“What was your fantasy about what the trip would be like before you left?”

Charlotte drops her head. “I thought I’d meet the love of my life. I know, that’s stupid, ridiculous. I feel like an idiot even saying it.”

“It’s not stupid, Charlotte, it’s a wish. But maybe it would have been good if we had talked more about your imaginings about the trip before you went so that you could have anticipated several scenarios, thought of the good things that might have happened, as well as the disappointing things. And I know that although many people like it, traveling alone can be very hard.”

Charlotte starts to cry. “It was very hard.”

Considering

 “I wanted to let you know,” Tammy says immediately upon sitting down, “I’m considering changing therapists.”

I’m surprised and try to recall what if anything might have occurred in our last session that would have prompted her possible termination. “Because…?” I ask.

“We just don’t seem to be getting anywhere. It’s over two years. And, yeah, I know, therapy is a process, not a destination.”

“Is this something you’ve been considering for a while?”

“Uhm. No, not really.”

“Can you say what started your thinking along these lines?”

Tammy squirms in the chair. “Uhm, I guess I’d rather not.”

“Why would you rather not?” I ask bemused.

“This is why I want to change therapists! You question everything! You want answers to everything! Why? Why? Why? I’m sick of it.”

“And what would you prefer instead?”

“Somebody who just left me alone and let me live my life!”

“Then why would you want to be in therapy at all?”

“I considered that too. But not being in therapy feels too scary. I don’t trust myself enough to not be in therapy. Who knows what I might do.” 

“I realize that you’d rather not say what started your thinking about changing therapists, but I think it’s important that you do. You know if you decide to change therapists I certainly would support you in whatever way I could. But given what you just said about not trusting yourself, I suspect that means you know you can make impulsive decisions and that despite you’re not liking to be asked why, it is an important question for you.”

Tammy sighs deeply, rolls her eyes, looks at me and smirks. “I ran into Michael, my ex-boyfriend, Michael.”

“And?”

“What do you think?”

“He wanted to get back together.”

“Right. I told him I was engaged to Philip and he just laughed. Said he couldn’t believe I was still with that nerd. And that he bet I was still in therapy with you too. I told him yeah, I was. He says it figures, that you’d want me to be with a loser, always chasing my own tail.”

“Do you feel I want you to be with a loser?”

“No, not exactly, but you are always pointing out how good Philip is to me, how he cares for me and tries to take care of me.”

“And those are bad things?”

“No, of course not. But they can get kind of boring.”

“Did you have sex with Michael?”

“No, but I was tempted.”

“So it’s Philip or Michael and me or some other therapist?”

“I guess that’s about right.”

“And who’s the other therapist?”

“I don’t know. I haven’t gotten that far.” Pause. “But maybe he would be a man. That would be different; might make it more interesting.”

“Are you saying it might make it more dangerous or more sexual…”

“I’m not sleeping with any therapist!”

“I wasn’t suggesting you were, but wondering if having a male therapist would introduce the possibility of sex into the treatment and that might feel more tantalizing.”

“I chose a female therapist in the first place because I didn’t want that sexual element to be a part of it.”

“And now you think you might?”

“I don’t know. I guess that’s why I said I was considering changing therapists, not that I’d decided.”

“This is a big conflict for you, Tammy: safety and comfort on the one hand, or excitement and danger on the other. It gets played out with Michael and Philip, with me and a male therapist, and also in your work. Should you give up your job as a nurse and see if you could make it as a singer?”

“That’s just a dream, I’m not doing that. Too risky.”

“And are you comfortable, resolved saying that?”

“Makes me a little sad, but yeah. I’m 36, I’m not making it onto the charts. Too many of me out there.”

“So that’s one of the things you’ve come to accept.”

“Yeah, I guess.”

“You know, it actually might have been helpful for you to have seen a male therapist from the start…”

Tammy shakes her head adamantly from side to side.

“No?” I inquire.

“No. Then I really couldn’t have trusted myself and who knows what stupid thing I might have done, maybe even made an ass of myself and tried to seduce the guy.”

“So maybe now the question is do you want a break from the nice, caring me and/or Philip and add a bit of spice to your life in the way of Michael and/or a male therapist.”

