There’s Something Wrong With Me

Staring down, Cristina pulls at the fingers of her hands. She has been unable to say anything since entering my office.

As Cristina’s silence continues and her tears fall silently from her eyes, her pain becomes palpable. “I can see how much pain you’re in, Cristina. Can you tell me what’s wrong?”

She shakes me head. But then she practically whispers, “Me. I’m wrong. I’m all wrong.”

Although I have no idea what Cristina’s referring to, I feel the heaviness of her burden.

“I’m sorry you’re in so much pain, Cristina. Can you tell me what’s causing your pain?”

“There’s something wrong with me,” she replies, barely audible.

“Can you say what makes you feel there’s something wrong with you?”

Tears pour down her cheeks. She makes no attempt to wipe them away.  

“I can’t love her,” she says looking up at me beseechingly. “What normal mother can’t love her child?” She pulls harder at her fingers. “They said it was post-partum depression. And maybe it was. But no one has post-partum depression for two years. And, besides, I didn’t feel that way with my son. Peter was my precious baby. I couldn’t stop holding him and cooing at him. I loved him instantly. And I still do. But with her, it’s different. It was different from the start. And it hasn’t gotten any better.”

“So your daughter is two and your son is …?”

“Five.”

“And her name is …?” I ask, aware that she spoke her son’s name, but not her daughter’s.

“Caroline. I want to love her. I do. But it’s not there.” Pause. “Can you help me? Can you cure me? Can you make me normal again?”

“I can certainly help, but it isn’t like you have a disease, Cristina. I understand that you want to love Caroline, but perhaps first we have to understand why your feelings about Caroline are different from your feelings about Peter. And if you could try to understand what you feel rather than beating yourself up for your feelings, that would be really helpful.”

Cristina shakes her head empathically. “It’s not normal. I’m not normal.”

“Is anyone telling you you’re not normal?”

“Oh, yeah. My mother. She’s told me I’m not normal my whole life.”

“Because?”

“Because I’m not like her. My mother is one of these brash, strong, outdoorsy types who won’t take anything from anybody. And me, well today’s not a great example of how I usually look, but I’m usually pretty well put together. People tell me I’m pretty. I care about clothes and my nails, kind of a girlie girl. My mother couldn’t stand that about me.” Pause. “The truth is she wanted another boy, boy number four, but she got me instead. Unfortunately for both of us.”

“Do you think there’s a connection between how your mother felt about you and you feel about Cristina?” I ask.

Cristina looks at me blankly. “In what way?”

“Well, your mother didn’t like you because you were a girl and it sounds like you’re saying it’s much easier for you to love Peter, your boy, than Caroline, your girl.”

“You’d think I’d love Caroline all the more because I know how awful it feels not to be loved.”

“Well, rationally that may be true, but we humans don’t always act on the basis of rationality. There’s our unconscious to consider. There’s, for example, identifying with the parent who hurt us and then despite our best intentions behaving like them. I’m not saying that’s what’s going on for you, but it does sound as though your feelings about your daughter are similar to your mother’s feelings about you.”

“But I don’t know if Caroline is going to turn out to be a girlie girl.” Pause. “But she is tiny. And she seems so vulnerable.” Crying, Cristina adds, “My mother hated vulnerable. I think that’s what she hated more than anything. She hated when I cried. She hated that I cried. Said I wasn’t normal to cry so much. I guess I’m proving her right.”

“No, you’re not proving her right. You’re proving that you’re human. There’s nothing wrong with crying. And there’s nothing wrong with feeling vulnerable. We all feel vulnerable. And children feel most vulnerable of all.”

“You know, that is one of the things that bothers me about Caroline. She seems so fragile. And for some reason rather than being drawn to that fragility and wanting to protect her, I want her to get it together and be strong.” Pause. “You’re right! I sound like my mother. That’s awful. I never wanted to be like my mother. Now I have something else to hate myself for.”

