Considering

 “I wanted to let you know,” Tammy says immediately upon sitting down, “I’m considering changing therapists.”

I’m surprised and try to recall what if anything might have occurred in our last session that would have prompted her possible termination. “Because…?” I ask.

“We just don’t seem to be getting anywhere. It’s over two years. And, yeah, I know, therapy is a process, not a destination.”

“Is this something you’ve been considering for a while?”

“Uhm. No, not really.”

“Can you say what started your thinking along these lines?”

Tammy squirms in the chair. “Uhm, I guess I’d rather not.”

“Why would you rather not?” I ask bemused.

“This is why I want to change therapists! You question everything! You want answers to everything! Why? Why? Why? I’m sick of it.”

“And what would you prefer instead?”

“Somebody who just left me alone and let me live my life!”

“Then why would you want to be in therapy at all?”

“I considered that too. But not being in therapy feels too scary. I don’t trust myself enough to not be in therapy. Who knows what I might do.” 

“I realize that you’d rather not say what started your thinking about changing therapists, but I think it’s important that you do. You know if you decide to change therapists I certainly would support you in whatever way I could. But given what you just said about not trusting yourself, I suspect that means you know you can make impulsive decisions and that despite you’re not liking to be asked why, it is an important question for you.”

Tammy sighs deeply, rolls her eyes, looks at me and smirks. “I ran into Michael, my ex-boyfriend, Michael.”

“And?”

“What do you think?”

“He wanted to get back together.”

“Right. I told him I was engaged to Philip and he just laughed. Said he couldn’t believe I was still with that nerd. And that he bet I was still in therapy with you too. I told him yeah, I was. He says it figures, that you’d want me to be with a loser, always chasing my own tail.”

“Do you feel I want you to be with a loser?”

“No, not exactly, but you are always pointing out how good Philip is to me, how he cares for me and tries to take care of me.”

“And those are bad things?”

“No, of course not. But they can get kind of boring.”

“Did you have sex with Michael?”

“No, but I was tempted.”

“So it’s Philip or Michael and me or some other therapist?”

“I guess that’s about right.”

“And who’s the other therapist?”

“I don’t know. I haven’t gotten that far.” Pause. “But maybe he would be a man. That would be different; might make it more interesting.”

“Are you saying it might make it more dangerous or more sexual…”

“I’m not sleeping with any therapist!”

“I wasn’t suggesting you were, but wondering if having a male therapist would introduce the possibility of sex into the treatment and that might feel more tantalizing.”

“I chose a female therapist in the first place because I didn’t want that sexual element to be a part of it.”

“And now you think you might?”

“I don’t know. I guess that’s why I said I was considering changing therapists, not that I’d decided.”

“This is a big conflict for you, Tammy: safety and comfort on the one hand, or excitement and danger on the other. It gets played out with Michael and Philip, with me and a male therapist, and also in your work. Should you give up your job as a nurse and see if you could make it as a singer?”

“That’s just a dream, I’m not doing that. Too risky.”

“And are you comfortable, resolved saying that?”

“Makes me a little sad, but yeah. I’m 36, I’m not making it onto the charts. Too many of me out there.”

“So that’s one of the things you’ve come to accept.”

“Yeah, I guess.”

“You know, it actually might have been helpful for you to have seen a male therapist from the start…”

Tammy shakes her head adamantly from side to side.

“No?” I inquire.

“No. Then I really couldn’t have trusted myself and who knows what stupid thing I might have done, maybe even made an ass of myself and tried to seduce the guy.”

“So maybe now the question is do you want a break from the nice, caring me and/or Philip and add a bit of spice to your life in the way of Michael and/or a male therapist.”

“I guess so.” Pause. “I don’t know. I guess I’d like to continue considering it.”

“That sounds like an excellent decision. And we can continue to talk about it as well.”

