Shame

“I love you,” Melanie says, looking downward.

Twenty-five year old Melanie has been my patient for two years, a lovely young woman struggling with anxiety and depression.  One of six children raised on a farm by parents who saw their offspring as laborers, rather than cherished beings, Melanie has come to rely on me as one of the few people who is consistently in her corner. Professing her love for me doesn’t take me by surprise.

“Thank you, Melanie,” I say, “that’s a lovely gift.”

“No,” she replies. “It’s much more complicated.”

I wait, unsure what she means.

“I said that to my last therapist,” she says hesitantly. “You know, I’ve talked to you about Dr. Hopkins. I saw him for a couple of years before you.”

I nod.

“But I never told you what happened, why I left.” She pauses. “We had an affair.”

I’m shocked. Not that I’ve never heard of therapists inappropriately crossing sexual boundaries, but I’m surprised Melanie never told me something of such significance.

“I’m so sorry, Melanie. How come you never told me before?”

“I was too ashamed.”

The victim blaming herself. Not unusual I think to myself. “Do you realize that Dr. Hopkins abused you?”

“No. It wasn’t like that,” she protests. “I told you, I loved him. And he loved me back. That was the most wonderful surprise of my life. Someone I so looked up to and admired actually loved me!”

“Melanie, how did your therapy with Dr. Hopkins end?”

“Well, for a while we saw each on the outside and I continued to have my regular therapy sessions. Dr. Hopkins was very clear that we couldn’t do anything sexual in the office, that we had to remain professional during our sessions.”

I am beyond furious at this so-called therapist, but hope that I am successful at concealing my feelings.

“But then Dr. Hopkins told me he didn’t think I needed therapy anymore. So I quit and just saw him on the outside.”

Still seething, I wonder if Dr. Hopkins thought his prowess as a lover had “cured” Melanie or whether he just found it too difficult to keeps his hands off her during their sessions.

“But then one day,” she continues, “he said that we couldn’t see each other anymore. He told me his wife was sick and that he felt too guilty being with me. I was devastated. I mean, I knew he was married. I knew it wasn’t like we’d be together forever and ever. But I loved him so much. And I thought he loved me. So how could he just walk away?”

“When you say you thought he loved you, are you now questioning that?”

Melanie starts to cry. “I was a fool. I know I was a fool. Did I really think a smart, educated man more than twice my age would be in love with me? He wanted my body. But I just wanted so much for him to love me, that I deluded myself into thinking he did. That’s what I’m ashamed of, being such a fool.”

“There’s an awful lot to deal with here, Melanie, and I’m sure we’ll return to this many times, but I want to come back to us before the session ends. So what did it mean to you to tell me you loved me? And what response did you hope for – or fear?”

“I’m not sure. I know I don’t want to sleep with you, but I do want you to love me. I guess I want to crawl into your lap and have you stroke my hair and tell me you love me, just as you’d tell your own daughter. Is that wrong?”

“No, Melanie, what you wish for can never be wrong. But acting on that wish is different. You wanted Dr. Hopkins to love you, which really meant you wanted him to care about you, to cherish you and to act in your best interest, not his. He did abuse you, Melanie. He took advantage of your need, of your vulnerability and crossed what should have been an unbreakable boundary. As for us, the wish to crawl into my lap and be my daughter is a more than understandable wish for someone who was so neglected as a child. But if I were to act on that wish I would not be acting in your best interest, because I would be giving you the false hope that you can go back to being a child and get from me what you couldn’t get from either of your parents.”

“That makes me sad.”

“I’m sure it does. Mourning what you never got and never can get, is always sad.”

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.”

You're Back

“I’m really glad you’re back,” Christine says, her eyes filling with tears. “I know you were only gone a week, but it’s been a hard week. I thought I was more prepared, more ready to deal with my parents this time, but I don’t know, I guess it was the holidays. It was awful. I felt sorry for my girls. They were so looking forward to Nana and Poppy coming for Christmas and it was such a disaster. My parents never stopped fighting, my mother never stopped telling me what I was doing wrong, most particularly as a mother and, of course, as someone who couldn’t keep my husband from straying and my father just got more and more depressed.”

“I’m sorry, Christine. It does sound awful and so disappointing.”

“Yes, that’s exactly right, terribly disappointing. I guess I thought since we’d been working so much on my parents these days, I’d be able to handle them differently or be less affected by them or something.”

“So it sounds as though you’re saying that you’re disappointed in me too, in our work together.”

“No. I don’t think so. I was disappointed that you weren’t here to bounce things off of, to maybe give me some ideas of how to handle things differently.”

Although Christine’s denial doesn’t convince me, I let it go for the moment. “For example,” I say. “Can you give me an idea of what you thought you could have handled differently?”

“There are so many things. How I could have gotten them to stop fighting. How I could have stopped my mother from being so critical of me. How I could have stopped her from being critical of my girls.”

“All right, let’s look at those three things which don’t all strike me as the same. Could you have gotten them to stop fighting? If I’m not mistaken you’ve been trying unsuccessfully your whole life to get them to stop fighting.”

Christine looks startled. “Oh, right. One of the things I need to give up on. I forgot. I can’t keep hoping for what will never be. I need to accept my powerlessness. I knew you should have been here. But why did I forget? I feel ashamed of myself. Why couldn’t I hold onto that?”

“Seems like you said a lot there, Christine. First, I think you are angry with me for not being here. Then I think you got uncomfortable with your anger and felt ashamed instead. And, I agree we should look at why it’s easier for you to hold onto your feelings of hopelessness and powerlessness when I’m here.”

“I do feel ashamed of myself. We’ve talked and talked about my needing to give up hope with my parents and I just can’t seem to do it.”

“Well, it’s very painful. It means you can never have the parents you want or wanted either now or in the past. It involves mourning for what never was and never can be.”

“I know. I guess that’s why it’s harder to do when you’re not here. If you’re not here and I don’t have my parents – and I sure don’t have my ex any more – I feel all alone. Except for the girls of course, but that’s different.”

“That’s a great insight, Christine.”

“Thanks. But what about the other two things I mentioned, why did you feel they were different?”

“The second one might not be all that different, getting your mother not to be critical of you, but I guess I wondered what it is that you felt when your mother’s so critical.”

“I do feel angry, but I try to pretend it doesn’t bother me and just ignore her.”

“Because?”

“Confronting her only makes it worse.”

“And when she attacks your girls?”

“I guess I do about the same thing.”

I am annoyed by Christine’s passivity. I feel she is leaving her daughters unprotected, just as I felt unprotected by my mother in relation to my explosive father. I tread lightly. “I wonder what message you give your girls when you don’t stick up for them.”

“But I thought I’m supposed to give up hope of ever changing her,” she says plaintively.

“This could just be me, Christine, but I think there’s a difference between accepting there’s no way you’re ever going to change your mother and still giving your girls the message that it’s not okay with you for her to attack them, or you for that matter.”

“That’s confusing.”

“It’s like saying, you know you’re not going to change her behavior but you’re still going to let her – and your girls – know her behavior isn’t acceptable.”

“It scares me.”

“What scares you?”

“I guess her anger.”

“I get that. And perhaps your anger as well.”

“I don’t like all this talk about my anger.”

“I believe 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.”