“You’ve brought in a lot of material today, Cristina, and we’ll have plenty of time to work on it, but the more you could wonder why you do or feel what you do, rather than judging yourself, the easier it would be.”

Anger: Repressed and Expressed

Thirty year old Jacquelyn looks unusually pensive as she settles herself into the chair across from me.

“A weird thing happened this week. Kind of disturbing ,” she begins. “You know how I tell you that I always watch those gruesome  shows like Criminal Minds or CSI, but that I have to cover my eyes during the particularly gory scenes?” she says grimacing.

I nod.

“Well, one of those gory scenes came on, and instead of covering my eyes I felt sort of compelled to watch it. And I – this is kind of embarrassing. I, umm, I actually felt kind of excited and found myself rooting for the serial killer. I wanted to watch him kill that, that, umm, that woman.”

“What did you first think of, Jacquelyn, before you said ‘woman?’”

Jacquelyn lowers her head. “First I thought to say ‘bitch,’ then ‘sniveling baby,’ or ‘coward’ or ‘idiot.’ But they sounded too negative, so I settled on woman.” Pause. “You know, you’re always telling me that I have lots of anger, but that I keep it buried inside me.” Pause. “I didn’t feel angry, not even when I was wanting him to kill her.” Pause. “That doesn’t make sense when I say it out loud.”

Jacquelyn’s last comment is encouraging. Although I’m sure she’s at least of average intelligence, she tends to be quite concrete, has difficulty with self-reflection, and is often unable to take in what seems to me the most obvious of connections.

“Was it that you wanted this particular man to kill the woman or did you want this particular woman dead?” I ask.

“Do you think I’m terrible for thinking about this?”

“Not at all. You weren’t killing anyone, you were watching a TV show.”

“I guess,” she replies dubiously.

Silence.

“You want me to answer your question.”

“Yes.”

“I wanted this woman dead.”

“And can you say more about that? Why did you want her dead? Who did she remind you of?”  

“I don’t know.”

“Well, how about thinking about it now.”

Silence. Jacquelyn squirms in her chair.

“Can’t she just be a woman?”

“If you think about a woman, what woman comes to mind?”

“She wasn’t like my mother.”

“Does that mean your mother was the first woman you thought of?”

She nods, looking down.

“And what’s the similarity between your mother and this woman in the TV show?”

Still not looking at me she says, “They were both housewives.” Pause. “They had children.” Pause. “Umm. Umm. They couldn’t stand up to their husbands.”

Thinking to myself, ‘now we’re getting somewhere,’ I ask, “How did the woman in the TV show not stand up to her husband?”

She looks up. I suspected that it would be easier for her to talk about the TV character than her mother.

“There’s this scene at the breakfast table where her husband is screaming his head off at both her and the kids. You know he’d be cursing in real life but of course they can’t show that on TV. He goes off on the little girl when she spills a glass of milk, calling her an idiot and worthless. The little girl starts to cry and the woman tells her husband to calm down and that does it, now he’s really off the wall, screaming at the woman and even looking as if he might hit her. She cowers and turns back to washing the dishes while the father starts screaming at the girl to stop crying and when she doesn’t he slaps her across the face. The woman doesn’t do anything.”

“Does that sound familiar, Jacquelyn?”

Tears roll down her face. “I didn’t want to kill my mother. Oh my God, I hope not. I hope I didn’t wish her gone, because then I would have been left with him.” Pause. “We were both such cowards,” she says now sobbing.

“What do you mean?” I ask.

“Both of us. Neither of us could stand up to him.”

“Jacquelyn, you were a little girl. How were you going to stand up to him?”

She shakes her head and continues sobbing. “Cowards. We were cowards. We should have done something.”

“You’re angry at both yourself and your mother for not being able to fight back.”

“We were cowards.”

“You can’t accept your own vulnerability, Jacquelyn.”

“No! I can’t!”

