Seeking Protection and Connection

I smile at my new patient, Eileen, as I greet her in the waiting room, extending my hand in introduction. She doesn’t return my smile, but does warily shake my hand. Settling herself stiffly in the chair across from me, she looks slowly around the room.

Oh oh, I think, seems like a pretty disturbed woman, at best distanced and removed, perhaps paranoid, maybe a trauma survivor.  

“I like your office,” she says. “All the windows. Feels free, like floating in space.”

“Thank you,” I say, not sure how to take her comment. An attempt to relate to me? A fear of being confined? A desire for freedom? Hopefully not a wish to jump.

A few moments pass in silence.

“What brings you here?” I ask in traditional therapist mode.

“I have no friends.”

“Can you say more?” I ask, while thinking that her demeanor would certainly make having friends difficult.

“I’m 36 years old. I live alone. I work at home. I’m an IT person, a computer geek.” She shrugs. “There’s no one in my life.”

“Sounds sad.”

“I guess.”

“How do you feel about not having friends?”

“It doesn’t seem normal. People are supposed to have friends.”

“Eileen, what made you decide to come into therapy right now?”

“I found you online. You had a kind face. I liked your website.”

“Like maybe you hoped I’d be your friend?”

“Maybe.”

“Eileen, can you tell me a little about your background, your childhood, your family.”

“It was messed up. My parents divorced when I was two. They’re both alcoholics, drug addicts, both with so many different partners I lost count. And a ridiculous number of so-called siblings. I’d go from one household to the other. Sometimes there would be six, eight of us in a small apartment. I hated it. Felt like I couldn’t breathe. I just wanted everyone to leave me alone. And basically they did.”

“So you learned to put up a wall that said ‘stay away.’”

“Yeah, that’s a good way to put it,” she says nodding. I have the sense she’s pleased by my understanding, although there’s no obvious change in her demeanor.

“Have any idea what’s behind that wall?”  

“What do you mean?”

“Well, when you construct a wall, there’s usually something behind it, something you’re wanting to protect, perhaps something that feels vulnerable or scared.”

“I don’t do vulnerable or scared.”

“So it feels pretty scary to be vulnerable or scared,” I say smiling compassionately. I find myself liking Eileen, feeling sad for the deprived, needy child who must exist behind what feels like an impenetrable barrier.

“I didn’t say that,” she says, stiffening.

“Sorry,” I say, backing off. This is going to be slow, slow going. I need to be careful not to push to glimpse behind that wall too quickly. Her defenses are there for many reasons. They need to be respected, not ripped away.

“You said earlier that there’s no one in your life. Do you see your parents?”

“Not if I can help it. Maybe once or twice a year. Christmas time, Easter. Maybe not.” She shrugs. Doesn’t much matter to me.”

“Was there anyone in your life who did matter to you when you were a child?”

“Like who?”

“A grandparent, a teacher.”

“A math teacher in middle school. She thought I was more than a dumb oaf. She encouraged me. Maybe she was like my friend, except she was my teacher so she couldn’t be my friend. But she’s the one who helped me make something of myself. I don’t know where I’d be if it weren’t for her. Probably just like my parents. Except without the drugs. I’ve never touched drugs in my life. Swore I never would and I haven’t.”

“That’s pretty amazing determination, Eileen, given where you came from and what you’ve been through.”

“Mrs. H – that’s the teacher – she’d say things like that.”

“And when she or I say things like that, you feel a sense of warmth, of being understood and appreciated.”

She looks down. “Yeah, I guess that’s right.” She pauses. “So are you going to help me learn how to make friends?”

“Yes, Eileen, I am. But we have a lot of work to do before finding friends becomes our focus. First we have to help you find you. We have to find the person behind your wall and that’s going to take time. You’ve been hiding from that person for a long time and a sledge hammer isn’t going to work here. And I suspect it’s going to be painful and scary for you. I’ll be here with you and hopefully that will make it easier, but I’m sure there are times it will be tough going.”

“I’ve been through tough before.”

“Yes, I’m sure you have.”

I’m Nothing

Loretta Fischer has come into my office for the first time. She is an impeccably dressed, slender woman, who sits primly across from me, fidgeting slightly in the chair, staring at me expectantly.

I oblige. “What brings you here?” I ask.

“I’m just not happy,” she replies. “I’m alone. My husband died five years ago, my children are scattered all over the country. They call fairly regularly, but they’re not going to be keeping me busy on Saturday night. You know, I do the usual things women my age do, I play cards three days a week, go to the gym, go out to dinner and to the movies with friends.” She sighs. “It’s boring. I used to be an administrative secretary. My boss really relied on me. I was important. Now I’m nothing.”

“Now you’re nothing?” I say. “That’s a pretty dismal assessment of yourself.”

She shrugs. “That’s how I feel. I’m not a wife, not a mother, not a worker. I’m nothing.”

“What about your friends? The women you go out with?”

“They’re just women to go out with. They’re not really friends. Women my age don’t make friends.”

“How old are you?” I inquire.

