Emptiness

 

“I can’t understand it,” Valerie says sobbing. “Why would he want to leave me? We said it was forever. He’s breaking his promise! It’s not fair!! This should have been the best time of our lives. Approaching retirement, soon able to travel wherever we wanted. And now I’m just going to be alone.”

“Valerie, is Dave really choosing to leave you?” I ask gently.

“Of course he is. The doctor said there were several other chemo options he could try.”

I am more than familiar with the pain of losing a life partner, so I know to tread carefully in this most difficult of life experiences. “Can you understand Dave’s decision to stop further treatment?”

“No. Definitely not.”

“Do you have a living will, Valerie?”

“Yes, of course. I wouldn’t want to be kept alive if I was in a vegetative state, or if my mind was totally gone. But that’s not where Dave’s at.”

“Where is Dave at? What’s his quality of life? How does he spend his days?”

“He’s in bed a lot. He’s always tired. He sleeps. I know it’s partly from the lung cancer and partly the pain medication. But we still have conversations. We still sleep in the same bed. Sometimes we watch TV together. He coughs all the time, sometimes says he can’t catch his breath. Tells me he has a lot of empathy for Covid patients but he also says…” Valerie breaks off, puts her head in her hands and sobs.

When she composes herself she continues, “He says at least they have vaccines for Covid now and new medications and that at least Covid patients have the chance to get better and live normal lives. He no longer has hope. But I have hope. He could try some of these other drugs, these other regimens.”

“It sounds as though Dave is very tired, Valerie.”

She sobs again. “You think I should let him go?”

“Sounds like he’s saying he’s had enough.”

She sobs. “I’m so scared. I’m going to miss him so much. I’m not saying our marriage
was perfect, no marriage is perfect I know that. But we’ve been together for over 30 years. I don’t know what it’s like to live alone. I’ve never lived alone. I lived with my parents then roommates and then Dave. I just see myself locked in that house rotting away.”

“Rotting away? That’s a very graphic image. What makes you think you’ll rot away?”

“I don’t know. I guess like old food in the refrigerator that is left and forgotten about and just rots away. Like no one would know whether I’m alive or dead.”

“I don’t in any way doubt that you’re describing your feelings, but it’s surprising to me that you picture yourself so desolately. Before your husband’s illness you seemed to have a very active social life, to be involved with lots of people, in lots of different ways.”

“All meaningless. And besides, it was my husband who was the social one. Left on my own I just rot.” Pause “There’s that word again, rot.”

“Do you feel as though you’re rotten, Valerie? Rotten as in bad?”

“No, I don’t think I’m bad.” Pause. “I just think I’m not much of anything. Kind of a blob. My husband brought life into our home. Left to my own devices I’m afraid I’ll be swallowed by the emptiness.”

“I know depression can put a pall over everything, but this sounds like something more, like you’re literally afraid of disappearing into the void.”

“That’s it exactly. No Dave, no me, just an empty blob.”

Feeling more and more of Valerie’s despair, I ask, “And you felt that way as a child as well and as a young adult, like in college?”

“Well, there were my parents to tell me what I was supposed to do and then, as I said, I had roommates and sort of followed along with the crowd.”

“It sounds, Valerie, as though you’ve spent your life following along with whomever you’ve been with. And now, with Dave’s decision to stop treatment, you’re confronted with the terrifying feeling of not knowing who you are apart from him, and perhaps of never knowing who you were.”

“I’m terrified. I think you’re absolutely right and that makes me need Dave even more. Do you think I can persuade him to continue treatment until you and I can work this out? Until you can fix me?”

“Right this minute you may feel that you need Dave more, but nothing has actually changed. We definitely do need to work on your feeling more your own sense of self, but whether Dave will stay around until we accomplish that I can’t say.”

“I’m not sure I can survive. I want to survive but I’m not sure I can.”

“You just said something very important. You said you want to survive. That’s you, Valerie, knowing what you want.”

Self = Bad

 “So I’ve been thinking about where we ended last time,” Paula says, starting right in from our previous session. “You said we’d need to figure out why I can’t forgive myself for not being more attentive to my mother when she was dying. I’ve thought about it and I don’t see why I SHOULD forgive myself. I know I was a teen-ager, but I was old enough to know better. I did know better. I was being cruel and nasty and just plain BAD.”

“So what made you bad?”

“I suppose I was just born that way – selfish, self-centered, only caring about myself. And that’s how I was being when my mother was dying, paying attention to me not her.”

