“I think I’m going to sell my house,” Marybeth says. “It’s just too much for me to handle on my own. I’m sixty-five. It’s enough. Every time I turn around there’s something else going wrong. Last month the air-conditioner went. This month there was a roof leak. I don’t have it in me to keep dealing with it all. When Phil was alive it was different, we could share the burden. Now it just feels overwhelming.”
Tell me about it, I think to myself. I just had carpets pulled out of my house because of water damage. Juggling adjusters, repair men and my work schedule was no mean feat. And, yes, it certainly would have been different if my husband was alive. George was a contractor who once could have done all the work himself and certainly could have expertly supervised everything that needed doing. His absence has felt particularly acute. But I’m not selling my house. No way. “How would it feel to sell your house?” I ask Marybeth.
“Sad,” she answers immediately. “It’s where Phil and I raised our kids. There are so many memories there.” She pauses. “I wish you hadn’t asked me that. I don’t want to feel sad. I don’t want to keep missing Phil. It’s been three years already. I should be over feeling sad.”
I smile inwardly. It’s been over seven years since George died and although I no longer cry every day, I never don’t miss him. “There’s no statute of limitation on feeling sad about the death of someone you love,” I say gently.
“But I don’t want to stay in my house anymore,” Marybeth says emphatically.
“Did you hear me telling you you should stay in your house?” I ask, furrowing my brow.
“You focused on my sadness, rather than on my relief, my moving forward.”
I’m taken aback by Marybeth’s response. Was I being too negative? Was I encouraging Marybeth to stay stuck in the past, rather than, as she said, moving forward? Was I putting my sadness onto her? Suddenly I flash on my overwhelming feelings of sadness and despair when I left my Michigan home for the last time. The pain felt almost unbearable, but I was still leaving. Yes, that’s the problem, Marybeth was confusing feeling and action.
“Well?” she says, impatiently.
“Well?” I think to myself. I had only been lost in thought for a few seconds.
“Can I ask you, Marybeth, what did you feel in the few moments that I was silent?”
“I thought you were pulling that silent therapist technique on me.”
“But what were you feeling?”
“I don’t know. Annoyed, I guess.”
“It’s hard for you to feel sad, Marybeth. It makes you feel “weak” and vulnerable and you want to get away from those feelings. So if I ask how you feel when you think about selling your house and you feel sad, you immediately think you can’t sell your house because you have to get away from your sadness. And if I’m silent for a bit, you feel I’ve left you alone with your sadness which feels intolerable to you, so you become annoyed with me instead. Does that make sense?”
“Yes, but don’t you think I’ve felt enough sadness?”
“I’m not saying you should feel sad, Marybeth. I’m not trying to torture you. I’m saying that when you do feel sad, you need to allow yourself to feel what you feel. You can still do things – such as selling your house – even if selling the house makes you sad. It may also make you feel relieved and content and free. It’s possible to feel more than one feeling at the same time and a feeling doesn’t mean you can’t act despite what you’ll feel.
Marybeth’s eyes fill with tears. “I’m so tired of feeling sad. I don’t want to sell my house. I don’t want Phil to be dead. I sound like a spoiled brat, wanting what I want.”
“You don’t have much compassion for yourself, Marybeth. You don’t sound like a spoiled brat. You sound like a grieving widow who is thinking about yet another loss, your home, and feeling understandably sad about it.”
“I hate it.”
“I know.”
Loretta Fischer has come into my office for the first time. She is an impeccably dressed, slender woman, who sits primly across from me, fidgeting slightly in the chair, staring at me expectantly.
I oblige. “What brings you here?” I ask.
“I’m just not happy,” she replies. “I’m alone. My husband died five years ago, my children are scattered all over the country. They call fairly regularly, but they’re not going to be keeping me busy on Saturday night. You know, I do the usual things women my age do, I play cards three days a week, go to the gym, go out to dinner and to the movies with friends.” She sighs. “It’s boring. I used to be an administrative secretary. My boss really relied on me. I was important. Now I’m nothing.”
