I Lied

A tall, too-thin, young blonde woman looks up at me with beseeching eyes when I open my waiting room door. She does not return my smile. Slowly, tentatively she walks to my office and waits until I gesture for her to sit, which she does almost reluctantly, teetering at the edge of the chair.

Oh, oh, I think to myself. This young woman is in trouble and probably means trouble for me as well.

She looks down at the floor, pulling at her fingers. Anxiety fills the room.

“Bethany,” I begin, planning to ask what has brought her to therapy.

At the sound of her name, she flinches.

“That’s not my name,” she says, practically whispering.

For a moment I’m confused. Did I misremember the name she gave me on the phone?

“I lied,” she says.

“You lied about your name?” I ask, surprised. In all the years I’ve been doing therapy, I don’t think anyone has lied about her name.

She nods, still looking down at the floor.

I wait.

“My name’s Belinda,” she says.

Belinda I think to myself, an unusual name. Tall, thin, blonde. The pieces fall into place. “You’re Chelsea’s friend,” I say.

“You have to see me,” she says raising her head, her eyes now boring into mine. “I’ve seen lots of therapists over the years. I knew you wouldn’t see me if I told you I was Chelsea’s friend, so I lied. I planned to lie for a while, until we had a relationship going, but I was too afraid. I didn’t think I could pull it off.”

I’m swimming in conflicting thoughts and feelings, and suspect that my confusion mirrors Bethany’s – I mean Belinda’s. Why is Belinda so determined to see me? What does it mean about her 

relationship to Chelsea? Why did she choose subterfuge and then immediately abandon it?

“Why don’t you say something?” she asks.

“I guess because I’m feeling confused and uncertain what to say or do, much as I imagine you often feel yourself.”

Belinda’s face lights up. “Yes! That’s exactly how I feel. I knew you’d be the only one who could understand me.”

Immediate idealization always followed by falling off the pedestal. But it can never get that far. I need to extricate myself from this situation as soon as possible for, as Belinda correctly surmised, I cannot treat both Chelsea and Belinda. They are good friends, both disturbed young women with eating disorders. They’re also extremely competitive with each other. I can just imagine the jostling that would occur as each tried to win my favor. Way too complicated for me to ever consider.

“I assume, Belinda, that Chelsea doesn’t know you came to see me,” I say.

“You’re not going to see me,” Belinda says, tearing up.

“No, Belinda, I’m not going to see you, but I would like for us to understand why it was so important that you see Chelsea’s therapist. There are many good therapists I could refer you to, why did you want it to be me?”

“It has to be you!”

“Because?”

“Because of how much you’ve helped Chelsea.”

“That could be one reason you want to see me. Might there be others?”

Silent tears pour down Belinda’s cheeks. In the next second she’s beating her fist into her thigh, her face contorted with rage.

“Stop it!” I say. “Stop it and tell me what you’re feeling.”

“I always, always lose. I hate myself! I hate myself! I’m never good enough!”

“Belinda, I know almost nothing about you, but I do know that today you set yourself up to lose. You knew coming in that I wouldn’t see you when I’m already treating one of your best friends.”

“We could keep it a secret,” she says interrupting.

“You know I’m not going keep a secret from a patient. You wouldn’t want your therapist to keep a secret from you. Is there something that happened between you and Chelsea that made you suddenly decide you wanted to be my patient?”

She shakes her head no.

“Is there something that happened in your life?”

“My sister got engaged.”

“So you felt that your sister won over you and you thought maybe you could win over Chelsea.”

She nods. “But of course I couldn’t. I always lose.”

“But again, Chelsea, with me, you set yourself up to lose and I think that’s something important for you to understand. Can I give you the name and phone number of a therapist I think you’d work well with?”

“I don’t know.”

“Well, why don’t I give it to you and hopefully you’ll think about it and give her a call.”

Russian Roulette

Two women occupy my office chairs today. I have seen Georgia, a tall, stately, perfectly coifed 49 year old woman on and off for 14 years. When I first began treating her, her daughter Tricia was seven years old. Now a beautiful 21 year old sits across from me, a straight A pre-med junior at the University of Florida.

Tricia’s success has been Georgia’s obsession. Through the years we have worked at diminishing her anger at her accountant husband for not being sufficiently successful to send Tricia to an Ivy League College. Although I always thought I came from an overprotective family that relentlessly pushed me to succeed, working with Georgia introduced me to a whole new definition of relentless, coupled with a rule-bound, rigid household.

It’s unusual for me to agree to see a patient’s family member, but Georgia pleaded with me and I thought the situation sufficiently alarming to agree.

“It’s a pleasure to meet you, Tricia,” I say smiling. “I’ve certainly heard a lot about you over the years.”

“I bet!” she replies. “Sometimes I think I’m the only person my Mom ever thinks about.”

Good insight, I think to myself. “And how do you feel about that?” I ask.

“It gets old. I tell her I’m a big girl now. I can take care of myself.”

“Sounds like you’re getting right to the point of your mother’s concern, having unprotected sex.”

“I know the guys I’m sleeping with. It’s not like I’m hooking up with one-night stands. I know who they are, who they’ve slept with.”

“You don’t know, Tricia,” Georgia says, her voice tense and annoyed. “You can never know. I don’t understand why you’re being so reckless, playing Russian roulette with your life.” 

“Maybe that’s a good question. Why do you think you need to be reckless, Tricia?”

“I’m not being reckless. I told you I know who these boys are.”

I remember stories from Tricia’s early teen-age years when she would sneak boys into her room at home, often managing to get caught. I definitely understand her need to rebel, to break the shackles of her mother’s iron grip, but I don’t think Tricia is aware of the motivation behind her own behavior. 

“What were the messages you got from your mother regarding sex?” I ask.

“You’re kidding, right? No sex before marriage. Sex is holy. Only meant for a married man and woman. We’ll leave the same-sex part of that out completely.”

“What?” Georgia shrieks. “Have you had sex with a woman?”

“No comment,” Tricia replies snidely.

“That’s an interesting statement Tricia. Because it seems to me you’ve made many comments – directly and indirectly - about your sex life and I have wondered why that is. How does your mother know you’re having unprotected sex? How come she knew you were having sex as a teenager? And why did you just casually throw out the possibility of lesbian sex?”

“She asks me.”

“Tricia, I know you’re a very smart young woman. Yet you seem determined not to consider the meaning of either your statements or your behavior. For one, you already said you don’t think your mother thinks of anyone but you and that you don’t like that, but you manage to increase her thinking about you by being provocative. And, while you’re reeling her in on the one hand, you’re rebelling against her and everything she believes in on the other.”

“I don’t know what you mean.”

“I think you’re not sure how close you want to be to your mother. You tell her everything to stay close and then rebel against her to move away. I do understand, Tricia, that your Mom has held onto you very tightly and that makes the process of separating more difficult.”

“So now it’s my fault,” Georgia says angrily.

Always the problem with introducing a family member into an ongoing treatment, the patient ends up feeling dismissed and betrayed.

“It’s not a question of fault, Georgia. It’s a problem that exists for both of you today. I know you want Tricia to be healthy and happy and have a full life and in order to do that she needs to separate from you in a way that’s not destructive to her.”

“She always makes it about her,” Tricia says, exasperated. “Of course, you’re making it about her too.”

I smile. “You really are a very insightful person. There’s no way I as your mother’s therapist is going to be able to help you separate. But I do think it would be a good idea for you to go into your own therapy, with your own therapist. As you said, you’re a big girl now and you need to take care of yourself.”