Searching for Mother

“I’ve decided to really start looking for my biological mother,” Liz says at the beginning of our session.

I have seen 27 year old Liz for a tumultuous five years, and although she has brought up trying to find her biological mother on previous occasions, today she does sound more determined.

“Did something happen that reawakened your desire to find your biological mother?” I ask.

She shrugs. “I’ve talked about it before. I just think it’s time. I know you don’t think it’s a good idea, but I want to know who she is.”

“It’s not that I think it’s a bad idea, I just want you to be prepared if the reunion with your biological mother doesn’t prove as idyllic as you hope.” I think of all the adopted people I have known – both patients and friends – who have found their biological mother only to be horribly disappointed yet again, people who have been outright rejected, others whose mother wanted to take over their lives, still others who wanted to be financially supported. Finding the perfect fantasized mother is rarely the outcome.

“What choice do I have?” she asks.

There’s a familiar edge to Liz’ voice, an underlying anger, an underlying demand. I look at her quizzically and remain silent.

“Don’t play dumb,” she says. I now definitely know that something is going on between us. “I have no mother. My so-called mother doesn’t give a shit about me. She was just thrilled when I finally moved out of the house so she could start redecorating and have my father all to herself. And then there’s you. You’re just never going to be more than my therapist. If I even move slightly towards wanting more from you, you run for the hills.”

This is a familiar refrain, one that has played out repeatedly over the time we have worked together. From the beginning, Liz wanted me to be her mother. She had fantasies of moving in with me, fantasies of traveling with me, fantasies of curling up next to me on a couch and watching a movie. Sometimes she presented these as poignant longings, at other times she lashed out at me in rage, furious at my refusal to satisfy her desire. I cared deeply about Liz, understood her longing and was able to hang in there with her during even the most difficult times. I think back on our last session and suddenly realize what has led Liz to experience me as pulling back and wanting to search for a more perfect mother.

“You were angry that I didn’t want you to take my picture,” I say.

“I don’t see what the big deal was. It was only a stupid picture! Everybody takes pictures these days, pictures of dogs, pictures of signs, pictures of themselves. So what was the big deal with taking your picture?”

“You tell me, Liz. What was the big deal about taking my picture? Obviously you have a lot of feelings about my asking you not to take my picture.”

“Yeah and you gave me some mumbo, jumbo about my needing to take you in and have a picture of you in my mind without needing to have an actual picture. So? I can do that. I have you in my mind. We worked on that for a long time and now I can do it.”

“That’s great, Liz. So the question remains, then why did you want an actual picture?”

Liz looks angry and then seems to deflate in front of my eyes. She sighs deeply and looks down at her hands. “I guess because people always have pictures of their family,” she says quietly.

“I know it’s very hard for you, Liz,” I say with compassion, “But the reality is that I will never be your mother. That doesn’t mean I don’t care about you, it doesn’t mean that I won’t be here for you, it doesn’t mean you’re not important to me, but it does mean that however much you may want it, I will never be your mother.”

“I hate when you say that,” Liz says, more sadly, than angrily.

“I know,” I reply.

“Can we still talk about my looking for my biological mother?”

“Of course. But as much as possible, you need to try and separate your wish to find your biological mother from your wish that I was your mother. And, as I’ve said, you also need to be prepared to be disappointed in your biological mother as well.”

“I hate when you say that, too.”

“I know.”        

Gifts

This is the beginning of Marjorie’s fourth month of therapy. She’s a reserved 45 year old woman who finds little meaning in her life as the third wife of a rich, older man who was born into money. Her days are spent attending luncheons, galas, and fundraisers. 

She hands me a check for last month’s payment, then reaches into her Gucci purse and pulls out a small oblong package wrapped in stripped red and gold paper, tied with a gold bow. I groan inwardly.

“Marjorie …” I begin.

“I know, I know,” she interrupts. “I’m not supposed to give you gifts. I’m supposed to talk about why I want to give you gifts. But I know why I want to give you gifts. I don’t want to just give you your check. I want to give you more. You’re finally someone I can talk to, someone I can really talk to as opposed to all the ridiculous chatter I do every day.”

