Boredom

I look at the clock. Camilla is now 15 minutes late for her session. I’m not surprised. She’s been consistently late for every session since we started working together several weeks ago. She always apologizes, always has some reason – the car wouldn’t start, she got a last minute phone call, the traffic was bad. 

Finally I see the red light that signals a patient is in my waiting room. 

“I’m sorry,” she says, breathless. “I told myself I’d be on time today. But my Mom called and was telling me I needed to call my Grandmother. I know I should. I love my Grandmother, but I don’t like talking to her on the phone. It’s boring. She asks the same questions – how’s my job, have I met any nice boys, am I going out with my friends. Boring!”

“What makes it boring?” I ask and then immediately regret my question. I want to talk to her about her lateness. Or at least ask her what she means by boring. 

“I told you,” she replies, crossing and uncrossing her legs, combing her fingers through her long brown hair. “She always asks the same questions. My job is fine, I haven’t met anyone and, yes, I go out with my friends.”

We sit in silence for a few seconds until she says, “What? You think I should call my Grandmother?”

I shrug my shoulder. “I think that’s up to you.”

She sighs. “I wish my mother felt like that.”

Silence.

“What?” she asks again. “Aren’t you going to ask me anything?”

“What do you feel in the silence?” I ask.

“What?”

“What do you feel in the silence?”

“Like we’re wasting time, not getting anywhere.”

“That’s what you’re thinking, what are you feeling?”

“I don’t know.” Pause. “Bored I guess.”

“Sounds like it’s easy for you to feel bored.”

“Yeah, I guess,” she says fidgeting in the chair. “I don’t like sitting still. I don’t like quiet. I need to have stuff going on. That’s why I like my job at Saks, even though my parents say they didn’t pay for me to go to college for me to work at Saks. But there are people around and all those great clothes. Even if we have no customers I can walk around picking out clothes, holding them against me, deciding if I see something I really, really want. Although that’s frustrating because I can’t afford most of that stuff anyway, even with the employee discount. Not until my parents give me an allowance again. They say they’re paying for my apartment and until I get a real job that’s all I get.” Pause. “But I’ve told you all this already. What else should we talk about?” she asks, glancing at the clock.

“Do you have any thoughts about why you looked at the clock just then?”

“I don’t know. I guess because I’m bored and because time is just crawling by.”

Ah ha, I think. “Camilla, do you think it’s possible that you’re consistently late here because 45 minutes feels like a long time to sit and talk to me?”

She looks startled. Then smiles. “Yeah! 45 minutes is a long time! I never sit for 45 minutes. It’s why I always nix going to the movies. Who can sit for two hours watching a dumb movie?”

“So you come late so you don’t have to sit so long?”

“Yeah. But it’s not like I decide to come late. It just happens.”

“I understand. But it may ‘just happen’ because you unconsciously don’t want be here for the full session.”

“I suppose.”

“Is there any other reason you might want not to come here?”

“I don’t know. What are you getting at?”

“Well, I was wondering if coming here is kind of like calling your Grandmother. You feel you should do it. You know your parents want you to do it. But maybe it’s not really something you want to do.”

“Maybe,” she says shrugging.

“You’re 25 years old, Camilla. You don’t have to be here if you don’t want to.”

“I know,” she says looking down. “But I have to do some of the things my parents ask.”

“I think it would be important for you and for us to know what it is that you want to do.”  

“I don’t know what I want to do! That’s why I’m here.”

“Does that mean you’re not only being an obedient child by coming here, but that you do want help figuring yourself out?”

“I guess.”

“That doesn’t sound too certain.”

“Can we make the sessions 30 minutes?”

“No. My schedule is based on 45 minute sessions. And, besides, if you decide you want to come, I think it would be good for us to work on what makes it so difficult for you to be still, on what you feel underneath what you call boredom. And perhaps we could look at your lateness – or being on time – as a message about how you’re feeling about me and the therapy. That’s if you decide to continue. And that’s something you will have to decide.”

Echoes of the Past

“This has been a bad week,” says 44 year old Jennifer, her straight brown hair pulled into a bun, jeans and a pale yellow shirt covering her slim frame.

“Madison moved out,” she continues.

I’m surprised. Her daughter Madison is only 16. 

“She had one of her to-dos with her father. I don’t know why this happens again and again.”

Although I say nothing, I think: Because your husband is a narcissistic control freak who your daughter rebels against.

“Frank was driving Madison and her friend Amy back from the movies. He started to speed and she asked him to slow down. She says he just looked at her and went faster. She says she was getting scared and started to scream at him to stop. He says she was getting fresh and that if she wanted him to stop, he’d stop. So he screeched to a halt and told them to get out of the car. By this time I guess they were both crying, but they got out and stood there. Of course he came back for them and then he says that Madison called him an asshole and that he pulled over and slapped her across the mouth screaming telling her not to talk to him that way.

