Lying

He sits fidgeting in the chair, alternately looking down at his hands and staring at me. I don’t usually treat 17 year old boys, but his mother was frantic when she called, convinced that her oldest son David was going to commit suicide. 

After several minutes of silence I say, “Your mother was very worried about you. Have you been thinking of killing yourself?”

He wrings his hands, continuing to move jerkily in the chair. “It’s a lie,” he says, almost in a whisper. 

“What’s a lie?”

He swallows. Tears brim in his eyes. “I don’t want to kill myself. I just made that up.” Pause. “Like always.” Pause. “I always lie. I don’t know if I can tell the truth. You know, like that guy Santos, the Congressman,” his words now coming out in a rush. “I wasn’t sure I could tell you the truth. I’m still not sure, but I’m going to try. I have to try. I don’t want to be the laughing stock of the country when I grow up. I don’t want to be the laughing stock of the school right now!”

I flash on a childhood friend when we were both in the third grade. She told the class she had three siblings, although she only had one. Since we lived in the same building the teacher asked me if it was true. I didn’t want to get my friend into trouble so I said I didn’t know. I felt compassion for my friend. I’d seen her mother scream at her and beat her with a belt. I feel a similar compassion for this young man who sits across from me. I’ve known compulsive liars, people who wanted to gain an advantage over others or who enjoyed the power of putting one over on someone. But my guess so far is that isn’t David. 

“Have you always lied?” I ask David gently.

“It’s been worse since high school. But… but I guess I always lied at home. I lied to protect my Mom, to make her feel better. I’d tell her about my friends in school, about how well I did playing soccer. Those were all lies.” Pause. “I know I didn’t make her feel better by telling her I wanted to kill myself. I guess I do sometimes think I would be better off not being here, but I know I said it like I was going to do it any minute now.”

“Why did you want to give her that impression, David?”

“I guess I felt desperate, like I have to talk to someone, to someone I can tell the truth.”

“And what is the truth?”

“I’m a bad person. I hate so many people. I hate my Dad, my younger sister, the jocks in school. Sometimes I even hate my Mom and that makes me really bad.”

“Because?”

“Because she tries so hard. And I know how much she loves me.”

“She tries so hard to…?”

“To make everyone happy. To get along with my Dad. To keep him from yelling at me. But she can’t. And in the end she’ll say, ‘Well you know your Dad just wants what’s best for you’ or ‘You know your Dad’s under a lot of pressure.’”

“So in the end you feel she sides with him.”

He nods his head. 

“And that feels pretty awful.”

“Yes. But I shouldn’t hate her for that. She’s just trying to do what’s best, what’s best for everyone.”

“But maybe doing what’s best for everyone isn’t what’s best for you.”

“I guess.”

“What would you like her to do?” 

“To tell my Dad to fucking lay off!! Oh, I’m sorry, I shouldn’t have said that. I apologize. I…”

“You don’t have to apologize, David. Here you get to say anything and everything you want.” Pause. “Has your Dad always picked on you, David?”

He nods. “He’s a college football coach. As you can see I’m not exactly made in his image. I’m this little, puny, ugly kid who’s sucked at sports all my life. He’s the life of the party. I’d rather go read a book. He can’t stand looking at me. So I make things up. I make myself more than I am.”

“I’m so sorry, David, sorry that your Dad can’t appreciate you for the caring, sensitive person you are.”

“Sensitive is the last thing my father wants me to be. He constantly accuses me of being too sensitive. And if I’m so caring, how come I just scared my Mom?”

“My guess is that you lie as a way of expressing your anger, as a way of fighting back and not being the puny, too-sensitive kid.”  

“I’m not sure I get that.”

“That’s fine, David. It’s kind of a heavy statement to throw at you just as we’re ending this session. We can pick up from here next time.”

“So you will work with me?”

“Definitely. It would be my pleasure.”

Russian Roulette

Two women occupy my office chairs today. I have seen Georgia, a tall, stately, perfectly coifed 49 year old woman on and off for 14 years. When I first began treating her, her daughter Tricia was seven years old. Now a beautiful 21 year old sits across from me, a straight A pre-med junior at the University of Florida.

Tricia’s success has been Georgia’s obsession. Through the years we have worked at diminishing her anger at her accountant husband for not being sufficiently successful to send Tricia to an Ivy League College. Although I always thought I came from an overprotective family that relentlessly pushed me to succeed, working with Georgia introduced me to a whole new definition of relentless, coupled with a rule-bound, rigid household.

