If You Loved Me

“I got a great idea after our last session,” 30 year old Melinda says enthusiastically.

I remain silent.

“You know how we’re always arguing about whether or not you care about me? Well, I figured out how you can prove it to me.”

Oh my, I think to myself. Whatever’s coming can’t be good.

“You can stop charging me for some period of time we agree on. That way I’d believe you cared about me and weren’t just in it for the money.”

I feel as though I’m going to be walking through a field full of land mines. Other than agreeing to Melinda’s request which I know I’m not going to do, whatever I say has the very likely potential of a large explosion. I’m also aware of feeling angry and put upon. Hmm, I think to myself, I bet at some level Melinda could have anticipated that would be my reaction. 

“When you came up with this idea, Melinda, how did you think I’d respond?”

“I don’t know. How should I know how you’d respond?”

“Well, we’ve worked together for about three years, you might have some thoughts about what I would or would not say or would or would not do.”

“You’re not going to do it, are you? You’re just stalling, playing games,” she says, her anger building. 

“Is that what you would have expected?” I ask.

Melinda crosses her arms over her chest and glares at me. “I’m not saying another work until you answer me directly.”

I sigh inwardly. Melinda and I have frequently found ourselves in these kinds of power struggles. I can refuse to say anything, at which point she will indeed not say another word until she storms out at the end of the session. Or I can submit to her demand that I answer her, which feels to me like an uncomfortable submission. Or perhaps, just perhaps, I can try and interpret what’s happening between us. Melinda’s mother died when she was nine, leaving her to be raised by her distant, authoritarian father, who she rebelled against while desperately wanting his love and approval. In her interaction with me, Melinda can take the role of her authoritarian father who tries to force me to be as she wants me to be. Or she can be the needy, demanding child who wants both to win her father’s love, while insuring that her mother will not abandon her.

“So I’m going to run a few assumptions by you and you can tell me what you think. First, I think you knew – if only unconsciously – that I would not agree to your request, that it would stretch the boundary of our relationship in a way that would not be acceptable to me. Second, the reason you find it so difficult to believe – and accept, I might add – my caring is that you felt abandoned by your mother and rejected and criticized by your father. It’s also easy for you to become your father in this room with me and just as you refused to bow to your father’s demands, at some level you know that I will not bow to your demands either.”

“It wasn’t a demand, it was a compromise, a negotiation.”

“I’m not sure about that Melinda. I think you came prepared to fight with me. And that’s probably the most interesting question. Why is it that you want to fight with me?”

“I don’t want to fight with you. I fight with you because you won’t give me what I want.”

“Which was exactly your relationship with your father.”

“I guess,” Melinda says reluctantly.

“But I think that as much as you say you want my caring, you often do things that prevents your getting exactly what you say you want, which leads me to wonder if you need to reject my caring.”

“That doesn’t make sense. Why would I do that? I think you’re just playing therapist tricks, trying to get away from your not caring about me.”

I choose to ignore Melinda’s last provocation. “Melinda, if you accepted my caring you would be saying that you were a person who deserved caring about. And if you allow that in, then you’re left with the realization that you are indeed loveable and that no matter what you did – or do – you couldn’t keep your mother from dying and you can’t keep your father from being a cold, critical person. And that leaves you feeling powerless and helpless and we know how awful those feelings are for you.”

“Is there any way you’d consider my suggestion?”

So much for interpretations, I think to myself. What I say is, “Now I know you know the answer to that question, so I guess you’re saying you’re mad at me.”

“Yeah. I think you should have to do something to prove your caring.”

“I guess we’ll continue talking about this next time.”   

Near Death

I open the door to my waiting room and see Ben sitting there, perhaps a little thinner, perhaps a bit more gaunt, but basically looking like his old self. I blink back tears. He’s alive. He looks up and smiles at me. “I made it,” he says, echoing my own thoughts.

“I want to start by saying how much it meant to me that you came to see me at the hospital.”

A near fatal heart attack. Quadruple by-pass. Multiple infections and his first words are about my visiting him at the hospital. “Of course I’d come to see you.”

“It didn’t feel like an ‘of course’ to me. It felt like you cared about me. That I wasn’t just a patient.”

I think about Ben’s angry, rejecting mother and reflect on how difficult it is for people who weren’t cherished by a parent to take in that they’re cared about. “Ben, we’ve known each other for a long time. I’ve watched you become so much more of a feeling, related person, but it’s still hard for you to believe that I – or others - care about you.”

“This experience did show me how many people care about me. And my wife, she was amazing. I know it’s impossible, but it felt like she never left my side, that every time I opened my eyes she was there looking at me, squeezing my hand, smiling at me.”

Suddenly I’m besieged by images of my late husband lying in a hospital room with me sitting beside him. Many years, many images. Waiting for the results of his angiogram; the terror of his first angioplasties; the pain of a double knee replacement; the horror of discovering he had undiagnosed heart damage perhaps fatally complicating a minor heart attack after his first chemotherapy; his miraculous survival; his deterioration …  

My patient interrupts my reverie. “You look sad. I’m sorry. You must be thinking about your husband. “

Ben began working with me about a year before my husband’s death, now over seven years ago. It was an agonizing and vulnerable time for me, a time I revealed more about myself than was typical of me.

I say, “You’ve just demonstrated to yourself how much our patient-therapist relationship is a human relationship, how two people who have known year other for years, come to understand and care about each other. And you’re right, I was thinking about my husband, but I apologize for distracting you from your appreciation of your relationship with your wife.”

