Inside/Outside
Showing posts with label connection. Show all posts
Showing posts with label connection. Show all posts

Friday, March 10, 2023

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.”


Friday, June 26, 2020

Starting Therapy Remotely

“Hello,” I say to an attractive, dark-haired woman who appears before me on FaceTime. “I’m glad to meet you.” And so begins my first experience beginning therapy remotely.
I practice in Florida, one of the states that is seeing a sharp uptick in Covid-19. Although I have toyed with the idea of returning to in-office sessions, I continue to find myself reluctant to do so. During the initial phase of the pandemic, I turned away new referrals, uncomfortable starting treatment with anyone I could not meet at least once in person. But as my time away from the office continues, I decide I need to go beyond my comfort zone.
“Hi,” Jennifer replies. “This already feels weird. I’ve been in a lot of therapy, but obviously in person. I kept thinking I’d wait until I could go to your office, but who knows when that will be, and I’m having a really hard time.”
“It feels strange to me too,” I say, “But why don’t you tell me how I can help you.”
I watch her take a deep breath. “I’m 49, I’m alone, I’m terrified of the virus and I just found out that my ex-husband has lung cancer. And that he hasn’t told our daughter yet. I’m so anxious I can’t stand myself.”
“That is a lot.”
“I’ve always been afraid of being alone and now I’m alone all the time. I mean, I talk to my daughter, but she’s in New York and she’s had a really hard time so I don’t want to lay all my stuff on her. And I worry about how she’ll respond to the news about Greg, that’s my ex.”
“Lots of people have been struggling with their aloneness during the pandemic, can you talk about what it’s like for you.”
“I’ve always hated being alone, ever since I was a little girl. I was the kid who was afraid of monsters under the bed, always had to have a light on, and would run into my parent’s room in the middle of the night. That’s why it took me so long to leave Greg, even though I knew about his affairs for years. And when he moved out I put way too much pressure on my daughter to be my companion, just as my Mom did to me. I mean, my parents stayed married, but they had a lousy relationship and I was my mother’s confidant. My Mom’s still alive. She remarried after my father died and she’s much happier now. We’re close, but not like it was when I was a kid.”
“Are you saying you miss your childhood relationship with your Mom or that you’re relieved?”
“I don’t know. Maybe both. When I’m happy, I’m relieved. But now that I’m so anxious, I guess I want my Mommy. I know that sounds silly.”
“Not at all. I totally understand.”
“I did tell my Mom about Greg, but she didn’t get it at all, thought I’d be happy that something really bad happened to him.”
“And is a part of you happy?”
“Oh no! I mean he certainly wasn’t a good husband but I could never be glad he got cancer.”
“So you’d feel guilty if you felt glad?”
“Definitely. I was brought up to be the good girl and the good girl I remain.”
“Can I ask you how this is feeling to you right now?”
“I guess it still feels weird. And I’m still anxious. I’m used to having my anxiety get better when I’m in
a therapist’s office. But I guess I’m not in your office. It’s like you’re here and not here. It’s similar to how I feel talking to my New York friends on the phone. They don’t feel really present to me so I’ve pretty much let most of those relationships kind of peter out.”
“Oh oh,” I say. “Does that mean you’re likely to do the same thing with us?”
She shrugs. “I don’t know.”
“Maybe you yearn for relationships that duplicate the early connection you felt with your mother, perhaps that’s the connection that reduces your anxiety, makes you feel safe, and that without that kind of connection you feel afraid.”
“I guess that’s true. But I thought I wanted to get away from my mother.”
“I suspect that a part of you does want to get away, but the scared little girl part of you still yearns for what you experience as safe.”
“I suppose.”
“I feel as though you’re less engaged with me right now.”
“Yeah. It’s not you. I just don’t know if this is going to work.”
“I suppose the question is whether you’re willing to give it a chance. We’ve actually talked about quite a bit today: anxiety, guilt, your need to be a good girl and, I suspect, although we haven’t talked about it, your difficulty allowing yourself to feel angry.”
Jennifer brightens. “That’s right! I feel really bad when I get angry.” Pause. “But right this minute I feel a little less anxious.”
“Maybe it helped that I figured something out about you, and that made you feel more connected, less alone.”
“Could be.”