Convinced of the futility of arguing with Paula’s view of herself, I pursue an alternative approach. “How does it feel for you to see yourself as selfish and self-centered?”

“It feels …” Pause. “It feels accurate and true and I guess kind of shitty….” Pause. “And familiar.”

“Familiar?”

“Yeah, like I’ve always seen myself like that.” Pause. “And I guess my parents, especially my mother, always told me I was selfish, like ‘why can’t Monica go with you to the movies?’ My mother was always trying to get me to take my sister along with me and my friends.” Pause. “I hated Monica. I hated her from the moment she was born. Everyone fussing over the baby. I didn’t see anything so special about her. She just lay there and stared. And then when she turned out to be autistic, well that just made everything worse. All the attention went to poor Monica, understanding Monica, making allowances for Monica. But you see, you see how selfish I am, wanting all the attention, wanting Monica and all her problems to just disappear.”

Here again I feel the pull to reassure Paula, to tell her she was just a child who of course had angry, rejecting feelings towards her younger, challenging sister. Yet I know that Paula will only dispute what I say. “Paula, if I were to try and reassure you, to tell you all children have negative feelings towards their siblings, you’d tell me that your feelings were worse, stronger, more heartless, right?”

“Yes. Because it’s true. And you’re only trying to make me feel better. But I don’t deserve to feel better.”

“Why don’t you deserve to feel better?”

“Because I’m bad, very bad.”

“It sounds as though being bad is almost like a core sense of who you are. Being Paula equals being bad.”

“Yes. I’m bad because I hated my sister and didn’t want to be there for my mother.”

“I wonder if you had fantasies about killing your sister.”

She nods. “See, I told you I was bad, worse than bad, evil.”

“It’s not unusual for children – or adults for that matter – to have fantasies of killing a sibling, or a parent, or boss or whomever. But I suspect my saying that isn’t going to make you feel any less bad.”

“I’m bad. I’ve always been bad. My grandma used to tell me that I was like that girl in an old movie, “The Bad Seed,” I think she called it.”

“Why did your grandma think you were bad?”

“She never liked me. She thought I was mean to both my mother and sister. And she doted on Monica. The sun rose and set on Monica.” Pause. “I think grandma might have been on the spectrum too, but of course no one talked about that.”

“Paula, do you have a sense of who you’d be if you weren’t ‘bad?’”

“But I am bad.”

“I understand that’s your view of yourself. But I’m asking if you can imagine you as someone who isn’t bad.”

“No, that’s impossible.”

“So that’s one of the big problems we have here. Being ‘bad’ is such a core sense of yourself that to imagine anything else is destabilizing. It’s like you said, being ‘bad’ feels familiar.”

“It’s familiar because it’s accurate.”

“Do you want me to dispute that with you right now?”

“What do you mean?”

“Well, it feels as though you’re almost asking me to say ‘no, that’s not so.’ But If I disagree with you, does that give you the hope that you might in fact not be bad or does it just help you shore up your argument when you counter me?”

“I’ve never thought of that.” Pause. “I wouldn’t want you to think I’m as bad as I think I am.” Pause. “So I guess maybe I am hoping that I could eventually see myself as you see me. It makes me sad when I say that.”

“I understand that. If you see yourself through my eyes, it means giving up seeing yourself through the eyes of your parents and your grandma, which means leaving them behind and bringing up feelings of loss and sadness.”

An Apology

An Apology

“I’ve been depressed since our session this past Monday,” Paula begins. “I’m not exactly sure why.” Pause. “I guess it’s because we were talking about my mother’s death – for a change – and that always makes me depressed. It’s been almost 20 years for God’s sake, I don’t see why I can’t let it go.”

“I know you get depressed when we talk about your mother’s death, Paula, but I thought about our last session too. I feel as though I was pushing you too hard and I want to apologize for that.”

“That’s what you get to do. If you didn’t push me, I’d be even more stuck than I am already.”

“I don’t know. You were talking about your guilt about your mother’s death and although it’s true that from my perspective you have nothing to feel guilty about, what matters is your perspective. I don’t think I gave you enough of a chance to talk about your feelings, including your guilt feelings.”

“My mother died of cancer. I get that I was a teen-ager, more preoccupied with my own life. But I could have gone to the hospital more. I could have spent more time with her. I could have just sat holding her hand.” Pause. “Besides, why would I get depressed if you were pushing me to not feel guilty? You’d think I’d appreciate it.”