“Now you’re nothing?” I say. “That’s a pretty dismal assessment of yourself.”
She shrugs. “That’s how I feel. I’m not a wife, not a mother, not a worker. I’m nothing.”
“What about your friends? The women you go out with?”
“They’re just women to go out with. They’re not really friends. Women my age don’t make friends.”
“How old are you?” I inquire.
“That doesn’t matter. What matters is that I’m unhappy.”
I’m startled. Loretta alludes to her age twice in a brief period of time and then refuses to tell me her age when I ask. Is she provoking me? “Is there a reason your age is a secret?” I ask.
“You know it’s not polite to ask a woman her age. How would you like it if I asked you your age?”
This is beginning to feel like a minefield. In a matter of minutes, what is usually the friendly getting to know you beginning of therapy has evolved into a confrontation. I suspect that Loretta is not only unhappy, but quite angry as well. “Well,” I respond gingerly, concerned that I’m moving too quickly, “I actually wouldn’t object if you asked me my age, but I think the more important question is whether your manner of responding reflects both your need to protect yourself and your anger at having to give anything of yourself.”
“What are you talking about?” Loretta says sternly, knitting her brows. Then she sighs and shakes her head. “They told me you were an excellent therapist, not like the others I’ve seen. They said you were more real. And here you are spouting the usual kind of nonsense. Your whole field is ridiculous.”
I feel scolded, diminished and angry. As these feelings wash over me, I realize that in very short order, Loretta has enabled me to feel exactly what she feels, “like nothing.” I’m torn about how to proceed. I wonder how many therapists she’s seen before me. I wonder if her age is a particularly sensitive issue or if she unconsciously needs to bate me. Regardless, I need to mend the breach in our relationship if this therapy is to have any chance of succeeding. “I’m sorry, Loretta,” I say. “I am getting way ahead of myself. But let me ask you something, you say you feel like nothing because you’re not a wife, a mother or a worker, what did you feel before you were wife, mother and worker? Did you feel like nothing then too?”
“Are you trying to get me to go back to my childhood? Another piece of nonsense. I suppose everything is my mother’s fault?”
I feel my anger rise. But maybe she does think everything is her mother’s fault. Her anger and criticalness and feeling like nothing have to come from somewhere. “Loretta, my sense is that you’re angry. I don’t know yet what or whom you’re angry at, but I do know that it took next to no time for us to be at odds with each other. I get that you’re unhappy and I’m sure it feels awful to feel like “nothing,” but I do think it’s important for you and for us to understand where that feeling comes from in both the past and the present.”
“So you’re assuming I’m coming back?” she says smugly.
“I don’t know if you’re coming back, Loretta. That’s something you’ll have to decide. But I do know that most everything you say feels like a provocation to me and I can’t imagine that would be helpful to you in your life.”
“I’ll make another appointment and we’ll see.”
I bite back the answer that comes to mind, “We’ll both see,” and settle for, “Seems fair. We’ll meet again and see what develops.”
“I’ll never be able to have sex again,” sobs 22 year old Ashley, her face, buried in her hands with her long brown hair falling forwards, her voice barely audible. “I don’t know how I could have been so stupid. I know better. I’m not some dumb freshman, for God’s sake. I know you don’t get drunk at a frat party and go have unprotected sex with some guy you’ve never met before. My life is over!” she wails.
It has been a month since Ashley confirmed that she has herpes. We have been dealing with nothing else since her diagnosis. She is understandably distraught, unable to move beyond the feeling that she has forever ruined her life.
I think about some of the patients who have, over the years, told me about having herpes: The 60 year old woman who felt forever dirtied and punished by God. The session with a man who began by saying he needed to tell me his “secret,” and was then for so evasive, that I became afraid he was going to tell me he had committed murder. The young woman who said she contracted herpes after she had been drugged and raped, only to tell me months later that she had fabricated that story to hide her shame. All tragic stories that forever cast a shadow over the person’s life. And now there is Ashley.
“I can’t believe I’ll never be able to have sex again. I’m only 22. I’ll never get married. Never have children.”