“I can’t guarantee I’ll do that every session, but if you’re willing to give this a try, maybe our work together could be helpful, despite not being in person.”  

Thursday, December 12, 2019

Losses

“I couldn’t wait to get here today,” Carol says, practically breathless. “I had the most awful dream. It’s not as though anything so awful happened in the dream, but it felt awful.”
I have been seeing Carol in intensive treatment for many years. She entered therapy her mid-40s, terrified of being depressed and non-functional like her mother. She felt overly anxious and unsure of herself and although by all external appearances she had a successful life, inside she felt like a scared little girl.
“In the dream,” she says, “I was back in the apartment I grew up in as a child, which of course was awful in itself. I was sitting at the same shabby kitchen table I sat at as a child. We were having dinner. It was just me and my parents. I don’t know where my sister was. Maybe she had a fight with my father and stormed out. My mother was her usual depressed self, beaten down, defeated. My father was stuffing his mouth, but I had the feeling he was fuming. Of course he was always fuming, so that’s no surprise. I felt terrified. I don’t know if I was waiting for my father to explode. I don’t know, but I hated it! I hated that I was dreaming of that place again.” 
“What comes to mind about the dream?” I ask.
“I don’t know. It seemed to come out of nowhere. You know I’ve been feeling really sad since Thanksgiving. I would have thought I’d be dreaming about that, all the losses. You remember, sitting around my daughter’s table and thinking of all the people who weren’t there.”

I did indeed remember. Thanksgiving brought up similar feelings for me, an awareness of all the absences, all the people who had died. 
She continues. “My husband dead of pancreatic cancer, my son killed in Iraq, so many of my friends. I’m only 50, how can there be so many people in my life already dead. I mean I love my daughter and she made a beautiful Thanksgiving, but the losses, the losses overwhelm everything.” 
She pauses, dabbing tears from her eyes. “So what am I doing dreaming about my childhood apartment? That’s one thing I don’t mind having lost. I guess I felt sad when my mother died, but in many ways I thought she welcomed death. Now at least she could be at peace. And my father, I know it’s terrible, but truthfully his death was a relief.”
“So why do you think you’re dreaming of your childhood apartment at this time?” I ask, a thought forming in my mind. I also used to dream of having to leave my idyllic home and adult life and return to the apartment of my childhood. For me those dreams were about my fear of loss, of losing what I so cherished in my present, adult life. For Carol many of the losses have already happened. 
“I wish I knew.”
“Is there a connection between the losses you felt so acutely at Thanksgiving and the dream of returning to your parent’s apartment?” 


“What I just thought is, maybe there’ll be no one left, maybe everyone will die, maybe there’ll be no place to go. If there’s no one left, maybe the only place I can go is to go back to them! I mean I know that doesn’t make logical sense because they’re dead too, but maybe that’s how it feels. If everyone leaves me, I’m back to being an abandoned child, a helpless, dependent child who has to go back to my parents.” She starts sobbing. “No,” she whispers. “No, that won’t happen. I have you. And as long as I have you, I don’t ever have to worry about going back there. You’ll remind me I’m not that helpless, dependent child. And if I do slip into that helpless place, you’ll be here to help me back up.”

I hesitate. We’re near the end of the hour. This has been a difficult session for Carol. But… “Carol, I wonder if you realize how much you’ve been your own therapist this hour, how much of me you’ve taken in over the years…”
“You’re not leaving are you?” she interrupts, panicked. “You’re not retiring? You’re not dying?” Her fear is palpable.
“I have no plans to go anywhere. But as you well know, we never know what life has in store for us. I do know I won’t live forever. And I also know that you’ve taken in so much of me. Did you recognize, even just in this session, how much you were able to do your own therapeutic work?”
“But…” she begins.