It’s unusual for me to agree to see a patient’s family member, but Georgia pleaded with me and I thought the situation sufficiently alarming to agree.

“It’s a pleasure to meet you, Tricia,” I say smiling. “I’ve certainly heard a lot about you over the years.”

“I bet!” she replies. “Sometimes I think I’m the only person my Mom ever thinks about.”

Good insight, I think to myself. “And how do you feel about that?” I ask.

“It gets old. I tell her I’m a big girl now. I can take care of myself.”

“Sounds like you’re getting right to the point of your mother’s concern, having unprotected sex.”

“I know the guys I’m sleeping with. It’s not like I’m hooking up with one-night stands. I know who they are, who they’ve slept with.”

“You don’t know, Tricia,” Georgia says, her voice tense and annoyed. “You can never know. I don’t understand why you’re being so reckless, playing Russian roulette with your life.” 

“Maybe that’s a good question. Why do you think you need to be reckless, Tricia?”

“I’m not being reckless. I told you I know who these boys are.”

I remember stories from Tricia’s early teen-age years when she would sneak boys into her room at home, often managing to get caught. I definitely understand her need to rebel, to break the shackles of her mother’s iron grip, but I don’t think Tricia is aware of the motivation behind her own behavior. 

“What were the messages you got from your mother regarding sex?” I ask.

“You’re kidding, right? No sex before marriage. Sex is holy. Only meant for a married man and woman. We’ll leave the same-sex part of that out completely.”

“What?” Georgia shrieks. “Have you had sex with a woman?”

“No comment,” Tricia replies snidely.

“That’s an interesting statement Tricia. Because it seems to me you’ve made many comments – directly and indirectly - about your sex life and I have wondered why that is. How does your mother know you’re having unprotected sex? How come she knew you were having sex as a teenager? And why did you just casually throw out the possibility of lesbian sex?”

“She asks me.”

“Tricia, I know you’re a very smart young woman. Yet you seem determined not to consider the meaning of either your statements or your behavior. For one, you already said you don’t think your mother thinks of anyone but you and that you don’t like that, but you manage to increase her thinking about you by being provocative. And, while you’re reeling her in on the one hand, you’re rebelling against her and everything she believes in on the other.”

“I don’t know what you mean.”

“I think you’re not sure how close you want to be to your mother. You tell her everything to stay close and then rebel against her to move away. I do understand, Tricia, that your Mom has held onto you very tightly and that makes the process of separating more difficult.”

“So now it’s my fault,” Georgia says angrily.

Always the problem with introducing a family member into an ongoing treatment, the patient ends up feeling dismissed and betrayed.

“It’s not a question of fault, Georgia. It’s a problem that exists for both of you today. I know you want Tricia to be healthy and happy and have a full life and in order to do that she needs to separate from you in a way that’s not destructive to her.”

“She always makes it about her,” Tricia says, exasperated. “Of course, you’re making it about her too.”

I smile. “You really are a very insightful person. There’s no way I as your mother’s therapist is going to be able to help you separate. But I do think it would be a good idea for you to go into your own therapy, with your own therapist. As you said, you’re a big girl now and you need to take care of yourself.”  

Unleashed

“I didn’t want to come today,” Penny says quietly. “I knew I’d have to tell you what I did and I’m not sure I want to. I’m not sure I can.”

Penny’s anxiety is palpable and mine rises along with hers. It’s difficult when patients introduce a topic this way. I always think of something dreadful – she attempted suicide, she started cutting herself, she killed her daughter. I remain silent.

Penny sits looking downward, her dark, straight hair partially covering her face. She makes no attempt to wipe away the tears that fall down her cheeks.

“I beat up Jennifer,” she finally says in a whisper.

Even though my internal list of dreadful possibilities did include Penny having killed her child, I didn’t really expect to hear that Penny had done anything violent, not this petite, delicate woman who sits across from me. And what does she mean by ‘beat up’?  

“I swore I’d never be like that,” she continues. “I swore I’d never be like my mother. I waited years to have a child because I was so afraid of being like her. And then I am. I’m just like her, just as out of control crazy,” says Penny between sobs.

Penny’s mother was an enraged woman with an explosive temper who beat Penny and her sister with straps and belts and anything else at her disposal. Did Penny indeed lose control like her mother? No longer able to contain my own anxiety, I say, “Can you tell me what happened, Penny.”
 