Marjorie and I have been discussing the issue of gifts since her second session. That day, when I went to greet her in the waiting room, she had placed a flowering plant in the middle of the coffee table, carefully rearranging the magazines to either side. I was taken aback and suggested we go to my office and discuss the plant.

“I just thought the waiting room needed a plant. I felt more alive after our first session than I had for years and thought a living plant was the perfect thank you.”

“That’s a lovely sentiment, Marjorie. And saying just that without actually bringing the plant would have been more than gift enough. That’s what we do here, we talk about our feelings, we don’t act on them.” 

Many thoughts and feelings went through my mind: What if I can’t keep the plant alive? I remembered years ago when I practiced in Ann Arbor a patient saw the plant in my office as one or the other of us and how that plant fared took on huge significance. I also felt intruded upon. Was that a feeling born from the present interaction with Marjorie or was the feeling tainted by my childhood feelings about my parent’s intrusiveness? What if I didn’t want a plant in my waiting room? 

For the moment, Marjorie and I agreed to disagree. 

Following a particularly difficult session when Marjorie told me her life-long secret, namely that she had been molested by her uncle as a child, she brought me a crystal blue paperweight. “I know I’m not supposed to give gifts, but there was no other way I could thank you for allowing me to unburden myself from my lifetime of shame, for your accepting me, when I was sure no one ever could.”

That time I felt more compassion for Marjorie, experiencing her gift as an expression of her feeling that she herself wasn’t enough, that she had to offer more than herself to express her gratitude. “I appreciate your kindness, Marjorie, but I want you to realize that you, yourself are enough. I don’t need a gift. Your presence, your trust in me, your thank you is gift enough.”

“But I don’t feel that,” Marjorie said.

“I understand that,” I said. “We’ll work on it. But no more gifts.”

So this time, when Marjorie extends the red and gold package towards me, I feel my anger rise. Shaking my head, I say, “I’m not taking the gift this time, Marjorie. My understanding was that we were going to work on you and your words being enough.”

Marjorie looks stricken. “You’re not going accept my gift?”

“I’m not rejecting you, Marjorie. I’m rejecting your insistence on devaluing yourself.” I hear my choice of the word ‘insistence’ and realize that I’m not being completely honest, I’m not dealing with my feeling of Marjorie thrusting her gifts on me. And then I understand.

“Marjorie, I’m going to say something that might be hard for you to hear, but I do think it’s important. I know you give me gifts because you don’t think enough of yourself. But I think there’s something else as well. Your uncle. He presented himself as if he was giving you a gift, giving you something pleasurable.”

Marjorie gasps, covers her mouth with her hands, “You think I’m molesting you?” she says in horror.

“What I think is that you’re helping me to feel how you felt as a little girl. Your uncle was literally intruding on you, abusing you, but he was also giving you pleasure and that’s always what’s most difficult for childhood sexual abuse victims.”

“I feel so dirty,” Marjorie says. “I never wanted it to feel good.”

“I know,” I say, compassionately, “but it’s hard not to crave the attention and your body can’t help but react.”

Barely audible, she adds, “And, each time, he brought me a gift.”      

Why Can’t I Leave?

“I’m such a mess,” Janette says. “And a coward. I hate myself. He does it again and again and I do nothing. I couldn’t believe it when I asked him last week where our tax returns were and he said he asked our accountant for an extension. My stomach dropped through the floor. He tried playing innocent, like he just didn’t have the time to get all the paperwork together and our tax guy was swamped anyway, etc., etc. But I knew better. I was so mad I started hitting him with my fists. He kept trying to worm out of it, but he knew I knew.

“So then he got all apologetic. Sorry! As if that could fix everything! I’m so mad. He goes to his Gamblers Anonymous meetings, he has a sponsor – supposedly anyway – but he keeps betting on those damn games and losing more and more of our money. It’s our money I remind him, but I’m just talking to myself. I know, he’s an addict, but that’s not an explanation. Besides, it doesn’t matter anymore why he does what he does, the problem is that I stay.”

I remain silent. Janette and I have been here many times and she indeed knows the problem.

She sighs. “I know, I’m reliving my childhood, my father an alcoholic, my mother a gambler. You would have thought I’d know better, but here I am, stuck in it all over again. I do hate myself. I’m furious at Joe, but I despise myself for my inability to get out. I know, I should feel more compassion for myself – that’s what you always say – but how can I feel compassionate when I’m so stupid.”

