Frustration

Jennifer Holland sighs deeply as she settles into the chair. “Well, another holiday season is upon us and I’m alone.”

“I thought both your sons were coming with their families,” I say too quickly and concretely.

She sighs again. “It’s not the same.”

“You mean your husband Dave isn’t here?”

Her eyes fill with tears as she nods. “It’s been five years since he passed. Five years of being alone.” 

“I understand that no one can replace Dave, but that doesn’t mean you’re alone.” 

“It’s not the same,” she repeats.

I’m back in a familiar place with Jennifer. I do understand her feelings. As a widow myself, I know all too well that the holidays bring one’s sense of loss and loneliness to the foreground. But Jennifer’s inability to appreciate what she does have, to take in anything positive from anyone – including me – leaves me feeling angry and frustrated.

“I know it’s not the same, but I wonder how your sons would feel if they heard you discounting their love and caring.”     

“They can’t understand. I know they lost their father, but they have their own families, their own lives.”

Feeling my anger rise, I wonder if I am feeling not only my own anger, but Jennifer’s as well. “Are you angry that your sons have their own lives, that they’re not here with you?”

“I’d prefer they were here. But boys don’t stay with their mothers. I have friends who are widows whose daughters live nearby. I get jealous whenever they bring up spending time with them. But me, I’m alone.”

“You just said you have friends,” I say, immediately aware that I am fruitlessly attempting to change Jennifer’s mind. 

“Yes. But they’re just friends.”

I try to get beyond my frustration and my wish for Jennifer to be different and say, “Do you hear yourself reject anything positive you might receive from anyone: friends, your sons, me?”

“But it doesn’t feel positive.”

Stymied again.

“What would be positive?” I ask.

“Having Dave back,” she says, crying.

From most patients, I would experience such a statement with great empathy. With Jennifer, I feel only anger. “I’m sure that’s true,” I say, trying to conceal my anger, “But you can’t have Dave back.”

“I hate when you say that!”

“Do you hate me?”

“No, I could never hate you. You’re trying to help me.”

“Are you saying you feel that you’re not allowed to hate me because I’m trying to help you?”

She nods.

“But you might hate me even if you feel you shouldn’t.”

“You’re confusing me. Besides, I don’t know why we’re talking about this. I want to know how to be less alone.”

I’m ready to scream. I try to step back and understand what’s going on between us. What I feel is that Jennifer is determined to spit me out. Well, I think, maybe that’s a starting place.

“Jennifer,” I say, “I know that your life has been unbearably sad and painful since Dave’s death, but my experience of the immediate right here and now, of this session right at this moment, is that you reject anything I offer that might help you to feel less alone, like you’re spitting me out.”

“But you haven’t said anything to make me feel less alone.”

“If you’re saying I haven’t said anything that’s going to bring Dave back, that’s true. If you’re saying you’re unwilling to take in anything that might make you feel better unless it’s bringing Dave back, I’d say you’re holding out for the impossible. And if you are saying you’re going to reject anything that isn’t going to bring Dave back, I’d say that’s what we need to work on.” Am I being too harsh, I wonder? Is my frustration turning into hostility?

“I don’t know what you want from me,” Jennifer says plaintively. 

Yes, I’m being too aggressive but Jennifer’s passivity and sense of entitlement is difficult for me to handle. I try to soften my tone. “Can you say what you’d like from me, Jennifer? Or what you think you might be able to do to help yourself to feel better.”

“I don’t know,” she laments. “I thought you were supposed to tell me that.”

“It’s so, so hard for you, Jennifer, to take in positives, to feel good about your sons coming, to feel pleased to have friends.”

“It’s not enough.”

“I understand they’re not Dave. But maybe you won’t be able to begin to take in the positives in your life until you’re able to accept that regardless of how much you might want it, Dave can’t come back.”

“I hate when you say that.”

“I know. It’s a reality you don’t want to accept.”

To Tell The Truth

An acquaintance asked me the other day how I knew if patients were telling me the truth. I gave her the response I usually do: It doesn’t really matter. I can only know the world through my patient’s eyes, so whatever he or she presents is what matters. Besides, I added, none of us ever know if we’re telling “the truth,” we’re only telling our version of what we assume the truth to be.

After I left, however, I began to think more about my answer. Did I really believe it didn’t matter if a patient deliberately lied to me? Since I believe in the crucial importance of the therapist/patient interaction, certainly a patient’s deliberate lie has meaning. It’s not that the patient is “bad” for lying or that the content of the lie is important in and of itself, but rather that the patient’s need to lie says something about what is happening in the relationship.

I thought of a patient I saw many years ago who had been raped. After I returned from a vacation, she told me that she had been raped again by the same man. A look of doubt must have passed across my face, because she angrily proclaimed, “You don’t believe me!”

Oops. I remember hesitating, feeling uncomfortable. “Well,” I said, “I certainly wouldn’t say it’s not possible, but I wonder about the timing. Is it true that you were raped again, or are you saying that you’re angry with me for leaving you and that you felt much more unsafe while I was gone?”

She burst into tears, told me I was correct, and then started yelling at me for abandoning her. 

Despite our difficulties, that patient and I had a solid relationship and her lie made sense in the context of that relationship.

And that led me to think of Jessica, the adolescent I saw who just lied – all the time, for no apparent reason, regardless if her lie would be discovered. 

Her parents, who seemed concerned and caring, had no idea what to with their daughter.  My initial assumption was that Jessica lied like all adolescents lied. I’d been an adolescent. I remembered. Lies about where you were, who you were with, what time you got home. 

Jessica did tell those “normal” lies, lies about going to school, about showing up for soccer practice, about spending the night at the home of one of her girlfriends. And she was good at it. She’d look you straight in the face and you’d believe her. Except now her parents checked on her. They called the school, the coach, the friend’s mother. She was always found out. She’d shrug and move on.

She also told stories. Some of them might even have been true. “On my way to school today I saw a man on a motorcycle hit a deer. He was hurt. I ran to the house near-by and they called an ambulance.”

Realizing that questioning everything Jessica said was getting us nowhere, I tried to understand the meaning behind the story.

“How did you feel being able to help that man, Jessica?” 

“I don’t know. Good, I guess.”

“Was the man grateful to you?”

“I couldn’t wait around. I had to get to school.”   

Or, “I was home alone and some guy knocked on the door asking directions. When I opened the door he looked kind of dirty. I got scared. I started to shut the door. He tried to push it open, but I managed to close it. I called the police. They came and talked to me. I gave them a description of the guy. They said they’d look for him.”

“That must have been scary,” I say, again deciding not to question the validity of the story.

“Yeah.”

“And how do you feel being home alone, Jessica?”

“I don’t know. No problem, I guess.”

“Will this incident make you more afraid?”

“Maybe. Maybe not. I just won’t open the door.”

Trying to talk with Jessica more generally about her stories also got us nowhere.

“Jessica, do you know why you make up stories? Does it make you feel smart, creative, like you can out smart other people?”

“I don’t know. I’m not so smart.”

“Is it that you don’t feel smart? That you feel bad about not feeling smart?”

“I don’t know. I guess I’m smart enough.”

This isn’t a story that has a miraculously happy ending. Jessica and I never formed a relationship. I was never able to help her. In fact, I wasn’t even able to understand her. Sometimes I wonder what became of her. Did she become a thief? A politician? Or is she just someone who always lies?