“Ashley, I’m by no means minimizing the pain and difficulty of having herpes, but it doesn’t mean you can’t have sex or get married or have children,” I say, trying to temper Ashley’s overwhelming feelings of despair.
“And risk doing to someone else what that asshole did to me! Never!!”
I think about the anger that almost invariably accompanies contracting herpes: the 60 year old who talked of being punished by God, my fantasy that my male patient might have committed murder, the young woman who fabricated a story of rape. Rage makes its way into the experience one way or another.
“I certainly understand your angry at that guy.”
“Yeah, I’m angry at him. Lot of good that will do me.”
“Well, it’s important that you’re aware of your anger, rather than being scared of it.”
“What are you talking about?”
“You’re angry. You’d love to get back as this guy, but there’s really no way to do that. So you feel powerless and that makes you even more angry.”
“So, yeah, and what does all that mean?”
“You notice, Ashley, that you’re also getting angry with me, which is perfectly all right, but I think it’s an indication of how angry you feel and how easy it is to direct your anger at me or someone else.”
“Sorry.”
“You have nothing to apologize for. It’s just important that we look at what’s happening and try to understand it because I think it’s related to why you think you can never have sex again or get married or have children. I think you’re afraid – not consciously, of course – that your anger would spill over to a new partner, that perhaps you’d want to give him herpes, just as it was given to you.”
“No way” Ashley says, shaking her head emphatically, her hair flying from side to side. “I’d never, ever want to do that to someone else.”
“I know you’d consciously never WANT to harm someone else, but your unconscious desire for revenge is another matter. If you’re afraid of wanting to hurt, you might try to protect others from what you’re afraid is your dangerousness by depriving yourself of the pleasure of sex and marriage and children.”
“But how could I possibly have sex with someone and know I could harm him - especially if you’re saying I want to harm him?”
Although Ashley’s question might sound as though she’s still stuck, I hear some hope for she’s at least considering the possibility of having sex again. I reply, “It’s not that you’d want to harm a new partner, it’s that you might be afraid your anger could be expressed in that way. And the more we can deal with your anger here, the more you know about your anger, the less afraid you would be of expressing it unconsciously.”
“Roberta keeps saying that she has no life, that the only thing she does is run in circles doing her mother’s biding and that no matter what she does it’s never good enough for her mother anyway.”
So begins Dr. Kaitlyn Rose’s supervisory session. She is a 32 year old psychologist, licensed for two years, and struggling to establish a private practice. Like many young professionals she has discovered that her formal graduate school training, including her internship, has not adequately prepared her to deal with real patients in the real world. Recognizing that she could benefit from the expertise of a more seasoned professional and having heard me present at a seminar, she asked if I would supervise her. I readily agreed, both admiring her awareness of her own limitations and appreciating the chance to impact the clinical skills of a new generation of therapists.
Dr. Rose continues: “I keep asking Roberta why she tries so hard when she knows that her mother will never be satisfied, but she just shrugs and tells me she has no choice. Besides, she says, she has nothing better to do anyway. So then we start talking about how she spends her days and how empty her life is and how come she never got married, and so on and so forth.”
“So how do you feel as you tell me this Kaitlyn or as you listen to Roberta?”
“Frustrated. I feel frustrated. I can’t do anything to help her.”
I smile. “Interesting, isn’t it, that you feel the same way in relation to Roberta as she feels towards her mother. Nothing you do can help; nothing is good enough. It’s a parallel process, you’re enacting the same experience with Roberta as she’s enacting with her mother.”
“That’s true,” Kaitlyn replies pensively. “I never thought of that.” She pauses. “But I have to do something!” she exclaims.
“Because…?” I ask, provocatively.
“Because that’s what therapists do, we help.”
“So you have no choice but to try and help, again, just like Roberta has no choice but to try and help her mother. Let me ask you this, why do you think Roberta keeps trying so hard with her mother?”
“I don’t know. She won’t tell me.”
“But what’s your guess?”
“I have no idea.”
