Pretending

 “I did it!” Charlotte says, gleefully.

“Congratulations,” I say enthusiastically, “And welcome back.”

“I’m not talking about going by myself to Italy.”

“Oh! What did you mean?” 

“I did go by myself to Italy. It was hard. And all you’ve heard about Italian men, don’t believe a word of it. No one gave me a second glance. Oh course, why look at a middle-aged woman when you have all these gorgeous young, half-dressed I might add, girls running around. But seriously, don’t you remember what we talked about our last session?”

“I thought I did but… Oh, Charlotte, you really didn’t…”

She smiles broadly nodding at me.

“You pretended you were sick,” I state matter-of-factly.

“Correct! You see, not even you can remember me unless I do something daring, outrageous.”

“Of course I remember you. I didn’t remember that you were considering presenting yourself as someone who was ill, but I remember …”

“It doesn’t matter. I figured out how to get the attention I wanted. The more outrageous I made the story the more attention I got. It’s amazing how solicitous flight attendants can be when you tell them you’re dying of cancer or that you just had a chemo treatment.”

“And is that whose attention you wanted?”  

“Anyone is better than no one, but no, that’s not whose attention I wanted. But it was fun trying out different stories and seeing what provoked the most sympathy or what made people the most uncomfortable.”

“What did make people the most uncomfortable?”

“If they thought I was going to throw up all over them. That was a good one, especially on a plane with the person sitting next to me.”

“Sounds like you took a lot of pleasure making people uncomfortable.”

“Yes, I did. Felt like I was getting back at all the people who’ve made me uncomfortable, people who look at me like I’m ugly or don’t look at me at all, as if I don’t exist.

“What do you feel as you tell me all this?”

“First word that came to me? Triumphant!”

“And since you’ve been home?”

“It’s back to the same boring life. Biller in an ophthalmologist’s office. Real exciting. A great place to not be seen.” Pause. “But I am thinking about bringing my little pretense back home. Maybe in grocery stores or gas stations – I can go someplace I don’t usually shop. I’ve even considered taking it to work. Who’s to say I couldn’t start telling my co-workers I haven’t been feeling well, that I’ve gone to the doctor, that I have some kind of cancer, etc., etc.”

“Charlotte, when you first started talking today I felt annoyed with you, annoyed for the people you were duping and angry that you felt you had to stoop to subterfuge to get people to pay attention to you. But as you’ve kept talking, I find myself feeling sadder and sadder. And I suspect you also feel both angry and sad. You’re such a bright, insightful person. You could do so much more with your life.”

“Except that I’m ugly.”

“I know you feel ugly, and this is something you and I constantly disagree about, but you don’t have to be the most beautiful woman in the room to have friends, to have lovers, to have a job that fulfills you.”

“You mean billing doesn’t fulfill me?” she asks sarcastically.

I sigh. “I know your mother didn’t value you. I know you feel your older sisters were prettier and smarter than you. And given all that, it is still possible to have a meaningful life.” Pause. “You’ve always talked about writing. You certainly demonstrated that you can be creative with your storytelling about yourself. Put the stories down on paper instead of acting them out.” Pause. “I’m sorry. I’m preaching. I know I can’t decide your life for you.”  

“I’m 55 years old. Don’t you think it’s too late for me? How do I change now?”

“You went to Italy.”

“And my most fun was spinning a death fantasy about myself.”

“What was your fantasy about what the trip would be like before you left?”

Charlotte drops her head. “I thought I’d meet the love of my life. I know, that’s stupid, ridiculous. I feel like an idiot even saying it.”

“It’s not stupid, Charlotte, it’s a wish. But maybe it would have been good if we had talked more about your imaginings about the trip before you went so that you could have anticipated several scenarios, thought of the good things that might have happened, as well as the disappointing things. And I know that although many people like it, traveling alone can be very hard.”

Charlotte starts to cry. “It was very hard.”

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.”

