So Much To Do!

“There’s just so much I have to do. Mom’s sister is coming from LA. Her best friend is coming from New York. I have to get food in the house. The house is such a mess, especially with Mom’s hospital bed in the living room. And there’s Melissa, getting her to school, to swimming, to play dates. I’ve tried to keep her life as normal as possible.”

These words rush from Chelsea the moment she enters my office. She continues:

“I’ve thought about asking Melissa’s father to take her for a while, but I don’t know, I don’t know how she’d feel about being sent away.”

“How do you feel, Chelsea? How do you feel about sending Melissa away? How do you feel about your Mom?” I ask, interrupting the flow.

“I don’t have time to feel. Except for stressed. I’m plenty stressed. There aren’t enough hours in the day. And I don’t want to leave Mom alone. I know the hospice nurse is there, but she’s a stranger. Mom doesn’t know her.”

“Chelsea, can you slow down a bit, can you …”

“I can’t slow down,” Chelsea interrupts. “I don’t have time as it is.”

I’m discomforted by Chelsea’s agitation. I know about anxiety taking over during times of impending loss, being propelled into action to escape the sick feeling in one’s stomach, hoping that doing something, anything will decrease feelings of helplessness.  But it’s possible – in fact, helpful – to remain aware of the ever-present sadness.  Chelsea is using her incessant activity in an attempt to rid herself of her feelings, an impossible task that only increases her anxiety – and mine.

“But you have time here, Chelsea,” I say. “You have time to feel. Your Mom is dying. She’s been living with you for several years. You’ve been her caretaker. You have feelings about losing your Mom.”

“Of course I have feelings,” she replies. “But what’s the point of dwelling on it. And her sister and best friend are coming. I can’t very well tell them not to.”

“Are you saying you’d rather they not come?”

“It doesn’t matter what I want. They want to come see Mom and they certainly have a right to.”

“But you can have a preference, a feeling about their coming, even though you understand their need to say good-bye to your Mom.”

“I guess I’d rather they not come. But they’re still coming.”

I feel myself becoming increasingly sad, although I don’t know why. Is Chelsea becoming more aware of her own sadness? Is she less aware and projecting her sadness onto me?

“Do you know why you’d rather they not come?” I ask.

“It’d be a lot less work.”

“Any other reason?” I persist.

Suddenly Chelsea is still. Her blue eyes fill with tears. “I know this is silly, but I’d rather have my Mom all to myself. I hadn’t thought of it, but I wonder if that’s why I considered sending Melissa to her father. I want it to be just Mom and me, just like it was when I was little. Oh God! I knew I didn’t want to go here! I can’t stand it! I’m not sure I’ll make it without Mom!” Tears stream down her cheeks. She buries her head in her hands, her body wracked with sobs.

My eyes well up. I remain silent, giving Chelsea her time.

After several minutes she reaches for the tissue box, blows her nose and wipes her eyes. “I’m sure I look like a mess.” She pauses. “But I actually feel calmer. Isn’t that weird?”

“No, Chelsea, not weird at all. You spend a lot of energy running in circles, trying to avoid your sadness. But when you stop and feel the sadness, although it’s very intense, you feel grounded again and you don’t have to be frantically worrying about things that don’t matter much at all.”

“But sometimes I’m not sure I will survive without Mommy,” she says in a whisper.

“I understand that’s your fear.”

“We were so close. It’s even been hard these last few months when she’s really not with me anymore. But I can pretend. I can pretend she knows who I am, that she hears me, that she responds to my voice. And maybe she does. But soon I won’t even have that. I don’t want to start crying again. I have to go soon anyway. Oh, I can begin to feel myself starting to rev up.”

“Good that you recognized that.”

“But better to be running around like a whirling dervish, than to be afraid I won’t survive without Mom.”

“Well, hopefully we can help you feel less like a helpless child who can’t survive without your mother. I’m sure you’ll miss her and grieve a lot. But you will survive.”   

Unnamed

I had seen Rhonda briefly six years ago when she first started her ophthalmology practice. She was anxious, unsure of whether she could handle either the patients or the necessary business responsibilities. She described herself as being an anxious person most of her life, but refused to focus much on her past, saying that she wanted to address present day concerns. Soon she found reasons not to come – she had to see a patient, go to a net-working luncheon, attend a meeting. Eventually she dropped out. I was surprised to hear from her again.

“Thanks for seeing me,” she says smiling. “A lot’s happened since I saw you. My practice is going very well, I got married and a little over six weeks ago I had a baby.”

“Congratulations. You’re right. A lot has happened.”

“My husband, Andy - he’s a physician too, an internist - he said I needed to come. He said it wasn’t normal that I haven’t named the baby yet.”

Inadvertently my eyes widen, my eyebrows raise.