“Bill and I came home earlier than we expected and there was my 15 year old daughter on the couch making out with this… this boy I’ve told her to keep away from. He’s one of those bad boys. I bet he never even finishes high school. I just snapped. I started screaming and screaming. Bill told him to leave, Jennifer started to give her father an argument and I just went over and slapped her across the face. Twice. She looked at me shocked. I stopped. I couldn’t believe what I did. I couldn’t believe I was just like my mother.”

I can feel myself breath again. Although Penny was briefly out of control her behavior was a far cry from her mother’s. In fact, I can remember a time in a somewhat similar situation when I was about Penny’s age when my mother slapped me for the first and only time of my life. It didn’t scare me. Just made me mad, even though I knew I’d been out of line. But Penny is now frightened of herself, beating up on herself not with a belt, but with self-recrimination and guilt.

“I can’t even look at Jennifer without bursting into tears. And yet I’m still mad at her. She knew she shouldn’t bring that boy into the house. I don’t want her near him anyplace let alone in my home. But I shouldn’t have snapped like that. Bill tells me I’m being too hard on myself, but he doesn’t understand.”

Remembering my own musings before Penny told me what actually happened, I ask, “Is it what you did that’s bothering you so much or what you felt?”

“What do you mean?”

“Well, if we just look at what happened: You come home and find Jennifer with a boy you don’t approve of. You get angry and yell and slap her twice across the face. The facts themselves aren’t so terrible. Maybe that’s what Bill means when he says you’re being too hard on yourself.  But the question might be, what did you feel? Did you feel so out-of-control with rage that you might even have wanted to kill Jennifer? And even if you consciously didn’t feel that, was it the extent of your rage that frightened you so much, made you feel like your mother.”

“I didn’t want to kill her!”  Pause. “At least I don’t think so. But I’ve never been so angry in my life.”

“You know, Penny, you present as this gentle, almost meek, little person who would never want to hurt a fly, who could never, ever feel angry at anyone. And maybe that’s the problem. You’ve been so intent on not being like your mother, in keeping any possible similarity to your mother buried far, far away that when that anger was unleashed it burst out like a volcano.”

“That makes sense. But I don’t know what to do with that.”

“Well, it’s too intellectual right now. But I suspect we’re going to need to spend more time looking back at your childhood and finding the anger you needed to keep buried back then, anger that’s still buried and looking for a way to get out.”

Echoes of the Past

“This has been a bad week,” says 44 year old Jennifer, her straight brown hair pulled into a bun, jeans and a pale yellow shirt covering her slim frame.

“Madison moved out,” she continues.

I’m surprised. Her daughter Madison is only 16. 

“She had one of her to-dos with her father. I don’t know why this happens again and again.”

Although I say nothing, I think: Because your husband is a narcissistic control freak who your daughter rebels against.

“Frank was driving Madison and her friend Amy back from the movies. He started to speed and she asked him to slow down. She says he just looked at her and went faster. She says she was getting scared and started to scream at him to stop. He says she was getting fresh and that if she wanted him to stop, he’d stop. So he screeched to a halt and told them to get out of the car. By this time I guess they were both crying, but they got out and stood there. Of course he came back for them and then he says that Madison called him an asshole and that he pulled over and slapped her across the mouth screaming telling her not to talk to him that way.

“When they got home Madison and Amy went straight to her room. Next thing I know she’s packed a suitcase and tells me she’s moving in with Amy, that Amy’s Mom said it was okay.  So now Frank is screaming that she’s not going anywhere and I’m trying to figure out what happened.”

As Jennifer relays her story, I feel my stomach tighten and realize that I’m clenching my hands, a familiar reaction for me when Jennifer describes these scenarios between Madison and her father. Although my father was never physical, he had a hair-trigger explosive temper. I was always afraid of him, but I always fought back. And I know what’s coming next in her story, the dynamics in my patient’s family being an uncanny duplicate of mine.    

“I told Madison she was too young to go anywhere and that she had to be more understanding of her father, that he was under a lot of pressure and that he just needed to let off steam, that he didn’t mean anything by it.”

I knew it, I think, just what my mother said to me. I feel my anger rise and wonder how I am going to respond to Jennifer as my patient, rather than as my mother.

She continues. “So she left. I’ve spoken to her each day, but she’s determined not to come home. I’m going to have to talk to Amy’s mother. It’s embarrassing. Meanwhile Frank’s being a bear. He says he doesn’t care and that she can stay where she is, but you can tell he’s hurting.