I feel Janette’s frustration, as well as my own, not so much at her inability to leave her husband, but at her unmerciless attacks on herself. “I doubt it’s that you’re stupid, Janette, but rather that you can’t give up hope. When you started this session you said you couldn’t believe it when you realized Joe had been gambling again. I think you couldn’t believe it because you keep hoping Joe will change, just as you hoped that your mother would change and your father would change.”

“Well,” Janette, asks defiantly, “Isn’t that proof that I’m stupid. If you keep hitting your head on the same brick wall, hoping that it will stop hurting, you must be stupid.”  

Janette’s response intrigues me. “That’s an interesting response, you didn’t say hoping the wall would break, you said hoping it would stop hurting.”

“So, what’s that supposed to mean?”

“I’m not sure, but can you talk about your anger at me?”

“I’m just mad. Mad at me. Mad at Joe. Mad at you. We’ve been going round and round on this for a long time, and I’m still here.”

I wonder whether the “here” means with me or with Joe, but I ask, “How does it feel to feel mad at me?”

“Pointless. Just as it feels with Joe. You’re not going to change.”

“How would you like me to change?”

“Tell me how to get out of this damn marriage.”

The response that goes through my head – hire an attorney, file for divorce and don’t go back – shows me I’m more annoyed than I realize. “And if I can’t tell you how to get out of your damn marriage, what do you feel?”

“Angry.”

“I believe that you’re angry, but I wonder if you also feel scared and powerless?”

“I’m scared that he’s going to go through all our money. But I’m not powerless. All I have to do is be brave enough to leave.”   

“What about when you were a child, Janette, when your father was drinking and your mother had gambled away your school lunch money?”

Her eyes fill with tears. “Why’d you have to bring that up?” She pauses. “Yeah, I was powerless then and I hated it. But if I started “sniveling” – that’s what my father called it – he’d just start screaming at me for being such a baby.”

“So that’s what you’re doing, Janette, you’re screaming at yourself just like your father screamed at you. And you keep hoping, not only that Joe and your parents will change, but that you can endure their repeated disappointments without feeling any pain. It’s an impossible task. But if you can acknowledge your own powerlessness and mourn both the husband and the parents you never had, you’ll be more able to make the break.”

“Doesn’t sound easy.”

“No, it’s not. Definitely not easy.”

Secrets

Tall, thin, with neatly coifed grey hair, Estelle Harrison, fidgets in the chair, looking decidedly uncomfortable. “I’ve never done this before. I’m almost 80 years old. I can’t believe I’m coming to a psychologist. But I have to talk to someone. My husband has lung cancer and he won’t let me tell anyone. Another secret. I’ve been the keeper of secrets my entire life.”

“Why is your husband’s cancer a secret?” I ask, thinking how unimaginable it would have been for me to keep my late husband’s cancer secret, how more impossible it all would have been without the support of friends and family. 

“He feels ashamed of being sick, like it’s a weakness.”

“So you’ve told no one?”

“Our daughters know. They call. But they have their own lives. And truthfully,” she says sighing, “I’m not sure how much they’d care anyway. Dave wasn’t a very good father. In fact, he was a terrible father. He used to beat them. That was another secret I kept. He’d take down their pants and beat them with a belt.”

For a reason I cannot completely explain, I think, “Did he get off on it?” What I ask is, “How old were they?”

“I can’t remember how old they were when he started. Young. Too young.”

“Until …?” I ask.

“They both left the house pretty early, so I’d say until they were seventeen. Actually after Maureen left – she’s the oldest – Liz got it worse.”   

Finding this difficult to listen to, I say nothing. My mother didn’t protect me from my father’s rages, but he wasn’t beating me and his rage wasn’t fueled by a perverse sexual desire as seems to be true for Dave Harrison.  

As if reading my thoughts, Mrs. Harrison says, “You think I’m terrible don’t you?”

“I don’t think you’re terrible, but I’m not sure why you didn’t try to intervene, to protect your daughters.”

“I was afraid he’d get physical with me too.”

“And did he?”