“When they got home Madison and Amy went straight to her room. Next thing I know she’s packed a suitcase and tells me she’s moving in with Amy, that Amy’s Mom said it was okay.  So now Frank is screaming that she’s not going anywhere and I’m trying to figure out what happened.”

As Jennifer relays her story, I feel my stomach tighten and realize that I’m clenching my hands, a familiar reaction for me when Jennifer describes these scenarios between Madison and her father. Although my father was never physical, he had a hair-trigger explosive temper. I was always afraid of him, but I always fought back. And I know what’s coming next in her story, the dynamics in my patient’s family being an uncanny duplicate of mine.    

“I told Madison she was too young to go anywhere and that she had to be more understanding of her father, that he was under a lot of pressure and that he just needed to let off steam, that he didn’t mean anything by it.”

I knew it, I think, just what my mother said to me. I feel my anger rise and wonder how I am going to respond to Jennifer as my patient, rather than as my mother.

She continues. “So she left. I’ve spoken to her each day, but she’s determined not to come home. I’m going to have to talk to Amy’s mother. It’s embarrassing. Meanwhile Frank’s being a bear. He says he doesn’t care and that she can stay where she is, but you can tell he’s hurting.

“How can you tell?” I ask, immediately regretting my question that’s coming from an angry place in me.

“Well, he’s angry, barely talking to me, going around slamming doors, grumbling around the house.”

“And how do you feel when he does that?” I ask, wondering if my question wasn’t so off base.

“I understand,” she says. “He’s upset.”

I want to scream. Instead I ask, “But how do you feel?”

She shrugs. “Nothing, I guess. I’m just worried about Madison.”

This isn’t getting us anywhere. “And how do you think Madison feels?”

She shrugs again, “I don’t know. She says she’s all right.”

“Do you think she might feel hurt or scared?”

“Yeah, I guess.”

Although my mother was an incredible denier, she wasn’t as out of touch with her feelings. My mother and Jennifer feel different now, making it easier for me to remain in my role as therapist. “You know, Jennifer, it occurs to me that it’s difficult for you to know much about feelings – your own or others – except for Frank’s. His feelings are so out there, although they’re usually expressed as anger, you can’t help but be aware of them.”

“Yeah, I guess that’s true.”

“Do you think that’s one of the reasons your relationship with Frank works for you. He expresses the feelings you can’t.”

“That makes sense,” she says nodding.

“I wonder what would happen, Jennifer, if you started to get more in touch with your own feelings, if you could know when you’re angry or scared or hurt.”  

She shakes her head. “I don’t know. That seems like I’d have to be a different person. And right now I have to figure out what to do about Madison.”  

“I understand, Jennifer,” I say, realizing both that she’s frightened and that the present crisis takes precedence. “Let’s talk more about the situation with Madison, but perhaps we can also keep in mind looking at how you feel.”  

Cancellations

“What do you mean you’re going to charge me for last week’s session? I cancelled!” Carly says indigently. 

I’ve been working with 22 year old Carly for well over a year.  She knows that my cancellation policy is 48 hours’ notice or she gets charged for the session. There was a time that therapists allotted various time slots to their patients and that the patient paid for that time whether or not they came. It was as if someone paid a fee for a semester of classes. The person would pay that fee, regardless of how many classes were attended. Some therapists still follow that procedure, believing both that it increases the patient’s commitment to the process and insures that the therapist’s income is not subject to the whim of a particular patient. Still, that line of thought has been waning and I’m more comfortable with my 48 hour policy.

Except that I’m not always good at enforcing it. On the positive side, I could say that I’m flexible and willing to take my patients’ individual needs and circumstances into account. There can, however, be negative consequences as well. A patient might feel more unsafe about other boundaries in the treatment room – or in life in general - if I’m unable to be firm about my own policy. Or not standing firm, might lead a patient to feel increasingly entitled and therefore to become more demanding both in and out of the treatment room.

Either way, Carly knows that I won’t always stand firm. Her mother fell and had to go to the hospital. I didn’t charge her. Her car broke down on her way to the appointment. I didn’t charge her. She woke up with an attack of vertigo and was afraid to drive. I didn’t charge her. But this cancellation crossed my line. “My friend Charise came into town and needed someone to play tennis.”

“You know that my cancellation policy is 48 hours, Carly,” I say evenly.

“But you didn’t charge me when I got dizzy that time and couldn’t come!” she says.     

I sigh inwardly. The problem with not following my own rules is that I’m then in a position of having to pass individual judgments on what I deem worthy or not worthy of a forgiven cancellation.

“Does it seem to you Carly,” I ask, “that there’s a difference between being dizzy and unable to drive and going to play tennis with your friend?”

“But I see her so infrequently,” she exclaims.