“You don’t think it’s normal either,” she says, reading my surprised expression.

“I don’t know about normal, but I can see that it could be a problem. What do you call … Boy or girl?”

“Girl. You know, cutie pie, sweetie, lovey, baby.”

“And what’s your sense of why you haven’t named her?”

“I don’t want to make a mistake. I wouldn’t, for example, want to call her some sweet girlie name, only to have her be a tomboy. Or vice versa.”

“And how would you be able to know?”

“That’s the problem. I can’t. But I figure if I wait just a little longer, I’ll have more of an idea, more of a sense of her personality.”

“Does your husband get a vote?” 

“He’s wanted to name her either Amanda or Kim right from the beginning. But I don’t know, they just don’t seem to fit.”

“How do you feel about your name, Rhonda?”

“I hate it!”

Aha, I think. Perhaps we’re getting someplace. “Because …?”

“My mother gave me the name. It was her mother’s. My father put the name Alexandra on my birth certificate but she crossed it out and put Rhonda. Alexandra is so much more … more regal sounding. I hate Rhonda. In fact, I go by Rho. Not regal sounding either, but not so clunky.”

“Did you know your grandmother, Rhonda, I mean Rho?”

“She was a witch. She lived with us. My mother waited on her hand and foot. In fact, I’d say Mom often neglected me and my sister because she was so busy catering to my Grandma.”

“Sounds like you feel pretty angry at both of them.”

“I guess that’s true.”

“And how do you feel about your baby?”

“My baby?! I love her, of course. Are you saying I don’t love my baby because I haven’t named her?”

“I’m not saying that, Rho …”

“Oh God! I hope I love my baby. What made you ask that?” Rhonda says interrupting me, giving me no chance to answer her question. “I wasn’t sure I wanted a baby right now, what with my practice and all. But my husband said it was time, that we weren’t getting any younger. Do you really think I don’t love my baby? I couldn’t bear that. It’s like I’d be passing it down the line, the indifference I experienced.”

“Rho, there’s a lot going on here, which doesn’t mean you don’t love your baby. You can love your baby and still have ambivalent feelings about being a mother. You can love your baby and be scared of repeating the experiences of your past in the present. It sounds like you’re aware of all that and that certainly puts way ahead of lots of people.”

Rhonda looks down at her clenched hands. “I can see how not naming my baby could make her feel unimportant. I don’t want to do that,” she says crying.

“I’m sure you don’t, Rho.”

“I’m going to tell Andy he can name her whatever he wants.”

That’s not being any more involved, I think to myself. “What do you want to name her, Rho?”

“I don’t know. I know from what we just said that there’s more to it, but when you ask me the question point blank, I go back to where we stated, I don’t want to make a mistake.”

“Sounds like naming your baby is so intertwined with your mother and grandmother, that it’s become impossible to separate them out.”

“I don’t know what to do. I feel I have to do something and I’m stuck. Do you have another session this week?”

“For sure.”

“Thanks. I guess I’ll go home and discuss it with Andy.”

“Sounds like a plan.” 

Never Again

“I appreciate your seeing me again so quickly,” Marv says. 

“Of course,” I reply. Marv and I terminated about three years ago, but he called earlier this week saying he’d fallen into another depression and needed to see me. 

“Have you been following the news?” he asks.

“What specifically are you referring to?” I reply.

“Hungary,” he says, passing his hand over his eyes. “Putting them in a train and taking them to a ‘processing center.’ I can’t understand. How is it possible? How can it be happening again?”

I know exactly what he’s referring to and, truth be told, I felt very much like Marv when I first heard the story. Syrian refugees in Budapest with tickets to Germany boarded a train believing they were going to their destination. Instead they were taken against their will to a rural area in Hungary. It was a story that immediately brought to mind images of the Jews during World War II crammed into trains, taken to “labor camps,” taken to their deaths. What happened to “never again?” Still, these refugees’ story had a happy ending. They weren’t gassed. They were allowed to leave Hungary and were joyously welcomed into Germany. But I don’t have Marv’s history. I didn’t lose most of my relatives to the Nazi atrocity.

“Yes, Marv, it’s horrible. I understand the images it must bring forth for you.”

He begins to cry. “I’m glad you get it. My wife doesn’t. She thinks it shouldn’t affect me.”

“And how do you feel about that?”

“Alone. Depressed.  She says it all turned out fine, so why am I depressed. Yes, these people were saved. Some of the Jews were saved too. But millions were killed. And now thousands of refugees are dying on boats, in trucks, for God sakes. Besides, that’s not the point. It’s that most human beings are brutes. We never learn. We just go around brutalizing each other. What’s the point? What’s the point of anything? I give up.” 