Undecided Part II

 “It’s not good,” Stan says, shaking his head from side to side. “You have to tell me what to do! I can’t stand it! All I do is think about this day in and day out. Should I stay with Paulette and my family or should I throw it all up in the air and be with Frank?”

Silence.

“Tell me.”

“You know I can’t tell you Stan. No one can make that decision but you.”

He drops his head into his hands. “I can’t. I can’t make the decision.”

“If I told you what to do – which I wouldn’t – what would you hope I’d say? 

“That I should follow my heart and be with Frank.”

“So is that what you want?”

“Yes. Yes. It is what I want. But is what I want enough? Is what I want always what matters most? If I want to go murder my boss, should I go murder my boss? No, obviously not. Sometimes you can’t have what you want. Sometimes you shouldn’t hurt other people to get what you want.”

“That’s a very good point. Let me ask you something, why would my telling you to follow your heart and be with Frank, change what you just said about not hurting Paulette and your children?”

“And my parents. And the rest of my family”

“And why would my telling you to be with Frank change how you felt about hurting those people?”

“I guess because you’d be giving me permission. Because you’d be saying being gay isn’t bad, isn’t a perversion.”

“So now you’ve introduced something else. It’s not only about hurting people, it’s about whether you think being gay is bad.”

“Is it?”

“No. But it’s not about what I believe, it’s about what you feel. If you tell me you want to work on the negative feelings you have about homosexuality, I’m happy to do that, but you’ll still have to decide whether or not you want to leave your marriage. And I suppose there’s also the question of whether if you stay in your marriage and feel as though you’re accepting second best, are you making Paulette accept second best as well? Are you depriving her of feeling with someone else the same way you feel with Frank?”

“Oh no! You’ve just made this even more complicated!”  Stan stares at me intently. “Wait a minute, are you a lesbian? Do you feel I should be with Frank? That’s it’s better to be homosexual than heterosexual?”

I’m startled. “Now I’m confused,” I say. “I thought you wanted me to tell you to be with Frank which I certainly haven’t done, but now you wonder if I’m a lesbian because I raise the question of whether staying with Paulette is the only way to not hurt her?

“Wow!” Pause. “I guess it wouldn’t have been all right with me if you’d told me to be with Frank. Even giving me a possible reason to leave Paulette, like it would be kinder to leave her to find someone who was really into her, it… I don’t know. I guess it really scared me.” Pause. “I guess it’s that I don’t want to be gay. I don’t want to be rejected by my family. I don’t want all the hassles gay people have to go through. I just want to be normal, to have things be how they were.”

“And is that possible, Stan?”

“That scared me again. And again made me wonder if you really are gay.”

“I think you are very frightened. And when you feel as scared as you feel right now, it’s easy to think that there’s someone outside of you who’s frightening you, and right now that someone is me.”

“So you’re saying I’m being paranoid?”

“I’m saying right now you feel me as dangerous. And that’s okay. We can deal with that. We can explore what makes you so frightened both inside your head and outside in the world.”

“So you could think that homosexuality was okay and not be homosexual yourself?”

“Yes,” I say, concerned about how much less adult Stan feels to me right now. “Stan, you told me that you came from a Christian, conservative background. I assume the message was that homosexuality was bad, a sin?”

“Definitely.”

“And do you think that’s what’s scaring you now, that you’re afraid if you’re gay you’ll go to hell?”

“But maybe if I give up Frank and stay with Paulette I could go back to having a normal life and be redeemed.”

“I guess you’ve added a whole new dimension to your conflict. It’s not only figuring out what you want and not only trying not to hurt anyone, it’s also wrestling with a difficult religious question.”

“And can you help me with that?”

“Well, I can help you explore your thoughts and feelings, but I can’t answer the religious question for you any more than I could answer whether or not to be with Frank.”

“Thanks. I don’t know why, or how, but somehow I think this helped.”

“I’m not sure why either, but perhaps it was parsing out the different pieces of your conflict so that your feelings don’t seem so overwhelming.”

