Pretending

 “I did it!” Charlotte says, gleefully.

“Congratulations,” I say enthusiastically, “And welcome back.”

“I’m not talking about going by myself to Italy.”

“Oh! What did you mean?” 

“I did go by myself to Italy. It was hard. And all you’ve heard about Italian men, don’t believe a word of it. No one gave me a second glance. Oh course, why look at a middle-aged woman when you have all these gorgeous young, half-dressed I might add, girls running around. But seriously, don’t you remember what we talked about our last session?”

“I thought I did but… Oh, Charlotte, you really didn’t…”

She smiles broadly nodding at me.

“You pretended you were sick,” I state matter-of-factly.

“Correct! You see, not even you can remember me unless I do something daring, outrageous.”

“Of course I remember you. I didn’t remember that you were considering presenting yourself as someone who was ill, but I remember …”

“It doesn’t matter. I figured out how to get the attention I wanted. The more outrageous I made the story the more attention I got. It’s amazing how solicitous flight attendants can be when you tell them you’re dying of cancer or that you just had a chemo treatment.”

“And is that whose attention you wanted?”  

“Anyone is better than no one, but no, that’s not whose attention I wanted. But it was fun trying out different stories and seeing what provoked the most sympathy or what made people the most uncomfortable.”

“What did make people the most uncomfortable?”

“If they thought I was going to throw up all over them. That was a good one, especially on a plane with the person sitting next to me.”

“Sounds like you took a lot of pleasure making people uncomfortable.”

“Yes, I did. Felt like I was getting back at all the people who’ve made me uncomfortable, people who look at me like I’m ugly or don’t look at me at all, as if I don’t exist.

“What do you feel as you tell me all this?”

“First word that came to me? Triumphant!”

“And since you’ve been home?”

“It’s back to the same boring life. Biller in an ophthalmologist’s office. Real exciting. A great place to not be seen.” Pause. “But I am thinking about bringing my little pretense back home. Maybe in grocery stores or gas stations – I can go someplace I don’t usually shop. I’ve even considered taking it to work. Who’s to say I couldn’t start telling my co-workers I haven’t been feeling well, that I’ve gone to the doctor, that I have some kind of cancer, etc., etc.”

“Charlotte, when you first started talking today I felt annoyed with you, annoyed for the people you were duping and angry that you felt you had to stoop to subterfuge to get people to pay attention to you. But as you’ve kept talking, I find myself feeling sadder and sadder. And I suspect you also feel both angry and sad. You’re such a bright, insightful person. You could do so much more with your life.”

“Except that I’m ugly.”

“I know you feel ugly, and this is something you and I constantly disagree about, but you don’t have to be the most beautiful woman in the room to have friends, to have lovers, to have a job that fulfills you.”

“You mean billing doesn’t fulfill me?” she asks sarcastically.

I sigh. “I know your mother didn’t value you. I know you feel your older sisters were prettier and smarter than you. And given all that, it is still possible to have a meaningful life.” Pause. “You’ve always talked about writing. You certainly demonstrated that you can be creative with your storytelling about yourself. Put the stories down on paper instead of acting them out.” Pause. “I’m sorry. I’m preaching. I know I can’t decide your life for you.”  

“I’m 55 years old. Don’t you think it’s too late for me? How do I change now?”

“You went to Italy.”

“And my most fun was spinning a death fantasy about myself.”

“What was your fantasy about what the trip would be like before you left?”

Charlotte drops her head. “I thought I’d meet the love of my life. I know, that’s stupid, ridiculous. I feel like an idiot even saying it.”

“It’s not stupid, Charlotte, it’s a wish. But maybe it would have been good if we had talked more about your imaginings about the trip before you went so that you could have anticipated several scenarios, thought of the good things that might have happened, as well as the disappointing things. And I know that although many people like it, traveling alone can be very hard.”

Charlotte starts to cry. “It was very hard.”

When Silence Speaks

Emma settles into the chair across from me, takes a deep breath and speaks quietly, slowly, deliberately. She’s telling me about her week. Her son is excited about his softball team, her daughter is anxious about her upcoming school play, her husband is away on a business trip. “That makes it easier,” she says.

“It makes what easier?” I ask.

“His being gone. I know it’s terrible to feel like that and I know it’s not his fault, but it’s easier.”

“But what’s the ‘it’ that’s easier?”

There is a long, profound silence. Emma sits motionless. Although I’ve only seen Emma for a couple of months, I’ve become familiar with her stillness.  

“I’m trying to decide whether I should take the children out to dinner tonight,” she finally says. 

I’ve also become familiar with Emma’s tendency to avoid answering questions and to switch topics, often to something banal, almost as though there was nothing we had been discussing. 

“What just happened now, Emma?” I ask. “How did you get from it being easier when your husband’s gone to taking the kids out to dinner?”

“If I’m going to take the kids out to dinner, tonight would be a good night. Before he gets home.”

Yes, I think, but she still hasn’t addressed what makes it easier when he’s gone. I consider pushing, but find myself reluctant to do so.  

Another profound silence ensues. 

“Do you ever take vacations?” she asks suddenly.

“Yes, I do. Why do you ask? Do you feel anxious about my being gone?”

Another long silence. “No,” she says with a nervous laugh. “It would be easier. I wouldn’t have to think of what to say.”

“So it’s easier when your husband is gone and it would be easier when I’m gone.”

Silence.

“Speaking is obviously very difficult for you, Emma. What happens when you sit in your silence? What are you thinking? What do you feel?” 

Silence.

