Beyond Afraid

 I open my waiting room door to a mid-thirtyish man pacing back and forth in front of the couch. “Frank?” I ask.

He startles and turns to face me. “Oh, I’m so sorry. Did I frighten you? I didn’t mean to frighten you. I just can’t sit still. I’m so jittery. I just…”

I note that he’s afraid of having frightened me when he’s clearly the one who’s terrified. “It’s all right,” I interrupt. “Why don’t we go into my office and sit down.” 

He sits, but perches at the edge of the chair, as though posed for flight.

“What has you so frightened?” I ask.

“My, my, mother,” he stammers. “I’m afraid she’s going to die. My father died a year ago. He was fine, came home from work, went upstairs and died. Doctors said something about his heart. I couldn’t understand it. My Mom started screaming and screaming. I guess I did too. It still all a blur. But now I’m worried about my Mom. They say she has something in her uterus. I’m afraid she’s going to die. I couldn’t make it if she died. I couldn’t make it,” he says starting to cry. 

“What does she have in her uterus? Are her doctors concerned? Is she concerned?”

“She’s a wreck. Her doctors say it’s nothing, just something to watch. I don’t know, fibrosus?”

“Fibroids?” I ask.

“That’s it! Can that kill you?”

“I’m not a medical doctor, but my understanding is that fibroids aren’t usually a problem.”

“Are you sure?”

“Frank, do you think anyone can sufficiently reassure you?”

Still crying, he says, “I’ve always been this way. Everything scares me. Mom’s like that too. Dad was also kind of anxious. Only my sister isn’t. She’s the opposite. She’s in something like the Peace Corps. In India. My parents flipped out when she joined. But she was determined. And now she married an Indian guy so I guess she’s never coming home. I worry about her dying too, but it’s not as bad as with my Mom.”

“Can you tell me a little about your growing up, Frank. What was it like being a kid in your family?”

“It was great. I didn’t worry about anyone dying then.” Pause. “But I was always afraid. Hard not to be. My Mom worried about everything, about us being kidnapped, about us driving. I didn’t drive ‘til I was 20 or something. She’d take us to the doctor for the least little sniffle. Make us stay home from school.” Pause. “That was okay with me. I didn’t like school. I mean it wasn’t school I minded. I just didn’t like being away from home. I always felt scared being away from home. The other kids made fun of me, called me a Momma’s boy. I guess I was. Guess I still am.”

“Have you ever lived away from home?”

“I tried. Went away to college, but didn’t last a semester.  I came home, got a degree in accounting. Dad was an accountant. But I’m an assistant accountant. I didn’t want all that responsibility. I didn’t want the work to kill me like it killed Dad. I work mostly from home, especially since Covid, and especially since my Dad died. I want to be around for my Mom. She’s my responsibility now that he’s gone.”

“Have you been in therapy before?”

“I may have gone awhile when I was a little kid. But not really, no, not since I’m grown.”

“How do you feel about being in therapy? And how do you feel being with me?” 

“I guess I need it. I’d like to not be so scared all the time.” Pause. “And I like you. You’re nice. Sort of like my Mom, except not as nervous.” Pause. “Can you help me be less scared?”

“I certainly hope so. But I do want to say, Frank, that you may not always think I’m so nice. There are times therapy can be hard and painful. Like one of the things I suspect you and I are going to look at is your relationship with your mother.”

“Why? I have a great relationship with my mother.”

“Except it’s hard for you to have a life apart from her.”

“Are you going to take Mom away from me?” Frank asks, panic seeping into his voice.

“No, Frank. I don’t have the power to do that nor would I want to. But having part of your life be separate from your mother seems like something an adult child might want.”

“I guess.”

“You can always disagree with me, Frank. My saying something doesn’t make it so.”

“That’s not like my mother! She always wants me to think the same way as her.”

“Well, maybe that’s one thing we’ll get to look at together, how you feel about always needing to think like your Mom.”