“How can you tell?” I ask, immediately regretting my question that’s coming from an angry place in me.

“Well, he’s angry, barely talking to me, going around slamming doors, grumbling around the house.”

“And how do you feel when he does that?” I ask, wondering if my question wasn’t so off base.

“I understand,” she says. “He’s upset.”

I want to scream. Instead I ask, “But how do you feel?”

She shrugs. “Nothing, I guess. I’m just worried about Madison.”

This isn’t getting us anywhere. “And how do you think Madison feels?”

She shrugs again, “I don’t know. She says she’s all right.”

“Do you think she might feel hurt or scared?”

“Yeah, I guess.”

Although my mother was an incredible denier, she wasn’t as out of touch with her feelings. My mother and Jennifer feel different now, making it easier for me to remain in my role as therapist. “You know, Jennifer, it occurs to me that it’s difficult for you to know much about feelings – your own or others – except for Frank’s. His feelings are so out there, although they’re usually expressed as anger, you can’t help but be aware of them.”

“Yeah, I guess that’s true.”

“Do you think that’s one of the reasons your relationship with Frank works for you. He expresses the feelings you can’t.”

“That makes sense,” she says nodding.

“I wonder what would happen, Jennifer, if you started to get more in touch with your own feelings, if you could know when you’re angry or scared or hurt.”  

She shakes her head. “I don’t know. That seems like I’d have to be a different person. And right now I have to figure out what to do about Madison.”  

“I understand, Jennifer,” I say, realizing both that she’s frightened and that the present crisis takes precedence. “Let’s talk more about the situation with Madison, but perhaps we can also keep in mind looking at how you feel.”  

To Tell The Truth

An acquaintance asked me the other day how I knew if patients were telling me the truth. I gave her the response I usually do: It doesn’t really matter. I can only know the world through my patient’s eyes, so whatever he or she presents is what matters. Besides, I added, none of us ever know if we’re telling “the truth,” we’re only telling our version of what we assume the truth to be.

After I left, however, I began to think more about my answer. Did I really believe it didn’t matter if a patient deliberately lied to me? Since I believe in the crucial importance of the therapist/patient interaction, certainly a patient’s deliberate lie has meaning. It’s not that the patient is “bad” for lying or that the content of the lie is important in and of itself, but rather that the patient’s need to lie says something about what is happening in the relationship.

I thought of a patient I saw many years ago who had been raped. After I returned from a vacation, she told me that she had been raped again by the same man. A look of doubt must have passed across my face, because she angrily proclaimed, “You don’t believe me!”

Oops. I remember hesitating, feeling uncomfortable. “Well,” I said, “I certainly wouldn’t say it’s not possible, but I wonder about the timing. Is it true that you were raped again, or are you saying that you’re angry with me for leaving you and that you felt much more unsafe while I was gone?”

She burst into tears, told me I was correct, and then started yelling at me for abandoning her. 

Despite our difficulties, that patient and I had a solid relationship and her lie made sense in the context of that relationship.

And that led me to think of Jessica, the adolescent I saw who just lied – all the time, for no apparent reason, regardless if her lie would be discovered. 

Her parents, who seemed concerned and caring, had no idea what to with their daughter.  My initial assumption was that Jessica lied like all adolescents lied. I’d been an adolescent. I remembered. Lies about where you were, who you were with, what time you got home. 

Jessica did tell those “normal” lies, lies about going to school, about showing up for soccer practice, about spending the night at the home of one of her girlfriends. And she was good at it. She’d look you straight in the face and you’d believe her. Except now her parents checked on her. They called the school, the coach, the friend’s mother. She was always found out. She’d shrug and move on.

She also told stories. Some of them might even have been true. “On my way to school today I saw a man on a motorcycle hit a deer. He was hurt. I ran to the house near-by and they called an ambulance.”

Realizing that questioning everything Jessica said was getting us nowhere, I tried to understand the meaning behind the story.

“How did you feel being able to help that man, Jessica?” 

“I don’t know. Good, I guess.”

“Was the man grateful to you?”

“I couldn’t wait around. I had to get to school.”   

Or, “I was home alone and some guy knocked on the door asking directions. When I opened the door he looked kind of dirty. I got scared. I started to shut the door. He tried to push it open, but I managed to close it. I called the police. They came and talked to me. I gave them a description of the guy. They said they’d look for him.”