That’s what Marv does. He gives up. He surrenders. He surrenders to the world, to his wife and, in the past, to his tyrannical father. Giving up is not something I sit with easily. I want to shake Marv into action, into assertion. “Do you ever feel like brutalizing anyone, Marv?”

“No, never.”

“Never? Not the Hungarian government or your wife or your father?”

“Never. My father was the brutal one, taking his rage out on me and my brothers. I know he lost his whole family in the war – parents, aunts, uncles, everyone – but that shouldn’t excuse him. It should have made him appreciate us more.”

“Let me ask you this, Marv, did you ever feel like hitting him back?”

“I don’t think so. Eddie, my oldest brother, he’d talk about wanting to kill my father. I figured he was only talking, but it still scared me.” 

“So what did you feel when your father was beating you?”

“Scared.”

“Scared and powerless and like the little vulnerable boy you were.”

“Yeah. Sounds about right.”

“I wonder though, Marv, if you also felt enraged underneath. Felt a rage that you certainly couldn’t express and couldn’t even let yourself know about.”

“I don’t know. It’s all in the past. Doesn’t matter much anyway.”

Now I’m aware of feeling angry, angry at Marv’s immediate surrender. I suspect my anger stems both from my own intolerance of passivity, as well as Marv’s projection of his angry feelings into me. I say: 

“You know, Marv, it’s interesting that as soon as I started talking about your rage, you withdrew, gave yourself over to defeat rather than engaging with me in trying to find your anger, which I bet would help you feel less depressed.”

“How would that help the refugees?”

“Your depression won’t help the refugees either.” Oops, I think. I just acted out my frustration.

He sighs, even more dejected. “You’re right. It won’t.”

“Marv, I wish you could fight with me. I wish you could tell me that my last remark was uncalled for. I’m not your father. You can fight with me. You can put me in my place. And I don’t know what you could do for the refugees. But if you decided it was important enough to you, you could do something. It wouldn’t solve the crisis. It wouldn’t save the world. But it might help. And it might help you to feel more powerful. You don’t have to be either the brutalizing father or the scared, little boy. There’s a huge middle ground in between.”

Marv stares as me. “You got mad at me.”

“Yes, I got mad at you. But my anger won’t destroy you or me or our relationship. And your anger isn’t deadly either. In fact, I’m sure it’s far less destructive than your depression.”

Mix and Match

“I’m so glad to be back here, back at college, back where I don’t feel like such a freak,” Adam says relaxing into the chair. “I knew the summer would be rough, but I had no idea how rough. In Boca Raton I might get stared at for being black and yes sometimes I have to laugh to myself when I walk along the street and see these little old white ladies make sure their car doors are locked, but being gay in Savannah, Georgia, now that’s tough! And add Alex into the mix and then my family and it’s pure hell.”  

“Alex was with you?” I ask confused.

“Yeah, I know, that wasn’t part of the plan. But we got lonely for each other. Figured he could find some kind of work as easy in Savannah as Baltimore.”

“But I thought you weren’t out to your parents.”

“I wasn’t. Past tense. Didn’t plan to come out when Alex came down either. But after a while my Mom started wondering how come I was so close to this white dude that he’d come for a visit and then sort of move in. Besides, I’m sure we were giving off these vibes. Hard for us to keep our hands off each other. Not that we were having sex in my parent’s house. I wouldn’t be that stupid.

“Anyway, she flipped out. Said she didn’t care if it was legal in the courts. She knew God didn’t consider it right. And of course she told my Pop and then all hell broke loose. By brother freaked too. I think he’s afraid it’s contagious. Pop pretty much didn’t talk to me the whole summer. And Alex had to move out. A friend of mine let him stay at his house for next to no money, so that worked out okay.” 

“You know, Adam, I wonder if you didn’t want to come out to your parents.”

“You mean because I had Alex come down?”

“Yeah. As you said. He’s white, you could hardly keep your hands off each other and you couldn’t help giving off sexual vibes.”

Adam frowns and stares at me. “It wasn’t only sexual vibes. Loving vibes too.”

“I’m sure that’s true.”

“Are you sure?”

“You’re asking if I made the usual assumption about gay men, that it’s all about sex.”

“Yeah. Were you?” 

“That’s hard for me to answer, Adam. I’d say that consciously, no, I wasn’t making that assumption, but unconsciously, it’s impossible for me to know. I also wonder if I would have made the same assumption about a heterosexual couple who was twenty years old.”

“I’m sorry. I know you’re not homophobic. I guess I’m just hypersensitive given all I’ve been through this summer.”

“Nothing to apologize for. There’s plenty of gay prejudice out there, just like there’s plenty of racial prejudice. I couldn’t swear I’m free of all of it. For that matter, we don’t know if you’re free of all of it. Hard not to take in society’s attitudes and end up feeling less yourself.”  