“He slapped me across the face a couple of time.”

I am again silent.

“You younger generation, you all think I should have left him. But it wasn’t so easy back then. I was a housewife. I had no way to support myself. I wouldn’t have known what to do,” she says starting to cry.

Feeling more compassion, I say, “It sounds like your daughters are angry with you for staying, for not protecting them. That must make it harder for them to be available to you; that must make you feel all the more alone.”

She nods her head, still crying.

“This might seem like a foolish question, but why haven’t you told whomever you want about your husband’s illness, regardless of what he wants?”

She looks at me, startled. “I can’t do that. It’s his illness. If he doesn’t want me to tell, I just can’t.”

I feel myself getting angry at Mrs. Harrison’s passivity. Is that reasonable? Or is my anger at my mother seeping into this therapy session? Or, yet another possibility, am I feeling Mrs. Harrison’s own anger? 

“Are you angry with your husband, Mrs. Harrison?” I ask.

“I can’t be angry at him. He’s sick.”

“You can still feel angry with him. You can feel angry for his mistreating you and your daughters. You can be angry that he won’t allow you to speak, to tell people who could be supportive of you.” Suddenly I wonder, “Does your husband know you came here today?”

“Oh no, I could never tell him that. He’d be furious at me for telling our secrets.”

I again feel annoyed. Now I wonder if I am feeling angry like her husband, angry that she is so passive, angry that she presents as a martyr just waiting to be beaten. Does she carry within her both the beaten child and the angry parent, with the angry parent projected outward so she doesn’t have to feel the rage herself?  Way too complicated for a first session but I do ask, “What about your own childhood, Mrs. Harrison? Were you beaten?”

“Oh no. I was the good one. My brother and sister got my mother’s rage, but I always did what she wanted and I never talked about what went on at home.”

“Just as you did with your husband. But were you angry with your mother?”

“I couldn’t be. I was too afraid I’d give her some sassy answer one day and then I’d get it too.”

“Sounds like you might have lots of angry stored up inside.”

She shrugs. “I guess.”

Unsurprisingly, another passive response.” 

Suspicion

I have been seeing John for a little over a month. He is a reluctant patient: removed, distanced, openly skeptical that therapy can be of help. “I’ve tried it before. I can’t see how talking makes a difference. So what if I understand myself? It doesn’t mean that will make me different.”

John, now 60, grew up on a Midwestern farm with an alcoholic father and a depressed mother, neither of whom had the time nor inclination to pay attention to their son. John always knew he wanted out; always knew he wanted more. And he succeeded, at least financially. He started out acquiring small, undervalued properties and parlayed it into a now huge real estate fortune. Personally, however, John has been far less successful. He’s been married and divorced three times, has no relationship with any of his children, and spends most of his time alone, working or following the stock market. My sense of John is that he is protecting himself from knowing the extent of his own childhood neediness, erecting a fortress around him that neither he nor anyone else can penetrate.

At the end of today’s session John takes out his checkbook and says, “Let me pay you for last month.” He stops, looks at me and asks, “If I pay you in cash, will you reduce your fee?”

I’m startled. The session is over. No time to ask what this question means to him; what he’d think of me if I said, yes; what he’d think of me if I said, no. “I’m not comfortable with that,” I reply. He nods, writes out a check, hands it to me and leaves.

I am bothered and discomforted. Although I have other patients to see, John intrudes into my thoughts for much of my day. Why did he ask me that question? Is it just that he sees himself as a shrewd businessman, bargaining over his fee as he would a piece of property? Does he feel that everything and everyone is for sale? Was he testing me? And then a strange thought occurs to me, was this a set-up? Was he hired by someone to entrap me, to see if I’d be willing to take cash and not declare the income? What a crazy thought, I tell myself; a paranoid thought that’s completely out of character for me. 

At the end of my day, I’m finally free to explore the possible meanings of both my patient’s question and, more importantly, my own thoughts. It’s clear that my patient has profoundly affected me. He has intruded himself into my mind in a way that has resulted in my thinking inordinately about him, as well as thinking in an unusually suspicious manner.

