Unsure

“I feel ridiculous going into therapy because I can’t decide whether or not to get married,” Nina, a slender young woman with shiny dark hair and large brown eyes, begins. “I mean I’ve been in therapy before, lots of times. It’s been a lifesaver sometimes, but going into therapy because I can’t decide whether or not to marry Sam seems silly. Either I want to marry Sam or I don’t. I don’t know what makes it so hard to decide.”

“What does make it so hard to decide?”

“I guess because I don’t know if I love him. But is it even necessary that I love him? I’ve loved other guys and they all turned out like shit. I don’t know. I keep going round and around in my head.”

“Nina, I hear that you feel a lot of pressure to decide right now, but it would be helpful if you told me something about you, your background, why you’ve been in therapy before, maybe something about the shit guys.”

Nina sighs. “I knew I’d have to go through the whole thing again. It’s so tedious. Okay, here goes. When I was a kid, my life was pretty normal until I was six. Then my mother was hit by a car. She lived on a ventilator for a year or so until my Dad won the court battle with my Mom’s parents and had her disconnected. My Dad didn’t let me see my grandparents for quite a while, but then I got to see them and that was hard too because they talked such shit about my Dad. That’s when therapy was really helpful. Things got better after that until my Dad started dating and dating and dating. I guess he was trying to drown his sorrow in women, at least that’s what my therapist said. Fast forward, I now have my fourth step-mother except of course I don’t live at home any more so I don’t really care who he’s with. End of story.”

“That’s an overwhelming story, Nina, yet you told it like you were reading from a book, like it happened to someone else.”

“I just can’t feel about it anymore. I don’t want to feel about it anymore. I want it over.”

“But maybe it isn’t over.”

“What do you mean?”

“Well, that’s a tremendous amount of loss and trauma for anyone to go through, let alone a young child. You lost your Mom, your grandparents and your Dad.”

“My Dad’s not dead.”

“No, but it sounds as though once he started dating you felt as though you’d lost him.”

“Yep! But that was just me being jealous. That was another therapist’s opinion.”

“And what’s your opinion?”

“I don’t know. It felt too soon. It felt like he forgot about my Mom. It made me wonder if my grandparents weren’t right about him. It made me sad. I missed him. I missed them all,” Nina says, her voice breaking a bit.

“I’m sorry Nina.”

Her eyes fill with tears which she blinks back. “But what does this have to do with my not being able to decide whether or not to marry Sam?”

“First tell me whether the previous guys you loved were unfaithful to you or otherwise unavailable.”

She snorts. “You mean like married? Yeah, I had my share of those. And my share of womanizers too. So you think I have an Oedipal thing, right? You think I want my father just for me.”

“Is that what you think?”

“Maybe. I just don’t know any more.” Pause. “For sure Sam isn’t anything like my father. He’s kind and generous and faithful. I know he loves me. I just don’t know if I love him.” Pause. “So you’d say I have to give up on my Dad in order to allow a different kind of man into my life.”

I smile. “You’re certainly no stranger to therapy.”

She nods. “Too true.”

“But I wonder if, as you said, it’s only an ‘Oedipal thing.’ You’ve had so many early losses, Nina, losses that had to have a huge affect on your life. I wonder if you’ve walled yourself off from ever allowing yourself to be really close to anyone for fear that the pain of losing them would be too much. If you choose unavailable guys, they maintain the distance. If you choose a guy who is available, maybe that’s just too scary. What if you come to rely on him like you did your Mom or your Dad? What if he leaves or is in an accident? What if he dies? Maybe your six year old self doesn’t feel like she could cope with that.”

“But I’m not six.”

“The unconscious is timeless, Nina. We’re all whatever age we are today as well as six and ten and fifteen. That’s how we’re made.”

“But what do I do?”

“I’d say we have to go back so that you can feel the tremendous pain and loss and fear you felt as a child and help that child mourn and grow so that you can allow yourself to love and to know that however painful it might be you could again survive loss.”

“Sounds charming.” Pause. “When do we start?”

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.”

Unconnected

“I just ended another relationship,” says Brittany settling herself into my chair for the first time. She’s an attractive enough woman probably in her early 40s, simply dressed in black pants and a gray sweater. She didn’t smile when I greeted her in the waiting room, just extended her hand.  Her eyes didn’t smile either. She continues.

“I told myself I’d give it a year and I did. We got together last New Year’s Eve and I broke up with him this January 1. He was a nice enough man. But I can’t do it. I can’t be in a relationship. It’s like torture to me.”

Torture, I think to myself. What a strong word.

“I know it’s not normal,” Brittany continues. “That’s why I promised myself I’d go into therapy if I couldn’t handle this relationship. I’ve been in therapy several times, but maybe I’m more ready now. I certainly know this is my problem. Way too many relationships to think it’s the men’s fault. I don’t usually last a year, but that’s what I said I’d do, so I did.”

Questions swirl through my mind: What makes a relationship feel like torture? Do you feel smothered? Are you so terrified of loss that you can’t allow yourself to connect? Did your relationship with your previous therapists feel like torture also? Will you need to escape our relationship as well? I decide on a far more innocuous statement.

