Appeasement

“I won’t be here next week,” Mona begins. “I’m going fishing with my parents.”

I feel disappointed for Mona. I’ve been seeing her for a little under a year, working on her need to separate from her parents. A 30 year old paralegal, Mona works in the law firm where her mother was once senior partner and lives in a house her extremely successful father bought for her. Although Mona was raised by a series of nannies during her early years - her parents busy building a business and developing a career – they now crave her time and attention.   

“I know,” she continues. “We’ve talked about it and talked about it. No, I don’t really want to go. No, I don’t like to fish. Yes, it’s awful being stuck on a boat with my folks for a week. Yes, I wanted to save my vacation time so I could go to Europe.” Pause. “And I’m going fishing.” 

“Do you have a sense of why you made that decision?”

“The consequences of not going are too great.”

“And those consequences are?”

“My house. My job. Little things like that.”

“Do you think your parents would take away your house or your job if you said you didn’t want to go fishing with them?”

“It’s important to them. If I can make them happy, why not?”

“What about what makes you happy?”

“Oh yes. There is that I suppose.”

“What would make you happy, Mona?”

“Being on a desert island somewhere, all by myself.”

“Is that true?” I ask.

“Yes and no I guess. In some ways it would feel like I felt as a kid – alone and adrift – surrounded by my books instead of water. There were times that felt welcoming, peaceful. Other times I felt so, so lonely. All I wanted was Mommy or Daddy to come home and be with me. But even when they were home they weren’t with me. And that was worse.”

“So now Mommy and Daddy have come home to be with you.”

“I suppose.”

Pause.

“You know, I’m not sure that’s true,” Mona says. “I mean, yes, they’re always there. I can’t get rid of them. But I’m the Mommy and the Daddy. I have to take care of them.”

“So you’re still not getting what you need. And you’re certainly not getting what you needed as a child.”

“That’s for sure.”

“But I wonder, Mona, if you keep trying, if you keep trying to get what needed from them. If you keep trying to get them to take care of you as you hadn’t felt taken care of as a child.”

“No doubt. Look what I chose as a profession, a paralegal. Not putting paralegals down or anything, but I know I’m smart, I know I could have been anything I wanted to be – a doctor, a lawyer, CEO of a corporation. But, no, I’m a paralegal and Mommy and Daddy get to take care of me forever.”

“That’s really sad, Mona. You’re saying that you kept yourself from realizing your full potential in your attempt to get what you never got from your parents in the past.”

“It’s worse than that. Because what I get from them now are the same things I was able to get from them as a kid – material things. I never wanted for anything materially. But what I wanted was their time and attention. And, yeah, I suppose I do get that now, but it’s really all about them. I don’t even know why I keep trying.”

“I think you do know why, Mona. You keep trying because inside you there’s a needy dependent little girl who yearns for Mommy and Daddy to be home taking care of you.”

“I suppose that’s true.”

“The problem is that you can never make up for that, Mona. The past is past and however much you as that little girl might long for and deserve to have loving, attentive parents, there’s no way to redo that.”

“That’s charming. So what do I do?”

“You - and we - have to work on helping you to mourn that which you never had. It’s hard. It means feeling sad and angry, sad and angry, sad and angry, until you can get to a place of acceptance.”

“Doesn’t sound pleasant.”

“No, it’s a long, difficult process.”

“Meanwhile it will have to wait. I’m going fishing.”   

Mourning

“I still can’t believe it,” Marcy says, tears streaming down her face, her hands clenched into fists. “

I can’t believe my big brother is dead. In an instance. He’d just played racket ball that morning. To die just like that. No sign of any heart problems. I can’t believe it.”

“I’m so sorry, Marcy. I know how important your brother was to you, almost like a stand-in father.”

Marcy nods, sobbing, unable to speak.

“And his sudden death must bring up all the feelings you had as a child when your father died so suddenly.”

March nods again, reaches for a tissue and blows her nose. “That’s why I know Dave did everything he could not to repeat our father’s history, not to leave a wife and young kids. He never smoked, didn’t eat red meat, exercised. And he barely made it into his fifties. It’s so unfair,” she says. “Life is so God damn unfair!”

Silence. Marcy looks up at me and says, “You look so sad yourself.”

Marcy has read me correctly. I reverberate with her pain. Although I never had a brother and my father didn’t die young, I’ve had my share of losses. The intensity of Marcy’s pain brings back the feelings of agonizing loss, of emptiness, of disbelief at knowing you will never again see the one you loved. That life is unfair goes without saying. I no longer rail against that indisputable reality. Loss is a necessary part of love and life. And life without love isn’t worth living.  