“We’re not ending, Carol. I’m not going anywhere. And it is also important that you recognize your own strengths. They don’t reside in me. They live in you.” 

Wednesday, November 13, 2019

Removed

“I’m thinking of breaking up with the girl I’ve been dating,” Andrew begins. 
If I’m not mistaken, this is the third woman he’s broken up with in the several months I’ve been seeing him. Tall, with curly brown hair, 35 year old Andrew could be described as a handsome man, except that he feels too flat, too disengaged.  

“I know,” he continues, “I just said I thought she might be the one. I don’t know, we just don’t seem to click. I mean, we’re okay sexually, it’s not that. Maybe she’s too eager, too needy. I need her to back off. But that’s pretty crazy,” he says, half laughing at himself. “You’d think with my parents being so disconnected, I’d be dying to have a woman who’s really into me.”
“Can you say what she does that makes you feel she’s too needy and what goes on inside you?”
“I don’t know. Well, like she’s constantly texting me.” Pause. “But that’s not really true. She might text me in the morning and then once maybe after she’s done teaching for the day.”
“But it feels like a lot.”
“Yeah, that’s right. It feels like she’s always there.” 
“And when you’re actually with her?”
“I know this sounds bad, but I kind of want us to do whatever we’re going to do – go out to eat, go to the movies, whatever – go back to my place, have sex, and then have her leave. That’s enough for me.”
“While you’re with her, do you feel connected to her? You know, I just realized we’re both talking about ‘her,’ not using her name.”
“Her name’s Paula. And no, I don’t feel connected to her.” Pause. “I’m not sure I feel connected to anyone.”
“No one?”
“I don’t think so. I mean, I get along with people, I know what to say, how to act. But I wouldn’t say I feel connected. I tell my parents I love them. I hug my sister and my nieces. But it’s more that I know I’m supposed to do those things.” 
“Do you feel connected to me?”
“To you?” he asks, surprised.
I nod.
“No. We have a professional relationship. I pay you to listen to me and then I leave. I can’t imagine feeling connected to you.”
Kind of like what he wants from Paula, I think. What I say is, “Can you imagine feeling connected to anyone?”
“I guess my wife when I have one. And my kids, whenever that happens.”
“And not feeling connected, how does that make you feel?”
“I don’t know. Normal, I guess. Normal for me anyway. It’s how I’ve always felt.” 
“Do you ever feel lonely?”
“Lonely? I don’t know. I like being alone. I’ve always felt alone.”
“You know, Andrew, as I listen to you, I feel sad for you. You seem so alone, so cut off, so removed, both from others, as well as from your own feelings.”
He shrugs.
“And you did come into therapy. I think you said you wanted to figure out why you weren’t able to stay in a relationship with a woman. Sounds like we need to figure out why you can’t be in a relationship with anyone.”
“I guess.”
“Andrew, do you remember what you felt when you were little and your parents left you with one of your nannies and went away on business for months at a time.”
“That’s just how it was.”
“But how did you feel? How did you feel as that little boy?”
“I don’t remember.”
“Can you imagine doing that with your child some day?”
“Oh no! No, I couldn’t imagine ever doing that.”
“You seem to have more feelings about imagining leaving a child you still don’t have, leaving that imaginary child alone, than you’ve had about anything else we’ve talked about today.”
“I guess that’s true. But what does that mean?”
“That you’re that imaginary child; that buried deep inside you are lots of feelings about being left, sad feelings and scared feelings and angry feelings.”
“You think so?”
“Yes, I do.”
“So why don’t I feel them?”
“I imagine you locked those feelings away a long time ago and that opening that door feels overwhelmingly scary.”   
“And how’s that related to my not staying in relationships?”
“I think that when you start to get close to someone or if someone starts to get close to you, the possibility of needing or relying on that person brings you way too close to the scared, vulnerable, needy feelings you had as a child and you immediately close off and run away.”
“I guess that makes sense, but what do I do about it?”
“We start by carefully looking at your feelings as you go about relating to people in your life, including me, and seeing if we can find when you start to get scared and start pulling away.”
“Sounds like a long process.”