“Do you think being near death brings people closer?”

“What do you think?”

“I think it does. It makes you appreciate what you have when you see how it can all be gone in a second.  I actually thought about you when I saw how attentive and scared my wife was. I knew you would have been like that.”

“Ben, when you comment on your wife’s love and caring, when you reflect on your sense of me, I hope you can see how much you’ve changed, how much easier it is for you to genuinely connect to your wife, to me, and I’m sure to others as well.”

Ben nods his head, “Definitely. I feel like I’m a different person than the one who first came here.”

“And yet you’re still surprised by my coming to visit you in the hospital.”

“Yes. I don’t know. Is it because I feel I don’t deserve it?”

“Well, why wouldn’t you deserve it?”

“Because …,” he shakes his head. “I don’t know. I’m a pretty good person. And I do know …” Ben hesitates. “I do know you care about me.”

“Sounds like that was hard to say.”

“It was.”

Silence.

“I suddenly feel sad. You’d think it would make me happy to feel you cared about me.”

I remain silent, giving him a chance to reflect.

He continues. “I just got this picture we’ve talked about many times, when my mother beat me in front of my friends because I didn’t take the garbage out the minute she asked. It’s like I don’t know how to reconcile the two. How could she treat me like that if you and my wife care about me?”

“I think what you’re saying, Ben, is that if you’re deserving of love and caring today, you were deserving of it then, but your mother couldn’t give it to you. And if you realize that was her shortcoming, not yours, you have to give up hope that you could ever have gotten her love, regardless of what you did.”

Ben rubs tears from his eyes. “I think that’s right. But I am grateful for the love I have today.”

“I’m really glad to hear that,” I say as the hour ends.

      

She Loves Me, She Loves Me Not

 

In an earlier blog, “A Dog’s Life,” I talked about Terri, a patient who became angry with me for canceling a trip because my dog was sick, while she had almost died as a child when her parents left her to go to Japan. Although her anger turned to sadness as she left my office, the anger soon returned.

“What do you mean you care about me? I’m just a patient to you. One of many patients. A patient who gives you money. I’m your livelihood. That’s why you care you me. Would you see me if I didn’t pay you? No, of course not,” Terri says crossing her arms in front of her, glaring at me.

“It’s true that you pay me, Terri, but you’re paying me for my time, not for my caring.”

“Huh!” Terri snorts, “Sounds like you’ve said that before!”

“Yes, I have said it before, but that doesn’t make it any less true.”

“So tell me how you care about me. Show me.”

Although I’m beginning to feel annoyed, I acquiesce to Terri’s demand.

“Well, I listen to you carefully and thoughtfully, I try to say and do what’s in your best interest, I worry about you if you’re having a hard time or if you’re being in any way self-destructive, I talk to you when you call …”

“Fine, if my calling bothers you, I won’t call any more.”

 I feel a flash of anger, but recognize that Terri is trying to provoke me.

“Can I ask you something, Terri? Would it be possible for you to believe that I do care about you?”

“What do you mean?” she asks scowling.

“It feels like you’re trying not to take in any of the positive things I’m saying, that you’re turning them around so that you end up feeling rejected.”

“Right, so now it’s my fault that you don’t care about me!”

“Whoa,” I say, raising both hands. “Let’s stop a second here. It’s not a question of fault. What I’m suggesting is that it’s very difficult for you to allow in that anyone cares about you because you felt that neither of your parents loved you. That’s the lens through which you see the world. It’s a world where nobody loves you.”

“Yeah, I guess that’s true.”

“So the idea that I or someone could care about you is entirely foreign, a foreign concept that’s impossible to allow in.”  

“That’s depressing.”

“I agree. Now I’m going to go a little further here but, again, I’m not talking about blame, I’m just trying to look at why you might do what you do. Okay?”

“I guess,” Terri says reluctantly.

“I think you also need to reject caring – just as you rejected my caring earlier - because what would it mean if I cared about you and your parents didn’t? It would mean that it wasn’t anything you did as a kid to make them not love you. It would mean that you were and are loveable and that your parents were incapable of loving you the way you needed and deserved to be loved. It wasn’t your deficiency, it was theirs and that means no matter what you do you can never, ever win their love. And that’s really painful.”     

“You know what?” Terri says. “I think this is all a bunch of bullshit! We start out talking about you not caring about me and end up back on my parents. I think it’s you who are trying to turn things all around.”

“We’re kind of stymied here, Terri. I can say you’re turning things around to avoid taking in my caring and you can say I’m turning things round to avoid dealing with what you experience as my non-caring.”

“You’ve got a point there,” Terri says, almost smiling. ”I want to ask you something. You’re an analyst, right?”

I nod.

“That means you’ve been in therapy, doesn’t it?”

I nod again.

“Did you feel your therapist cared about you?”

“Yes, I did.”

“How come? How come you did and I don’t?”

“For exactly the reasons I mentioned earlier, except in reverse. Although not everyone in my early life cherished me, there were enough people who did, that caring isn’t foreign to me. I expect people to care about me and I can take in that caring without having to give up on all my early caretakers.”

“Thanks for telling me. I think.”

I smile. “Nothing is ever uncomplicated, Terri. My telling you might feel like a gift, which you might also feel the need to reject. And now you might not only feel envious of my dog, but of me as well.”

“I’ve had it for today,” Terri says as she bolts for the door.