You’re Number Five

 “You’re number five,” Alex says upon sprawling languidly in the chair opposite me.

“Number five?” I ask. 

“Yes, you’re the fifth therapist I’ve seen. I liked your website, maybe a bit too sappy, but still pretty good.”

“What happened to the other four therapists?” I say, choosing to ignore his comment about my website.

“I fired them.”

“Because…?”

“Because they weren’t smart enough. Well, I guess that’s not completely true. I saw the first one for maybe a year. He was pretty good, but then I moved, so that was the end of him. The other three I saw here, but like everything else in Florida, they were just too stupid.”

“You certainly sound as though you’re angry, angry and hard to please, like nothing is good enough.”

“Okay, that’s not a bad comment. You’d get about a seven out of ten for that.”

Feeling myself becoming annoyed, I say, “Why don’t you tell me about yourself and about how I can help you.”

“That’s just it, I don’t know if you can help me.”

“Then tell me what brings you here.”

“I’m not happy.”

“Because…?”

 “Because the world is a shit place. Because people are stupid and insensitive and uncaring.”

I hesitate and then decide to say what came to mind for me. “And you see yourself as sensitive and caring?”

Alex laughs sarcastically. “I see you didn’t include smart in that and, yeah, I see myself as smart even though you didn’t ask. Sensitive and caring, not so much, but probably more than you think.”

“Alex, this isn’t a sparring contest. I imagine you are more sensitive and caring than you appear, and that your aggressive, confronting tone is more of a defense against whatever sad or scary feelings lie underneath. If I’m going to be your therapist, I need to have a sense of who you really are, so maybe you could tell me a little about those scary feelings.”

“Wow! You go right for the jugular, don’t you?”

I bite back my first impulse which is to say ‘Takes one to know one,’ assuming that would just continue the one upmanship. Instead I say, “How about telling me a story from your childhood.”

He smirks. “Yes, that’s right, you’re a psychoanalyst.”

Silence.

“Silence. Another tool.”

“I understand that change is hard, Alex, but there’s nothing to be gained by your being here, unless you’re willing to give us a chance as opposed to assuming I’m the enemy or a dueling partner.”

“You’re pretty good. I can’t rile you up.”

“There are lots of clever rejoinders I could give to your statements, Alex, but this isn’t supposed to be a debate. We’re supposed to be on the same side.”

“No one has ever has been on my side.”

“That’s sad,” I say, feeling a ray of hope. “Can you tell me who particularly you were thinking of?”

“My mother died of cancer a year after I was born – although obviously that wasn’t her choice – my father hated me because he was stuck with me, my older brother hated me because he blamed me for my mother’s death, my father’s mother thought I was a nuisance, my teachers all hated me because I was such a smartass – which I was – my wife divorced me and turned the kids against me, etc., etc. Get the picture?”

“Sounds like a pretty dismal picture. But it also seems, at least in some instances, that you’ve helped the picture stay dismal by, as you said, being a smartass which only ends up driving people away. I’m sure that ‘smartass’ way of being felt essential for your survival as a kid, but now it’s a hindrance that drives people away and leads to your being alone and unhappy.”

“I’m not unhappy. I’m just not happy.”

“Not happy and alone?”

“Yes.”

“And sad?”

Before Alex responds I rush to say, “Not a smartass response.”

He laughs. “Yes, and sad.”

“And you’ve been sad most of your life and you cover it over by being sarcastic and pretending you don’t need anyone.”

“Yes.”

“Thank you for giving me genuine responses.”

“You’re welcome. And thank you encouraging me to make that possible.”

“You’re welcome.” 

Pause.

“So are we deciding to work together?” I ask.

“Yeah, I guess I’ll give number five a chance,” he says smiling genuinely. “I promise I’ll be easier on you next time.”

“I don’t imagine you’ll be able to give up your defenses that readily, so I don’t think either one of us should expect you to be an entirely different person by next week. Maybe we’ll just be able to be lighter about your smartass responses, as opposed to thinking you won’t have any.”

