Unrelenting Grief II

 

“I scared my wife when I got home from here last week,” Scott says. “I thought I’d cried myself out, but I took one look at her and fell into her arms sobbing. She kept asking me what was wrong and all I could do was cry. She asked if I was sick, if someone else died, if Gram died. And that made me cry even more. I don’t think I’d survive if Gram died right now. I know I told you Gramps was my protector and he was, but my Grandma is an incredible woman, so warm and loving. They had a great relationship. I’m afraid she won’t make it long without him. And you were right, both my grandparents just loved me for who I am. My parents each wanted me to be how they wanted me to be. And the thing that was most crazy-making was that they wanted totally opposite things from me.”  

Scott and I have very different stories, but his intense love for his grandparents and his profound sense of loss touches me greatly. Memories of my grandparents come flooding back, like the time my grandfather and I walked for what seemed to my little girl legs to be miles and miles, looking for a record that had struck a chord with me, “I’m a Lonely Little Petunia in an Onion Patch.”  

I bring myself back to my patient. “Sounds like you’ve been thinking a lot about your past.”

“Absolutely!” Pause. “You asked why I was so afraid of my father. That made me wonder if he had sexually abused me, but I don’t think so. I know some people forget that stuff, but I really don’t think so.”

“There are lots of reasons to feel frightened other than sexual abuse.”

He sighs. “Good. I’m glad. There are other reasons.” Pause. “He’s big. And loud. And anything can set him off. Especially in relation to me.” Pause. “I actually think he hates me.” Pause. “You didn’t rush to say you’re sure he doesn’t hate me. That’s what most people say, especially my mother, but even my wife.”

“I have no idea whether your father hates you or not, but I’m certainly interested in why that’s your perception.”

“He has such contempt for me. Even my choosing to be a nurse. He’s constantly calling me a wimp or a pussy or an almost-doctor or wondering if I chose to be a nurse so I’d see him be ashamed in front of his friends.”

“That’s awful, Scott. What do you say when he says those things?”

“Usually nothing. I gave up fighting with my father years ago. When I was little and stood up to him he’d beat the shit out of me. I feel like I remember him saying he wished I was dead rather than my brother. I don’t for sure remember that, but I seem to.”

“Perhaps whether he said it directly or not, that’s the feeling you had and that’s a terribly painful, scary feeling.”

He nods. Tears fall from his eyes. “Gramps would never let him beat me. Gramps rarely screamed except at my father to keep him from beating me. Once I thought they’d get physical, but they didn’t. Maybe my Mom intervened. I’m not sure. But if she did then my Dad would just scream at her and I’d feel scared about that too. Like I should protect her, except I was too scared. Unless Gramps was there. Then everything would be all right.” Pause. “Now nothing will ever be all right again,” he says, burying his head in his hands crying.

“You’ve carried a lot of fear and pain with you for many years, Scott. And it’s like your grandfather’s death has literally opened the floodgates.”

“But I hate my tears! It’s just proves my father is right. I’m a wimp!”

“That’s your father’s voice. That’s the voice of your father that you have taken in and that you hear beat you up when you cry and probably whenever you’re sad and sensitive or perhaps even caring. We’ll need to work on helping you moderate his voice so that you can be kind to the sensitive child you were and the man you continue to be. I suspect you have your grandparents loving voices inside you as well, and that their voices will help you to become kinder towards yourself.”

Scott sighs deeply. “Sounds like a good goal, but one not so easily reached.”

“We’ll work on it.”

Not Again

As Cynthia sits scowling from the chair diagonally across from me, I remember why I was both surprised and less than thrilled to have her call and ask to return to treatment.

After several minutes of us staring at each other I say, “What prompted your wanting to return to therapy with me?”

“The New Year,” she says curtly, as if that provides an adequate explanation.

“And…?” I ask, prodding.

“What the fuck! You know people make resolutions about what they’re going to do to improve their lives. As if January 1 was the magic date.”

“That would imply there were things in your life you wanted to improve.”

“Of course! You know anyone who doesn’t want to improve their life!”

“This all feels very familiar Cynthia. You say you want to improve your life, you asked to come back into therapy with me, yet you’re immediately attacking everything I say.”

“What? You can’t take somebody challenging you?”

“Okay,” I say, hoping I’m hiding my desire to strangle her. “Let’s look at that last comment: You can’t take somebody challenging you. What impelled you to make that particular statement?”

“What? How should I know. It seemed like a good response to your dumb ass comment.”

Silently counting to 10, I reflect on how uncomfortable it is to be angry and to have to contain it. “Okay,” I say. “We already know you’re angry. And we know you have good reason to be angry. But would I be making a wild guess to say that perhaps one of the ways you’d like to make your life better is to be less angry?”

She shrugs.

We again sit in silence, but this silence feels a bit more comfortable, not as raw, not as challenging.

She mumbles something.

“I’m sorry,” I say, “I didn’t hear you.”

“It’s not a good way to make friends,” she says, barely over a whisper.

“True. In fact I think that sometimes you use your anger to keep people away.”

“Why would I want to do that?” she asks, the edge back in her voice.

“I wasn’t criticizing you when I said you use your anger to keep people away. I was making a comment that, if correct, might help you to think about when and why you try to keep people away and when you you’d like a person to be closer.”