I feel my own level of frustration rise. Is this yet another parallel process, my enacting with my supervisee what she enacts with her patient which the patient enacts with her mother? A never-ending series of mirrors that enables me to feel the frustration and powerlessness of desperately wanting to make someone different. “Let me ask you this, Kaitlyn, why did you want to become a therapist?”
“So I could help people.”
“Yes, I’m sure that’s true, but why do you think it was important for you to help people?”
Kaitlyn blushes and averts her eyes. “I…I… My mother was very depressed. I know it’s childish but I think I believed if I became a psychologist I could help her.”
“No, Kaitlyn, it’s not at all childish. I don’t mean to intrude into your personal life. That’s not my place here. I was just trying to show you that we all have complex reasons for everything we do and, as you just said, your need to help people, to change people, was fueled at least partially by your desire to change your mother. And I’d venture to guess and you don’t have to tell me if I’m right because, as I said, I’m not your therapist, I suspect you felt the need to change your depressed mother so that she could be more available to you, be the mother you needed and deserved as a child.”
Kaitlyn’s eyes fill with tears.
“So now what might be your guess about why Roberta keeps trying and trying to please her mother?”
“I get it,” Kaitlyn says, nodding sadly. “She keeps trying because she keeps hoping that her mother will approve of her, love her, give her what she always wanted.”
“That’s really well put, Kaitlyn. Roberta and you and me and the rest of the world, we keep trying and trying to win with the parent or parents we lost with, hoping to win in the present that which we lost in the past, hoping against hope that we will finally feel like the loved, valued little child. And the process of giving up that hope is a long and painful one.”
“I just ended another relationship,” says Brittany settling herself into my chair for the first time. She’s an attractive enough woman probably in her early 40s, simply dressed in black pants and a gray sweater. She didn’t smile when I greeted her in the waiting room, just extended her hand. Her eyes didn’t smile either. She continues.
“I told myself I’d give it a year and I did. We got together last New Year’s Eve and I broke up with him this January 1. He was a nice enough man. But I can’t do it. I can’t be in a relationship. It’s like torture to me.”
Torture, I think to myself. What a strong word.
“I know it’s not normal,” Brittany continues. “That’s why I promised myself I’d go into therapy if I couldn’t handle this relationship. I’ve been in therapy several times, but maybe I’m more ready now. I certainly know this is my problem. Way too many relationships to think it’s the men’s fault. I don’t usually last a year, but that’s what I said I’d do, so I did.”
Questions swirl through my mind: What makes a relationship feel like torture? Do you feel smothered? Are you so terrified of loss that you can’t allow yourself to connect? Did your relationship with your previous therapists feel like torture also? Will you need to escape our relationship as well? I decide on a far more innocuous statement.
“Sounds like when you make up your mind to do something you certainly follow through.”
Brittany’s mouth forms an almost-smile, while her eyes brighten slightly eyes as well. “That’s definitely not my problem. If I decide to do something, I do it. I wouldn’t be where I am today if it weren’t for my determination. I own a chain of yogurt stores and am about to start franchising nationwide. Not bad for an abandoned orphan left by the side of the road.”
“Literally?” I ask, surprised.
“I’m exaggerating about that side of the road bit, but my parents were a piece of work. They were both drug addicts and definitely didn’t know what to do with a baby. At some point they just left me. Social services got involved and I went from one foster home to another until I was 10 when one family finally kept me until I was 16. Then I got myself declared an emancipated minor and went off on my own. And the rest is history.”
“That’s an amazing story, Brittany. A really sad story, but you tell it with no feeling at all.”
“I’ve repeated it a million times.”
“But you still must have feelings about it. About your parents abandoning you, about your going from one home to another, about the family you lived with for six years.”
“They were good-enough people. The family I lived with for six years. But it was the same problem. They wanted something from me I couldn’t give them. They wanted me to love them, to be a part of their family, to remember birthdays and care about Christmas. I don’t have it in me.”