“I understand that, but you could have played tennis with her later or earlier or on a different day,” I say. Even while speaking, I realize this is a ridiculous conversation. Although Carly is young and somewhat immature, she’s smart and clearly knows the difference between sickness and tennis.

I think about what might be going on here. Was there something that happened in our session before the cancellation? Is there something in Carly’s past that’s being repeated with me in this room? Nothing springs to mind, so I decide to ask Carly herself.

“How did you feel about us not meeting last week?”

”What do you mean?”

“How did you feel about cancelling last time?”

She glances out the window and down at her hands. “I liked it. I felt like I was playing hooky from school.”

Now we’re getting someplace, I think.

“And you wanted to play hooky because…?”

“Because I could. I never could as a kid. My parents would have killed me. And besides I would have felt way too guilty. Always have to be good, especially when it comes to school.”

I get that. I so internalized my family’s attitude towards education that I too could never have imagined playing hooky. But I rebelled in other ways, allowing me the separation from my parents that was necessary for my growth. Carly has been pretty much the consistently good kid. Now I’m in a bind – both wanting to support her need to pull away, while enforcing the consequences of her rebellion.

“I understand, Carly,” I say. “I understand that you’ve been the all-too-good kid and that playing hooky can be an important step for you towards independence. But I suspect if you were able to come in here and talk about your desire to play hooky with me, we could help to be your own person in relation to your family where it really counts.”

“You’re still going to charge me, aren’t you?”

“Yes, I’m still going to charge you. And I’m definitely going to want us to continue talking about how you feel about that and what it means to you.”

“It means I’m being punished for being my own person,” Carly says angrily.

“I hear you, Carly. It’s fine for you to be angry and we will continue to talk about it.”

Submission

“I can’t believe that I’m spending all my time in therapy talking about my job,” Pauline exclaims, bursting into tears. “I thought you talk about your childhood or relationships, not a dumb job!”

I’ve seen Pauline only a short time and she’s correct, she’s spent most of her time talking about her job. She’s a graphic designer, a good one it seems, but she’s been in a state of panic since the administration in her company changed, resulting in her reporting to two different supervisors.

“This week the artistic director wanted me to drop everything and work on one project, while the marketing director wanted me to work on a totally different project. What am I supposed to do?” she asks, crying. “I’m think I’m going to quit. I can’t stand the stress!”

“Pauline, I understand that you can’t possibly do two different things at the same time, but what I don’t understand is why it is so, so distressing to you.”

“But I can’t do what both of them want!”

“I understand that you can’t do what they both want,” I say. “But I don’t understand why that throws you into such a state of panic. I don’t know a lot about you, about your history, your past, so it’s hard for me to know what might be going on for you, but since your anxiety is so intense, I would suspect it does have something to do with your childhood. I’m only guessing here, but was there a lot of conflict between your parents? Did you feel you had to choose between them?”

“No, not at all. They presented a united front. There was no room for discussion. You just obeyed. You did what they said. My mother was the tough one, though.”

Pauline hesitates. I wait.

“This is hard for me to talk about. I feel like I’m betraying her. She was doing what she thought was best.”

I can feel Pauline’s anxiety. I also see the beginnings of a connection, the issues of obedience and betrayal perhaps linking the past and the present.

“You never disobeyed my mother. She wouldn’t talk to you for days, for weeks if you did. She knew that she and Dad were right and that you just had to do what they said. I couldn’t stand that silent treatment. I felt like I’d lost her. So I did what she wanted. Even about work. I was really good at math and science as a kid. I wanted to be a doctor. But my parents said no, that I’d never find a husband if I became a doctor, that I’d never have children and a life, so I couldn’t do it. I was good in art too, so I became a graphic artist. It’s okay. At least it was.”

Inside I scream, “No! No! You need to do what you want to do!” Part of this reaction is probably my experiencing Pauline’s unfelt anger and rebellion. But I know that some of the feelings are all mine. My father was an angry, explosive man who hated psychology and psychoanalysis and always opposed my career choice, responding with both anger and contempt. But as afraid as I was of him, I fought for what I wanted. My grandmother taught me that. Pauline probably didn’t have such a role model in her past. She submitted.

“You couldn’t resist your parents and pursue your dream. You had to submit.”

“Submit. Yes, that’s a good word. I’ve submitted my whole life. With my parents, with men, with work, whatever.”

“It sounds like that’s why this work situation is so difficult for you. You have two authority figures wanting different things from you. You can’t obey them both. So you feel scared just as you did as a child. Then you can’t think from the place of an adult and figure out a way to handle the situation however you need to do.”

“That’s true! I always want to please. But I can’t please two people at once.” She pauses. “So what should I do?”

I smile. “I understand that you’re very used to having people tell you what to do, but maybe that’s one of the things we can work on changing. I suspect you know a lot more about your company and the people involved than I do and that you’re the one who’s best able to figure out what to do.”