“I never know,” Cynthia says, again barely above a whisper. “I do want more people in my life. But when they come at me, I don’t know, I just can’t take it.”

“Interesting choice of words, Cynthia – when they come at me – like when your parents came at you to punish you, beat you, hurt you.”

She nods, dropping her head. “Yeah.” Pause. “People aren’t safe.”

“Some people are safe.”

“You can always get them mad.”

“I guess you’re saying YOU can always get them mad by prodding and poking and challenging. Or by running away.”

“Who says I run away?!”

“There’s that edge again, Cynthia. I say you run away. If you didn’t run away you’d have more people in your life. You’d be less lonely.”

“I never said I was lonely!”

“You didn’t imply it?” I ask gently.

She shrugs. Pause. “I guess.” Pause. “I don’t want people getting too close. I could get hurt.”

“I understand that, but I wonder if you’re also saying it feels really scary to want people, to need them. Like it feels really scary to need me, to say you want to be here, that you need to be here.”

“Go fu…” Pause. “I was just going to tell you to go fuck yourself, but then that seemed like exactly what you were saying, that I use my anger to keep people away and maybe it’s because I don’t want to need any of those fucking people who are just going to hurt me again and again.”

“I’m impressed, Cynthia, that you were able to catch that yourself, reflect on it and keep yourself from giving an automatic angry response.”

“Yeah. I guess that was pretty good.”

I smile. “I’m glad you were able to take in a positive comment about yourself and accept it.”

“I guess.”

“Now don’t get too enthusiastic,” I say teasingly.

“I… I’m glad I came back.”     

“Thank you, Cynthia,” I say. “I’m really, really glad you came back too.”

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.”

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.”

Lying Part II

 

“When I left your office last time I was thinking that I’d go home and confess to my Mom that I really hadn’t wanted to kill myself,” David begins immediately. “But that’s not what happened. My Mom had called my Dad and he was there when I got home. He wasn’t happy. He asked me what kind of shit I was pulling, why I had to scare my Mom, that he knew I was just bullshitting and I better knock it off and he wasn’t paying for any wimpy therapy. My Mom jumped in and said she would pay for it, that if her son even had a fleeting notion of killing himself, she was going to be sure he got help. My father exploded. Told her she was an idiot. That she was making me a Momma’s boy and that he didn’t want anything to do with either of us. Then he stormed out of the house.”  

“Wow! I’m sorry David.” 

“I was shaking. I did tell her I liked you and that I promised I wouldn’t kill myself. I asked if she’d really pay for therapy, even if Dad refused and screamed and yelled. She said she would, but I was scared all week it wouldn’t happen. But I’m here!” he says with an almost-smile. “My Mom gave my father the cold shoulder all week and my father hardly said a word to me, but something must’ve worked.”

“And how did all that make you feel?”

“Scared, really scared.”

“I certainly can understand that. But I imagine you must have felt really angry with your father. And how did you feel about your Mom sticking up for you?”

“I was surprised.” Pause. “I guess I really scared her last week,” he says with a sly grin.

“So you’re pleased that you scared her, helped get her in your corner.”

“Oh no, I wouldn’t say that. I don’t want to scare my Mom.”

“Maybe part of you doesn’t want to scare your Mom, David, but I wonder if that’s completely true of all of you. You said last week you were angry at your Mom for always going over to your Dad’s side. But this was one time she didn’t. You won. You told her you wanted to kill yourself and that did it! She was staying on your side.”

“Yeah, I guess that’s true.” Pause. “But that makes me feel bad.”

“I think you do feel bad about being angry, David, particularly at your Mom. That’s why I said last time that I thought your lying was a way for you to express your anger. It’s a way of getting back at her for not always being in your corner.”

“Oh! Now I get it.” Pause. “But it’s not like I feel angry and then deliberately decide I’m going to lie to my Mom to get back at her. Usually I lie to make her feel better.”

“But is that really genuinely making her feel better, David? If you got an A+ on a paper and told her you got an A+ on a paper that would be genuinely making her feel better. But if you got a C on a paper and told her you got an A+ that would be putting one over on her, telling her she can’t make you study more or do better than you want to and that you resent the pressure she puts on you.”

“How did you know that? How did you know that I resent the pressure she puts on me?”

I smile. “I didn’t know that, David. I was actually just making it up but I think it’s pretty common for adolescents to resent the pressure their parents put on them.”

“I guess,” he says, sullenly.

“What’s going on David?”

“What?”

“I don’t know, you sounded unsure.”

Silence.

“Oh. Do you think I’m lying to you? You think what? That your mother told me that she put pressure on you to do better in school?”

Silence.

“I guess that’s a problem with lying, David, you end up assuming that everyone lies to you too. I promise you, I will never, ever lie to you, even if telling the truth is difficult or hurtful. Therapy necessitates openness and honesty and that’s hugely important to me.”

“Okay.”

“Sounds like that means ‘okay, I’ll try to believe you.’ Let me also say, David, that if your Mom or Dad ever contacts me I will tell you that they did and will tell you what they said. And I’d tell them I was going to tell you before they spoke to me.”

“Really? That sounds pretty good. So there would be no secrets?”

“No, no secrets. Oh, I should say if you told me you were going to hurt yourself and I believed that was a real possibility, I would contact your Mom.”

“I get that. That’s okay. I’m not going to kill myself.”

“I’m very glad to hear that.”  

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.”