Panic

“I couldn’t wait to get here,” Ray says, almost breathless. “Pamela asked me for a divorce. She said we’ve been working on our relationship for years and it just doesn’t get any better. She wants out. She wants a chance to find greater happiness with someone else.”

“I’m sorry, Ray,” I say empathically.

“I…I’m a mess. I don’t think I’ve slept two hours since she told me. I never thought she’d leave me. I don’t know what to do. I can’t think straight. I’m like beyond panicked.”

“What’s fueling your panic?”

“What? What do you mean?”

“I can certainly understand you’re feeling sad and scared and maybe even angry, but what’s underneath your panic?”

“I’ll be alone. She’ll leave and take the kids and I’ll be alone. Oh my God, I can hardly say that. I can’t breathe.”

“I’m here. You’re not alone now. Take a few deep breaths and then let’s try to look at what feels so terrifying to you about being alone.”

Ray looks at me incredulously. He buries his head in his hands and tries to slow his breathing. He bursts into tears.

I sit silently while Ray cries, hoping he has broken through some of the anxiety to feel his sadness underneath.

“Why? Why? Why did she do this?”

Ray’s shock about his wife’s decision is rather surprising to me since they have indeed been working on their relationship for years. Ray told me she had repeatedly said she was unhappy in the relationship, feeling him unable to give to her emotionally or sexually.   

“What did prompt her decision?” I ask.

“I don’t know. Maybe because we didn’t have sex?” he says questioningly.

“You’ve told me that has been one of Pamela’s consistent complaints. That you withhold from her.”

“Do you break up a 15 year relationship because of sex?”

Ray’s consistent disbelief feels incredibly naïve to me. I even wonder if it’s disingenuous. Then I have another thought.

“You feel very much like a scared, hurt child to me,” I say gently.

Crying again, Ray mumbles, “That’s exactly how I feel.”

“So perhaps that’s why you’re panicked. When a child is left he feels panicked because he can’t survive without his mother - or some caretaker.”

“So you think Pamela’s leaving me feels like my mother leaving me?”

I nod.

“But my mother never left me.”

“That’s not exactly true Ray. You’ve told me how she reacted after your father died.”

“Yeah, that’s true. Before I was seven – when my father died – we had a very close relationship. In fact, she was all over me. Sometimes I just wanted to get away from her. It was too much. But after he died, I don’t know, it was like she died too. She got so depressed and didn’t want me anywhere around. In fact she shipped me off to her sister’s for a while. It was awful. My cousins hated me. I’m sure they didn’t want another kid in the family. I had to change schools and that was awful. The whole thing was awful.” Pause. “And when I went back home, my mother still rejected me.” Pause. “And then she started dating. That was worse. All those men. And then my step-father. The whole thing was a nightmare.” Pause. “You know what just went through my mind? I wanted my Mommy back.”

Crying, Ray adds, “And that’s how I feel right now. I want my Mommy. Except it’s Pamela.”   

I remain silent, thinking this is not the time to explore the meaning behind Ray’s similar feelings about his mother and Pamela.

“I guess that helps explain my panic,” he continues. “But it doesn’t take it away,” he adds, looking at me beseechingly. “Can’t you take it away?”

“So perhaps now I’m the Mommy who you want to take away all your fears and sadness.”

“Can you?”

“That’s clearly your wish, but I’m afraid I have no magic wand.”

“No?”

“No, but we can look at your desire for that magic wand, for the all-powerful, all-perfect mother who can take away all your fears, all your sadness so that you feel nothing but perpetual bliss.”

“Sounds wonderful.”

“But I wonder if it would feel wonderful or, as you said before about your early mother, whether it would feel too much and you’d want to get away.”

“I don’t know. Right now it sounds wonderful.”

“When faced with abandonment you yearn for closeness, but when there’s closeness it can feel like too much and you yearn to get away.”

“I don’t know. I can’t deal with all that now.”

“I understand. We’ll have plenty of time.”

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.”

Divorce?

“I’m considering getting a divorce,” 52 year old Evelyn says, starting the session.

Although her marriage has been rocky for some time, this pronouncement surprises me given that her husband recently had a heart attack and by-pass surgery. She seemed genuinely concerned about him and committed to helping him through the rehabilitation process. I remain silent.

“I was listening to this program on NPR, On Point, and there was this doctor on who wrote a book about solving medical mysteries. I don’t remember his name, but it was interesting.”

I heard a small part of that program too, but I wait to hear what led Evelyn from that program to her considering divorce.

“There was a man who had a heart attack who’d had a bad heart so his heart attack was no surprise, kind of like Jack. But then the doctor went on to say that like the very next day or something like that, his wife had a heart attack too. And she had been perfectly healthy. And the doctor said it was the stress, almost like being too close to her husband and having to have a heart attack just like him. Well, I don’t want that to be me. I know this might sound awful, but Jack’s not worth my health. He hasn’t been a good enough husband for me to lay down my life for him.”