Starting Therapy Remotely

“Hello,” I say to an attractive, dark-haired woman who appears before me on FaceTime. “I’m glad to meet you.” And so begins my first experience beginning therapy remotely.

I practice in Florida, one of the states that is seeing a sharp uptick in Covid-19. Although I have toyed with the idea of returning to in-office sessions, I continue to find myself reluctant to do so. During the initial phase of the pandemic, I turned away new referrals, uncomfortable starting treatment with anyone I could not meet at least once in person. But as my time away from the office continues, I decide I need to go beyond my comfort zone.

“Hi,” Jennifer replies. “This already feels weird. I’ve been in a lot of therapy, but obviously in person. I kept thinking I’d wait until I could go to your office, but who knows when that will be, and I’m having a really hard time.”

“It feels strange to me too,” I say, “But why don’t you tell me how I can help you.”

I watch her take a deep breath. “I’m 49, I’m alone, I’m terrified of the virus and I just found out that my ex-husband has lung cancer. And that he hasn’t told our daughter yet. I’m so anxious I can’t stand myself.”

“That is a lot.”

“I’ve always been afraid of being alone and now I’m alone all the time. I mean, I talk to my daughter, but she’s in New York and she’s had a really hard time so I don’t want to lay all my stuff on her. And I worry about how she’ll respond to the news about Greg, that’s my ex.”

“Lots of people have been struggling with their aloneness during the pandemic, can you talk about what it’s like for you.”

“I’ve always hated being alone, ever since I was a little girl. I was the kid who was afraid of monsters under the bed, always had to have a light on, and would run into my parent’s room in the middle of the night. That’s why it took me so long to leave Greg, even though I knew about his affairs for years. And when he moved out I put way too much pressure on my daughter to be my companion, just as my Mom did to me. I mean, my parents stayed married, but they had a lousy relationship and I was my mother’s confidant. My Mom’s still alive. She remarried after my father died and she’s much happier now. We’re close, but not like it was when I was a kid.”

“Are you saying you miss your childhood relationship with your Mom or that you’re relieved?”

“I don’t know. Maybe both. When I’m happy, I’m relieved. But now that I’m so anxious, I guess I want my Mommy. I know that sounds silly.”

“Not at all. I totally understand.”

“I did tell my Mom about Greg, but she didn’t get it at all, thought I’d be happy that something really bad happened to him.”

“And is a part of you happy?”

“Oh no! I mean he certainly wasn’t a good husband but I could never be glad he got cancer.”

“So you’d feel guilty if you felt glad?”

“Definitely. I was brought up to be the good girl and the good girl I remain.”

“Can I ask you how this is feeling to you right now?”

“I guess it still feels weird. And I’m still anxious. I’m used to having my anxiety get better when I’m in

a therapist’s office. But I guess I’m not in your office. It’s like you’re here and not here. It’s similar to how I feel talking to my New York friends on the phone. They don’t feel really present to me so I’ve pretty much let most of those relationships kind of peter out.”

“Oh oh,” I say. “Does that mean you’re likely to do the same thing with us?”

She shrugs. “I don’t know.”

“Maybe you yearn for relationships that duplicate the early connection you felt with your mother, perhaps that’s the connection that reduces your anxiety, makes you feel safe, and that without that kind of connection you feel afraid.”

“I guess that’s true. But I thought I wanted to get away from my mother.”

“I suspect that a part of you does want to get away, but the scared little girl part of you still yearns for what you experience as safe.”

“I suppose.”

“I feel as though you’re less engaged with me right now.”

“Yeah. It’s not you. I just don’t know if this is going to work.”

“I suppose the question is whether you’re willing to give it a chance. We’ve actually talked about quite a bit today: anxiety, guilt, your need to be a good girl and, I suspect, although we haven’t talked about it, your difficulty allowing yourself to feel angry.”

Jennifer brightens. “That’s right! I feel really bad when I get angry.” Pause. “But right this minute I feel a little less anxious.”