“Well, what is one of the big problems you had with your mother even before she got sick?”

“She was always in my face, always on top of me, telling me what to do, telling me what I should think, what I should feel … Oh! I get it! You think you were being like my mother, intrusive like my mother”

“Yes.”

“Hmm. I guess that’s a good point.” Pause. “But I still don’t know why that would get me depressed.”

“Well, what did you feel when I was pushing you to not feel guilty”

“I don’t know if I felt it then or whether I’m feeling it now that we’re talking about it, but right now I guess I do feel, hey, isn’t this where I get to talk about my feelings? How come you’re not letting me feel what I feel?  I thought that’s what I get to do here!” Paula pauses. On my video screen I watch as she drops her head, her straight brown hair falling forward over her face. “I’m sorry,” she mumbles, “I didn’t mean to get annoyed.”

“Paula, what just happened? You seemed to go from a person expressing her feelings and her right to be heard, to what seemed to be a scared, apologetic little girl?”

“I felt guilty for being ang… annoyed at you.”

“So you can’t even say you’re angry at me.”

“I’m afraid to be angry at you.”

“Because?”

“I don’t know,” she says in a barely audible voice.

Silence.

“Your anger feels dangerous?” I ask.

She nods. “I was angry at my Mom and look what happened to her. It’s much better to keep it tucked safely away.”

“Except it’s never ‘safely away.’ It’s turned inward on yourself so that you end up feeling depressed.”

“So you’re saying I was depressed after last session because I was angry at you and turned it on myself, not because my mother died? That makes me sound even more selfish and self-centered!”

I feel the urge to argue against Paula’s interpretation of her depressed feelings and wonder if her way of being self-deprecating, tends to elicit a reassuring, albeit intrusive, response from me. Do I feel a similar pull with other patients? Does Paula unconsciously set up this dynamic?” I’ll have to think about all that, but right now I need to respond to Paula.

“I think you can be depressed for more than one reason, but it sounds as though you’re saying you should feel depressed about your mother’s death.”

“Yes, of course I should feel depressed about my mother’s death. She’s dead!”

“You can certainly feel sad about your mother’s death, but I don’t know that carrying depression around as a heavy weight that burdens all aspects of your life is at all helpful.”

Paula sighs. “I guess after almost 20 years I should be able to cut myself some slack.”

I nod, smiling.

“But why is that so difficult for me?”

“I guess because you still feel the need to punish yourself.”

“I think you’re right.” Pause. “But what can I do about that?”

“I guess we’ll need to talk more about why you can’t forgive yourself for what you see as your adolescent ‘sins.’”

Endless Despair

 “I don’t understand,” Amber wails over the phone. “I was doing fine. I had a good day. I took my dog for a long walk. And then with one phone call I’m a wreck. I can’t stop crying. I feel as though I want to beat my head against the wall,” she says sobbing.

“Can you tell me what happened during the phone call?”

“Nothing! I mean nothing that would lead me to feel awful. I don’t understand. Why doesn’t it stop? Why do I always, always feel so awful?”

Having seen Amber for several years, I realize nothing I say at this point is likely to be of help. Still, I reply, “You don’t always feel awful. You were just telling me you were having a really good day.”

“But it always comes back! Why does it always come back?”

“Part of the problem for you is that when you feel awful, the feeling takes you over completely and you can’t remember that you felt really good yesterday or the day before.”

“But why does it always come back?”

“What’s the ‘it’ that always comes back?”

“The bad feelings. They always come back.”

“You know, that’s a really good question. Why do your bad feelings always come back? Like today, you said you didn’t think the phone call should have triggered your bad feelings, but it did. And perhaps I should ask what specifically you mean by bad feelings.”

“Sad feelings. Depression. Feeling everything’s pointless.”

“Okay. So why do your sad, depressed feelings always come back?”

“I don’t know!”

“Well, what did happen on the phone call?”

“My boss told me I did a really good job on the marketing project. She had a few minor corrections, but basically complimented me on a job well done.”

“And you felt how about that?”

“While I was on the phone with her I felt good, pleased. But then, I don’t know. It just washed over me and I felt like shit.”

“What washed over you?”

“Despair. Like what does it matter anyway. It’s just a stupid marketing job, for some stupid liquor company that’s just going to turn people into alcoholics.”

“Whose voice is that, Amber?”

“It’s mine.”