“That doesn’t matter. What matters is that I’m unhappy.”

I’m startled. Loretta alludes to her age twice in a brief period of time and then refuses to tell me her age when I ask. Is she provoking me? “Is there a reason your age is a secret?” I ask.

“You know it’s not polite to ask a woman her age. How would you like it if I asked you your age?” 

This is beginning to feel like a minefield. In a matter of minutes, what is usually the friendly getting to know you beginning of therapy has evolved into a confrontation. I suspect that Loretta is not only unhappy, but quite angry as well. “Well,” I respond gingerly, concerned that I’m moving too quickly, “I actually wouldn’t object if you asked me my age, but I think the more important question is whether your manner of responding reflects both your need to protect yourself and your anger at having to give anything of yourself.”

“What are you talking about?” Loretta says sternly, knitting her brows. Then she sighs and shakes her head. “They told me you were an excellent therapist, not like the others I’ve seen. They said you were more real. And here you are spouting the usual kind of nonsense. Your whole field is ridiculous.”

I feel scolded, diminished and angry. As these feelings wash over me, I realize that in very short order, Loretta has enabled me to feel exactly what she feels, “like nothing.” I’m torn about how to proceed. I wonder how many therapists she’s seen before me. I wonder if her age is a particularly sensitive issue or if she unconsciously needs to bate me. Regardless, I need to mend the breach in our relationship if this therapy is to have any chance of succeeding. “I’m sorry, Loretta,” I say. “I am getting way ahead of myself. But let me ask you something, you say you feel like nothing because you’re not a wife, a mother or a worker, what did you feel before you were wife, mother and worker? Did you feel like nothing then too?”

“Are you trying to get me to go back to my childhood? Another piece of nonsense. I suppose everything is my mother’s fault?”

I feel my anger rise. But maybe she does think everything is her mother’s fault. Her anger and criticalness and feeling like nothing have to come from somewhere. “Loretta, my sense is that you’re angry. I don’t know yet what or whom you’re angry at, but I do know that it took next to no time for us to be at odds with each other. I get that you’re unhappy and I’m sure it feels awful to feel like “nothing,” but I do think it’s important for you and for us to understand where that feeling comes from in both the past and the present.”   

“So you’re assuming I’m coming back?” she says smugly.

“I don’t know if you’re coming back, Loretta. That’s something you’ll have to decide. But I do know that most everything you say feels like a provocation to me and I can’t imagine that would be helpful to you in your life.”


“I’ll make another appointment and we’ll see.”

I bite back the answer that comes to mind, “We’ll both see,” and settle for, “Seems fair. We’ll meet again and see what develops.”   

Unconnected

“I just ended another relationship,” says Brittany settling herself into my chair for the first time. She’s an attractive enough woman probably in her early 40s, simply dressed in black pants and a gray sweater. She didn’t smile when I greeted her in the waiting room, just extended her hand.  Her eyes didn’t smile either. She continues.

“I told myself I’d give it a year and I did. We got together last New Year’s Eve and I broke up with him this January 1. He was a nice enough man. But I can’t do it. I can’t be in a relationship. It’s like torture to me.”

Torture, I think to myself. What a strong word.

“I know it’s not normal,” Brittany continues. “That’s why I promised myself I’d go into therapy if I couldn’t handle this relationship. I’ve been in therapy several times, but maybe I’m more ready now. I certainly know this is my problem. Way too many relationships to think it’s the men’s fault. I don’t usually last a year, but that’s what I said I’d do, so I did.”

Questions swirl through my mind: What makes a relationship feel like torture? Do you feel smothered? Are you so terrified of loss that you can’t allow yourself to connect? Did your relationship with your previous therapists feel like torture also? Will you need to escape our relationship as well? I decide on a far more innocuous statement.

“Sounds like when you make up your mind to do something you certainly follow through.”

Brittany’s mouth forms an almost-smile, while her eyes brighten slightly eyes as well. “That’s definitely not my problem. If I decide to do something, I do it. I wouldn’t be where I am today if it weren’t for my determination. I own a chain of yogurt stores and am about to start franchising nationwide. Not bad for an abandoned orphan left by the side of the road.”

“Literally?” I ask, surprised. 

“I’m exaggerating about that side of the road bit, but my parents were a piece of work. They were both drug addicts and definitely didn’t know what to do with a baby. At some point they just left me. Social services got involved and I went from one foster home to another until I was 10 when one family finally kept me until I was 16. Then I got myself declared an emancipated minor and went off on my own. And the rest is history.”

“That’s an amazing story, Brittany. A really sad story, but you tell it with no feeling at all.”

“I’ve repeated it a million times.”

“But you still must have feelings about it. About your parents abandoning you, about your going from one home to another, about the family you lived with for six years.”

“They were good-enough people. The family I lived with for six years. But it was the same problem. They wanted something from me I couldn’t give them. They wanted me to love them, to be a part of their family, to remember birthdays and care about Christmas. I don’t have it in me.”

