Inside/Outside
Showing posts with label therapist-patient relationship. Show all posts
Showing posts with label therapist-patient relationship. Show all posts

Friday, July 16, 2021

Too Close

 

“I went out with Charles again last night,” Ashley begins. “You know the guy I met on Match who I’ve been out with a few times.”

“I remember,” I say, nodding at the computer screen. “You kind of liked him.”

“I guess, but he was a little too much last night.”

“Meaning?”


“I don’t know. Like he started telling me all about his childhood, which was pretty terrible. He was physically abused by his mother, like really bad. And he wanted to know all about me. I’m not sure I was ready for that.”

“What made you uncomfortable?”

“What if we don’t work out? Why should I tell him all about me? Does he really need to know that my mother died of cancer when I was four and that my father wanted nothing to do with me?”

“I’d say there would be no reason for him not to know.”

“I never understand why you feel I should be blabbing my whole life to anyone and everyone.”

“Well, if you’re not presenting who you are to people it’s kind of impossible to get close to them and it takes a lot of energy to be play acting through a large part of your life.”

“Aren’t you play acting? Isn’t being a therapist all play acting?”

“In what way?”

“You could be in terrible pain right now, physical or emotional, and you wouldn’t tell me about it, right?”

“That’s true. We do all have roles that we inhabit in our lives and…”

“See, I told you! So I’m no different than you or anyone else!”

“We all have roles that we inhabit. Being a therapist is one


role, just as being an attorney is another. And, no, in our professional roles we’re not telling everyone everything about us. You’re not going to be in front of a judge and say, “Your Honor I can’t try this case today because I had to put my dog down yesterday and I’m a total basket case. But yesterday, when you put your dog down – obviously I’m just using that as an example – would you have been able to call a friend and say I need to talk?”

“I don’t have a dog,” Ashley says matter-of-factly. “I don’t want a dog.” Pause. “Actually, dogs are kind of like that guy last night. They want too much. They’re always there, always begging. I guess you’ll say that’s my need to keep my distance.”

“Yes, I would. And there’s the question of why that distance feels so necessary for you.”

“It just popped in my head that we’re back in your office next week. I don’t like that idea either. This is much more convenient. I don’t have to drive to and from your office. I don’t have to waste time sitting in your waiting room. I just turn on my computer screen and here you are.”

“So I assume by bringing that up right now, you’re making the connection that returning to my office feels closer – literally and figuratively - than virtual therapy.”

“Right. And I’d prefer continuing just as we are.”

“So do you have any thoughts about what makes closeness so uncomfortable?”

“It’s messy. People are just so needy. They want so much. Just like a dog.”

“Are you needy, Ashley? Do you want so much?”

“Me? No way! I can take care of myself.”

“I think you learnt that early on. If there’s no one really there for you, you learn that you have to take care of yourself.”

“Right!”

“But there’s a problem with that, Ashley. When you were four years old you couldn’t take care of yourself. You were a helpless, dependent little girl who just lost the most important person in your life. That little girl is still inside you. She still wants and needs and longs for someone to care for her…”

“Ugh! That’s disgusting. I hope that’s not true. And if it is true I want her gone, poof! Like she never existed.”

“I wonder, Ashley, if that’s exactly the reason you didn’t like the man you saw last night and the reason you don’t want to return to in office visits and the reason you don’t want a dog, all of that brings you closer to that dependent, childhood part of yourself.”


“So what should I do about it?”

“Well, first we’ll resume in office visits and we’ll talk about how that feels for you. And when you’re with someone and feel the need to get away, maybe you can try to pay attention to what you’re really trying to get away from. I suspect it might be the needy part of yourself.”

“What if I just avoided people?”

“Well, what do you feel when you avoid people? What did you feel when we were locked down in the pandemic?”

“Lonely. Like something was missing.”

“I guess that’s your answer.”