“Yes, but isn’t it also someone else’s voice? You’ve certainly told me that your mother was always critical of you, always telling you what a failure you were, how you couldn’t do anything right.”

She sighs. “Yup. That’s my mother.”

“So when you were talking to your boss you could take in your her voice, you could take in the compliment. But when you got off the phone, your mother’s voice returned with a vengeance.”

“I guess so.” Pause. “But why?”

“What are your thoughts?”

“I certainly heard her voice a lot longer. It’s louder, telling me how stupid I was and that I’d never amount to anything. And she still does. Why did I go into marketing? Why couldn’t at least have been a teacher? Why aren’t I married? Why am I such a bad daughter, etc., etc.”

“Yes, her voice is louder. And I also wonder if you’re invested in staying attached to your mother’s negative voice.”

“Why?”

“If you move away from your mother’s voice, maybe it’s like moving away from her, leaving her behind. And she is, after all, the only mother you ever had.”

Amber starts sobbing. “I can’t leave her. I can’t. I’d feel way too guilty.”

“Plus, if you take in more positive voices and leave your mother behind, you’d also have to mourn never having the mother you wanted or deserved, not as a child and not as an adult.”

Amber continues sobbing. “I can’t! I can’t! You can’t make me! Oh my God, I’m being swallowed up by those bad feelings again!”

“No, Amber, I can’t make you. I neither could nor would force you to do anything. But I think you can see how terrifying the thought is for you, the thought of moving away from your mother, of mourning who she isn’t and wasn’t.”

More sobbing. “But maybe she’s right. Maybe I am bad and stupid and incompetent, maybe that’s why she couldn’t be nice to me.”

Softly I say, “I understand that it feels safer to take the badness inside you, to take it away from your mother, so that as long as it’s inside you you can hold onto the hope that if only you were different she would treat you differently, would love you more.”

“Wouldn’t she?”

“Only you can answer that, Amber, but from what you’ve said, it sounds as though your mother was rejecting of you from the moment you were born, for her own reasons, stemming from her own problems, but extraordinarily destructive and painful for you.”

“I can’t. I just can’t.”

“I understand. You can only do what you can do. And we’ll keep working, working at a pace that you can tolerate, that isn’t unbearable to you.”

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.” 

Blocked

“I feel like such a loser. A loser and a whiner. I should be able to get over myself already. I’m reading Gloria Steinem’s “On the Road.” She’s 82 years old and still going strong. She’s made a huge contribution to women, to society. And her childhood was certainly no picnic.”

I’ve been seeing almost 60 year old Carol for several months now. She came into treatment because she was no longer able to paint, a creative outlet that had been important to her for many years. She said she was probably depressed, but could think of no particular reason to be depressed except that she was soon going to turn 60. “Old, old, old,” she said. “The big six zero.” 

“And me?” she continues. “My life has been a big nothing. Yes, I got married. I guess my marriage is okay, sort of so-so, maybe like all marriages. I have two children. They’ve had their own struggles but they’re decent people. And I used to paint. I’ve been wondering lately if I stopped painting because I really was never particularly good at it. How do I know if I’m good? Exhibiting every so often doesn’t mean you’re a good painter.” 

I’m aware of having conflicting feelings as I listen to Carol, vacillating between wanting to protect her from her own self-criticism to finding myself agreeing with her that she’s complaining about much of nothing. It’s as if I go from being the comforting parent to the critical parent and back again. I suspect Carol carries this critical parent inside her head, always ready to attack her.  

“You’re certainly very critical of yourself, Carol,” I say.

“That’s for sure. Always have been. I guess I figured if I was critical of myself I could make sure I did everything right and that way I’d ward off my father’s criticism. Never worked. He could always find something to be mad about, from not making my bed perfectly to having friends he, for some reason, didn’t like. It was impossible to please him.”  

“So now you carry your father around with you in your head.”

“Yup! You’d never know he was dead. It’s ironic you know. I thought I couldn’t wait for my father to die and now here I am keeping him alive inside my mind.”

“That’s a great insight.”

Silence.

“My father used to paint too. Representational stuff. He was pretty good. Of course he hated what I painted. Said it looked like something a kindergartener would do. But that was the one place he couldn’t get at me. I painted what I wanted to paint. I would have liked his approval, but in my painting I accepted that I’d never get it.”

“And you felt how about that?”

“Sad, defeated.” Pause. “You know, I’m not sure that’s true. I feel sad and defeated when I talk about it now, but I’m not sure that’s how I used to feel. I think I felt a sense of pride that I could paint how and what I wanted to paint.”

