“So,” Philip begins, “There’s something I’ve been thinking about and after all these years I certainly know I’m supposed to talk about everything I’m thinking about. So, here goes,” he says, inhaling deeply. “We have two weeks, six sessions left and for our last session I’d like to take you out to dinner.”
Many thoughts and feelings flit through my mind. I’m surprised. Philip is a 55 year old obsessive man who despite years of therapy is still fairly rule-bound. Taking me out to dinner would definitely be bending those rules. So should I consider his request an indication of progress? Perhaps, perhaps not. Either way, I know I’m not going accept. To do so would be stepping way outside the bounds of our relationship. I have gone to lunch or dinner with patients who have been out of treatment for long time, but then I know that the treatment is definitely over and it’s more like catching up with an old friend. Last sessions and, in fact, the entire process of termination is fraught with many intense and conflicting feelings. A restaurant is definitely not the place to deal with them.
“What makes you ask? Why do you want to take me to dinner for our last session?”
He looks instantly deflated. “You’re not going to do it.”
I smile inwardly. My apparently neutral question wasn’t so neutral after all. “No, Philip, I’m not going to accept. I’ll explain why, but first I’d be interested in knowing why you want to.”
“Is it because I’m a man? I mean I know we dealt with some of my, uhmm, feelings about you along the way, but this has nothing to do with that. I just want to say thank you for all you’ve done for me.”
“And when you say ‘thank you for all you’ve done for me,’ you’ve given me more than enough, a gift. You’ve been able to put your feelings into words. And your warm feelings at that. That’s a major accomplishment for you.”
“You didn’t answer my question.”
“I’m sorry. No, it’s not because you’re a man. Did I hear a hint of anger in there?”
“No one likes to be rejected.”
“Whoa. Let’s go back a minute. You say that you want to take me out to dinner to thank me for what I’ve done for you. What do you imagine you might be feelings that last day? Or the last week? Or what are you feeling today about ending?”
“Hard to separate out what I’m feeling about ending and what I’m feeling about your turning me down.”
“Okay. Just say what you feel right now.”
“Hmm. I feel disappointed. And hurt. And a little angry. And confused. I don’t understand why.”
“So let’s say we were at a restaurant right now. Would you like to be dealing with all those feelings at the restaurant?”
“I wouldn’t be having these feelings if we were at a restaurant.”
“Ah ha! So perhaps you’ve just told us another reason why you might want to take me to dinner for our last session. Maybe it’s so you won’t feel all the feelings you might be having during that session.”
“Oh.”
“Last sessions can be pretty emotional. I know there’s some excitement about leaving, a feeling of accomplishment. Some people describe it as feeling like graduation. But even graduation has sadness mixed with it, ending a chapter in your life, ending your relationship with me. We’re known each other a long time. It’s always sad to say good-bye. Sad for me too. I’m happy for you and your progress, but your leaving is a loss for me as well as for you.”
Philip stares at me. “You’re so dear to me,” he says softly. “You will always have a special place in my heart. You’ll be with me always and I’ll miss you more than I can say.”
“That’s so beautiful, Philip. Thank you. That means so much to me. I think about how you couldn’t even identify what you were feeling when we first started working together, let alone express it. And to be able to express such deep, caring feelings warms me all over.”
He smiles. “I was just going to say, ‘So how about dinner?’ and then I realized I was just running from all the feelings in the room. I guess we’ll be meeting here for the remainder of our sessions. Five more to go. Makes me sad.”
I am sitting with Lila – or L as she insists on being called – in uncomfortable silence. A tall, heavy woman in her mid-twenties, with disheveled hair and wrinkled clothes that look as though they’ve been purchased at a thrift shop, L stares at the floor, occasionally glancing up to glare at me. We have been here many times before. I know I need to say something or L will leave, looking back at me with undisguised contempt.
L doesn’t want to be here. Her father insisted. Despite her obvious intelligence, she barely made through college and has done nothing since she graduated but sit glued to the TV or her computer. Her father, a wealthy businessman, insists that I “fix” his daughter. He travels for his company so isn’t home much, but hears from the servants that his daughter does nothing with her time. His ex-wife, he told me, is entirely out of the picture. She left with another man when L was a baby, leaving him to hire a succession of nannies.
“What are you feeling right now?” I ask lamely.
She sneers at me. “Five minutes of silence and you can’t do better than that?”
Although I agree with L’s assessment, I’m again becoming angry, a feeling that often plagues me in L’s sessions.
“What would you like me to ask?”
Another sneer. “What? So now you want me to do your job for you?”
“Okay,” I say. “Let’s start over. We both know if we continue along this path, we’ll both end up being angry and then you’ll leave.”
“Good guess.”
“Do you like to make me angry, L?”
She shrugs.
Silence.
“I can see that you might want to make me angry, that you might want me to feel what you feel.”
“So I’m angry. So what?”
“I can’t imagine that it feels good to be angry all the time.”
Another shrug.
More silence.
“Can you tell me why you’re angry, L?”
“Why don’t you tell me,” she snaps back.
Trying to keep the conversation going, I reply, “Well, at the very least, you’re angry about being here.”
“Wow what a brilliant insight! Give the lady a gold star! And you’re considered a great therapist because…?”