So what might have happened here? My assessment of John is that he is consciously aware of his own distrust, but totally unaware of his own neediness. In therapy, the boundary between patient and therapist can be fluid, such that the patient can unconsciously prompt the therapist to experience feelings the patient himself may not be aware of. Today’s interaction with John left me feeling suspicious, like John himself, as well as preoccupied with him, raising the possibility that John may have unconsciously communicated to me his need to have me both think about him and feel as he does.    

But I’m not an empty shell that a patient can just put feelings into. What was my contribution to this interaction? Although I am not aware of being consciously tempted by John’s proposal, I also know that I too have an unconscious and, by definition, the unconscious is unconscious. Perhaps an unknown part of me was tempted, felt guilty and then needed to punish myself by imagining that I would be caught and punished for my transgression.   

In our next session, although I doubt John will gain much awareness from the discussion, I raise the issue of why he asked if I’d lower my fee for cash and how he felt about my declining.

He shrugs. “It never hurt to try. Thought it could be a good deal for both of us.”

“But is this about a deal, John, or is about a relationship?”

“I pay you, don’t I?”

“Yes, you pay me. And we’re still two people relating to each other, sometimes about really important and painful feelings and experiences.”

He shrugs again. “No big deal.”

Last week’s experience comes into my mind: John denying his need, while “taking over” my mind. “That’s where I’d disagree, John. I’d say you are a big deal, so that anything that pertains to you and anything that happens in this room is of utmost importance.”

John stares at me quizzically. I’d guess he’s not sure he believes me. I’d guess we have a long, long way to go. 

I Don’t, Session 2

“I wasn’t sure I wanted to come today,” Patrick begins.

Having realized in our first session that Patrick can put me in an adversarial position, I say nothing.

“I mean, what is there to talk about? Angela and I are engaged and getting married. I know she loves me, even though she says she doesn’t.”

Unable to resist I say, “Didn’t you tell me at the end of our last session that once Angela agreed to marry you you got scared and weren’t sure if she didn’t love you or if you didn’t love her?”

“I said I got scared,” he says with an edge to his voice. “Of course I love her. And, as I said, I know deep down she loves me.”

Already feeling stymied, I change course. “Patrick, I’m not here to talk you out of marrying Angela. I’m here to help you figure out what it is you want; what it is you feel. My sense is you think you have to argue with me. Except we’re on the same side. So I wonder if what you’re doing is arguing with yourself.”

Patrick smiles. “Occupational hazard. I’m a lawyer.”

Realizing that Patrick’s style of interacting is a very effective way of keeping distance, I ask, “Patrick, who in your life have you been really close to?”

“Wow! That came out of left field. Well, I guess my Dad and my brother. I had a girlfriend in college, except she was never really interested in me. And Angela, of course.”

“Can you tell me about your relationship with your Dad and your brother?” I ask, aware that he’s described as “close” two women who didn’t or don’t love him.

“Well, John, my brother, was 10 years older than me, so I guess we didn’t have that much of a chance to be close. But I always knew he had my back. And my Dad, he was a rock, holding it all together after my mother died. He worked a lot, tried to do as much overtime as possible.  But he’d make time to toss a football around with me.”

Feeling the absence of emotional connection in Patrick’s life, but not wanting to get into a battle of words, I proceed cautiously. “When you said you got scared when Angela agreed to marry you, can you say more specifically what you were scared of?” 

“I don’t know. Marriage. It’s a big step.”

“That’s true,” I say nodding. “And what does marriage mean to you?”

“Well, it means being with the same person for the rest of your life. It means being responsible for that person and having to take care of her. It means “for better or for worse.” It means …” Patrick stops and swallows hard.

“What just happened there, Patrick?”

“I was about to say, it means there’s no way out. I didn’t like that I thought that. And thinking it scared me. But it’s not like that with Angela. I love being with her. We have lots of fun together.”

“Your brother has your back, your father was a rock who tossed a football around with you, and you have fun with Angela,” I summarize. “You have relationships with these people, but I don’t know if they’re emotionally close relationships. I think the idea of an emotionally close relationship really scares you.”

“Why should it?” Patrick asks.

“Well, both because it feels so foreign and what’s foreign is scary and also because a really close relationship might open up feelings inside you that you’ve kept buried for a very long time.”