Undecided

“I appreciate your willingness to see me, even virtually,” Stan begins. He’s a nice looking man who seems anxious, unsure, fidgeting with his fingers, moving in his seat.

“How can I help you?” I ask.

“I just hope you can help me. I want to leave my wife. No, no, that’s not exactly true. I don’t want to leave my wife. I love Paulette. But I have to leave her. I love her and I love my two boys, but I just can’t go on like this. I’m sorry, I know I’m not making any sense.”

“You can say whatever you need to say, however you need to say it.”

“I’m in love with someone else. A man! I can’t believe it. I don’t even know how this happened. I’ve never been attracted to a man before. Or, or maybe I have. I don’t know. But all I know is that I love Frank. I never expected to love Frank, I mean I don’t know if I even liked Frank at first, but then, there it was, he kissed me and I don’t know if I ever felt anything so powerful in my life. So that’s it. I love Frank and I love Paulette. But I can’t keep lying to Paulette. I don’t even know how she hasn’t figured it out. I do everything I can to avoid having sex with her. Not that I mind having sex with her, but it feels like I’m being unfaithful to Frank! Which I know is completely crazy”’ Stan takes a breath. “So that’s the story. Do you think I’m awful?”

“No, of course not. I think you’re in a lot of pain. Can you to tell me a little more about yourself?”

“I’m 38. I’ve been married for 12 years. I have two boys, six and ten. I was supposed to be a physical therapist, but I ended up selling solar panels. I like it. Makes me feel I’m helping people. And the environment. That’s how I ended up in Florida. It’s a good place to sell solar panels. My wife and I are actually from a small town in Ohio west of Cleveland, conservative, Christian area. South Florida was an adjustment, but we’ve learned to love it.” Pause. “‘We’ve learned to love it.’ That’s the problem, ‘we’ has always meant me and my wife. I don’t know. I don’t know if I can leave that ‘we,’ break up my family, have to explain all this to my wife. And to my parents. I don’t even want to think about them.”

 “And if you do think about your parents…?”“They’ll never accept it. I don’t think they’d say they didn’t want to see me again, but I know my mother would cry hysterically and my father would preach endlessly about my going to hell.” Pause. “This whole thing is such a mess. What would I tell my kids? Would my wife keep me from seeing them? No, I don’t think she’d do that. You know, the more I talk about this the more I wonder if I should just leave things as they are, keep lying, keep seeing Frank on the side. Maybe this thing with Frank will just burn itself out. Maybe it’s not love, maybe it’s just lust.”

“Can we talk a little about your sexuality? You said Frank was the first man you’d been attracted to and then you didn’t seem sure of that.”

“I played football in high school. And you know, we’d all be in the locker room, showering, trying to see whose was bigger while pretending we weren’t looking. Sometimes there would be a guy and, I don’t know, I guess you could say I might have been attracted to him, but I didn’t think much about it. I dated girls. I had sex with girls. I met my wife in college, we had sex, we dated a while, we got married and here we are.”

“And how was the sex with girls? With your wife?”

“Good. Good. It was good.”

“But not as good as with Frank?”
“Nowhere near. I never had sex like with Frank. I can see with across the room and all I want to do is jump into bed with him. He was my customer, buying solar panels for his house. At first I thought he was stuck-up, arrogant. Seemed like an awfully big house for one person. When I came by he started asking me to have a glass a wine. And that led to lunch. And that led to sex and where I am today.” Pause. “What do you think I should do?”

“I can’t possibly answer that…”

“What would you say if I was your son?” Stan asks, interrupting.

“What makes you ask that?”

 

“I don’t know. I guess you’re probably about my parent’s age.”

“It sounds as though your concern about what others think makes it hard for you to sort out what you want for you.”

“That’s definitely true.”

“I know you feel a lot of pressure to try and make a decision right now, but I’d suggest that you give yourself some time and that you give us some time to figure out what you really want.”

