“I really appreciate your seeing me again. I didn’t know who to turn to. I’m so scared, so, so scared.”
Across from me sits Jennifer, a patient I have not seen for over eight years. We’d worked intensively for a five year period, until Jennifer gave birth and decided that she’d like to try it on her own. I’d questioned her timing. The victim of childhood sexual abuse by an uncle she’d kept secret from everyone but me, I’d wondered what feelings might resurface with the birth of her daughter. But she was insistent and I had to respect her decision.
“I saw Samantha masturbating in the living room a couple of weeks ago. It freaked me out, but I talked to myself, said it didn’t mean anything happened to her, just a kid exploring her body. So I told her those were things we do in private. She seemed to accept that and I let it be. It still bothered me – I even started to have my scary dreams again – but I dropped it with Samantha. Then it happened again and I got more scared.
“So I tried to talk to her about it. I reminded her what I had said before about that kind of stuff being private, but this time I asked her if anyone else had touched her down there. She didn’t say anything, just looked away from me. I panicked. I told her I wouldn’t be mad at her, but she needed to tell me if anyone else was touching her. Then she nodded and I thought I would die. Not again I wanted to scream. This can’t be happening to my daughter too,” Jennifer says, crying, tearing at her hands. I feel my own anxiety rise along with hers.
She continues. “I asked her if she could tell me who it was and she pointed to the house next door. That confused me because there’s no man next door, just a divorced Mom with kids. She has a daughter, Emma, who’s the same age as Samantha and they play together sometimes. Then I thought maybe the Mom was dating someone, or was it the Mom herself, all these thoughts racing through my head. Then she almost whispered, ‘Howie.’ For a second I didn’t even know who that was and then I realized that was Emma’s brother who’s probably ten. Is that abuse? He’s ten. What were they doing? Was anyone with them? Where was Emma? I asked the last question. Samantha just shrugged. So I stopped. And I called you.”
“I’m glad you called, Jennifer, I know how very difficult this is for you. It would be difficult for any Mom, but it sets off so many old terrors for you.”
Jennifer’s tears cascade down her face. Her agitation decreases. “I knew you’d understand. I talked to my husband, Bill. He said I was over-reacting that they were just kids, doing what all normal kids do. Maybe he’s right. I don’t want to terrify Samantha. I don’t want to give her the message that sex is bad and dirty. I’ve had more than enough of that to deal with myself. Please tell me what I should do.”
Thoughts have been swirling through my mind during Samantha’s panicky recitation. I always believed that her daughter’s sexuality would present problems for Jennifer, but the possibility of sexual abuse raises those issues a hundredfold. On the other hand, Jennifer comes in with a good deal of insight. She knows she has to rein in her fears to avoid terrorizing Samantha, although children easily intuit their parent’s underlying and unspoken feelings. And there are the practical questions. What should Jennifer do? What did actually happen? Although the facts do matter in a case such as this, how one understands those facts will vary greatly depending upon the lens through which they are viewed.
“There a lot going on here, Jennifer. Are you asking me what you need to do about your feelings, about how to deal with Samantha, about what actually happened?”
Jennifer stares at me. “I don’t know. I can’t even think straight. All of the above, I guess.”
“You’re feeling overwhelmed by your feelings and you can’t think straight. Is it possible for you, for example, to talk with Bill again about your feelings, to talk with the Mom next door, have the two of you talk with the Mom?”
“I can’t,” Jennifer wails.
I remember that forlorn cry. “You still haven’t told anyone but me about your abuse, have you?” I ask.
Jennifer shakes her head sobbing.
“I’m sorry. I’m sorry you still feel so much shame you can’t speak. Let’s see if you can come in again tomorrow. I don’t want to leave you feeling so distraught.”
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?
I’ve only seen Sergio for a few sessions. Originally from Columbia, he and his wife risked all they had to come to the United States, seeking a better life for themselves and especially for their unborn children. They have four children now and it’s because of them he came to see me.
“My wife says I push them too much. And that it got worse after Mother’s Day. You know, school’s about to get out. I tell them, I don’t want any presents, save your money. What I want is all As on your report cards. I work hard. I carry bedpans, wash people’s butts, put up with not nice people. I smile. I don’t complain. It’s a steady job. I’m lucky to have it. I’ve taken my kids to that nursing home. I show them what their father does all day. Is this what you want, I ask them? And my wife, she’s cleaning people’s houses. All we do is work.”
“Do you think you might be pressuring them a bit too much?” I ask gingerly.
“No!” he replies emphatically, “My wife and I struggle every day. Every day we work to give them a better life. So why shouldn’t they get all As? That’s their work.”
I like Sergio. I admire his grit, his determination. Yet conflicting and complex emotions course through me. The immigrant experience, I think warmly to myself, flashing on my beloved grandparents who only wanted “better” for their children and for me. I think of being five and sitting at their kitchen table and my grandmother telling me I was going to be the next Madame Curie. That’s the warm side, the good feelings. But then there was my father. He was contemptuous of his immigrant parents, wanting only to distance himself from them, avidly pushing education and success for both himself and me, his only child. The pressure often felt unbearable.
“And did all you children bring you straight As?” I ask.
“No!” he says angrily.
“And you were obviously angry. How did you show your anger?”
“I wouldn’t talk with them all Father’s Day.”
Ouch! I think to myself, feeling the press to protect his children, as I wish I too had been protected.
“Sergio, is it possible that not all of your children are capable of getting straight As in every class, every time?”
“Why shouldn’t they be?”
“Well, different children have different strengths. Some are good in math and not good in English or the other way around. And sometimes if you’re too strict with children, they rebel, they try to get back at you by not doing well, even if they’re not aware of it.”
“No!” he exclaims, shaking his head from side to side. “That will not happen!”
This isn’t working. In my eagerness to protect the children, I’ve lost sight of my patient.
“Sergio, how do you feel when say – what’s the name of your eldest?”
“Eduardo.”
“When Eduardo doesn’t get straight As?”
“Angry. He’s not working hard enough! Too much time on the computer.”
“I understand, but what does it mean for you that he’s not working hard enough. In addition to anger, what do you feel?”
Sergio sits thoughtfully. “I don’t know how to say it. It makes me feel bad. It makes me feel, I don’t know. I can’t find the words.”
“Do you think it makes you feel sad for you, for your life? You’ve made so many sacrifices. You continue to make so many sacrifices – a job you barely tolerate, long hours, no time with your wife – that it’s really, really important that your children make it all worthwhile.”
“Yes, that’s it,” he says smiling.
“I know this may be hard for you to believe, Sergio, but you can’t expect your children to make your life worthwhile. You can make your own life worthwhile. Wait! Wait!” I say, seeing that he’s about to interrupt me. “Of course you want your children to do well. But hopefully you want that for them, not for you. Hopefully you want them to do what will bring them good feelings about themselves and their lives, not necessarily what you want for them. What if Eduardo was really good working with his hands? What if he wanted to be a mechanic or a carpenter?”
“I don’t know,” he says hesitantly.
“I know,” I say. “That was a long speech.” Directed, I think to myself, to both you and to my father. “You can think about it and we’ll talk more next week.”