“That’s interesting. I wonder if when you were able to give up seeking your father’s approval – at least as far as your painting went – you could paint. But now when you feel sad and defeated about not having his approval, you’re blocked, unable to paint.”

“That’s true.” 

“Any thoughts about what changed?”

“First thing that popped into my head is that I’m approaching 60.”

I remain silent, waiting to see where Carol’s thoughts will take her.

“My father had a heart attack at 60. Two years later his second heart attack killed him. I felt a lot worse about his death than I expected. Actually, I got depressed. I couldn’t paint then either.”

“When your father died you lost the chance of ever winning his approval.”

“Yup.”

“So you felt helpless and defeated, like you feel now when you’re about to turn 60, the year he had his first heart attack.”

“So does turning 60 myself remind me of his mortality and therefore my mortality?”

“I’d say that’s a piece of it. But I wonder if it also brings you back to the time that you were so acutely aware that you had forever lost the chance of getting your father’s approval.”

“Makes sense.”

“And, when you were able to paint and not need your father’s approval, that was a victory for you. Now I wonder if you feel guilty about reclaiming that feeling of victory, of celebrating your being alive to still be able to paint and to paint as you wish. Perhaps it even feels as though you’re killing him off.”

“Wow! That’s pretty deep. I’ll have to give that some thought.”  

Never Again

“I appreciate your seeing me again so quickly,” Marv says. 

“Of course,” I reply. Marv and I terminated about three years ago, but he called earlier this week saying he’d fallen into another depression and needed to see me. 

“Have you been following the news?” he asks.

“What specifically are you referring to?” I reply.

“Hungary,” he says, passing his hand over his eyes. “Putting them in a train and taking them to a ‘processing center.’ I can’t understand. How is it possible? How can it be happening again?”

I know exactly what he’s referring to and, truth be told, I felt very much like Marv when I first heard the story. Syrian refugees in Budapest with tickets to Germany boarded a train believing they were going to their destination. Instead they were taken against their will to a rural area in Hungary. It was a story that immediately brought to mind images of the Jews during World War II crammed into trains, taken to “labor camps,” taken to their deaths. What happened to “never again?” Still, these refugees’ story had a happy ending. They weren’t gassed. They were allowed to leave Hungary and were joyously welcomed into Germany. But I don’t have Marv’s history. I didn’t lose most of my relatives to the Nazi atrocity.

“Yes, Marv, it’s horrible. I understand the images it must bring forth for you.”

He begins to cry. “I’m glad you get it. My wife doesn’t. She thinks it shouldn’t affect me.”

“And how do you feel about that?”

“Alone. Depressed.  She says it all turned out fine, so why am I depressed. Yes, these people were saved. Some of the Jews were saved too. But millions were killed. And now thousands of refugees are dying on boats, in trucks, for God sakes. Besides, that’s not the point. It’s that most human beings are brutes. We never learn. We just go around brutalizing each other. What’s the point? What’s the point of anything? I give up.” 

That’s what Marv does. He gives up. He surrenders. He surrenders to the world, to his wife and, in the past, to his tyrannical father. Giving up is not something I sit with easily. I want to shake Marv into action, into assertion. “Do you ever feel like brutalizing anyone, Marv?”

“No, never.”

“Never? Not the Hungarian government or your wife or your father?”

“Never. My father was the brutal one, taking his rage out on me and my brothers. I know he lost his whole family in the war – parents, aunts, uncles, everyone – but that shouldn’t excuse him. It should have made him appreciate us more.”

“Let me ask you this, Marv, did you ever feel like hitting him back?”

“I don’t think so. Eddie, my oldest brother, he’d talk about wanting to kill my father. I figured he was only talking, but it still scared me.” 

“So what did you feel when your father was beating you?”

“Scared.”

“Scared and powerless and like the little vulnerable boy you were.”

“Yeah. Sounds about right.”

“I wonder though, Marv, if you also felt enraged underneath. Felt a rage that you certainly couldn’t express and couldn’t even let yourself know about.”

“I don’t know. It’s all in the past. Doesn’t matter much anyway.”

Now I’m aware of feeling angry, angry at Marv’s immediate surrender. I suspect my anger stems both from my own intolerance of passivity, as well as Marv’s projection of his angry feelings into me. I say: 

“You know, Marv, it’s interesting that as soon as I started talking about your rage, you withdrew, gave yourself over to defeat rather than engaging with me in trying to find your anger, which I bet would help you feel less depressed.”