“I guess so.” Pause. “I don’t know. I guess I’d like to continue considering it.”

“That sounds like an excellent decision. And we can continue to talk about it as well.”

You’re Number Five

 “You’re number five,” Alex says upon sprawling languidly in the chair opposite me.

“Number five?” I ask. 

“Yes, you’re the fifth therapist I’ve seen. I liked your website, maybe a bit too sappy, but still pretty good.”

“What happened to the other four therapists?” I say, choosing to ignore his comment about my website.

“I fired them.”

“Because…?”

“Because they weren’t smart enough. Well, I guess that’s not completely true. I saw the first one for maybe a year. He was pretty good, but then I moved, so that was the end of him. The other three I saw here, but like everything else in Florida, they were just too stupid.”

“You certainly sound as though you’re angry, angry and hard to please, like nothing is good enough.”

“Okay, that’s not a bad comment. You’d get about a seven out of ten for that.”

Feeling myself becoming annoyed, I say, “Why don’t you tell me about yourself and about how I can help you.”

“That’s just it, I don’t know if you can help me.”

“Then tell me what brings you here.”

“I’m not happy.”

“Because…?”

 “Because the world is a shit place. Because people are stupid and insensitive and uncaring.”

I hesitate and then decide to say what came to mind for me. “And you see yourself as sensitive and caring?”

Alex laughs sarcastically. “I see you didn’t include smart in that and, yeah, I see myself as smart even though you didn’t ask. Sensitive and caring, not so much, but probably more than you think.”

“Alex, this isn’t a sparring contest. I imagine you are more sensitive and caring than you appear, and that your aggressive, confronting tone is more of a defense against whatever sad or scary feelings lie underneath. If I’m going to be your therapist, I need to have a sense of who you really are, so maybe you could tell me a little about those scary feelings.”

“Wow! You go right for the jugular, don’t you?”

I bite back my first impulse which is to say ‘Takes one to know one,’ assuming that would just continue the one upmanship. Instead I say, “How about telling me a story from your childhood.”

He smirks. “Yes, that’s right, you’re a psychoanalyst.”

Silence.

“Silence. Another tool.”

“I understand that change is hard, Alex, but there’s nothing to be gained by your being here, unless you’re willing to give us a chance as opposed to assuming I’m the enemy or a dueling partner.”

“You’re pretty good. I can’t rile you up.”

“There are lots of clever rejoinders I could give to your statements, Alex, but this isn’t supposed to be a debate. We’re supposed to be on the same side.”

“No one has ever has been on my side.”

“That’s sad,” I say, feeling a ray of hope. “Can you tell me who particularly you were thinking of?”

“My mother died of cancer a year after I was born – although obviously that wasn’t her choice – my father hated me because he was stuck with me, my older brother hated me because he blamed me for my mother’s death, my father’s mother thought I was a nuisance, my teachers all hated me because I was such a smartass – which I was – my wife divorced me and turned the kids against me, etc., etc. Get the picture?”

“Sounds like a pretty dismal picture. But it also seems, at least in some instances, that you’ve helped the picture stay dismal by, as you said, being a smartass which only ends up driving people away. I’m sure that ‘smartass’ way of being felt essential for your survival as a kid, but now it’s a hindrance that drives people away and leads to your being alone and unhappy.”

“I’m not unhappy. I’m just not happy.”

“Not happy and alone?”

“Yes.”

“And sad?”

Before Alex responds I rush to say, “Not a smartass response.”

He laughs. “Yes, and sad.”

“And you’ve been sad most of your life and you cover it over by being sarcastic and pretending you don’t need anyone.”

“Yes.”

“Thank you for giving me genuine responses.”

“You’re welcome. And thank you encouraging me to make that possible.”

“You’re welcome.” 

Pause.

“So are we deciding to work together?” I ask.

“Yeah, I guess I’ll give number five a chance,” he says smiling genuinely. “I promise I’ll be easier on you next time.”

“I don’t imagine you’ll be able to give up your defenses that readily, so I don’t think either one of us should expect you to be an entirely different person by next week. Maybe we’ll just be able to be lighter about your smartass responses, as opposed to thinking you won’t have any.”

“Sounds reasonable, Doc. Thanks.”