“I’m not planning on going anywhere.”

Tuesday, April 11, 2017

Seeking Protection and Connection

I smile at my new patient, Eileen, as I greet her in the waiting room, extending my hand in introduction. She doesn’t return my smile, but does warily shake my hand. Settling herself stiffly in the chair across from me, she looks slowly around the room.
Oh oh, I think, seems like a pretty disturbed woman, at best distanced and removed, perhaps paranoid, maybe a trauma survivor.  
“I like your office,” she says. “All the windows. Feels free, like floating in space.”
“Thank you,” I say, not sure how to take her comment. An attempt to relate to me? A fear of being confined? A desire for freedom? Hopefully not a wish to jump.
A few moments pass in silence.
“What brings you here?” I ask in traditional therapist mode.
“I have no friends.”
“Can you say more?” I ask, while thinking that her demeanor would certainly make having friends difficult.
“I’m 36 years old. I live alone. I work at home. I’m an IT person, a computer geek.” She shrugs. “There’s no one in my life.”
“Sounds sad.”
“I guess.”
“How do you feel about not having friends?”
“It doesn’t seem normal. People are supposed to have friends.”
“Eileen, what made you decide to come into therapy right now?”
“I found you online. You had a kind face. I liked your website.”
“Like maybe you hoped I’d be your friend?”
“Maybe.”
“Eileen, can you tell me a little about your background, your childhood, your family.”
“It was messed up. My parents divorced when I was two. They’re both alcoholics, drug addicts, both with so many different partners I lost count. And a ridiculous number of so-called siblings. I’d go from one household to the other. Sometimes there would be six, eight of us in a small apartment. I hated it. Felt like I couldn’t breathe. I just wanted everyone to leave me alone. And basically they did.”
“So you learned to put up a wall that said ‘stay away.’”
“Yeah, that’s a good way to put it,” she says nodding. I have the sense she’s pleased by my understanding, although there’s no obvious change in her demeanor.
“Have any idea what’s behind that wall?”  
“What do you mean?”
“Well, when you construct a wall, there’s usually something behind it, something you’re wanting to protect, perhaps something that feels vulnerable or scared.”
“I don’t do vulnerable or scared.”
“So it feels pretty scary to be vulnerable or scared,” I say smiling compassionately. I find myself liking Eileen, feeling sad for the deprived, needy child who must exist behind what feels like an impenetrable barrier.
“I didn’t say that,” she says, stiffening.
“Sorry,” I say, backing off. This is going to be slow, slow going. I need to be careful not to push to glimpse behind that wall too quickly. Her defenses are there for many reasons. They need to be respected, not ripped away.
“You said earlier that there’s no one in your life. Do you see your parents?”
“Not if I can help it. Maybe once or twice a year. Christmas time, Easter. Maybe not.” She shrugs. Doesn’t much matter to me.”
“Was there anyone in your life who did matter to you when you were a child?”
“Like who?”
“A grandparent, a teacher.”
“A math teacher in middle school. She thought I was more than a dumb oaf. She encouraged me. Maybe she was like my friend, except she was my teacher so she couldn’t be my friend. But she’s the one who helped me make something of myself. I don’t know where I’d be if it weren’t for her. Probably just like my parents. Except without the drugs. I’ve never touched drugs in my life. Swore I never would and I haven’t.”
“That’s pretty amazing determination, Eileen, given where you came from and what you’ve been through.”
“Mrs. H – that’s the teacher – she’d say things like that.”
“And when she or I say things like that, you feel a sense of warmth, of being understood and appreciated.”
She looks down. “Yeah, I guess that’s right.” She pauses. “So are you going to help me learn how to make friends?”
“Yes, Eileen, I am. But we have a lot of work to do before finding friends becomes our focus. First we have to help you find you. We have to find the person behind your wall and that’s going to take time. You’ve been hiding from that person for a long time and a sledge hammer isn’t going to work here. And I suspect it’s going to be painful and scary for you. I’ll be here with you and hopefully that will make it easier, but I’m sure there are times it will be tough going.”
“I’ve been through tough before.”