“How would that help the refugees?”

“Your depression won’t help the refugees either.” Oops, I think. I just acted out my frustration.

He sighs, even more dejected. “You’re right. It won’t.”

“Marv, I wish you could fight with me. I wish you could tell me that my last remark was uncalled for. I’m not your father. You can fight with me. You can put me in my place. And I don’t know what you could do for the refugees. But if you decided it was important enough to you, you could do something. It wouldn’t solve the crisis. It wouldn’t save the world. But it might help. And it might help you to feel more powerful. You don’t have to be either the brutalizing father or the scared, little boy. There’s a huge middle ground in between.”

Marv stares as me. “You got mad at me.”

“Yes, I got mad at you. But my anger won’t destroy you or me or our relationship. And your anger isn’t deadly either. In fact, I’m sure it’s far less destructive than your depression.”

Parallel Process

“Roberta keeps saying that she has no life, that the only thing she does is run in circles doing her mother’s biding and that no matter what she does it’s never good enough for her mother anyway.”

So begins Dr. Kaitlyn Rose’s supervisory session. She is a 32 year old psychologist, licensed for two years, and struggling to establish a private practice. Like many young professionals she has discovered that her formal graduate school training, including her internship, has not adequately prepared her to deal with real patients in the real world. Recognizing that she could benefit from the expertise of a more seasoned professional and having heard me present at a seminar, she asked if I would supervise her. I readily agreed, both admiring her awareness of her own limitations and appreciating the chance to impact the clinical skills of a new generation of therapists.   

Dr. Rose continues: “I keep asking Roberta why she tries so hard when she knows that her mother will never be satisfied, but she just shrugs and tells me she has no choice. Besides, she says, she has nothing better to do anyway. So then we start talking about how she spends her days and how empty her life is and how come she never got married, and so on and so forth.”

“So how do you feel as you tell me this Kaitlyn or as you listen to Roberta?”

“Frustrated. I feel frustrated. I can’t do anything to help her.”

I smile. “Interesting, isn’t it, that you feel the same way in relation to Roberta as she feels towards her mother. Nothing you do can help; nothing is good enough. It’s a parallel process, you’re enacting the same experience with Roberta as she’s enacting with her mother.”

“That’s true,” Kaitlyn replies pensively. “I never thought of that.” She pauses. “But I have to do something!” she exclaims.

“Because…?” I ask, provocatively.

“Because that’s what therapists do, we help.”

“So you have no choice but to try and help, again, just like Roberta has no choice but to try and help her mother. Let me ask you this, why do you think Roberta keeps trying so hard with her mother?”

“I don’t know. She won’t tell me.”

“But what’s your guess?”

“I have no idea.”

I feel my own level of frustration rise. Is this yet another parallel process, my enacting with my supervisee what she enacts with her patient which the patient enacts with her mother? A never-ending series of mirrors that enables me to feel the frustration and powerlessness of desperately wanting to make someone different.  “Let me ask you this, Kaitlyn, why did you want to become a therapist?”

“So I could help people.”

“Yes, I’m sure that’s true, but why do you think it was important for you to help people?”

Kaitlyn blushes and averts her eyes. “I…I… My mother was very depressed. I know it’s childish but I think I believed if I became a psychologist I could help her.”

“No, Kaitlyn, it’s not at all childish. I don’t mean to intrude into your personal life. That’s not my place here. I was just trying to show you that we all have complex reasons for everything we do and, as you just said, your need to help people, to change people, was fueled at least partially by your desire to change your mother. And I’d venture to guess and you don’t have to tell me if I’m right because, as I said, I’m not your therapist, I suspect you felt the need to change your depressed mother so that she could be more available to you, be the mother you needed and deserved as a child.”

Kaitlyn’s eyes fill with tears. 

“So now what might be your guess about why Roberta keeps trying and trying to please her mother?”

“I get it,” Kaitlyn says, nodding sadly. “She keeps trying because she keeps hoping that her mother will approve of her, love her, give her what she always wanted.”

“That’s really well put, Kaitlyn. Roberta and you and me and the rest of the world, we keep trying and trying to win with the parent or parents we lost with, hoping to win in the present that which we lost in the past, hoping against hope that we will finally feel like the loved, valued little child. And the process of giving up that hope is a long and painful one.”