I respond honestly. “Yes, Marcy. I am. I feel the depth of your loss, your sadness and just as your brother’s death brings up past feelings about your father’s death, it also stimulates feelings about my past losses.”

“I’m sorry. I didn’t mean to make you sad,” she says, immediately illustrating the problem of a therapist being self-revealing.

“That’s perfectly okay, Marcy. You don’t have to take care of me. You have more than enough to do right now taking care of your own feelings. And, besides, although your pain now feels overwhelmingly agonizing, I know that you wouldn’t have given up having your brother in your life. And that’s true for me and my losses as well.”

“Oh no! I would never have given up having him in my life. Not for a moment. I literally don’t know what I would have done without him as a kid.” Pause. “But I’m still going to miss him,” she adds plaintively. “I feel like a kid when I say that,” she says between sobs.

“We all carry the child part of us along with our adult self, so I’m sure both the adult you and the child you will miss him. Very much.”

Silence.

“You know what you said about my not having to take care of you?”

“Right. You don’t.”

“I was thinking how different that was than when my father died. I was only six, but I felt that I had to take care of my mother. I was supposed to be the one to make her feel better. And I couldn’t do that. She felt bad for a long, long time. I can feel how I felt as that child. That long, long time felt like forever. And while I tried to take care of her, she wasn’t so good at taking care of me. Good thing my brother was 18, or who knows what would have happened to me. Probably shipped off to some aunt I hardly knew. My brother tried hard. But sometimes my clothes didn’t match or my hair was all messy. I don’t remember the other kids making fun of me. They mostly felt sorry for me, but that didn’t feel so good either.”

“It all sounds terribly painful, Marcy. So hard for you.”

“And now I’m back at it again. Trying to make Mom feel better. But it always seems reasonable. First she loses her husband, now her son. What could be worse than that? But I don’t want in that role again. It’s such a burden.”

“Are you concerned, Marcy, that you will need to take care of me, too?”

“No,” she says hesitantly.

“You don’t sound too sure.”

“Well, you don’t seem depressed and you’re certainly functional.” Pause. “But maybe making you feel sad worries me. Like I’m not supposed to do that.”

“I understand, Marcy. We should continue to look at that. And maybe looking at your feelings of needing to take care of me, will help you work through some of the past issues with your mother and free you from the burden of feeling responsible for her happiness.”       

Family Connections

“I’m kind of in a state of shock,” Sheila begins. “My sister was arrested for shoplifting. A lipstick for heaven sakes! She could have bought a million lipsticks! I don’t get it. And she doesn’t seem to be able to explain it. At least not to me.”

“You’ve never talked much about your sister,” I say to Sheila. “What’s your relationship like?”

Sheila sighs. “Pat’s two years younger than me, 36. I guess we’ve never been close. Not as kids, not now when we live less than a half hour apart. She was always difficult, always getting into trouble, creating some drama in the house. She’s very pretty. My father liked that. I guess I was jealous of her. I was the good girl, the one who always did well in school, the one who obeyed the rules. I got points for that, but her looks made her popular with the “in” girls and always got her dates with the most desirable boys. And then she married Cliff, married into all that wealth. She calmed down after that. I thought she was happy. Who knew?”

“Do you still feel jealous of your sister?”

“I guess. It seemed she was always creating problems, but still got everyone to love her. But I don’t know about this time. My parents are definitely not happy. And I can only imagine how Cliff’s family will react.”

“Does that bring you some satisfaction?”

“I wouldn’t say that to anyone but you, but yes, it does. Except she’ll probably get out of this too. And I really shouldn’t complain. I have a great career, a wonderful husband and a lovely daughter. You can’t ask for much more than that.”

“Do you feel less than your sister?”

“That’s a good question. It’s like if I think about my adult self and my adult life, I have absolutely no reason to feel less than Pat – except for her money, but that’s really not the issue for me. It’s these feelings from the past that creep in and suddenly I’m the one who gets to stay home on Saturday night, who watches my father look adoringly at my sister and, yes, I feel less than. Silly, right?”

“Not silly at all, Sheila. Our unconscious is timeless and the experiences and feelings we had at five and ten and fifteen, are as much with us, as our present day experiences and feelings.”

“Makes sense.”

“You haven’t talked at all about your mother’s feelings about you or your sister.”

“I guess that’s because I never knew how my mother felt. About anything. She was always efficient and proper and did the things she needed to do, including taking care of us, and I suppose loving us, but there was a shallowness to her feelings. Or maybe it’s that feelings were too messy. She did what she needed to do, her feelings on the shelf.”    

“So in relation to your mother, your sister and you were equal, neither of you getting very much.”

“Oh, I wouldn’t say that. I mean we may have been equal, but it’s not that we didn’t get very much.”

“Emotionally?”

“Are you saying you think we were emotionally deprived?”