Feeling unsure what to say, I continue to remain silent.

“Do you think I’m awful?” Evelyn asks.

“No, of course not, but I am a little confused. I heard a small part of that program too…”

“Do you remember the doctor’s name? I thought I could get his book.”

“No, I didn’t hear much of the program, but what I remember is that he was talking about a couple that was extremely loving and close and that it was that closeness that led to the wife’s distress and her perhaps unconscious need – those are my words, not his – to identify with her husband and go through the same experience he had.”

“Well I guess if that was true, I wouldn’t have to worry about that.”

“Evelyn, am I mistaken or do you feel particularly angry today?”

She shrugs. “I guess.”

“Can you say what’s going on?”

“I’ve been busting my butt taking care of Jack and do you think I even get so much as a thank you?!” All he does is bitch and complain – I’m in so much pain, I’m scared, what if this happens again, why does my right arm still hurt. Complain, complain, complain. I’m sick of it.”

Jack has definitely been a less than ideal husband - inattentive, otherwise preoccupied and, most likely, unfaithful. Still, Evelyn has stayed with him, continually hoping that she could make him different, just as she longed to do with her absent and eventually abandoning father. Still, right after a major scare and trauma seems an unusual time to be considering divorce. Then a thought comes to me.

“Evelyn, do you think this time you especially thought it would be different? Jack was scared and vulnerable. Maybe he’d need you in a different way? Maybe he’d let you in as he hadn’t before?”  

Evelyn hangs her head. “Stupid of me, wasn’t it,” she says, her anger now turned on herself.

“No, definitely not stupid. It was you hoping again, hoping you – or something – could make Jack different, just as you hoped with your father.”

“But it is stupid! How many times do I have to go through the same thing to know it’s not going to work? It’s like continually hitting my head against the same brick wall.”

“It’s hard to give up hope. It’s hard to mourn what never was and never will be.”

“I can’t stand when you talk about mourning. Who wants to mourn, who wants to be sad all the time?”

“So you’d rather be angry.”

“Damn straight.”

“Well, it’s reasonable to be angry, but if you’re only angry you can’t ever finish the process of letting go.”

Evelyn’s eyes pierce me with fury.

“And,” I continue, “to end up being angry at everyone – yourself, me, your children, your friends - that doesn’t lead to a very fulfilling life.”

“So should I stay with Jack?”

“That’s a decision only you can make, Evelyn. But I do know regardless of what decision you make, you will have to mourn the impossible.”

In Motion

“Sorry I’m late,” Ryan says, lowering his tall, broad, smartly dressed body into my chair.

So what else is new, I think to myself, aware of the annoyance and sarcasm in my thought.

“The real estate market is really picking up. It’s great. But the customers are keeping me hopping. Have to be there when they want or the sales go elsewhere.” 

I remain silent.

“OK, so let me switch gears. What’s been going on? Well, Charlene is starting to drive me crazy. I think I’m going to have to break up with her. The sex is still great and she’s funny, but she’s so needy. I mean, I don’t mind sending her a quick text during the day, but I can’t be stopping to have some intense conversation. And just because I don’t have a 9 to 5 job, doesn’t mean I can see her whenever she wants. It’s not like that. My time isn’t my own. I have to be available to my customers.”

“Kind of like what you said to me about being late.”

“Yeah! Exactly! And you get it.”

“What is it that you think I get?”

“That I can’t help it. That I have to be available to my clients.”

Varying thoughts flood my mind. Lateness and commitment are big issues for Ryan. He came into treatment two years after his divorce saying that he was having difficulty keeping a relationship. At that point he was despondent, dejected, wondering what he was doing wrong. But he’s now lost himself in a flurry of activity, moving away from self-reflection, just as he moves away from commitment. 

Lateness can also be an issue for me, although my years of doing treatment have diminished its affect. Still, there’s the scared, abandoned little girl in me waiting in the darkened school for my almost always late mother to pick me up. But Ryan’s lateness has a more dismissive quality, like he’s saying “you’re not worth my time.” 

“You do get it, don’t you?” Ryan say, interrupting my thoughts.

“I think lateness and time and commitment is a far more complicated issue for you Ryan.”

“You don’t get it! You think I do it on purpose. Hey, I have to make a living! Remember all that child support I have to pay?”

“Can you say what your anger is about right now, Ryan?”

“Who says I’m angry?”

I feel a flash of annoyance and then, probably drawing on my own childhood experience, I feel sad for Ryan. It’s time to rein him in, to bring him back from his frantic busyness and avoidance. “I wonder if not feeling understood by me makes you feel alone and rejected,” I say.

“Whoa! That feels like a leap!”

“Ryan, let’s slow down here. You came into treatment feeling discouraged with the quality of your life, your relationships. But then you got yourself into a whirlwind – yes I know you have to make a living and that the real estate market is picking up – but I also think you’re trying to avoid yourself and your feelings and me and Charlene as well.”