“Maybe it helped that I figured something out about you, and that made you feel more connected, less alone.”

“Could be.”

“I can’t guarantee I’ll do that every session, but if you’re willing to give this a try, maybe our work together could be helpful, despite not being in person.”  

Father’s Day

“I have to decide today,” says 44 year old Brian, a patient who started seeing me last month because of overwhelming anxiety. Passing his hand through his brown, wavy hair he continues. “I’ve delayed and delayed, but if I’m driving to Pensacola tomorrow in time for Father’s Day, I have to make a decision today. No more procrastinating.” Pause. “It’s no secret that I don’t want to go. Even my mother who’s calling me every day to bug me about coming knows I dread the idea. And my wife is staying out of the whole thing. Which is kind of her. All I’d need is for her to be pulling me in the other direction and saying I need to stay for our boys.”

“I notice you’ve mentioned your mother, your wife and your boys, but not your father.”

Brian chuckles. “You’ve got that right. I realize it’s supposed to be his day, but if it were only for him I know I wouldn’t go. I mean, he was awful my whole life, but ever since he banished my brother because he’s gay and then Trump was elected, it’s impossible to have five minutes of a civil conversation. My father has always been a tyrant. He has an opinion about everything and for some reason he thinks he’s an expert on everything too. Which is ridiculous, since he barely finished high school and clearly isn’t very bright.”

I think of my father, definitely smart, politically like-minded, but most definitely a tyrant. “So why would you go?” I ask.

“My mother.” Pause. “And she’s right, they’re not getting any younger. But she’s pulled out every guilt inducing maneuver she can think of. ‘What if Dad dies and you never see him again?’ ‘Why does his relationship with Paul have to affect you?’ ‘Can you imagine how embarrassing it would be for him if not one of his children is present?’ ‘You can bring Janet and the boys; we’d love to have them; the whole family together’ As if I would subject my boys to whatever explosion is bound to happen.”

“And how do you feel about your mother pressuring you?”

“I don’t know. It’s what mothers do.”

My mind wanders to the many difficult years I had with my father, coupled with my mother’s constant inability to ever see my point of view. Regardless of the circumstances I was always the one who had to make things right.

“But that doesn’t tell us how you feel about your mother pressuring you,” I say.

Brian sighs. “It’s the same old, same old. My mother’s whole life revolves around my father. She has nothing else in her life. Except for us of course. But she’s followed my father’s lead as far as my brother. I wonder how she feels about being totally disconnected from Paul.” Pause. “It’s sad.”

“Sad for her? For Paul?”

“I was thinking sad for her. But it must be sad for Paul too.” Pause. “You know, I’m getting more anxious as we talk about this.” Pause. “And feeling like I should go.”

Silence.

“I, I need you to say something. My anxiety is going through the roof,” Brian says, clenching his hands and fidgeting in the chair.

“So the silence made you more anxious, just like thinking about the disconnect between Paul and your mother.”

“Yeah, I guess so, but I’m not sure how they’re related.”

“Nothing comes to mind?” I ask.

Brian shakes his head, looking puzzled.

Although I would prefer to wait to see what might emerge from Brian, his escalating anxiety pressures me to speak. “I wonder if one of the things that makes you anxious is the fear of being disconnected, not connected to your mother or to me.”

“I’m not sure I understand.”

“Well, you were talking about how your mother has no relationship with Paul. I think that scared you. You wouldn’t want to have no relationship with your mother, so I suspect when that thought went through your mind – consciously or unconsciously – you felt you’d better go for Father’s Day.”

“Wow! You think that’s what my anxiety is all about, being disconnected from my mother?”

“Your anxiety could be the result of many things, but the fear of separation could certainly be one of them.”

“And with you too?”

“Well, you were already feeling scared of being separated from your mother and when I wasn’t speaking I think you experienced that feeling of separation with me as well.”

“I’ll have to think about that. But meantime, what should I do about Father’s Day?”

“I can’t decide that for you Brian. There’s not a right or wrong decision, just your decision.”