“Sounds reasonable, Doc. Thanks.”

Lying Part II

 

“When I left your office last time I was thinking that I’d go home and confess to my Mom that I really hadn’t wanted to kill myself,” David begins immediately. “But that’s not what happened. My Mom had called my Dad and he was there when I got home. He wasn’t happy. He asked me what kind of shit I was pulling, why I had to scare my Mom, that he knew I was just bullshitting and I better knock it off and he wasn’t paying for any wimpy therapy. My Mom jumped in and said she would pay for it, that if her son even had a fleeting notion of killing himself, she was going to be sure he got help. My father exploded. Told her she was an idiot. That she was making me a Momma’s boy and that he didn’t want anything to do with either of us. Then he stormed out of the house.”  

“Wow! I’m sorry David.” 

“I was shaking. I did tell her I liked you and that I promised I wouldn’t kill myself. I asked if she’d really pay for therapy, even if Dad refused and screamed and yelled. She said she would, but I was scared all week it wouldn’t happen. But I’m here!” he says with an almost-smile. “My Mom gave my father the cold shoulder all week and my father hardly said a word to me, but something must’ve worked.”

“And how did all that make you feel?”

“Scared, really scared.”

“I certainly can understand that. But I imagine you must have felt really angry with your father. And how did you feel about your Mom sticking up for you?”

“I was surprised.” Pause. “I guess I really scared her last week,” he says with a sly grin.

“So you’re pleased that you scared her, helped get her in your corner.”

“Oh no, I wouldn’t say that. I don’t want to scare my Mom.”

“Maybe part of you doesn’t want to scare your Mom, David, but I wonder if that’s completely true of all of you. You said last week you were angry at your Mom for always going over to your Dad’s side. But this was one time she didn’t. You won. You told her you wanted to kill yourself and that did it! She was staying on your side.”

“Yeah, I guess that’s true.” Pause. “But that makes me feel bad.”

“I think you do feel bad about being angry, David, particularly at your Mom. That’s why I said last time that I thought your lying was a way for you to express your anger. It’s a way of getting back at her for not always being in your corner.”

“Oh! Now I get it.” Pause. “But it’s not like I feel angry and then deliberately decide I’m going to lie to my Mom to get back at her. Usually I lie to make her feel better.”

“But is that really genuinely making her feel better, David? If you got an A+ on a paper and told her you got an A+ on a paper that would be genuinely making her feel better. But if you got a C on a paper and told her you got an A+ that would be putting one over on her, telling her she can’t make you study more or do better than you want to and that you resent the pressure she puts on you.”

“How did you know that? How did you know that I resent the pressure she puts on me?”

I smile. “I didn’t know that, David. I was actually just making it up but I think it’s pretty common for adolescents to resent the pressure their parents put on them.”

“I guess,” he says, sullenly.

“What’s going on David?”

“What?”

“I don’t know, you sounded unsure.”

Silence.

“Oh. Do you think I’m lying to you? You think what? That your mother told me that she put pressure on you to do better in school?”

Silence.

“I guess that’s a problem with lying, David, you end up assuming that everyone lies to you too. I promise you, I will never, ever lie to you, even if telling the truth is difficult or hurtful. Therapy necessitates openness and honesty and that’s hugely important to me.”

“Okay.”

“Sounds like that means ‘okay, I’ll try to believe you.’ Let me also say, David, that if your Mom or Dad ever contacts me I will tell you that they did and will tell you what they said. And I’d tell them I was going to tell you before they spoke to me.”

“Really? That sounds pretty good. So there would be no secrets?”

“No, no secrets. Oh, I should say if you told me you were going to hurt yourself and I believed that was a real possibility, I would contact your Mom.”

“I get that. That’s okay. I’m not going to kill myself.”

“I’m very glad to hear that.”  