“So you wanted to kill the woman in the TV show because of her ‘weakness,’ because of her vulnerability.

“I didn’t want to kill her, I wanted her dead.”

I think Jacquelyn has had enough for today and decide to back off.

“You’ve done a lot of good work today,” I say. “I wonder how you’re feeling.”

“Scared.”

“Scared of?”

“I’m not sure. Being slapped across the face like the girl in the TV show. That’s silly. I feel bad, like I did something wrong and I’m going to be punished.”

“I understand, Jacquelyn. You’ve gotten closer to your anger than you’ve ever been and I think that’s frightening you.”

“You think so?”

“Yes, I do.”

“Okay. I’ll try to think about that.”

Chaos

“Welcome back,” I say to Ed, smiling. He attempts a smile in return, walks into my office, sits down in the chair across from me, and sighs. A smart, sensitive, psychologically minded twenty year old college student, Ed has had difficulties for much of his life – anxiety, compulsivity, facial tics, self-flagellation - but seemed markedly improved before returning to his home in New York City for the summer.

Shaking his head from side to side, he says, “It was too soon. I shouldn’t have gone home. And I shouldn’t have participated in that anti-Trump demonstration. Too much, way too much.” I watch Ed’s eye begin to twitch. He raises his right hand, then catches himself, makes a fist and puts his hand down. “As you can see, it’s back,” he says contemptuously.

“I’m sorry, Ed. I really am. Did you really feel so angry with you that you wanted to hit yourself?”

“Yes. I wanted to beat the shit out of myself,” he says clenching his jaw. “I’m sorry. I know you’ve worked so hard to help me stop that.”

“You don’t have to apologize, Ed. I’m just sorry you’re in so much pain.”

“I’m weak. I’m a sniveling baby. I can’t do anything to help myself.”

“That certainly sounds like the voice of your father.”

“Yeah, so what else is new? I thought I could take him on. I thought I was ready. How stupid of me. And joining that demonstration was terrible.” Ed’s eyes widen. I can feel the fear seeping from him. He fidgets, crossing his legs from side to side. “There were so many people, angry people. And they should be angry. We have an insane bully in the White House. North Korea, Venezuela, racists, Nazis! It’s insane. It scares me. But all the anger scares me too. It reverberates in my head. I can’t turn it off. I feel like I’m crazy too.” Ed digs his nails into both fists. He looks down at those fists as though they’re an alien part of him. He starts to beat his thighs.

I want to go and hold his hands to subdue him, to reassure him, to prevent him from hurting himself. Instead, I softly say, “Ed, Ed please look at me. I’m here. We’ll get through this. You’re with me now. You’re not in that demonstration, you’re not with your parents.”

Ed looks at me, first as though he doesn’t see me and then with dawning recognition. Tears roll down his face. He buries his head in his hands. “I don’t want to be crazy. I don’t want to be crazy,” he mumbles through his hands.

“You’re not crazy, Ed. You’ve been traumatized, actually re-traumatized, and it will take us a while to work it through. Can you talk about some of the things that happened with your parents or does that feel like too much for today?”

He lifts his head and smiles at me. “Well, that never happened. No one was ever sensitive to my feelings. It’s amazing what a difference just a little understanding and caring makes. How many times have I said I wish you were my mother?”

“Except there’s usually a second part to that statement.”

“Yeah, I’m afraid that not even you could stand up to my father and I wouldn’t want to find that out. And then you say you couldn’t promise me that you’d be able to stand up to my father but you certainly hope you’d try.”

“I also say that your father’s rage is not the only rage you’re afraid of, that you’re afraid of your own rage as well.”

He nods.

“I wonder if that’s what happened in the anti-Trump demonstration. You were…”

Ed interrupts me. “I did think that my father is a lot like Trump. A bombastic bully who’s thin skinned and easily narcissistically wounded.”

“So you mean you’d be afraid of going up against Trump, just like you’re afraid of going up against your father?”