Forbidden

“I didn’t want to come today,” Marlene begins. “I don’t want to talk about what I know I have to talk about since it’s all I keep thinking about. I feel so ashamed.”

I’ve been seeing Marlene in therapy for a little over a year. She was concerned about being a good mother to her then six month old son, Dereck. She felt her own mother had never wanted children and that she remained cold and aloof until she died of cancer when Marlene was 12. Not surprisingly, Dereck’s vulnerability rekindled many of her own feelings of longing and loss, but nothing springs to my mind as something Marlene might do that would create this level of shame.

“I had this dream,” she begins hesitantly. “Dereck was cuddling in my lap.” Pause. “He was as cute as always,” she says, a brief smile flickering across her lips. She lowers her head. “He was naked. I was stroking his hair. He looked up at me and smiled. He reached up and grabbed my breast like he used to when he was nursing. Then he started stroking my breast. I could feel myself getting aroused.” Pause. “But… but this was the worst part. I stared stroking him back. First just his arms and shoulders. But then… but then I started stroking his penis and his penis started growing really big, almost like he was a grown man. What’s wrong with me?! That’s so disgusting!”

“I appreciate your being able to tell me the dream, Marlene. I realize how difficult it was for you. But you do need to remember it was a dream. You didn’t actually do anything to your son.”

“But it’s so perverted. How could I even think such a thing?”

“I would like us to try and understand the dream. Can you talk about it even though it’s difficult?”

“I guess.”

“You say you keep thinking about the dream, what do you think about?”

“It plays over and over in my mind. I’ve asked myself if I’ve ever done anything inappropriate to my son. Like when I’m changing his diaper. I don’t think I have. I mean I have to touch his penis to wash him, but that seems pretty normal. I thought it was cute, this little miniature penis. Is that all right?” she asks, panic rising in her voice. “Is it okay to think it’s cute?”

“Of course it is,” I say reassuringly. “Let me ask you, the tremendous feeling of shame you’re having, is the feeling familiar to you?”

“I don’t know.” Pause. “I was ashamed about how I thought my mother looked the last months of her life. The nurses would bathe her or change her in front of me, in front of any of us. She looked disgusting. I’d kind of look sideways at my Dad and he’d always have this gentle, loving look on his face and I’d wonder how he could not be disgusted too. They weren’t sleeping together at that point. She was in a hospital bed. But still…” Pause. “But that doesn’t seem to have anything to do with my dream.”

I wait.

“You’re not thinking my father abused me, are you?” she asks, wide eyed.

“No. I wasn’t thinking that. What made you ask?”

“I don’t know. Like my having this disgusting dream about my son and now I’m talking about my Dad. I don’t know. It doesn’t make sense.”

“Sounds like you felt bad for your Dad.”

“I did.”

“Were you and your Dad close during the time your mother was dying?”

“Close? I wouldn’t say that. The only person he was ever close to was my mother. He really didn’t care for anyone else. I mean he must have cared a little about us… and about my stepmother, but my mother was really the only person he loved.”

“Did you ever try to comfort your Dad when he was sad?”

“I think I remember stroking his arm sometime, like maybe even at the cemetery when we buried my mother. I don’t think he even noticed.” Pause. “I was talking to my Dad the other night. They’re going to come visit. It was our usual non-conversation, conversation.”

“When was your dream in relation to your conversation with your Dad?”

“I think it was the same night. Maybe the night after. No, it was the same night.” Pause. “Do you think there’s a connection?”

I proceed cautiously. “Well, your son is certainly a lot warmer and more responsive to you than your father. You stroke Dereck and he gets an erection. You stroke your father and he doesn’t even notice.”

“But I didn’t want my father to get an erection!”

“You wanted your father to care about you, you wanted a relationship like the one you and Dereck have.”

“But it’s not sexual! My dream was so sexual.”

“Longing for closeness can take many forms – wanting to be cared about, wanting to be loved, wanting to be sexual. Especially in the unconscious those get all mixed up.”