“You succeeded, L. I’m angry. But I still don’t know what purpose it serves you. Is it a way to keep me away, to make sure we never form a relationship? Is it a way to keep yourself safe?”
“Why don’t you just figure it out,” L says as she starts to leave.
Without thought, I’m up against the door barring her exit. “Stop it, Lila!” “Sit down.”
Towering over me, her eyes fill with fury. I wonder what compelled me to place myself in such a precarious situation.
“Why’d you call me Lila?” she says angrily. “My name’s L.”
Why did I call her Lila? I wonder. “No,” I say, “Your name is Lila and I’d like to know Lila. I’d like to know the person you were before you felt you had to rename yourself. I’d like to know you and I’d like you to stay.”
I watch the fury drain from Lila’s eyes. In its place I see surprise and confusion. She stumbles back to her chair.
“I can’t believe you did that,” she says. “I could have hurt you. Why did you do it?”
“I didn’t think much before I reacted. I know I was angry. And I know I wanted you to stay. And what I said is true. I do want to know you, Lila. I know there’s a sad, lonely kid underneath all that anger.”
“How do you know?” she asks, some of the defiance returning to her voice.
“Well, your mother abandoned you. Your father was never terribly interested in you. And you had a series of nannies who came and went. I can’t see how you could be anything but sad and lonely. And angry, of course.”
“So you think everything’s going to be rosy from now on?”
I smile. “No, I certainly don’t. And even if I did I know you’d show me very quickly I was wrong. No, Lila, I think we have a long road ahead of us. You’ve been hurt again and again and you’ve used your anger to wall yourself off from relationships and any more pain. But maybe we made a small inroad today.”
Lila nods. “It matters that you put yourself in danger because you wanted me to stay.”
“Why am I coming here?” Albert says as soon as he sits down. A depressed, distanced 58 year old man I have seen for two months, Albert is a difficult person to relate to.
He continues. “Nothing’s going to change. I’m never going to find a woman to be with. My two sons are going to continue ignoring me. I’ll never have friends and if I do they’ll always want something from me. It’s never going to change.”
Aware of feeling some anger at this litany of complaints I ask, “Do you feel angry when you say all that? Do you feel angry at me for not being able to make those things change?”
“What’s the point of being angry? They’re just not going to change.”
My anger inches upward. “Anger doesn’t necessarily have a point. It’s something you feel. Are you aware of feeling angry with me if I can’t help you change what you want changed?”
Albert shrugs. “This isn’t getting us anywhere.”
I have to agree. Time to change course.
“You’re right, Albert, I can’t bring women or friends into your life. I can’t change how your sons treat you. But are there things inside you you’d like to change? Things that perhaps make it more difficult for you to relate to people or for them to relate to you.”
“What kinds of things?”
“Well, you don’t seem to present yourself as someone who’s warm and friendly. You seem aloof, removed, perhaps angry, suspicious.”
“I have reason to be suspicious. When you make the kind of money I’ve made you have to know there are all kinds of gold-diggers out there. It’s not like my ex-wife didn’t take me to the cleaners. And my sons were always hitting me up for money. That’s all I was good for as far as they were concerned.”
“I’m not saying you don’t have reason to be suspicious or that you haven’t been taken advantage of, but I wonder if now you don’t use those reasons as an excuse, an excuse to keep yourself away from people, an excuse to protect yourself from being hurt, an excuse so that you don’t have to be vulnerable.”
“Damn right! Why would I want to be vulnerable?”
Feeling as though I am hitting my head against a brick wall, I say, “Because unless you’re vulnerable, unless you allow yourself to get close to people you live a very lonely, isolated life.”
“That’s how it’s always been,” Albert says, some of the edge gone from his voice.
Taking some hope from this change in voice tone, I say, “Tell me how it always was.”
“I already told you. I grew up in the middle of nowhere, a farm in Iowa for God’s sake, with parents who barely spoke English. I wore these clothes my mother made me because we were dirt poor, got laughed at school, did horribly, played hooky. It’s a miracle I ever got through. But I showed them. I showed them all. I made it bigger than all of them put together!”
Albert is back into his anger, the brief softer quality, gone. This time, however, I find myself feeling sad rather than angry. “Albert, for a minute, when I first brought up your living a lonely, isolated life, you seemed to soften just a bit, perhaps to be more aware of your sadness, but then as you talked about the deprivation and pain of your childhood, you went back into your anger.”
“So?”
“Well, that may be the question you need to answer, Albert. When you say, why should you come here, my answer is that you need to come here so that you can work on getting underneath some of your angry defensiveness to the sadder, more vulnerable person underneath. But that’s something you have to decide if you want to do. Do I think if we worked on that and you could find that more vulnerable person underneath that you would have a more fulfilling life? Yes, I do. But, again, that’s something you have to decide.”
After a few moments of silence, Albert says, “I don’t know.”
“I believe you,” I reply. “I imagine you feel quite torn. Your defensive anger has in many ways worked effectively for you for a lot of years. We can see how it goes. I know I said you have to decide, but it’s really not a decision. It’s more of a process, a process that ebbs and flows and we’ll ebb and flow along with it.”