“Sounds like when you make up your mind to do something you certainly follow through.”

Brittany’s mouth forms an almost-smile, while her eyes brighten slightly eyes as well. “That’s definitely not my problem. If I decide to do something, I do it. I wouldn’t be where I am today if it weren’t for my determination. I own a chain of yogurt stores and am about to start franchising nationwide. Not bad for an abandoned orphan left by the side of the road.”

“Literally?” I ask, surprised. 

“I’m exaggerating about that side of the road bit, but my parents were a piece of work. They were both drug addicts and definitely didn’t know what to do with a baby. At some point they just left me. Social services got involved and I went from one foster home to another until I was 10 when one family finally kept me until I was 16. Then I got myself declared an emancipated minor and went off on my own. And the rest is history.”

“That’s an amazing story, Brittany. A really sad story, but you tell it with no feeling at all.”

“I’ve repeated it a million times.”

“But you still must have feelings about it. About your parents abandoning you, about your going from one home to another, about the family you lived with for six years.”

“They were good-enough people. The family I lived with for six years. But it was the same problem. They wanted something from me I couldn’t give them. They wanted me to love them, to be a part of their family, to remember birthdays and care about Christmas. I don’t have it in me.”

The room feels heavy, steeped in despair, although I suspect I am the only one who feels it. Brittany is removed, protected by a suit of armor she constructed early on to shield her from repeated abandonment and neglect. How could she ever allow herself to care for another person who would likely, yet again, toss her aside? “Left on the side of the road.” That is her metaphor for her life. Brittany cannot allow herself to get any inkling of the scared, vulnerable, needy child who exists inside her. Instead, she prides herself on her truly amazing success, unaware of her underlying hunger for human connection. 

“How do you feel about not having it in you?” I ask.

She shrugs. “I know there’s something missing in me. And when I look around and see people, I can tell that relationships add something to their lives. So I guess I’d like to find out what’s missing.”

“I suspect, Brittany, that it’s not so much that something is missing, but that you’ve buried your hurt, neglected childhood feelings deep inside you and that when a potentially close relationship threatens to expose those feelings, you feel you’re being emotionally tortured. Then you bury the feelings even deeper and run away. It’s as though you’re saying, ‘I don’t need anyone and no one can hurt me ever again.’”

“I get the wanting no one to hurt me again, but I don’t know about my being afraid of needing anyone. I don’t think I do need anyone. That’s the problem.” 

“Well, I guess that’s something we’ll find out as we go forward,” I say optimistically. In my mind I add, assuming I’m able to keep you in therapy.

Inching Forward

I return in this blog to Kevin, the man who had difficulty feeling much of anything and who angrily rejected my compassionate remark. Consciously he experienced my response as pitying, as an indication of my seeing him as weak. Unconsciously my positive voice threatened the angry, critical voice of the father he carries around in his head, a voice he would have to relinquish and mourn if he was able to take in more positive voices.    

Progress with Kevin has been slow. He remains unemotional, distanced, reserved, and quick to criticize. For my part, I am often overly cautious, carefully weighing what I say, trying to avoid his attack, an attack which expresses the critical voice of the internalized father that both he and I carry in our minds.     

Today, however, Kevin appears quite different. He is unshaven, dressed in shorts and a T-shirt and looks stricken. Even so, I’m reticent, reluctant to ask if he’s all right, preferring to wait to hear what he’ll say.

“I’ve had one hell of a night,” he begins. “My daughter’s appendix burst. She was screaming in pain. We had to rush her to the emergency room.”

“I’m so sorry, Kevin,” I say. “Is she all right?”

“Yeah, they operated on her and they say she’ll be fine.”

“It must have been terrifying,” I say, despite worrying that my expressing too many vulnerable feelings may result in a backlash from Kevin. But he feels so different today, so much more raw, that I’m willing to take the risk.     

I’m still surprised, however, when Kevin starts weeping. “My poor little girl. She was scared and hurting and I couldn’t do anything! I don’t think I’ve ever been so terrified in my entire life!”

Images go through my head: the trauma of my own childhood tonsillectomy, the terror of so many of my late husband’s hospitalizations, the pain of watching my elderly cat become sicker and sicker. All images associated with despair and powerlessness. This is what Kevin is also feeling. But they are feelings quite alien to him and I’m still unsure how far he’ll be willing to go with them. I wait.

“I bet you never expected me to be bawling in here,” Kevin says, his sarcastic edge returning.

Despite the sarcasm, his vulnerability has made me feel less tentative. “How do you feel about your crying in here or, for that matter, crying at all? And how do you feel about the feelings you obviously have for your daughter?”

“I don’t know about the crying in here part, but I’m actually glad that I could feel so much for Tracy,” Kevin says, more softly than usual. “I know I’ve talked about my feelings about my kids, about how I wasn’t sure that I really felt what I should feel about them. Well, last night did away with that concern. I don’t know what I would have done if anything had happened to Tracy. I felt like my heart would break for her last night. And I was glad to be able to feel.” 

“I’m glad you could allow yourself to feel and that the feelings were not only tolerable, but actually felt good.”