“I don’t know. I still feel like a pervert.”

“I know this has been hard for you. It would be helpful if we could continue talking about your longings and it would be especially helpful if you could be less judgmental about yourself.”

The New Year

Heather blows her nose and rubs her very red eyes. “I feel as though all I’ve been doing since the New Year is crying,” she says. “I was sure Rob was it. I even thought he might propose on New Year’s Eve. Instead I just sat there waiting for him. Eventually I got panicked and started calling hospitals. He was always punctual. I don’t know why he couldn’t just call and tell me!”

“There you sound angry,” I say.

“I guess. But I can’t hold on to the anger. Mostly I just feel sad. And I think really stupid things like ‘it’s such a waste’ or ‘he was pretty good in bed.’ I know that’s ridiculous, he is who he is and that’s that.” Pause. “Except that I love him,” she exclaims, crying. “And I thought he loved me. When he finally got the nerve to call on New Year’s Day, he gave me that old line, he loves me but isn’t in love with me. Thought he could make it work until he met Brad and they just clicked. I had the sense they practically fell into bed two minutes after they met. And there I had one of those awful thoughts again. I was going to say, isn’t that what gay men do? I don’t want to be thinking that. That’s not who I am. I’m the most tolerant, liberal person around.”

“Perhaps that’s your anger speaking.”

“Maybe.” Pause. “This isn’t the first time,” she says softly.

“Isn’t the first time …?”

“I was involved with another man who realized he was gay. We weren’t quite as serious as Rob and I, but we’d been going together for a while.” Pause. “I’m not sure why I never told you. It was a pretty big deal to me, especially at the time. And now it’s happened again.”

“What are your thoughts about not telling me about the first man?”

“I’ve thought about it. I think I was ashamed. Ashamed that I wasn’t enough of a woman to hold onto a man. Or maybe ashamed of being a woman, that being a woman in and of itself isn’t enough.” Pause. “I think my mother thought that. I wasn’t enough and she wasn’t enough.”

“Enough for what?”

She shrugs. “Enough to be successful in the world, enough to be smart and educated and intellectual like my father. Enough to hold my father’s interest. He was never interested in her. He’d rather sit around with his fellow professors and have philosophical discussions. You know, I’ve told you, as a family we kind of weren’t. We all went our own way. My father paid attention to me when he wanted to impart some tidbit of knowledge, otherwise I was just kind of there. As for my Mom, we never talked, not even when we went on vacation. Just the two of us. My father never came.”

Heather continues. “You know. I wonder if there’s a connection between my not feeling like enough and choosing – unconsciously choosing – gay men. Almost like – this is ridiculous too – they’re less of a man and I’m less of a woman, so maybe I’d be able to hold onto them.”

“What was it like for you sexually, Heather? Did you feel like less of a woman in bed? Did you feel they were lesser men?”

“They weren’t lesser men. Rob was a very attentive lover, always wanting to please me. In fact, he embarrassed me. He wanted me to tell him what it felt like, what I felt when he’d do one thing or another. I didn’t like all that focus on my body. It embarrassed me, made me self-conscious. He’d always satisfy me, always. That made me uncomfortable too because he didn’t always … umm … ejaculate.”

“And the other man?”

“Now I’m really embarrassed.” Pause. “That was different. That was a lot rougher. Sometimes he’d tie my hands and like take me really hard and fast. It was a turn-on. For both of us. When he told me he was gay I asked him about our sex, about how exciting it seemed for both of us. He said it made him realize how much he wanted done to him what he did to me. That made me feel less than. I couldn’t do what he wanted, not only because I didn’t have a penis, but because I just couldn’t. I couldn’t be that aggressive.”

Heather pauses and then continues. “So what am I saying, that I’m not enough of a woman because I’m not a man? Wow! That’s wild. That’s messed up.”