Lying

He sits fidgeting in the chair, alternately looking down at his hands and staring at me. I don’t usually treat 17 year old boys, but his mother was frantic when she called, convinced that her oldest son David was going to commit suicide. 

After several minutes of silence I say, “Your mother was very worried about you. Have you been thinking of killing yourself?”

He wrings his hands, continuing to move jerkily in the chair. “It’s a lie,” he says, almost in a whisper. 

“What’s a lie?”

He swallows. Tears brim in his eyes. “I don’t want to kill myself. I just made that up.” Pause. “Like always.” Pause. “I always lie. I don’t know if I can tell the truth. You know, like that guy Santos, the Congressman,” his words now coming out in a rush. “I wasn’t sure I could tell you the truth. I’m still not sure, but I’m going to try. I have to try. I don’t want to be the laughing stock of the country when I grow up. I don’t want to be the laughing stock of the school right now!”

I flash on a childhood friend when we were both in the third grade. She told the class she had three siblings, although she only had one. Since we lived in the same building the teacher asked me if it was true. I didn’t want to get my friend into trouble so I said I didn’t know. I felt compassion for my friend. I’d seen her mother scream at her and beat her with a belt. I feel a similar compassion for this young man who sits across from me. I’ve known compulsive liars, people who wanted to gain an advantage over others or who enjoyed the power of putting one over on someone. But my guess so far is that isn’t David. 

“Have you always lied?” I ask David gently.

“It’s been worse since high school. But… but I guess I always lied at home. I lied to protect my Mom, to make her feel better. I’d tell her about my friends in school, about how well I did playing soccer. Those were all lies.” Pause. “I know I didn’t make her feel better by telling her I wanted to kill myself. I guess I do sometimes think I would be better off not being here, but I know I said it like I was going to do it any minute now.”

“Why did you want to give her that impression, David?”

“I guess I felt desperate, like I have to talk to someone, to someone I can tell the truth.”

“And what is the truth?”

“I’m a bad person. I hate so many people. I hate my Dad, my younger sister, the jocks in school. Sometimes I even hate my Mom and that makes me really bad.”

“Because?”

“Because she tries so hard. And I know how much she loves me.”

“She tries so hard to…?”

“To make everyone happy. To get along with my Dad. To keep him from yelling at me. But she can’t. And in the end she’ll say, ‘Well you know your Dad just wants what’s best for you’ or ‘You know your Dad’s under a lot of pressure.’”

“So in the end you feel she sides with him.”

He nods his head. 

“And that feels pretty awful.”

“Yes. But I shouldn’t hate her for that. She’s just trying to do what’s best, what’s best for everyone.”

“But maybe doing what’s best for everyone isn’t what’s best for you.”

“I guess.”

“What would you like her to do?” 

“To tell my Dad to fucking lay off!! Oh, I’m sorry, I shouldn’t have said that. I apologize. I…”

“You don’t have to apologize, David. Here you get to say anything and everything you want.” Pause. “Has your Dad always picked on you, David?”

He nods. “He’s a college football coach. As you can see I’m not exactly made in his image. I’m this little, puny, ugly kid who’s sucked at sports all my life. He’s the life of the party. I’d rather go read a book. He can’t stand looking at me. So I make things up. I make myself more than I am.”

“I’m so sorry, David, sorry that your Dad can’t appreciate you for the caring, sensitive person you are.”

“Sensitive is the last thing my father wants me to be. He constantly accuses me of being too sensitive. And if I’m so caring, how come I just scared my Mom?”

“My guess is that you lie as a way of expressing your anger, as a way of fighting back and not being the puny, too-sensitive kid.”  

“I’m not sure I get that.”

“That’s fine, David. It’s kind of a heavy statement to throw at you just as we’re ending this session. We can pick up from here next time.”

“So you will work with me?”

“Definitely. It would be my pleasure.”