“Yes.”

“That makes a lot of sense.”

“But you were you going to say something when I interrupted you.”

“Oh, yes. About your anger. I was wondering if in the demonstration you saw all these people who seemed comfortable with their anger and that that scared you, made you afraid that your anger might get out of hand, especially since, as you just said, Trump reminds you of your father.”

“You know, I’ve never quite gotten that bit about my anger, but somehow it makes sense in the context of that demonstration. There were all these people yelling their heads off, shouting terrible things about Trump. I wanted to join in, to become a part of the crowd. But instead I drew in and had all this noise going on in my head.” Pause. “Thank you. I feel much better.”

“My pleasure. See you Thursday.”

“Thanks again.”

Unleashed

“I didn’t want to come today,” Penny says quietly. “I knew I’d have to tell you what I did and I’m not sure I want to. I’m not sure I can.”

Penny’s anxiety is palpable and mine rises along with hers. It’s difficult when patients introduce a topic this way. I always think of something dreadful – she attempted suicide, she started cutting herself, she killed her daughter. I remain silent.

Penny sits looking downward, her dark, straight hair partially covering her face. She makes no attempt to wipe away the tears that fall down her cheeks.

“I beat up Jennifer,” she finally says in a whisper.

Even though my internal list of dreadful possibilities did include Penny having killed her child, I didn’t really expect to hear that Penny had done anything violent, not this petite, delicate woman who sits across from me. And what does she mean by ‘beat up’?  

“I swore I’d never be like that,” she continues. “I swore I’d never be like my mother. I waited years to have a child because I was so afraid of being like her. And then I am. I’m just like her, just as out of control crazy,” says Penny between sobs.

Penny’s mother was an enraged woman with an explosive temper who beat Penny and her sister with straps and belts and anything else at her disposal. Did Penny indeed lose control like her mother? No longer able to contain my own anxiety, I say, “Can you tell me what happened, Penny.”
 
“Bill and I came home earlier than we expected and there was my 15 year old daughter on the couch making out with this… this boy I’ve told her to keep away from. He’s one of those bad boys. I bet he never even finishes high school. I just snapped. I started screaming and screaming. Bill told him to leave, Jennifer started to give her father an argument and I just went over and slapped her across the face. Twice. She looked at me shocked. I stopped. I couldn’t believe what I did. I couldn’t believe I was just like my mother.”

I can feel myself breath again. Although Penny was briefly out of control her behavior was a far cry from her mother’s. In fact, I can remember a time in a somewhat similar situation when I was about Penny’s age when my mother slapped me for the first and only time of my life. It didn’t scare me. Just made me mad, even though I knew I’d been out of line. But Penny is now frightened of herself, beating up on herself not with a belt, but with self-recrimination and guilt.

“I can’t even look at Jennifer without bursting into tears. And yet I’m still mad at her. She knew she shouldn’t bring that boy into the house. I don’t want her near him anyplace let alone in my home. But I shouldn’t have snapped like that. Bill tells me I’m being too hard on myself, but he doesn’t understand.”

Remembering my own musings before Penny told me what actually happened, I ask, “Is it what you did that’s bothering you so much or what you felt?”

“What do you mean?”

“Well, if we just look at what happened: You come home and find Jennifer with a boy you don’t approve of. You get angry and yell and slap her twice across the face. The facts themselves aren’t so terrible. Maybe that’s what Bill means when he says you’re being too hard on yourself.  But the question might be, what did you feel? Did you feel so out-of-control with rage that you might even have wanted to kill Jennifer? And even if you consciously didn’t feel that, was it the extent of your rage that frightened you so much, made you feel like your mother.”

“I didn’t want to kill her!”  Pause. “At least I don’t think so. But I’ve never been so angry in my life.”