“And you think that’s why I want to be with Angela? I thought it was because I was supposed to be trying to save her like I couldn’t save my mother.”

“The reasons we do whatever we do is always multi-determined, Patrick.”  

“What other reasons?” Patrick asks, challengingly. 

“I’ll answer that, Patrick, but first let me say that my sense is that your need to challenge and dispute is also a way of maintaining distance. You can’t be close to someone you’re always arguing with.”

“Makes sense. But you said you’d answer my question.”    

“I think you also pick unavailable women to try to win in the present with women who are similar to the women you lost with in the past. Let me say, Patrick, that I’m concerned that we’ve covered so much ground today. It feels overwhelming so me, I can only imagine how it feels to you.”

“I’m okay. It’ll give me lots to think about.”

“And maybe if we can slow it down a bit, it will also give you lots of feel about.” 

When Values Clash

“I had another big fight with my wife,” Bob says throwing himself into the chair. “I don’t get it. I don’t understand how she could even argue with me about this one. It’s a no-brainer. Why would she want to expose the twins - seven year old girls I might add - to those two lezzie perverts living next door? I don’t care if they have kids my daughters’ age. I don’t want my girls exposed to that garbage. As far as I’m concerned women with women and men with men are just sick!”

I try to keep my expression neutral while inside my stomach churns. Dealing with a patient whose values drastically conflict with my own is difficult, especially as I struggle with the question of where the therapeutic ends and the political begins. Earlier experiences with patients flash through my mind. While still a graduate student, one of my first patients extolled the virtues of Hitler, while I sat frozen, unable to respond. Another patient, shortly after 9/11 suggested incarcerating all Arabs in this country. I thought my face was neutral, but obviously not. “You don’t agree” she said. Impulsively I responded, “I’d rather be dead.” Although certainly not a therapeutic response, it did give us much to talk about. Or the patient who was convinced he knew my political leanings and baited me with statements he was sure I’d disagree with. The latter was less of a problem since I was able to address the reasons behind the patient’s wish to provoke me.          

But so far Bob is only stating his opinion. So despite my strongly held beliefs to the contrary, I need to address this as any of the many arguments between my patient and his wife, remembering that my focus needs to remain on the patient. Right? Except it doesn’t feel right. Would I remain neutral if Bob told me he was beating his wife? Obviously not. But that’s an action, not a belief. Yet this man’s belief can also do harm. Here’s the question of whether the therapeutic and the political can or should be separated. 

“So what do you think, am I right?” Bob continues, asking me the dreaded question. 

I avoid answering. “You seem so certain of your position, why do you want my opinion?”

“I don’t know. Seems kind of normal to want to know the opinion of the person sitting across from you.”

“I suppose. Or does it speak to some uncertainty on your part or some desire to have me – perhaps an authority figure in your eyes – confirm your opinion?”

Bob shakes his head. “You can agree with me or not. It’s not going to change my mind.”

“I gather your wife didn’t agree with you and that didn’t change your mind either.”

“Damn right!”

“Clearly you and your wife have different ideas about this childrearing issue, how are you going to resolve the difference?”

“My kids are not going over to that house!” Bob says, his voice rising.

“And your wife feels how about that?”

“I don’t care how she feels!”

“What are you afraid of Bob? What do you imagine might happen if your kids go over to their house?”

Crossing his arms in front of his chest and scowling at me, Bob says, “They could put their hands on my little girls. They could play with them down there.”

“Do you worry that some of your friends, the heterosexual fathers of your children’s friends will abuse them?”

“Of course not!”

“And what’s your sense of the difference?”

“They’re lezzies, that’s the difference!” Bob says shouting. “You’re obviously one of those gay lovers too. I suppose you believe they should be allowed to marry!”

This hasn’t gone at all well. I suddenly realize that ever since I mentioned being an authority figure, Bob has been both defensive and provocative and I have engaged with him in a debate, rather than trying to understand what was going on between us. Time to change direction. 

 “Do you like to argue, Bob?”

 “I guess,” he says, “I can hold my own.”

“Are you saying arguing makes you feel powerful?”

“I suppose you could say that.”

“How do you usually feel when you’re in this room with me? Do you feel powerful?”