The room feels heavy, steeped in despair, although I suspect I am the only one who feels it. Brittany is removed, protected by a suit of armor she constructed early on to shield her from repeated abandonment and neglect. How could she ever allow herself to care for another person who would likely, yet again, toss her aside? “Left on the side of the road.” That is her metaphor for her life. Brittany cannot allow herself to get any inkling of the scared, vulnerable, needy child who exists inside her. Instead, she prides herself on her truly amazing success, unaware of her underlying hunger for human connection. 

“How do you feel about not having it in you?” I ask.

She shrugs. “I know there’s something missing in me. And when I look around and see people, I can tell that relationships add something to their lives. So I guess I’d like to find out what’s missing.”

“I suspect, Brittany, that it’s not so much that something is missing, but that you’ve buried your hurt, neglected childhood feelings deep inside you and that when a potentially close relationship threatens to expose those feelings, you feel you’re being emotionally tortured. Then you bury the feelings even deeper and run away. It’s as though you’re saying, ‘I don’t need anyone and no one can hurt me ever again.’”

“I get the wanting no one to hurt me again, but I don’t know about my being afraid of needing anyone. I don’t think I do need anyone. That’s the problem.” 

“Well, I guess that’s something we’ll find out as we go forward,” I say optimistically. In my mind I add, assuming I’m able to keep you in therapy.

The Specter of Death as Ever-Present

I am returning in this blog to Leslie and Harvey, the couple who was dealing with Harvey’s diagnosis of lung cancer. They had never spoken about their fears of Harvey dying, leading to his pulling away in order to protect her from the pain of his possible death.

Before continuing, however, I would like to clarify that just as in my book, Love and Loss, most of the patients in my blogs are composites of individuals I have worked with over the years, although I do try to remain true to the patient or idea I am presenting. Similarly, the dialogue, which I use extensively to bring the patient/therapist relationship to life, flows from my mind, not from verbatim transcripts. 

I return now to the couple. Although Leslie is my patient, Harvey has asked to come in for another joint session, a request his wife Leslie is more than happy to accommodate.

“I appreciate you agreeing to see me, to see us again,” Harvey says, smiling a bit as he switches the “me” to “us.” “I guess you’d call that a Freudian slip, ‘cause I do think this session is more for me than for Leslie.” He looks pensive. “I’ve been thinking a lot about what you said last time I was here, how the awareness of death can provide an opportunity for greater closeness, for a chance to live life to the fullest.”

I nod.

“It’s never been like that for me. I mean not only since I’ve been diagnosed with lung cancer, but forever. I’ve always been terrified of loss, of death.”

“Really?” Leslie says, clearly surprised. “I never knew that.”

“I’m not sure I really knew it either until that last session. But then I realized it’s always been this way, even as a kid. I’d like go to the drug store to get some candy, there was this one guy behind the counter who was always nice to us kids, and I’d leave and wonder what would happen if I never saw him again and how terrible that would be. Or if one of my kids got sick, even like a cold or something, I’d wonder how I’d survive if they died, like I didn’t think I would survive. And then when I got sick, it’s like, wow! I’m going to lose everyone, everything, how horrible is that?”

The session is suffused with a heavy sadness.

“Harvey,” I begin tentatively, aware that he is not strictly my patient, “Hasn’t Leslie told me that your father died of cancer when you were quite young?”

“Yeah. I was seven. It was terrible. My mother was a wreck, depressed – not that I blame her – and us kids were pretty much left to fend for ourselves. I don’t know what we would have done without my grandmother, my father’s mother, although she wasn’t in such great shape either.”

“So your whole childhood became filled with sadness and loss and death.”

“Yeah, and my dog died right about then too.”

“I’m so sorry, Harvey. What a lot for a little boy to bear. You lost everyone who was dear to you, everyone who you needed to depend on, to rely on. And, not surprisingly, it’s still a sadness you carry with you.”

“But I guess that’s what I’ve been thinking about. Even though I’d constantly have these thoughts about loss or death almost whenever I met someone, even if they weren’t someone close to me, I’m not sure I felt the sadness.”

I look at him quizzically. “You certainly seem to be feeling the sadness now, right here in this room.”

“Yes, I definitely feel it now and I’ve been feeling it more, but I realize that I’ve protected myself from those feelings my whole life. I mean even though I really, really love Leslie and my kids and even though I think I’ve been a loving husband and father…”

“You have been!” Leslie interjects.

“But not completely,” Harvey continues, sadly shaking his head. “I think I’ve always kept a piece of myself back. And I don’t want to stay at this place. I don’t want to get to the end of my life and feel that I’ve cheated myself and the people I’ve loved because I haven’t been able to totally let myself go, let myself love to the fullest and get the very most out of life.”

Leslie is crying. “I’m so sorry, Harvey. I’m so sorry I didn’t know.”

“I didn’t know myself, Leslie, so it’s hardly your fault.”

Tears fill my eyes, as I think of the good-fortune of my intensely loving relationship with my husband and, of course, the pain of his loss.  

I’m not sure where Harvey will go from here, but he’s clearly taken a big step towards greater love and connection.