The room feels heavy, steeped in despair, although I suspect I am the only one who feels it. Brittany is removed, protected by a suit of armor she constructed early on to shield her from repeated abandonment and neglect. How could she ever allow herself to care for another person who would likely, yet again, toss her aside? “Left on the side of the road.” That is her metaphor for her life. Brittany cannot allow herself to get any inkling of the scared, vulnerable, needy child who exists inside her. Instead, she prides herself on her truly amazing success, unaware of her underlying hunger for human connection.
“How do you feel about not having it in you?” I ask.
She shrugs. “I know there’s something missing in me. And when I look around and see people, I can tell that relationships add something to their lives. So I guess I’d like to find out what’s missing.”
“I suspect, Brittany, that it’s not so much that something is missing, but that you’ve buried your hurt, neglected childhood feelings deep inside you and that when a potentially close relationship threatens to expose those feelings, you feel you’re being emotionally tortured. Then you bury the feelings even deeper and run away. It’s as though you’re saying, ‘I don’t need anyone and no one can hurt me ever again.’”
“I get the wanting no one to hurt me again, but I don’t know about my being afraid of needing anyone. I don’t think I do need anyone. That’s the problem.”
“Well, I guess that’s something we’ll find out as we go forward,” I say optimistically. In my mind I add, assuming I’m able to keep you in therapy.
“I’ve decided this is going to be our last session,” Beth begins. “It’s the end of the year, so it’s a good time to wrap things up.”
I’m beyond startled. I’ve seen 32 year old Beth in twice weekly therapy for over three years. She hadn’t said anything about wanting to terminate and I hadn’t picked up any clues in her material. Besides, we have a relationship and a relationship requires time to say good-bye. Termination is the part of therapy I like the least, feeling the pain of losing the connection with a person I have come to know intimately over an extended period of time. But I do know that all relationships end and that the process of leave-taking, although often painful, can be both rewarding and growth producing.
Beth has certainly made progress in her treatment. She no longer experiences sudden panic attacks nor feels overwhelmed by life’s small difficulties. However relationships continue to be a problem for her, as she vacillates between excessive clinginess and total indifference, a repetition of her experience with her mother. I’m now experiencing the indifference side of the equation and I don’t like it at all. I feel discounted, dismissed and discarded.
“Are you dismissing me, Beth, just as you felt dismissed by your mother?” I ask.
Beth rolls her eyes, crosses her arms and jiggles her leg. “Do you have to interpret everything?” she says, clearly exasperated. “It’s time, time for me to go. I’ve been here long enough. Besides, like I said, it’s the end of the year.”
Trying to keep my annoyance in check, I ask, “Have you been thinking about this for a while because if you have, I wonder why you hadn’t mentioned it?”
“No, not really. I just decided.”
“’Just’ meaning …?”
“I don’t know,” she says, tossing her head. “Sometime during the week.”
‘The week’ I think to myself. That’s right, because of the holidays I only saw Beth once last week and am scheduled to see her only once this week as well. She also spent Christmas with her family which is guaranteed to bring up issues. I decide to explore the family question first.
“Did something come up with your family at Christmas?” I ask.
“No,” she says casually, indifference oozing from every pore. “It was the usual zoo. My mother totally frazzled and expecting me to know what she wants me to do by reading her mind and not asking me a single thing about my own life. So what else is new? It was fine,” she adds, shrugging again, “Just one day in the year.”
So Beth felt dismissed by her mother and, in turn, is now dismissing me. But she also felt dismissed by me, because I treated Christmas like, “just one day,” rather than appreciating that she might have feelings about us not meeting. Beth needs to feel important without feeling intruded upon, not always an easy tightrope to walk. And she doesn’t like to be reminded of her need to rely on me, which makes the tightrope even more slippery.
“Several things occur to me,” I begin.
“I’m sure,” she says snidely, interrupting me.
“But maybe we should look at why you’re taking jabs as me today,” I say, putting aside what I planned to say.
She shrugs.
“So let’s say you’re angry with me.”
“Why would I be angry with you?”
“Well, I know you knew we weren’t going to meet on Christmas or New Year’s, but I think I took that too much for granted without giving you the opportunity to talk about how you felt.”