Bob squirms in his chair. “No,” he says shaking his head. “You’re a lot smarter than me. You have a lot more answers. Lots of times I don’t even know the questions.”

“So you’re saying that you feel ‘less than’ me. But when you argue, when you ‘hold your own,’ you feel better about yourself.”

“I guess,” he says sheepishly. 

“I wonder if you don’t often feel ‘less than.’ We’ll need to figure out why that is.”

“That won’t change my mind about those lezzies.”

“I hear you.” 

I say nothing else. Bob needs to have the last word.

A Therapist’s Mistake

Philip is a new, reluctant patient. He hasn’t been in therapy before, isn’t sure “how it works,” and doesn’t know for sure why he called. He’s getting into disagreements with people at work. He’s not sure why. Yes, he does tend to be a bit obsessive. Maybe his coworkers are put off by his insistence on perfection. And yes, he does worry about making a mistake. It makes him anxious. What if he did something “wrong” and “something bad” happened as a result? 

In our first several sessions I’ve focused on the harsh voices that exist in Philip’s head telling him that danger lurks around every corner. I’ve also tried to explore what feelings exist underneath his anxiety and his need for perfection – anger, sadness, fear? He steps gingerly into those feelings – perhaps he is angrg that he was passed up for promotion – but scurries quickly away.

Today he knows exactly what he wants to talk about. “I had a huge fight with my wife. She got mad at how I punished our 10 year old daughter. Samantha opened up a mouth to me and I spanked her. I didn’t beat her, for heaven’s sake, I just gave her a spanking.”  

“What did Samantha say to you?” I ask as neutrally as possible.

“She raised her voice and told me I was making her nervous and not helping her at all with her math homework.”

“And that’s why you spanked her?” I ask, the neutrality slipping from my tone.

“What? You don’t think that’s a smart-ass comment that needs to be nipped in the bud?”

“Is that what your father would have done to you?”

“You bet! That and more.”

“And you feel how about your father and what he did?”

“He was trying to teach me right from wrong.”

“But can you tell me how you feel?”

“I feel like he was being a father.”

“A particular type of father,” I say, ignoring that Philip has not told me how he felt.

“What do you mean by that?”

“Well, he’s the type of father who made you into the man you are today, someone who has a rigid sense of right and wrong and who is terrified of making a mistake.”

“So we’re on to blaming the parents. And I suppose I’m doing the same thing to my daughter?”

Throughout this interaction I’ve been thinking of my father. He never spanked me, but his explosive temper terrified me. He didn’t so much have a rigid sense of right and wrong, but an uncompromising conviction that only his ideas and beliefs were valid and that everyone else was “wrong” and “stupid.” 

“I don’t know,” I reply. “It depends if your daughter capitulates to you or resists. It depends if you break her spirit like your father broke yours or if she’s able to fight back.” I fought back. And I’m routing for his daughter.

“You think I’m breaking my daughter’s spirit?”

“I think when you’re sure that you’re right and you try to foist that belief on someone else, yes, you’re trying to break their spirit.”

“That’s a lousy thing for a therapist to say.”

I stop. Philip is right. He’s my patient, not his daughter. I’ve gotten into a debate with him, trying to convince him of my way of thinking, rather than trying to understand his. I’m being just like him, his father and my father, trying to convince him of the correctness of my point of view. My past, my relationship with my father has affected my ability to be the good-enough therapist. 

Not trying to minimize my contribution to this interaction, I also realize that I have re-enacted a scenario typical of patients with this harsh, rigid conception of right and wrong. They are often battling the voices in their head – is this right or wrong? am I right or wrong? – and those battles can get projected into interactions with others. The fight then becomes externalized and is played out with me, coworkers, wife, daughter, or whomever.    

“You’re right, Philip. That was a lousy thing for me to say and I apologize. I should have been asking you what you felt when your daughter responded to you as she did, not trying to convince you to be different.”

Silence.

“What are you thinking?” I ask.

“I was wondering if I should be seeing you if you can make a mistake like that.”

I can feel the pull to try to persuade him, to ask him if he can’t forgive me, if he can’t allow me to be less than perfect. I resist. Besides, the hour is almost up. “I understand. But I hope you will come back next week so we can look at how you felt about my making a mistake and about my apologizing.”