Tuesday, December 15, 2015

Frustration

Jennifer Holland sighs deeply as she settles into the chair. “Well, another holiday season is upon us and I’m alone.”

“I thought both your sons were coming with their families,” I say too quickly and concretely.

She sighs again. “It’s not the same.”

“You mean your husband Dave isn’t here?”

Her eyes fill with tears as she nods. “It’s been five years since he passed. Five years of being alone.” 

“I understand that no one can replace Dave, but that doesn’t mean you’re alone.” 

“It’s not the same,” she repeats.

I’m back in a familiar place with Jennifer. I do understand her feelings. As a widow myself, I know all too well that the holidays bring one’s sense of loss and loneliness to the foreground. But Jennifer’s inability to appreciate what she does have, to take in anything positive from anyone – including me – leaves me feeling angry and frustrated.

“I know it’s not the same, but I wonder how your sons would feel if they heard you discounting their love and caring.”     

“They can’t understand. I know they lost their father, but they have their own families, their own lives.”

Feeling my anger rise, I wonder if I am feeling not only my own anger, but Jennifer’s as well. “Are you angry that your sons have their own lives, that they’re not here with you?”

“I’d prefer they were here. But boys don’t stay with their mothers. I have friends who are widows whose daughters live nearby. I get jealous whenever they bring up spending time with them. But me, I’m alone.”

“You just said you have friends,” I say, immediately aware that I am fruitlessly attempting to change Jennifer’s mind. 

“Yes. But they’re just friends.”

I try to get beyond my frustration and my wish for Jennifer to be different and say, “Do you hear yourself reject anything positive you might receive from anyone: friends, your sons, me?”

“But it doesn’t feel positive.”

Stymied again.

“What would be positive?” I ask.

“Having Dave back,” she says, crying.

From most patients, I would experience such a statement with great empathy. With Jennifer, I feel only anger. “I’m sure that’s true,” I say, trying to conceal my anger, “But you can’t have Dave back.”

“I hate when you say that!”

“Do you hate me?”

“No, I could never hate you. You’re trying to help me.”

“Are you saying you feel that you’re not allowed to hate me because I’m trying to help you?”

She nods.

“But you might hate me even if you feel you shouldn’t.”

“You’re confusing me. Besides, I don’t know why we’re talking about this. I want to know how to be less alone.”

I’m ready to scream. I try to step back and understand what’s going on between us. What I feel is that Jennifer is determined to spit me out. Well, I think, maybe that’s a starting place.

“Jennifer,” I say, “I know that your life has been unbearably sad and painful since Dave’s death, but my experience of the immediate right here and now, of this session right at this moment, is that you reject anything I offer that might help you to feel less alone, like you’re spitting me out.”

“But you haven’t said anything to make me feel less alone.”

“If you’re saying I haven’t said anything that’s going to bring Dave back, that’s true. If you’re saying you’re unwilling to take in anything that might make you feel better unless it’s bringing Dave back, I’d say you’re holding out for the impossible. And if you are saying you’re going to reject anything that isn’t going to bring Dave back, I’d say that’s what we need to work on.” Am I being too harsh, I wonder? Is my frustration turning into hostility?

“I don’t know what you want from me,” Jennifer says plaintively. 

Yes, I’m being too aggressive but Jennifer’s passivity and sense of entitlement is difficult for me to handle. I try to soften my tone. “Can you say what you’d like from me, Jennifer? Or what you think you might be able to do to help yourself to feel better.”

“I don’t know,” she laments. “I thought you were supposed to tell me that.”

“It’s so, so hard for you, Jennifer, to take in positives, to feel good about your sons coming, to feel pleased to have friends.”

“It’s not enough.”

“I understand they’re not Dave. But maybe you won’t be able to begin to take in the positives in your life until you’re able to accept that regardless of how much you might want it, Dave can’t come back.”

“I hate when you say that.”

“I know. It’s a reality you don’t want to accept.”