“You’ve described your father as the source of power in the family, the person both you and your mother hoped to ‘interest,’ so it’s not surprising that only maleness feels like enough. How that relates to your choosing gay men isn’t clear – at least to me – and something we’ll have to continue talking about.”

“Definitely. I’m not interested in repeating this for a third time.”  

How Grown Up Am I?

“My house feels like a morgue,” 20 year old Chelsea says looking down at her hands. “I guess that’s a poor choice of words, since it sort of is, but not exactly. I mean, I’m not happy I had to have an abortion, but I also don’t think it will be the greatest tragedy of my life. And truthfully, I don’t think it’s the abortion that my parents are so upset about. They don’t like the idea that their ‘little girl’ was having sex. It’s not like I’m 14. And Brad and I have been going together for two years. He was pretty upset too. I think he feels guilty that he didn’t use a condom 100% of the time.”

I have been seeing Chelsea for several years now, watching her struggle between wanting to remain the child who is forever taken care of by her parents and striving towards adulthood with her own dreams and desires. We have a close bond although, not surprisingly, her internal struggle is often replayed with me in the consulting room.

“What are you going to use for birth control in the future?” I ask.

“We’re not. We’re not going to have sex.”

I knit my brows, puzzled and skeptical. “You mean you’re not going to have sex until you give yourself some time after the abortion?”

“No. We’re not going to have sex. Or at least not intercourse. Maybe we’ll fool around a little, maybe not.”

“Why?” I ask.

“Why, what?”

“Why did you decide not to have sex? Do you feel more guilty about the abortion than you’re saying? Is it a way to punish yourself?”

“No! For heaven’s sake, I don’t know why you’re making such a big deal about it. You sound like my parents!”

“In what way?”

“In making such a big deal about sex.”

“Wait. I’m getting confused. I thought your parents were making a big deal about your having sex. I’m questioning your saying that you’re not going to have sex.”

“You mean you don’t believe me? You don’t think I can give up sex?” Chelsea says angrily.

“I’m trying to understand why you’d want to give up sex.”

“Because I don’t want to risk getting pregnant again. That seems pretty simple.”

“I hear you’re angry with me but I’m not clear why.”

“Everyone thinks I’m doing something wrong and you’re just like everyone else,” Chelsea says, her voice cracking. “If I say I’m not going to have sex, I’m not going to have sex! End of discussion.”

“And how does Brad feel about that?”

Chelsea crosses her arms in front of her chest and glares at me. “Why should I care how Brad feels?”

Aware I’m feeling more and more confused, I suspect my feelings mirror Chelsea’s own confusion. “Chelsea, tell me what’s going on. What’s going on inside of you? What has you so distressed?”

“Brad wanted me to have the baby. He said we should get married, that we were old enough, that we could both work and go to school and take care of the baby.” She pauses. Tears fall silently from her eyes. “I couldn’t. I couldn’t do it. I’m not ready. I don’t want to be responsible for another person. I don’t want to leave my parent’s house and go off on my own. It’s way too scary. Brad’s really mad at me. I’m not even sure we’ll stay together.”

“I’m sorry, Chelsea. It’s like your parents are mad at you for being too adult and Brad’s mad at you for not being adult enough and each side represents your own conflict about how grown up you feel or want to be.”

“Yeah, that’s right. That’s exactly right.”

“And does my asking you about birth control feel like I’m pushing you towards the adult side?”

“I guess. I hadn’t thought of it that way, but I suppose it does.” She pauses. “So what about my deciding not to have sex? Is that my going towards the child side?”

“What do you think?” I ask, aware that my not answering her question could also be construed as my pushing her to be more adult.

“Yeah, I suppose it is,” she sighs. “But is that so bad? Can’t I take a little break here?”

“You can, but none of us can stop time. We keep growing older whether we like it or not, but that doesn’t mean you can’t have conflicting feelings about growing up and it also doesn’t mean you have to push yourself to act or be more grown up than you feel.”

“Thanks. You gave me a lot to think about.”