He stares out the window. “It’s getting darker out there. Looks like it’s going to rain.”

“Sounds like that’s how you feel. If you stop for a minute, you can feel the darkness, the sadness come over you.”

“So what am I so sad about?”

“What are your thoughts?”

“My failed marriage. My not getting to see enough of my kids. I said I’d never get a divorce, never do to my kids what my parents did to me. Split between two homes, neither one having enough time for me, neither one knowing if I was going to school, doing my homework. It felt as though they didn’t give a shit. They probably did, but they were too busy trying to make ends meet.”

“It’s interesting, Ryan, when you just said it felt as though they didn’t give a shit, that’s exactly how it feels to me when you come in here and toss off a ‘sorry I’m late.’ It feels as though you don’t give a shit. So you’re behaving towards me as your parents behaved towards you and allowing me to feel what it felt like to be the kid you.”

“Wow! That’s deep. I’m not sure I’m smart enough to create that scenario.”

“It’s not something that you decide to do or figure out consciously. You act it out automatically so that in your relationships someone is always being the rejecting parent and the other person feels like the rejected child.”  

“That would be a good reason for relationships not to work out.”

“Yes, that’s definitely true.”

“And what do I do about it?”

“First step is being aware of it. And we’ll definitely keep it in mind in our work here.” 

Black and White

“I was so depressed I didn’t go out of the house all weekend,” Liz says, her mouth pinched, her eyes downward, staring at her hands. 

“I’m so alone. No one cares about me. No one cares if I live or die.”

Rather than feeling compassion for my obviously unhappy patient, I’m aware of feeling immediately annoyed. There are reasons I could feel compassion. Liz’s husband Bob decided he wanted a divorce after almost 45 years of marriage, leaving her adrift at age 65, never having lived on her own, never having been involved with any man but her husband. Still, I feel annoyed. This tells me two things: one, I have a hard time with someone who remains stuck in the victim role because it’s a role I can’t tolerate myself and, two, underneath her depression, Liz is angry and is unconsciously communicating that anger to me.

I remain silent.

Liz continues. “Bobby went to see his father again this weekend. He was just there for Father’s Day. You’d think he could have stopped by.”

“So you’re angry that your son saw your husband again and not you.”

“I guess.”

“What do you mean, you guess?”

“I wouldn’t have called it anger, more like disappointment.”

“Can you feel both?”

“I suppose. I just don’t know why I don’t see more of him. He obviously has time for his father and for the girls he’s always chasing. I don’t see why he can’t squeeze a little time in for his mother. He’s all I have left in the world and I never see him.”

I consider and reject various responses: What about your daughter and her three children? What about your sisters? What about the friends you’ve been trying to develop? Although all these are all realities, they are irrelevant to Liz at this time. For the moment all that matters is that her son saw her husband instead of her.

“When was the last time you saw your son?” I ask although I fear that even that question veers too far from Liz’s feelings and her present state of mind. Still, her answer surprises me.

“He took me to dinner earlier last week.”

My unspoken response is, I thought you said you never see him, but I recognize the futility of going down that path. Instead I said, “I think you really are angry at Bobby, Liz, angry that he sees your husband despite how much Bob hurt you.”

“Well he did hurt me horribly. And he didn’t even leave for another woman. He left because he couldn’t stand me anymore. How do you think that makes me feel?”

“Of course it’s hurtful, Liz. Of course you feel lousy. But I wonder if you’re also feeling angry with me right now?”

“With you? Why should I be angry with you?”

“Perhaps because you don’t feel I’m being sufficiently understanding. Perhaps because when you get angry your anger gets bigger and bigger until it’s hard to find anything good or positive about anyone. It’s like you see the world in black and white with no shades of gray. It’s like when you’re angry at Bobby, you forget all the positive or caring or loving things he’s ever done. And then your anger keeps expanding until it encompasses everyone in your life and you’re left with only blackness, you’re left feeling all alone.”

“I definitely do feel all alone.”

“I know you do. But I wonder if you really are as alone as you feel or if it’s your anger that erases all goodness. It is possible – and I know this is very difficult for you – but it is possible to be angry with Bobby or with me or with anyone and still love them and care about them and know they care about you.”

“That’s really hard for me. I don’t even know that I’m angry until you point it out.”

“Well that’s a problem too. Instead of recognizing your anger, you tend to turn it on yourself and feel worthless and depressed. So, yes, first you have to recognize your anger as anger. And then we have to work on your being able to hold anger and more positive feelings at the same time.”

“So you’re not giving up on me?”

“Why would you think I’d be giving up on you?”

“I don’t know. Sometimes I think you’re impatient with me.”

“Maybe you’re right. Maybe sometimes I do feel impatient. But that would be a good example of my being able to feel something negative like impatience and still hold on to caring about you and being committed to our work together.”

“I understand. I just don’t know if I can do it.”

“That’s what we’re here for.”