“You know, Penny, you present as this gentle, almost meek, little person who would never want to hurt a fly, who could never, ever feel angry at anyone. And maybe that’s the problem. You’ve been so intent on not being like your mother, in keeping any possible similarity to your mother buried far, far away that when that anger was unleashed it burst out like a volcano.”

“That makes sense. But I don’t know what to do with that.”

“Well, it’s too intellectual right now. But I suspect we’re going to need to spend more time looking back at your childhood and finding the anger you needed to keep buried back then, anger that’s still buried and looking for a way to get out.”

To Wed or Not to Wed

“I can’t understand it,” says Beverly, an attractive 48 year old attorney, passing her hand through her short, curly black hair. “I’ve been with Joanne for over 20 years and now that there’s the possibility that we might be able to get married, I’m getting cold feet. We love each other, we get along. I just don’t understand myself. I haven’t said a word to Joanne. She’s floating on air. I don’t want to burst her bubble. 

“She’s such a good person,” she continues, warmly. “I never want to hurt her, although I know I have. There were those years that I had lots of affairs. Looking for more exciting sex. But I’m really committed to Joanne now. You and I worked on it and I haven’t seen another woman for a long time. I promised Joanne I wouldn’t and I’d never go back on my word. We have a decent sex life. It’s not what it was 20 years ago, but what couple who’s been together for 20 years does?”

Beverly and I have worked together for several years. She was initially a difficult patient, challenging, argumentative, defensive. But she’s now far more thoughtful and open.   

“Does it seem to you that if you get married you’ll be more tied down, less able to turn to other women if you chose?” I ask.

“That doesn’t seem right. I promised Joanne and my word means more to me than a piece of paper.” 

We sit thoughtfully in silence. I think about the wonderful gay wedding I attended last year, the glorious celebration of love and possibility. I think about my lesbian friend who died suddenly many years ago and whose partner could not speak of her loss in the school system where she worked. I’d like Beverly to be able to get married, but that’s my desire, not necessarily hers. 

“I was thinking about my parents.” She laughs. “I do that a lot here. My sisters and I have already begun planning their 50th anniversary party. It makes me nauseous. What’s to celebrate in 50 years of misery! I still don’t understand why they’re together. My father’s this horrible, authoritarian person who bosses around my meek, mousy mother who is constantly depressed and bemoaning her life. I know, I know, they must get something out of it to have stayed together. I think they enjoy torturing each other. Besides, no one else would have either of them.” She sighs. “Am I afraid my marriage would end up like theirs?”

“That’s a good question, are you?”

“Not consciously. One of the good things about being gay was that I knew my relationship could never look like theirs, at least not literally.”

“So how about figuratively?” I ask, hoping to help get beyond the conscious.

“When my sister got married, my mother decided to tell her about her own wedding night. I mean she knew my sister wasn’t a virgin, so I don’t know why she had to tell her all that stuff. She said how painful sex was and how my father didn’t care about her, just his own pleasure. So what else is new? He takes what he wants and she cries about it. Ugh! It’s such an awful relationship.”

I think about my own parents who shared some similarities with Beverly’s. My father was explosive and tyrannical; my mother was compliant, but definitely a competent, capable person, who saw both the world and my father through rose-colored glasses. They loved each other and, although I would have disagreed, they both would have said they had an excellent marriage. Unlike Beverly, I had a mother I could identify with, without getting stuck in a passive, depressed position. For Beverly to propel herself into the world, she needed to identify with her father, an identification that has carried some negative consequences for her. 

“I was thinking, Beverly, that you said at the beginning of the session how you never wanted to hurt Joanne but that you did with sexual relationships with other women. And now you’re talking about how your father took his pleasure sexually and was unconcerned about your mother. Do you think you’re concerned that marriage will give you more of a license to hurt Joanne, sexually or some other way?”

“Hmm. I know that makes no sense logically, but I don’t know. I’ve certainly learned about the power of the unconscious. So if I get married, I’ll be more like my father – married – and therefore more likely to act like him. I’ll have to give that more thought.”

