Twins

Bethany squirms uncomfortably in the chair across from me. She’s a slender, attractive woman, her blonde hair pulled back into a pony tail accentuating her high cheek bones and large blue eyes. I’d guess her to be in her late twenties to early thirties.

“It’s hard to start,” she says. “I guess that’s because I feel guilty. My sister, Heather just got engaged. He’s a great guy. An attorney, sweet, caring. He’s crazy about her. But all I can think of is, why her, why her and not me. I forgot to say, we’re twins. Identical. I mean we look identical. But that’s where it ends. She’s smarter than me or at least she did better in school. She was way more popular. She always got the cool guys. I just stumble along through life.”

“Sounds hard to always be comparing yourself negatively to your sister.”

“I come by it honestly. My whole family does it, especially my mother.”

I flash on the memory of patient who years ago told me about giving birth to identical twins and feeling an immediate connection to the first twin that she didn’t experience with the second. Did Bethany’s mother have a similar experience with her twins that has shaped Bethany and Heather’s experience in the world? An unanswerable question, but an interesting one nonetheless.

“That must be painful.”

“I guess, but I suppose I’ve gotten used to it. I’ve always been shier than Heather, more introverted. I like to draw. I like art. That’s sort of what I do. I work in a design studio that sells lots of art. Although I work mainly in the back. I’m not the greatest sales person. I try, but it’s hard for me.”

“And do you show your own work?”

She shakes her head. “People tell me I’m good enough. But it feels so exposing. And the idea of marketing myself feels overwhelming.”

“Tell me about your family, Bethany.”

“Well, I have an older brother who’s been out of the house for a long time. And then there’s me and my sister and my parents. They’re all very social, outgoing people. They have lots of friends, go to parties, invite people over. I have friends too. I don’t want you to think I’m a total recluse. But we’re different. We sit around and talk, go to the movies, sometimes go to museums.”

“Sounds pretty rewarding. Why is what you do with your friends less valuable than what your parents or sister do?”

She shrugs. “I don’t know. I guess because my mother always seems so disapproving of me. I don’t have enough fun. I don’t wear make-up. I don’t get my hair done. She always wants me to be doing something different than what I’m doing.”

“Has that always been true?”

“Always. I remember when I was little. My friends and I would sit around the house drawing, or playing school, or making up stories and my mother would be telling me to go outside, to ride my bike, to go swimming. Whatever I was doing she wanted me to do something else.”

“Did that ever make you angry, Bethany?”

“Sometimes. But mostly it just made me feel bad about myself. Like what’s wrong with me? Why aren’t I more like Heather?”  

“Did your mother ever praise you for your art? Did she ever listen to the stories you and your friends made up?”

“Never. Or at least not that I remember.”

“What just happened there, Bethany? First you said ‘never’ and then you quickly changed it to ‘not that I remember.’”

“Well, I was only a kid. I could have forgotten.”

“Or maybe it’s hard for you to think anything negative about your mother, like it wasn’t fair of her not to praise you for your strengths, just as she praised Heather for hers.”

“I was about to say, I didn’t have any strengths, but I know that’s not true. I really am a good artist. But my strengths weren’t important in my family.”

“You know, Bethany, when children aren’t valued, it’s very hard for them to think that it’s their parent’s problem for being unable to cherish them. They’re much more likely to feel it’s their fault and if only they could change, then their mother or father would love them.”

“I definitely feel that. I always wanted to be like Heather.”

“Well, I’ve only just met you, but it seems to me you have lots of wonderful qualities, qualities that would be loved and valued in many families. Maybe we can help you to learn to value yourself and give up on trying to win the approval of a mother who can’t seem to appreciate you for who you are. It’s really her loss, but I know you’re a long way from feeling that.”    

“A long way.”

“I know. But we’ve just begun our work.”

Disaster

“I had a dream about all these disasters last night,” Jenny says. “It was frightening. There was one disaster after another. I mean I know there have been lots of disasters – floods, hurricanes, earthquakes, tornados – but it was strange for me to be dreaming of them. I don’t know if I was in the disaster or watching the disaster or helping at the disaster. It was weird.”

Jenny‘s a young medical student. I wonder if, at a surface level, she’s anxious about how she will handle her responsibilities as a physician. I remain silent, waiting to see where Jenny’s thoughts will take her.

“My mother called last night. She was complaining about my step-father for a change, about this step-father, just like she complained about all the others. I don’t know why she keeps marrying them, always sure this one will be her most perfect love. I think I’ve even lost count of what number she’s up to. Ugh. I don’t think I ever want to get married. Or not until I’m really, really sure. I guess I see her as a disaster. That’s sad to say about your own mother. I joke with my friends that she’s my negative role model. I want to be everything she’s not and not be anything she is. Sad.”

“Did you feel that way as a child?” I ask.

“Maybe not as a small child, but before I became a teen-ager for sure. Our house was a revolving door. At least she was smart enough not to have any more kids, except that there were always the so-called Dad’s kids who revolved through and then disappeared forever.”

“Was that hard? Forming an attachment to these father figures or siblings and then having them disappear?”

She shrugs. “I don’t know. Maybe. Or maybe I just learned to do my own thing, be involved with my schoolwork, with my friends. I liked being alone.”

Despite the matter-of-factness in Jenny’s tone, I find myself becoming sad. I wonder about her desire for aloneness as a defense against loss. And I think again about her dream, since disaster almost always involves loss.

“When did you last see your own Dad?”

“Who knows. He vanished a long time ago. Every so often he’ll make an appearance, but I certainly wouldn’t want to count on him.”

“I wonder if it’s possible for you not to feel sad about all these losses, Jenny?”

“I’m too busy.”

To avoid sadness, I think to myself. I ask, “What were the disaster survivors doing in your dream?”

“I was going to say they were doing what disaster survivors always do, dig through their houses looking for stuff, try to find things that are important to them. But I don’t think so. I don’t remember seeing people. It was like one of those apocalyptic novels. Maybe there were a few people, I don’t remember, but basically it was empty, barren.”

“Sounds really sad.”

Silence.

“I just had a weird thought. I wonder if it wasn’t me in all those disasters, but you. Like I was the observer, but you were the one who was there. I wonder what that would mean,” she muses. “I could get it if you’re the one who’s trying to help in the disaster. But would that mean I’m the disaster? I don’t feel like a disaster. So am I trying to reduce you, to make you like me, so I don’t feel like so much of a disaster?” Pause. “I guess that’s possible.”

“Are you saying, Jenny, that it feels like a disaster to need people, to need help, to not want to be all alone in the world?”

“It is a disaster to need people. No one is ever there. You can’t count on anyone. Not your mother, not your father …” Her voice trails off.

“Were you going to say, ‘not your therapist’?”

“Yes,” Jenny says looking down. “I mean I know you’ve been there for me, but you’re only my therapist. Eventually this relationship will end. And then what? Then I’ll be alone. Again. Just like always.”

“It’s hard for you to imagine that even when we do end – which we certainly don’t have to do until you’re ready – that you will take me with you, as part of you, just as a part of you will remain with me.”

“I don’t know if I believe that,” she says. A moment letter, Jenny is crying. “And I’m not sure I even want to believe it,” she says between sobs. “What would that mean, that I would stay with you when my parents could discard me so easily?”

“It would mean that you are loveable and that it was your parent’s great loss that they weren’t able to cherish you as you needed and deserved to be cherished.”

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.

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.