“Yes, I’m sure you have.”

Tuesday, August 11, 2015

Memories

“I can’t understand,” says Jackie, tears trickling down her cheeks. “I thought it would be so wonderful to return home, to drive through Iowa on our way out west, to look at the old farmhouse, to show my kids where Mom used to live. But it was awful. It was all broken down, dilapidated. Nothing’s the same. I remember the huge trees we used to climb when we were young. They’ve all been cut down.” 

Jackie pauses. “One thing’s for sure. Our work together has changed me. I didn’t go numb. I definitely felt my sadness.” 

I feel Jackie’s sadness as well. And my own. Although I have no attachment to my childhood New York apartment, the home I lived in on a small lake outside of Ann Arbor, Michigan during my 30s and 40s was my idea of nirvana. Leaving that home was gut-wrenching for me; seeing it again was worse. I felt as though both the house and the landscape had been defiled. The atrium had been ripped out, replaced by a slab of wood covered by a carpet and a piano. And my beautiful weeping cherry tree was no more. I couldn’t stop crying. And that was when my husband was still alive. Now when I return to the Ann Arbor area I can barely tolerate driving by the highway exit to what was once my home.

“But it is a bit silly,” Jackie continues. “I hadn’t been home for over 30 years. What did I expect? It’s not like my family’s there anymore. In fact, my Mom and sister are right here in Florida. Why isn’t this home?”  

The question of where’s home. “Well, why isn’t it?”

“It is home. My kids were born here. I feel as though I’ve lived here forever. And, as I said, most of my family is here. And when I talk about Florida right here, right now it does feel like home.”

“And your sadness lifts.”

“Yes, that’s true. But when I think about standing in front of that old farmhouse I feel lost.”

“’Lost.’ That’s a good word. Sounds like you’re saying that you lost your past, lost your home, lost your foundation. As if you were untethered, floating in space.”

“That’s exactly right.”

“And when you think about being here in Florida, about your life being here, you feel reconnected. This is home.”

“Yes. Right.” Jackie pauses. “It feels weird though. Like I’m split. If I think of being here, I feel fine. If I think of being there, I’m overcome with sadness.”

I feel shrouded with sadness myself and worry that my sadness makes me less able to be helpful to Jackie. Our stories aren’t the same. She does feel a sense of home in Florida, she does experience a sense of connection. I try to get outside myself and focus on Jackie’s feelings. 

“What about if you think of your childhood memories of that home, of, for example, climbing the trees, playing in the yard?”

“Well, right now it just feels sad. All I feel is the absence. There are no more trees to climb. But I think before I went back to Iowa it used to make me happy to remember. Not that everything in my childhood was so great, but still, I remembered the good times and it made me smile.”

“Perhaps as the memory of your present visit fades, those positive childhood feelings with come back.”

Jackie frowns slightly. “This seems like an odd conversation we’re having. It’s almost like we’ve switched places. I’m the one who’s feeling my sadness and you’re the one who’s trying to get me to stop feeling it.” 

I immediately realize the truth of Jackie’s statement. It’s as if the sadness was too much for me, not too much for Jackie; as if I wanted to escape my own sadness, not that Jackie needed to flee hers. “You’re absolutely right, Jackie. I apologize. You were feeling your sadness and doing fine with it.”

“Did you think it would be too much for me? That I’d start going numb again?”

“No, Jackie, I didn’t. Truthfully, this was more about me than about you. I think I’m the one who wanted to get away from my own sadness, so I was thinking I was being helpful by trying to get you away from yours.”

“Wow! I’m sorry I made you sad.”

“You didn’t make me sad, Jackie. We all carry sadness inside us. And when it comes to the surface we need to do just what you’re doing, feel it and feel it until you don’t feel it any more. It’s part of living life.”