“I even felt closer to my wife last night. Beth was stronger than I thought. She didn’t fall apart even though I could see how scared she was and how much she loved Tracy. I don’t think it’ll fix everything between us, but it felt good, if only for last night. 

“I had some other thoughts, too,” Kevin continues. “I thought about my mother. We don’t talk about my mother much. My father always seems to be in the foreground. I remember when I’d get injured playing sports, especially football. Once I even broke my arm. She did what she was supposed to do. She took me to the hospital, gave me my medicine, asked if I was doing all right, but she wasn’t there emotionally. I could tell how different she was from Beth or even from me – if you can believe that! Yeah, I could tell that I felt more on an emotional level for my daughter than my mother felt for me. That was a revelation.”

“So you had an angry, attacking father and an unemotional, distant mother. It’s no wonder that emotional closeness is so difficult for you.”

“Yeah, I guess that’s true. So am I cured, Doc?”

“I’d say that last remark is an indication of your beginning to feel uncomfortable with the closeness between us and your need to pull back.”

“Come on, now. I didn’t mean anything by that.”

“Think about it. What does it sound like to you?”

“I guess you’re right. It’s sort of a smart-ass, off-hand remark.”

“And that’s fine. You can’t expect that one experience, no matter how terrifying, no matter how eye-opening can make everything different. But it obviously has affected you and it will affect you and us as we go forward.”

The Specter of Death as Ever-Present

I am returning in this blog to Leslie and Harvey, the couple who was dealing with Harvey’s diagnosis of lung cancer. They had never spoken about their fears of Harvey dying, leading to his pulling away in order to protect her from the pain of his possible death.

Before continuing, however, I would like to clarify that just as in my book, Love and Loss, most of the patients in my blogs are composites of individuals I have worked with over the years, although I do try to remain true to the patient or idea I am presenting. Similarly, the dialogue, which I use extensively to bring the patient/therapist relationship to life, flows from my mind, not from verbatim transcripts. 

I return now to the couple. Although Leslie is my patient, Harvey has asked to come in for another joint session, a request his wife Leslie is more than happy to accommodate.

“I appreciate you agreeing to see me, to see us again,” Harvey says, smiling a bit as he switches the “me” to “us.” “I guess you’d call that a Freudian slip, ‘cause I do think this session is more for me than for Leslie.” He looks pensive. “I’ve been thinking a lot about what you said last time I was here, how the awareness of death can provide an opportunity for greater closeness, for a chance to live life to the fullest.”

I nod.

“It’s never been like that for me. I mean not only since I’ve been diagnosed with lung cancer, but forever. I’ve always been terrified of loss, of death.”

“Really?” Leslie says, clearly surprised. “I never knew that.”

“I’m not sure I really knew it either until that last session. But then I realized it’s always been this way, even as a kid. I’d like go to the drug store to get some candy, there was this one guy behind the counter who was always nice to us kids, and I’d leave and wonder what would happen if I never saw him again and how terrible that would be. Or if one of my kids got sick, even like a cold or something, I’d wonder how I’d survive if they died, like I didn’t think I would survive. And then when I got sick, it’s like, wow! I’m going to lose everyone, everything, how horrible is that?”

The session is suffused with a heavy sadness.

“Harvey,” I begin tentatively, aware that he is not strictly my patient, “Hasn’t Leslie told me that your father died of cancer when you were quite young?”

“Yeah. I was seven. It was terrible. My mother was a wreck, depressed – not that I blame her – and us kids were pretty much left to fend for ourselves. I don’t know what we would have done without my grandmother, my father’s mother, although she wasn’t in such great shape either.”

“So your whole childhood became filled with sadness and loss and death.”

“Yeah, and my dog died right about then too.”

“I’m so sorry, Harvey. What a lot for a little boy to bear. You lost everyone who was dear to you, everyone who you needed to depend on, to rely on. And, not surprisingly, it’s still a sadness you carry with you.”

“But I guess that’s what I’ve been thinking about. Even though I’d constantly have these thoughts about loss or death almost whenever I met someone, even if they weren’t someone close to me, I’m not sure I felt the sadness.”

I look at him quizzically. “You certainly seem to be feeling the sadness now, right here in this room.”

“Yes, I definitely feel it now and I’ve been feeling it more, but I realize that I’ve protected myself from those feelings my whole life. I mean even though I really, really love Leslie and my kids and even though I think I’ve been a loving husband and father…”

“You have been!” Leslie interjects.

“But not completely,” Harvey continues, sadly shaking his head. “I think I’ve always kept a piece of myself back. And I don’t want to stay at this place. I don’t want to get to the end of my life and feel that I’ve cheated myself and the people I’ve loved because I haven’t been able to totally let myself go, let myself love to the fullest and get the very most out of life.”

Leslie is crying. “I’m so sorry, Harvey. I’m so sorry I didn’t know.”

“I didn’t know myself, Leslie, so it’s hardly your fault.”

Tears fill my eyes, as I think of the good-fortune of my intensely loving relationship with my husband and, of course, the pain of his loss.  

I’m not sure where Harvey will go from here, but he’s clearly taken a big step towards greater love and connection.