“You think I can’t live without you for a day?”
“I didn’t say you couldn’t live without me, I said you might have feelings about us not meeting. And you might have felt dismissed by my not giving you the opportunity to talk about those feelings.”
“You sure you just don’t want to lose a patient?” she asks, with less of an edge to her tone.
“I don’t want to lose you, Beth. And whenever you do decide you want to end, I want us both to have the time to deal with saying good-bye.”
“OK. I’ll stay.”
I look at Beth quizzically. “Had you really planned to terminate today or did you want me to show you that I cared enough to talk you into staying?”
She purses her lips and taps them with her finger, looking almost child-like. “I had decided to terminate. But I guess down deep I wanted you to change my mind.”
“I’m glad you could see that, Beth. And I don’t think either one of us is ready to say good-bye.”
“What should I do?” Janet asks plaintively as tears stream down her cheeks. “I always hate this time of year, but this is the worst. I don’t know why they have to go visit his mother. She has two other kids who could have visited her. Me, I have no one. I’m all alone.”
Aware of many thoughts and feelings churning inside me, I opt for an empathic, but relatively neutral response. “I understand it feels awful to be alone during the holidays.”
Janet cries harder. “That doesn’t help me! What should I do?”
“What are your options?”
“I don’t have any,” she wails. “It’s all Harry’s fault. If he hadn’t left me at least I’d have him to be with.”
Remaining silent, I think: Harry left 10 years ago and you’ve said you were glad to be rid of him; you were invited to join your daughter and her family at her in-laws in Colorado; you could call some of your friends. I also think of my annual Christmas dinner, my house filled with friends and family. My husband has been dead for seven years now. His absence still weighs heavily, but unlike Janet I have acted to make sure I am not alone and miserable.
“You’re not saying anything! Just like Kaitlyn. I keep calling her and crying and asking her what I should do while she’s having fun in Colorado and she doesn’t say anything either until she says she has to go.”
“It seems like you’re really angry at both me and Kaitlyn.”
“Angry?” Janet says, surprised.
“Angry,” I nod. “Neither of us is fixing your unhappiness and, in fact, you feel as though Kaitlyn is causing it.”
“She is.”
“Am I not remembering correctly? Weren’t you invited to join them in Colorado?”
“They knew I’d never go. I don’t like to fly, I mean I will if I have to, but during the holidays it’s just awful and then there’s the weather and possibly getting stuck for days.”
“When was the last time you were happy, Janet, or at least content?”
“What? What does that have to do with anything?”
“It seems to me you’re almost determined to keep yourself miserable. I get that you’re angry. I also get that you feel mistreated and abandoned by others. But it’s very hard for you to take charge of your life and do what’s helpful for you.”
“So now it’s my own fault. Great!”
“I know you always say you don’t want to talk about the past, but did you feel cared for as a child, Janet?”
“Is this going help me not be alone at Christmas?”
“I don’t know about that, but it could help you to understand why you’re alone this Christmas and perhaps help you to make future Christmases different.”
“No. No one ever cared about me. There were five of us. I was smack in the middle. My father was always depressed and miserable and my mother spent all her time catering to him. And my brothers were always beating me up. Happy now?”
“No. I’m not happy for your pain. I’m sorry. And I certainly understand why you’re angry. I also understand that it’s hard for you to move beyond wanting someone to help you, to guide you, to care for you, since you never got the caring you needed and deserved as a child.”
“So I get to talk about all that garbage and then I feel even more miserable.”
“That’s possible. For a while. And what I imagine is that in addition to your anger, we’d also find a very needy child who feels terribly sad and alone, just as you feel alone as an adult. Perhaps you even unconsciously create experiences of aloneness, hoping that this time someone will come along to make it different.”
“So you’re saying I should just live with being alone at Christmas and quit complaining.”
“I don’t think I said that, Janet. I said that we need to find you as the sad, needy child; that you need to have more empathy for her; and then hopefully at some point you’ll be able to move beyond her and be able to do what you need to do to take better care of yourself.”
