Why

“I can’t stand it!” Marilyn yells into the telephone. “Why did this have to happen? I can’t stand being all by myself. There’s no one here, no one. I’m totally and completely alone.”

“I’m here,” I say quietly.

“No, you’re not! You’re not here. I don’t even know where you are but I know I’m not with you. I have to be near you. I have to imagine being able to touch you, even though we never do! And that’s what I want right now. I want you to touch me! I want you to hold me!”

Like most therapists these days, I am ‘seeing’ my patients remotely from home. Since for most of my career I have used the telephone when patients cannot be in my office, I am more comfortable using this modality than facetime or video conferencing. Most patients have been able to adapt to this new reality.

“Sounds like you’re feeling alone and desperate and wanting me to take care of you.”

“Now there’s a therapist response if I ever heard one! What good are you? You’re just a disembodied voice floating out there somewhere in space. You can’t give me what I need.”

“I understand that you’re feeling alone and uncared for, just as you felt as a child,” I say. “I understand that you want me or someone to save you, just as you did as a child. We’re all scared, Marilyn. We’re all in the same frighteningly unknown scary position.”

“But not everyone’s alone.”

“No, not everyone’s alone,” I agree. I want to add that many people are alone. I want to suggest that she call friends, reach out to family. I want to suggest that she start some of the projects she’s been wanting to do around her house, anything that will help her to feel more adult. But I know Marilyn will not, at this point, be able to hear such suggestions. She feels far too scared, back to being a child with an explosive, alcoholic father and a depressed, absent mother.

“Is there someway I can be helpful to you, Marilyn,” I ask.

“You can tell me when this is going to end! You can tell me why this is happening to me! You can tell me why only bad things have happened to me my entire life! It’s not fair!! I hate it!! I hate it!!”

Although I can feel my patience fraying, I try to retain my image of Marilyn as the frightened and vulnerable child. “I hear you, Marilyn. And I’m sorry you’re in so much pain.” I refrain from saying that this isn’t only happening to her and that she has known good times in her life. I know the futility of such word.

“I know,” she says suddenly. “I know how you can help me. You can tell me your address and I can come by and give you a hug and we can sit in your living room and visit.”

I am taken aback by the outlandishness of her request. At first I begin to respond directly, “You know that’s not something…” Then a thought comes to me and I stop myself. “Marilyn, have you just set yourself up? Have you just asked for something you know I won’t do so that you can continue to feel that I’m just one more of the long list of people who aren’t there for you, who don’t care about you, who can’t save you?”

She bursts into tears. “But you don’t!! You don’t care. Why can’t I come see you? Why can’t I come hug you?”

“Marilyn, can you try to answer those questions yourself,” I ask gently.

She sobs on the other end of the telephone. “You don’t care about me! I’m just a patient to you.”

I again consider responding directly and then decide against it. “What if you allowed in that I do care about you? What if you allowed in that I care about you and still can’t tell you when this will be over or why it’s happening? What if you allow in that I can care about you without being able to save you?”

Marilyn is sobbing uncontrollably on the other end of the line. “That can’t be! That can’t be!” she says between sobs.

I am silent and then say quietly, “It’s very hard to give up the hope of being saved, of being saved in the present and of being saved in the past.”

“I want you to hold me, I want you to hold me.”

I imagine Marilyn hugging herself and rocking back and forth in her chair. “I know, Marilyn,” I say, “I know.”

Chaos

“Welcome back,” I say to Ed, smiling. He attempts a smile in return, walks into my office, sits down in the chair across from me, and sighs. A smart, sensitive, psychologically minded twenty year old college student, Ed has had difficulties for much of his life – anxiety, compulsivity, facial tics, self-flagellation - but seemed markedly improved before returning to his home in New York City for the summer.

Shaking his head from side to side, he says, “It was too soon. I shouldn’t have gone home. And I shouldn’t have participated in that anti-Trump demonstration. Too much, way too much.” I watch Ed’s eye begin to twitch. He raises his right hand, then catches himself, makes a fist and puts his hand down. “As you can see, it’s back,” he says contemptuously.

“I’m sorry, Ed. I really am. Did you really feel so angry with you that you wanted to hit yourself?”

“Yes. I wanted to beat the shit out of myself,” he says clenching his jaw. “I’m sorry. I know you’ve worked so hard to help me stop that.”

“You don’t have to apologize, Ed. I’m just sorry you’re in so much pain.”

“I’m weak. I’m a sniveling baby. I can’t do anything to help myself.”

“That certainly sounds like the voice of your father.”

“Yeah, so what else is new? I thought I could take him on. I thought I was ready. How stupid of me. And joining that demonstration was terrible.” Ed’s eyes widen. I can feel the fear seeping from him. He fidgets, crossing his legs from side to side. “There were so many people, angry people. And they should be angry. We have an insane bully in the White House. North Korea, Venezuela, racists, Nazis! It’s insane. It scares me. But all the anger scares me too. It reverberates in my head. I can’t turn it off. I feel like I’m crazy too.” Ed digs his nails into both fists. He looks down at those fists as though they’re an alien part of him. He starts to beat his thighs.

I want to go and hold his hands to subdue him, to reassure him, to prevent him from hurting himself. Instead, I softly say, “Ed, Ed please look at me. I’m here. We’ll get through this. You’re with me now. You’re not in that demonstration, you’re not with your parents.”

Ed looks at me, first as though he doesn’t see me and then with dawning recognition. Tears roll down his face. He buries his head in his hands. “I don’t want to be crazy. I don’t want to be crazy,” he mumbles through his hands.

“You’re not crazy, Ed. You’ve been traumatized, actually re-traumatized, and it will take us a while to work it through. Can you talk about some of the things that happened with your parents or does that feel like too much for today?”

He lifts his head and smiles at me. “Well, that never happened. No one was ever sensitive to my feelings. It’s amazing what a difference just a little understanding and caring makes. How many times have I said I wish you were my mother?”

“Except there’s usually a second part to that statement.”

“Yeah, I’m afraid that not even you could stand up to my father and I wouldn’t want to find that out. And then you say you couldn’t promise me that you’d be able to stand up to my father but you certainly hope you’d try.”

“I also say that your father’s rage is not the only rage you’re afraid of, that you’re afraid of your own rage as well.”

He nods.

“I wonder if that’s what happened in the anti-Trump demonstration. You were…”

Ed interrupts me. “I did think that my father is a lot like Trump. A bombastic bully who’s thin skinned and easily narcissistically wounded.”

“So you mean you’d be afraid of going up against Trump, just like you’re afraid of going up against your father?”

“Yes.”

“That makes a lot of sense.”

“But you were you going to say something when I interrupted you.”

“Oh, yes. About your anger. I was wondering if in the demonstration you saw all these people who seemed comfortable with their anger and that that scared you, made you afraid that your anger might get out of hand, especially since, as you just said, Trump reminds you of your father.”

“You know, I’ve never quite gotten that bit about my anger, but somehow it makes sense in the context of that demonstration. There were all these people yelling their heads off, shouting terrible things about Trump. I wanted to join in, to become a part of the crowd. But instead I drew in and had all this noise going on in my head.” Pause. “Thank you. I feel much better.”

“My pleasure. See you Thursday.”

“Thanks again.”