“Not to negate your possible fear of being more like your father, I’d say that your thoughtful, non-defensive interaction with me today indicates how far you’ve moved from being the authoritarian your father is.”

“Thank you. That means a lot to me.”

Time Pressure

Charlotte began treatment with me eight months ago when her mother was diagnosed with terminal cancer. Although well into her forties, married, with children of her own, Charlotte is very dependent on her mother, talking with her several times a day and consulting her for even minor decisions. She is consumed with anxiety at the thought of her mother’s impending death. 

“I never thought she’d die!” she sobs. “I know that’s ridiculous but she seemed invincible. I thought she would live forever. I don’t know what I’ll do without her. It’s hard to imagine how I can go on.”

Charlotte is an only child who grew up in a middle class family. Her father was an accountant, a reserved, passive man who saw Charlotte as his wife’s responsibility. He wasn’t hostile or ungiving, simply absent, seemingly involved with neither Charlotte nor his wife. 

Not surprisingly, the primary connection in the family was between Charlotte and her mother. Her mother was overly protective, constantly concerned about her getting hurt and insistent that she know where Charlotte was at all times. Charlotte never rebelled. She was her mother’s constant companion. Leaving for college precipitated the onset of severe anxiety, an anxiety that still plagues her.

I am struck with the similarities between myself and Charlotte, as well as the differences. Our mothers were alike, both overly protective and fearful of letting their daughters stray too far from home. As a young child I remember wanting to stay with my mother forever. But I had a very different father, an angry, explosive, tyrannical man. I wanted to get away from him. So I had to leave home, thereby beginning the process of separating from my mother.

I knew that Charlotte also needed to separate, but her process would be more difficult since her mother’s death loomed. Time was running out.

“Charlotte, why is it that you’re so afraid of falling apart when your mother dies?”

“I can’t imagine going on without her! I can’t imagine how I’ll function. I’m not even talking about being anxious all the time, and crying all the time because I’m sure that will be true, I just don’t know how I’ll get from one day to the next.”

Feeling the pressure of time, I push way too fast. “How do feel about your mother making you so dependent on her?” 

“What are you talking about? She didn’t make me dependent, that’s just who I am.”

“It is who you are. But I wonder how you got that way. Everyone in your family, including you, contributed to your feeling what I call ‘copeless,’ feeling like you can’t do anything on your own, despite the fact that you’re clearly a competent, capable adult.”

Charlotte is thoughtful. “Well, my mother always helped me with my homework, she wanted to check out all my friends, she never wanted me to go on school trips. I don’t know about my father. He was just absent. As for me, I guess I liked my mother’s attention. It made me feel loved.”

“So maybe one thing you’re saying is that your mother helped make up for the love you didn’t feel from your father.”

“I know he loved me. He just couldn’t show it. And that’s still true. You’d think this would be a time we’d get closer, but he’s just as unavailable as always, to both me and my mother.”

“So you felt you also had to love your mother more to make up for what she didn’t get from your father.”

“I never thought of it that way, but yeah, I guess that’s true.”    

Several months later, I say, “You know, Charlotte, it is all right to be angry with both your parents…”

“No, no,” she interrupts, “I can’t be angry with my mother now.”

“I understand, Charlotte, but it doesn’t mean you’re only angry with her. Of course you love her and you’ll miss her terribly. But your father was absent and your mother was clingy and what you needed as a little girl sometimes got lost along the way.”

Charlotte sobs. 

I’m rushing the treatment. I want Charlotte to be prepared, ready for her mother’s death. But then I realize I’m doing to Charlotte just what her mother did - as well as what my mother did to me. I’m treating Charlotte as a child who can’t take care of herself. I need to listen to Charlotte, to follow her lead, not assume I know what’s best for her. 

Therapy takes a long time and this treatment is no exception. Charlotte will be however she is when her mother dies and we will deal with that then.