Hooked

“I never thought I’d be seeing a therapist. And certainly not for this! After all, it isn’t a problem. It’s what everyone does. Everyone my age, anyway. But here I am,” Samantha says, looking at me expectantly, brushing her straight blonde hair away from her face.  

She’s been speaking at me rapidly for several minutes although I still have no idea to what she’s referring. I look back at her and wait.

She sighs deeply. “This is harder than I thought. I guess it kind of feels like talking to my Nana. Don’t get me wrong, I love my Nana but …”

I smile inwardly. “But you wouldn’t want your Nana to know about whatever this is. ‘

“Exactly,” she says brightly.

“Well, I’m not your Nana, but it would be helpful if I knew what’s troubling you or, if it’s easier, you can tell me a little about yourself.” 

“I’m 20, a sophomore in college, actually born in Florida, from Daytona. I have two younger brothers. My parents are divorced. My Mom’s a nurse, my Dad owns a car dealership. I told them I wanted to go into therapy because school has me stressed. Which is kind of true.” Pause. “That’s about it. So I guess I better tell you.” She takes a deep breath. “I assume you know about hooking up, where you just go on your phone and make a date to meet for sex, no strings attached?”

“Certainly,” I say nodding.

“Well, I do it quite a bit. Started in high school, much more in college.  Like I said, no big deal, just lots of fun. Sometimes great sex, sometimes just so-so, but it’s a fantastic way to get lots of experience without having to worry about it getting messy.”

I now feel like Samantha’s Nana. It’s hard for me to imagine the pleasure involved in totally anonymous sex. But I hope to keep my judgment to myself. “So what about hooking up is becoming a problem for you?”

“I can’t not do it.”

“What do you mean?”

“Well, used to be I’d only do it on the weekend, sometimes with four or more guys, but still only Saturday and Sunday. Then it was also Friday night. And then maybe a couple of other nights during the week. But now I can’t not do it! I can’t sleep if I haven’t hooked up with at least one guy, sometimes more. Sometimes I try. I pace the floor, I drink some wine, I take a Xanax. Nothing works. Sometimes I end up hooking up at 3, 4 in the morning. I’m driven. And I know, it’s like being an addict and no kind of addict is good. My Dad’s an alcoholic and my Mom used to be addicted to pills. She’s clean now. But I know. It’s not good. Right?”

“No, Samantha, it’s not good.” Corroborating Samantha’s assessment doesn’t feel judgmental, but rather supportive of the stronger, less impulsive part of her. “But tell me what hooking up does for you? What about it makes you feel relaxed when nothing else works?”

“Like you said, it relaxes me. I guess part of it is just the physical release. Although I know that can’t be all of it, because it doesn’t work if I … uh … if I do it myself.” Pause. “I guess it fills me up, makes me feel less alone. And I like being wanted. Like the guy can’t have enough of me. Or the guys. They just all want me. It’s a high. Just talking about it makes me want to run out and do it.”

“And if you don’t. If you sit with your feelings right now?”

“I guess I feel blah. Yeah, blah. I feel ordinary, like a nobody, kind of lonely, like no one wants me. Yuk! I don’t like it. I don’t want to feel like that.”

“Can I ask you, Samantha, are the feelings you just described familiar? Did you feel them when you were a child?”

“For sure! First there were the two younger kids, boys at that. Then there was the booze and the pills and the screaming and the divorce and more screaming. I thought they might fight about who had to take us, but I guess that was the one non-issue. My Mom got us, no questions asked. Except they kept screaming because my Mom wanted more money, my Dad said no way. I don’t have much of a relationship with my Dad. He has lots of women. We kind of get in his way.”

There are so many interpretations to be made here, all related to Samantha’s feeling unimportant and insignificant, whether in relation to her brothers, her father, her father’s women or her parent’s involvement with their own lives and addictions. But there’s no rush. If she can tolerate her feelings, I suspect Samantha will be in treatment for some time.    

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.”