“You were the good girl, your sister acted out. Maybe you were both trying to get more love and attention.”

Pause.

“I wonder if that’s why I sometimes get depressed out of the blue. It’s like everything is going along fine and suddenly there’s this black cloud.”

“That a great insight, Sheila. What you’re saying is that those childhood feelings we were talking about earlier catch up with you and suddenly you’re a kid again feeling needy and ungiven to and depressed.”

“That’s exactly right!” She pauses. “You know, that also makes me feel more sympathy towards my sister. I like that. It’s a new feeling.” Another pause.  “Do you think she shoplifted because she felt needy and thought the lipstick would make her feel better?”

“You’re saying she was trying to nurture herself with a material object, because she didn’t feel given to emotionally. That’s certainly a possibility. And I imagine there’s some anger thrown in there as well. Probably for both of you.”

“Hmm. I’ve never seen myself as an angry person, but I guess we’ll have to talk about that next time.”

“Okay. We will.”  

Welcome Back

Annette smiles wanly when I open the waiting room door, walks slowly into my office, and lowers herself gently into her usual chair.

“Welcome back,” she says with little enthusiasm.

“Thank you,” I reply, surprised by Annette’s distance and reserve. Although this was the Annette who began therapy with me many years ago, our close enduring relationship had allowed her to deal with her childhood sexual abuse and to transform into a warm, open, engaged woman. Now forty-five, she worked as a para-legal and had a full, satisfying life. Although she never married, she had several long-term relationships and a network of close friends. She was usually especially glad to see me after my return from vacation, eager to catch me up on her life.

After a brief silence I ask, “What’s wrong, Annette?”

“I have some really bad news,” she says, her voice barely audible. “I have metastatic colon cancer.”

My eyes widen, tears immediately filling them. “Oh Annette,” I say. “I’m so, so sorry. When did you find out?” I was only gone two weeks I think to myself, aware that I feel guilty I wasn’t here for her.

“Just yesterday. I guess I’m still in shock. I wasn’t feeling well, had some bloating, discomfort. I wasn’t hungry which, as you know, is unusual for me. I thought maybe it was just my usual stomach stuff, but I went to my GI doctor. He examined me and suggested a colonoscopy and a CAT Scan. I was too happy about that. And then the diagnosis, cancer. They want to start chemo. I don’t know. I don’t know what my chances are and if I’m going to die anyway, I’d rather not prolong the agony.”

I’m overwhelmed by sadness, sad for this woman who fought so hard in her therapy to get through the pain of her past, only to now be forced to confront a dire illness and the possibility of death. My own losses flash in front of me as well, my husband to metastatic prostate cancer, numerous friends to pancreatic cancer, liver cancer, breast cancer. The list seems unending.

“I’m sorry, Annette,” I say. “I know I’m not being helpful to you.”

There again is her wan smile. “No, you are. I can see how much you’re affected by my news. That means a lot to me. I know you care for me. I know I’m not just one in a long line of patients.”

“We’ve worked together a time long, Annette. Of course I care about you. And I’ll help you through this however best I can.”

“Will you support whatever decision I make about whether or not to get chemo?”

“I will, but there’s a “but” to that statement. I want you to be sure you’ve explored all your options and know what the doctors think of your chances.”

“I am going to see an oncologist.”

“Good. I’m glad. And I also think you need to give yourself some time. You just found this out yesterday. It’s overwhelming. It’s overwhelming to me, it must be more than overwhelming for you.”

“You’re the first person I told.”

“You didn’t call any of your friends?” I ask, surprised.

“No. I knew I’d see you today. I was afraid if I told anyone I’d totally fall apart. I called in sick to work. I couldn’t bear telling everyone there and I didn’t know if I could fake it. They know I haven’t been feeling well.”

“Do you feel you can tell your friends now?”

“I don’t know. I’ll see.”

“Annette, does this feel like part of the abuse all over again? Like an unwanted, foreign thing invading your body?”

“Oh my God, I hadn’t thought of that! But it’s true. I mean I know it’s not the same thing, but it does kind of feel that way. How did you think of that?”

“I guess because today you’re more like the self I knew when we first started seeing each other – removed, defended, isolating. I know it could be shock, but for you I thought it might be more. And it’s not only the cancer itself, but all the tests you had to take and will continue to have to take. So we’ll need to be sure that your decision about treatment isn’t contaminated by your desire to avoid what might feel like more abuse.”

“You’re right. I wouldn’t want that bastard to destroy me in the end.”

“I wouldn’t want that either. Go see the oncologist, tell some of your friends and hopefully you’ll have  time to decide what to do.”

“See you Thursday.”

“See you Thursday,” I repeat, aware of the now increasing importance of time.