“That must have been scary,” I say, again deciding not to question the validity of the story.

“Yeah.”

“And how do you feel being home alone, Jessica?”

“I don’t know. No problem, I guess.”

“Will this incident make you more afraid?”

“Maybe. Maybe not. I just won’t open the door.”

Trying to talk with Jessica more generally about her stories also got us nowhere.

“Jessica, do you know why you make up stories? Does it make you feel smart, creative, like you can out smart other people?”

“I don’t know. I’m not so smart.”

“Is it that you don’t feel smart? That you feel bad about not feeling smart?”

“I don’t know. I guess I’m smart enough.”

This isn’t a story that has a miraculously happy ending. Jessica and I never formed a relationship. I was never able to help her. In fact, I wasn’t even able to understand her. Sometimes I wonder what became of her. Did she become a thief? A politician? Or is she just someone who always lies? 

Stuck

I’d seen Billy before, during his senior year of high school. His plan was to go to school in central Florida, about three hours from his home, a plan he carried through despite considerable anxiety. He wasn’t sure what he wanted to major in or what career he wanted to pursue, pretty typical feelings for many adolescents. Still, his anxiety seemed excessive, related to a fear of separation and much ambivalence about growing up. 

Billy is now seeing me again after moving back home having graduated from college with a degree in English. Not surprisingly he has been unable to find a job.

“I haven’t really looked all that hard,” Billy says sheepishly, his sandy blonde hair hanging over his eyes. “I mean, I know it’s rough out there – the unemployment, especially for kids my age. I don’t have anything special to offer. I’m not sure I could stand the constant rejection.”

“How’s it feel being home?” I ask.

He shrugs. “OK, I guess. It’s like always.”

Billy is the second of six children, all spaced closely together. His parents have a marketing business they run from home. The house is usually pretty chaotic. Not much time put aside specifically for the family or for quality one-on-one time with each other.

“Are all your siblings home?” I ask, trying to gauge the degree of chaos.

“All except Christine. She’s working in Boston. And Melody will be going back to college, but other than that they’re.”

“What led you want to come back to see me?”

“I’m feeling kind of down. I’m like stuck, not doing anything. Mostly I stay in my room and busy myself on the computer. Just passing time.”

“You’re not seeing your friends?”

“Most of them aren’t here anymore. Or they’re working. I haven’t really called around much.”

“You do sound pretty depressed.”

“Yeah, I know. I was thinking I should go back and see the psychiatrist. I hate going back on that stuff, but I feel lousy.”

“Well, calling me and planning to call the psychiatrist is certainly taking action.”

“I guess. But that’s not going solve my problems for the rest of my life.”

“What do you think your problems are, Billy?”

“I don’t know. I don’t know what I want to do.”

“Is that the problem, or is the problem that you’re not sure – or at least a part of you isn’t sure - that you want to do anything.”

“What do you mean?”

“Well, I wonder if part of you feels comfortable living at home, having your parents take care of you.”

“That’s kind of true, but it also doesn’t make sense to me. It’s crazy at home. It’s like a zoo. And it’s like no one even knows I’m there!”

“I think you just said something very important, Billy. Maybe it’s that you want to stay home until someone does know you’re there. Maybe what you’re feeling is that you never got to be seen, to be appreciated and that until you get that – until you get what you never got – you’re going to stay home and wait.”

“But I’d wait forever!”

“That’s true, Billy, you would. You’d never get what you wanted and you certainly couldn’t get what you wanted in your past. There’s no way to turn back the clock.”

“Wow! This is heavy. Do you think that’s it? Do you think that’s why I’m stuck.”

“I think that’s one reason. We humans are pretty complex beings and it’s not like one reason explains everything. And not even knowing that one reason – assuming it’s correct – is going to automatically make you able to do things differently.”

“What will?”

“I think that involves really feeling what it was like for you as a little boy, surrounded by all these siblings, your parents harassed and busy with their own lives, never feeling cherished as a unique you. That means feeling your sadness and your anger, neither of which is exactly easy for you.”

“So you really think it’s about the past?”

“I think it’s about your past and your present and I think they both really impact your future.”

“It sounds hard. But I guess I’m not doing anything else. I might as well work on me.”

“That’s a very courageous response, Billy. I hope you can allow yourself to feel proud of yourself, because I certainly do.”

Billy turns red. Mumbling, “See you next time,” he makes a beeline for the door.