Emma’s silence, her non-responsiveness, her tendency to talk about apparently inane topics. None of it makes me angry. Sometimes bored, sometimes frustrated, but generally I hold myself still along with her. It’s like feeling frozen. Emma has told me a little about her background. She was the only child of a religious family who lived in the rural Midwest. Her father was extremely depressed, often unable to get himself to work for weeks at a time. Her mother was an angry, embittered woman who reached for the belt for any minor infraction.

“Emma, what about as a child? Was it difficult for you to speak then too?”

Another nervous laugh. And silence.

After a while I ask, “Can you say what you’ve been thinking during the last couple of minutes that you’ve been silent?”

After a while she responds, “They’re images.”

“Can you tell me what some of the images are?” I say gently.

“Cornfields. Sunflowers. My mother. It’s cold.”

I flash on a patient I saw years ago who, as a child, was punished by being left naked in the storm cellar. I wonder if Emma was similarly abused.

“Can you tell me about your mother, Emma?”

“She was mean. She hated me. She said I was the devil’s child, that she needed to beat the devil out of me.”

“What kinds of things did she beat you for?”

“Everything. Not getting up at exactly 6AM. Tracking mud in the house. Talking when she had one of her headaches. She always said her headaches were my fault. She never had headaches before I was born. That’s what she said.”

“You were terrified of her.”

She nods. 

“Did you ever feel angry with her?”

Silence.

“You can feel angry with someone even if you don’t express it,” I say.

“She gets bigger.”

“I’m sorry?” I say, confused.

“The image. It gets bigger.”

“You’re saying that if you feel angry at your mother you see her image getting bigger?”

She nods.

“And you feel more frightened.”

She nods again.

“Is that what happens when you talk to me, Emma? Does the image of your mother get bigger, like you’re not supposed to be telling me things?”

Silence.

“You know, Emma, you can always tell me to stop, that you’ve had enough. I’ll always respect your wishes. The last thing I want to do is be another abuser.”  

Silence. Then she says, “Maybe if it would be better if we didn’t go out to eat. It’s a school night. The children need to do homework.”

Although she can’t say it directly, Emma has clearly told me she’s had enough.

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.”

Before Death Does Us Part

“I don’t know what Pete wants from me,” Jackie says in her high-pitched voice, dissatisfaction oozing from every word. “I’ve already seen him through his surgery and now there’ll be chemo. And I’ll be there, picking up the pieces, as always.”

“You sound so angry, Jackie,” I say, stating the obvious.

“Look, he smoked for 30 years. Yes, he finally quit but, guess what, his years of being an ass came back to bite him. And guess what again, just when we get the kids launched – that’s the word these days, isn’t it? – he goes and gets lung cancer. So he’ll probably die and I’ll be left on my own to go looking for a new man at this not so young stage of my life.” 

I squirm in my seat, rubbing the thumb nail on my left hand. Jackie continues.

“I’m still being the good wife. I make his meals, I serve him, I clean up, same as always. I look at him sitting there just staring into space. But, yes, all I feel is anger.” 

And all I feel is sadness. Images of my husband’s illness and death flash through my mind – doing “laps” around our living room with his walker for exercise, determined to stay with me as long as possible; his final days, loudly proclaiming, “I love you, Linda” before going into hospice. Our love never wavered. My love still doesn’t waver, six years after his death. But perhaps I’m feeling not only my sadness, but the sadness Jackie cannot allow herself to experience.

“No sadness, Jackie?” I ask.

“What, I can’t feel angry?”

Oops. I guess I followed my feelings instead of hers.

“Of course you can feel angry,” I say backtracking. “But I’m not sure I understand the intensity of your anger. Do you feel angry for the things Pete did in the past, or because he’s sick, or because he’s going to die or for some other reason?”

“Well, he wasn’t such a great husband, that’s for sure. He was a good provider, I’ll give him that. But once he got home all he wanted to do was to be catered to. Me and the kids didn’t matter. Just give him his dinner and let him relax and watch TV, no talking about anyone else’s day or, heaven forbid, any problems. And in the bedroom? Forget that. It was what he wanted and when he wanted it. That’s one advantage to his being sick and coughing all the time. I got to move into one of the kid’s bedrooms and he couldn’t give me too much grief about it.”

I shudder internally. Jackie’s hostility is almost too much for me to bear. “What about when you got married, Jackie? What did you love about Pete then?”

“That was a lifetime ago.”

“I understand, but what did you love about him?”

“Why?” Jackie asks, staring at me defiantly.

I blink, knit my brow and look back at her. I’m beginning to think that it wasn’t only my sadness I was feeling after all. “That doesn’t seem like such a strange question. Why are you asking me why?”  

“You don’t like me being angry. That’s what I think,” she says crossing her arms over her chest.

“Perhaps,” I admit. “And perhaps you don’t want to risk feeling sad.”

“Why should I?”

“Well, remember what you said about Pete’s cigarette smoking coming back to bite him in the ass? That’s what can happen with feelings too. If you only feel your sadness and not your anger, you could, for example, end up being depressed. If you feel only your anger, in addition to missing out on a lot of love and closeness in your life, at some point you could be overwhelmed by your sadness or perhaps get physically sick, for example.”

“Sounds like a lot of psychobabble to me.”

“You know, Jackie, it seems like it’s not only Pete you want to stay angry at. It seems like you want to stay angry with me too.”

“I think you just can’t take my anger.”

“How about if I mull over that possibility and you consider whether you’re keeping your sadness at bay so you don’t have to deal with how scared and vulnerable you feel. Maybe we’ll be able to meet somewhere in the middle.”