Paranoia

“I’m afraid I’m going to be fired,” Tricia says.

I’m surprised. I’ve worked with Tricia over a year and she has given me only glowing reports about her success as a graphic designer.

“They think I stole Charlotte’s idea.”

“Did you?” I ask. Tricia has never spoken well of Charlotte. My sense is that Tricia is envious of Charlotte - her senior status, her looks, her ease in social situations.    

“Of course not,” she replies indignantly. 

“Then why should they think you did?”

“I just do.”

I wait.

“What, you don’t believe me? You think I’m lying?”

I knit my brows and look at Tricia, both perplexed and concerned. There’s a paranoid feel to this discussion that is making me anxious. “What’s going on, Tricia?”

“What? What do you mean?” she asks, raising her voice.

“I don’t understand why you’d think I thought you were lying or why you’re afraid you’ll be accused of stealing Charlotte’s idea and be fired.”

She stares at me defiantly and then deflates before my ideas, dissolving into tears.

“I’m bad. I’m bad and I’m going to be punished.”

I feel as though I am in the room with a child who’s been caught … Caught doing what? What comes to mind is caught with her pants down.  I file away my internal meanderings and wait to hear what Tricia will say. But Tricia, looking frightened, says nothing. 

Very gently, I ask, “Can you say what makes you bad, Tricia?”

She shakes her head, still not speaking. 

Fantasies go through my head. She had sex with Charlotte. She beat Charlotte up.  She hit someone with her car. She molested a child. She … I bring myself back to reality. Tricia’s anxiety is obviously contagious, but these are fantasies, not realistic possibilities. 

“I had sex with Peter,” she blurts out.

Aha, I think, her boss - and Charlotte’s. She had sex with a male authority figure, a stand-in for her father and is afraid of the punishment from both inside her head and in the real world. Clearly she’s already punishing herself, branding herself as bad. She also fears retaliation from Charlotte, from me, from her mother, and from the powers that be at work.

Suddenly I flash on a patient I saw many years ago. She had been a teacher, but could no longer work. She had an affair with a married principal and felt so guilty that she became convinced everyone in the school system talked about her. She was tormented by her thoughts, but unable to move beyond them. I don’t work well with paranoid people. They remind me too much of my father, I’m too easily sucked into unfruitful and untherapeutic attempts to convince them of the wrongness of their thinking. I must tread lightly with Tricia.

“Sounds like you feel pretty guilty.”

“How could I be so stupid?” she asks, hitting her thigh with her fist. “Not only my boss, but Charlotte’s too. And I know Charlotte has a crush on him. Besides, he’s only toying with me. He tries to get in every woman’s pants. Now he’ll want to get rid of me.”   

“So you feel you ‘stole’ Charlotte’s ‘man’ and that now he’ll get rid of you and choose Charlotte instead. That, you feel, would be your just punishment.”

“I don’t know what you’re talking about,” Tricia says loudly.

“Tricia, why do you feel what you did was bad? And why are you so frightened?”

“I told you! It was stupid!!”

“Let’s say you decide it was stupid, that doesn’t seem enough of a reason to conclude that you’re bad and that you’re going to get fired. I do believe you do feel terribly guilty, but I suspect the origin of that guilt stems a lot further back.”

“You mean some dumb Oedipal thing? I never wanted to sleep with my father!”

“But I suspect you did want your father to prefer you to your sisters and perhaps even your mother.”

“He did prefer me,” Tricia says quietly looking down. “That’s why my mother hated me so much.” 

I don’t know if Tricia’s assessment is accurate, but I suspect it is why Tricia feels so guilty and also why she’s convinced retribution must follow. 

“It’s important that we try to understand your feelings about the relationship between you and your parents, but right now I wonder what you’re thinking about being fired.”

“It still think Peter might try and get rid of me and that Charlotte hates me, but I’m not feeling quite as scared as before.”

“Maybe that’s because you’re not beating up on yourself quite as much.” 

Imprisoned

Andrea again calls me from home.

“I’m sorry,” she says, her voice hardly above a whisper. “I know I said I’d try to come today but I can’t. I can hardly get myself out of bed. I can’t leave the house. I keep calling in sick to work. I hope I don’t get fired. I just can’t function. I’m so scared,” she adds crying. 

Those of you who follow my blog will have met Andrea a few weeks ago, the woman who had been sexually abused by her father and felt herself more endangered after the Boston Marathon bombings. And now there’s the case in Cleveland, the shocking imprisonment for over ten years of three young women who were finally able to escape. 

“It’s all right, Andrea,” I say gently. “I understand. You know I always say that you can only do what you can do. We’ll do whatever we need to do to help you through this.”

“I don’t think I will get through this. I’m back there. I’m back in that horrible house. I keep seeing those disgusting green walls. And the closet. I’m locked in that closet. I feel like huddling in a corner, folded over on  myself, just like I was as a child, hoping that he’d leave me alone, but not wanting to be left in that closet for hours or days at a time. So did I wish he’d come back? That’s disgusting. I’m disgusting.”

“I bet you don’t think those three women are disgusting, Andrea.”

“No, of course not, they’re heroes. I don’t know how they endured for all those years. And that child! That child has never seen the outside world. That seems impossible to take in!”

“Notice how caring and compassionate you are towards those women and the child,” I say. “I wish you were able to have even a tiny bit of that compassion for yourself.” 

“It’s not the same.”

“In what way isn’t it the same, Andrea?” 

“They were imprisoned. They had no choice. I could have told. Why didn’t I tell?’ she asks plaintively, crying. “Why didn’t I run away?”

Although Andrea and I have covered this ground many times, her self-loathing and need to blame herself remains very difficult to change. To emotionally accept that she was an abused, helpless, dependent child without any options, is to accept her total vulnerability. And as awful as the guilt and self-hatred is, it is preferable to feeling completely powerless.

“You were a child, Andrea. And he was your father. There was no place for you to go. These women are adults now and they all went back to the embrace of their families. I’m not minimizing the horror of their story in any way. But I don’t want you to minimize the horror of yours either. You were as helpless and powerless as they were.”

“But that doesn’t make me feel better!” Andrea wails. 

“I understand that Andrea. I understand that hating yourself, thinking you could have done something, anything, in many ways feels better than experiencing your total helpless. But, and this is an important but, you’re no longer that helpless child. You’re a competent, capable adult. It doesn’t mean bad things can’t happen, but today you have many more options than you had as a child.”

“But why didn’t I tell?”

“Because you were afraid, because you were ashamed, because you didn’t know what would happen if you told.” Suddenly I have a thought. “I wonder Andrea, if in addition to these women’s story making you more frightened, whether it also made you even madder at yourself for not figuring out a way to tell. Here you see how supportive and welcoming and thrilled complete strangers are of these women and I wonder if that made you almost envious, like you’re still in hiding and no one ever got to applaud you.”

Andrea mumbles something on the other end of the phone.

“I’m sorry, Andrea, I didn’t hear you.”

“I said you’re right. I found myself almost wishing I were those women. And then I got furious at myself for that thought. Disgusting! How could I want to be them? What’s wrong with me? I must be sick, sick, sick.”   

“I think it makes complete sense, Andrea. So maybe you should try to stop beating up on you. And maybe, just maybe that might help you to feel less scared, like the person you’re really scared of these days is you.”