“That scares me too.”  

“Because?”

“What if I make a mistake?”

“What if you do?”

“I think I’m going to go. It feels like the safest choice.”

“You need to do whatever you need to do. There was a lot that came up in this session today, too much for us to deal with it all. So I’m sure whatever you decide will be fine and we’ll have other times to work on your anxiety and your relationship with both your parents and with me.”

Vacation

Belinda glares at me silently, arms crossed in front of her chest. “Look at you,” she says finally, “Sitting there so innocently, like you’re not about to shirk your responsibility and abandon us all.”


Finding myself more amused than angry, I wonder if Belinda is less distressed about my upcoming vacation than her words seem to imply. I’ve seen Belinda for a number of years now and watched her grow from a woman who was unable to feel much of anything, to someone who is more in touch with her emotions and more able to connect to others. But anger is her usual defense when she feels particularly vulnerable. “So you’re feeling angry about my being away for two weeks,” I say.

“Duh! Yeah, you could say that, great clinician that you are.”

I’m less amused. She may be angrier than I thought.

“This may seem like a silly question, but why? Why are you so angry?”

“That’s not silly, it’s stupid. Answer it yourself!”

“Belinda, what’s going on here? You’ve never liked when I’ve gone on vacation, but you seem particularly angry today.”

“All that talk about your being here for me, about my needing to take you with me, about my needing to rely on you. Great! So what happened to all that?”

“None of that has changed.”

“Right!”

Silence.

“Say something,” she demands.

I consider remaining silent and decide that would only escalate the confrontation. “I think you’re trying to provoke me, Belinda, and I’m not sure why that is.”

Silence.

“Do you feel anything besides anger about my being away for two weeks? Do you feel scared? Sad?”

“You’d like that wouldn’t you? You’d like me to be crying like a baby. Make you feel important. Like I couldn’t live without you.”

“You can live without me, Belinda, but that doesn’t mean you can’t have feelings about my being gone.”

“Why are you the one who decides when you get to leave? Why don’t I have a say in the matter? Why don’t your other patients?”

An image of my patients voting on when I should go on vacation floats through my mind and I again find myself amused. But then I wonder why I am being amused by Belinda’s anger today. Is it my defense? Is Belinda’s anger frightening me and am I trying to minimize it by finding it amusing? Or perhaps she’s the one who’s frightened of her anger.  

“Well?” she asks challengingly.

“Are you afraid of how angry you are, Belinda?” I ask.

“Are you?” is her retort.

“I don’t know,” I reply. “I didn’t think I was, but then I wondered if I was minimizing your anger and if that meant I was afraid of it. And then I wondered if you were afraid of your anger.”

Belinda’s face softens. She looks almost like she might cry. She shakes her head. “I can’t believe it. I was sure I’d never let you in today. I was sure I’d hold onto my anger. I was sure I wouldn’t tell you. I cut myself last night.”

My stomach turns over. “Why?” I asked, shocked. As far as I knew Belinda was never a cutter. 

“I just felt so angry you were leaving me. I didn’t know what to do with all the feelings. I tried screaming and hitting the wall but it didn’t help. So I took a knife and cut myself. Not much, truthfully. It was just a little nick. I don’t much like blood. I thought if I could really hurt myself, I’d probably feel better, but I couldn’t do it. And then I got even madder that you had that much power over me.”   

“I’m glad you didn’t really hurt yourself, but inflicting pain on you in any way is really scary, Belinda. I’m sorry you didn’t call me and try and talk about your feelings.”   

“That makes me mad too. Why would I call you and be even more dependent on you when there’s no way I’m going to be able to call you for two weeks?”

“It’s true, Belinda. I’m not going to be available for two weeks. But that doesn’t mean I stop existing for you or that you stop existing for me. We’re in each other’s lives; we’re in each other’s head. Our connection doesn’t vanish. And, yes, you can be angry that I’m going. And you can also feel sad and scared. And we can talk about all those feelings. But neither of us can or should try to take the feelings away or make light of them. You’re feelings always matter, because you matter.”