Please Help Me

 “My name is Lisa Henry. I’m forty. And I’m desperate. If you can’t help me I don’t know what I’ll do,” says this clearly anxious woman whose appearance reminds me of the stereotypical 50s housewife, page boy hair style, pink dress gathered at the waist, flaring outward. “Can you help me?”

“I think you’ll first need to tell me what you need help with.”

“My son.”

Silence.

“He… he just told me that he’s … that he’s gay,” she says taking a deep breath. “There, I said it!” 

“I gather that’s a problem for you?”

She looks startled. “Of course it’s a problem. How could it not be!”

“Is it a problem for your son?”

“He says it isn’t, but that’s impossible. He was a normal boy. He played baseball. He was always popular.” Pause. “And he grew up in our family.”

“And what was it like growing up in your family?”

“We’re a Christian family. My husband is always praying and reading the Bible. And of course we pray as a family before every meal. We eat together. There are seven of us. My son – the one I’m talking about – he’s my eldest. My husband will never, ever accept this. I’m afraid he’d disown my son, but that’s not going to be necessary because you’re going to help me, right?”

“Mrs. Henry, exactly what do you want me to help you with?”

“Telling me how to convince my son he’s not gay.”

“I’m sorry, but there’s no way I can do that. I can’t convince anyone that he isn’t gay and I can’t help anyone to change in any way who isn’t in my office and who doesn’t want to change.”

“That’s the first thing we need to do. We need to convince him he does want to change, that he isn’t gay and if he needs to see you that’s fine.”

“I’m sorry, Mrs. Henry. I can’t do that. I can help you try to come to terms with your son being gay…”

“No way,” she interrupts. “You have no idea what you’re saying! I could never accept such a thing. And even if I could … could … I don’t know, … pretend it’s not happening, my husband would never, ever be able to even look at my son again.”

I realize I have been so taken aback by this woman’s request, that I have been debating with her, rather than dealing with her underlying feelings. “That’s really sad, Mrs. Henry. You must be feeling very sad and scared that there’s going to be this tremendous breach in your family and that you might even lose your son.”

“No, no, no. That’s not going to happen. It can’t happen again. It can’t,” she says, starting to cry.

“I’m sorry, what do you mean it can’t happen again?”

“That’s what happened to me.”

I look at her, totally bewildered.

“I lost my family,” she says in a whisper. “My family were orthodox Jews. When I married outside the religion my family sat shiva for me. I haven’t seen any of them since.”

“I’m so sorry. That must be terribly painful.”

She nods, as tears fall down her face. “But I thought I put it behind me. I made my own family. And I was always going to have that family, the family I have now. You see, that’s why you have to help me, you have to help me not lose another family.”

“I understand why you feel so desperate, but there are some things I can help you with and some things I can’t help you with. I can help you to grieve the family you lost, your family of origin. I can perhaps help you to accept your son’s gayness. And I might even be able to help you find a way to talk with your husband about your son…”

She shakes her head vigorously.

“I understand that seems impossible to you now and it may be impossible, but I can help you to maintain a relationship with your son regardless of how your husband feels…”

“No, that’s not possible either. He would never allow it.”

“Do you love your husband, Mrs. Henry?”

“Yes, of course, what kind of question is that?”

“Does he love you?”

She hesitates for a moment but says, “Yes, yes of course.”

“So your relationship is important to both of you. Perhaps that means you could talk, negotiate…”

“No. My husband makes all the decisions.”

“And did your father make all the decisions?”

“Yes, yes he did. How did you know that?” 

“Different religion, but similar way of being in the world.”

“Yes, that’s true.”

“Mrs. Henry, our time is almost up for today and I don’t know if you want to continue working with me or not. I can’t help your son be not gay. I can help you deal with the very painful situation you’re in now, which also brings up a very painful loss in the past. But you’ll have to decide if that’s the kind of work you want to do before you decide whether or not to work with me.”

“I don’t know.” Pause. “Can I think about it?” 

“Of course. Just call and let me know what you decide. And know that regardless I wish you the best.”