“I was about to say I wish you didn’t matter to me, but I guess that’s really not true.”

“I’m glad. We still have one more session before I leave, so let’s continue talking about this. And no cutting.”

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.”  

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.”

Time Pressure

Charlotte began treatment with me eight months ago when her mother was diagnosed with terminal cancer. Although well into her forties, married, with children of her own, Charlotte is very dependent on her mother, talking with her several times a day and consulting her for even minor decisions. She is consumed with anxiety at the thought of her mother’s impending death. 

“I never thought she’d die!” she sobs. “I know that’s ridiculous but she seemed invincible. I thought she would live forever. I don’t know what I’ll do without her. It’s hard to imagine how I can go on.”

Charlotte is an only child who grew up in a middle class family. Her father was an accountant, a reserved, passive man who saw Charlotte as his wife’s responsibility. He wasn’t hostile or ungiving, simply absent, seemingly involved with neither Charlotte nor his wife. 

Not surprisingly, the primary connection in the family was between Charlotte and her mother. Her mother was overly protective, constantly concerned about her getting hurt and insistent that she know where Charlotte was at all times. Charlotte never rebelled. She was her mother’s constant companion. Leaving for college precipitated the onset of severe anxiety, an anxiety that still plagues her.

I am struck with the similarities between myself and Charlotte, as well as the differences. Our mothers were alike, both overly protective and fearful of letting their daughters stray too far from home. As a young child I remember wanting to stay with my mother forever. But I had a very different father, an angry, explosive, tyrannical man. I wanted to get away from him. So I had to leave home, thereby beginning the process of separating from my mother.

I knew that Charlotte also needed to separate, but her process would be more difficult since her mother’s death loomed. Time was running out.

“Charlotte, why is it that you’re so afraid of falling apart when your mother dies?”

“I can’t imagine going on without her! I can’t imagine how I’ll function. I’m not even talking about being anxious all the time, and crying all the time because I’m sure that will be true, I just don’t know how I’ll get from one day to the next.”

Feeling the pressure of time, I push way too fast. “How do feel about your mother making you so dependent on her?” 

“What are you talking about? She didn’t make me dependent, that’s just who I am.”

“It is who you are. But I wonder how you got that way. Everyone in your family, including you, contributed to your feeling what I call ‘copeless,’ feeling like you can’t do anything on your own, despite the fact that you’re clearly a competent, capable adult.”

Charlotte is thoughtful. “Well, my mother always helped me with my homework, she wanted to check out all my friends, she never wanted me to go on school trips. I don’t know about my father. He was just absent. As for me, I guess I liked my mother’s attention. It made me feel loved.”

“So maybe one thing you’re saying is that your mother helped make up for the love you didn’t feel from your father.”

“I know he loved me. He just couldn’t show it. And that’s still true. You’d think this would be a time we’d get closer, but he’s just as unavailable as always, to both me and my mother.”

“So you felt you also had to love your mother more to make up for what she didn’t get from your father.”

“I never thought of it that way, but yeah, I guess that’s true.”    

Several months later, I say, “You know, Charlotte, it is all right to be angry with both your parents…”

“No, no,” she interrupts, “I can’t be angry with my mother now.”

“I understand, Charlotte, but it doesn’t mean you’re only angry with her. Of course you love her and you’ll miss her terribly. But your father was absent and your mother was clingy and what you needed as a little girl sometimes got lost along the way.”

Charlotte sobs. 

I’m rushing the treatment. I want Charlotte to be prepared, ready for her mother’s death. But then I realize I’m doing to Charlotte just what her mother did - as well as what my mother did to me. I’m treating Charlotte as a child who can’t take care of herself. I need to listen to Charlotte, to follow her lead, not assume I know what’s best for her. 

Therapy takes a long time and this treatment is no exception. Charlotte will be however she is when her mother dies and we will deal with that then.