“You know, maybe that’s another reason I wanted Alex to come down. Even though I wasn’t out to my parents, I could see how people looked at me, my “brothers.” I could feel the contempt. Maybe I started feeling less than. Maybe I wanted someone who I knew loved me to be with me.”

“That’s a really good point, Adam. And maybe that’s another reason you wanted to come out to your parents. Maybe you hoped they’d love you enough to accept you even if you’re gay.”

“It’s not that I think they don’t love me. Or at least I know my Mom does. I don’t know about my Dad. But I don’t know if I expected them to accept my gayness. It’s a lot to ask of black Christian folks from the south.”

“You know, Adam, I have very mixed feelings about what you just said. On the one hand, it’s very adult and reasonable for you to be able to step back and accept your parent’s prejudice given who they are as people and where they come from. But there’s another side. If you were born blind, or with one leg, or with a low IQ, would you feel it was all right if your parents couldn’t accept that about you or is your willingness to “understand” their rejecting your gayness, another example of how a part of you still rejects your gayness yourself?”

“Wow! That’s heavy! I’ll have to think about that.” Adam smiles. “I love being here, doc. You always get me to think about things in different ways. As I said, I’m real glad to be back.”

Back From the Dead

“I don’t know what to do,” Cynthia says plaintively, pulling at her hair. “I saw Phyllis for so long and I was so devastated when she just left her practice. When she left me! I mean I knew she was really sick, that she was probably going to die. But you know, I’ve hardly been able to talk about anything else since I started seeing you. And then here she is, calling me on the phone, saying she’s better and wondering if I’d like to come back into treatment with her. What am I supposed to do?”

I’ve been seeing forty year old Cynthia for a little less than two months and, she’s right, she’s been able to talk about little else then her feeling of abandonment when her therapist became seriously ill and had to precipitously end her practice. Fear of abandonment has always plagued Cynthia, having it come to pass with her therapist of many years has left her anxious, angry and distraught.

“Do you have any sense of what you’d like to do, Cynthia?” I ask. 

Cynthia fidgets in her chair. She looks warily at me, takes a deep breath and says, “I don’t see how I can talk with you about this.”

“Because…?”

“Well, it’s like I have to decide between you and Phyllis.”

“You don’t have to take care of me, Cynthia. You need to figure out what’s best for you. I’d certainly understand if you decided to go back to seeing Phyllis. You’ve had years of a relationship with her. And I’d be happy to continue seeing you if that’s what you decide.”

“It still makes me uncomfortable. Like I’d hurt your feelings. But I’d hurt Phyllis’ feelings if I decide to stay with you. That feels really terrible.”

“Can you say what feels terrible about hurting each of us?”

“Phyllis almost died! I wouldn’t want to do anything more to hurt her.”

“I understand that, Cynthia, but you’ve been really angry with Phyllis and if you do decide to go back with her that’s one of the things you’re going to have to discuss.”

Cynthia shakes her head empathically. “I could never do that. I’d just have to pretend it was like before she left.”

“From what you’ve told me, Cynthia, Phyllis sounds like a good therapist. I’m sure she’d encourage you to talk about how you felt about both her leaving and her return.”

“I’d say I felt sad, but that I understood and that I was really glad she was back.”

“So you’re saying you’d go back into therapy with Phyllis and be dishonest?”

“What else could I do?” she wails. 

I feel myself becoming annoyed by Cynthia’s passivity, clearly remembering how angry Cynthia has been with Phyllis these past months. She’s felt guilty about her anger, but angry nonetheless. “I wonder if being dishonest with Phyllis would be a way of expressing your anger at her, of pulling back from her just as she did from you.”

“So you think I should go back to Phyllis and tell her I wish she’d died?”

I feel myself flinch, aware of the rage that exists in Cynthia barely below the surface. “First, I didn’t say that you should go back to Phyllis. I said I’d be happy to continue seeing you. Second, I think you’re really, really angry and that you’re afraid your anger can be deadly. Whether you can go back to Phyllis and deal with her with your anger is something you’ll have to decide. But one way or another I don’t think you’re going to be able to avoid dealing with it.”  

Suddenly a thought comes to me. “What did you tell Phyllis when you spoke with her on the phone?”

Cynthia hangs her head. “I told her I’d see her next Monday,” she mumbles, barely audible.

“So has this session been a charade, Cynthia? Had you already made up your mind and only pretended to be unsure?”

“I thought it would be less hurtful,” she says avoiding my eyes. 

“I think, Cynthia, it will be very important for you to work on why you think deception is less hurtful than honesty, but in order to do that you’re going to need to be honest.”

“Are you mad at me?”

After talking about honesty I feel obliged to respond truthfully. “Yes, Cynthia, I’m mad at you for presenting a charade this session, rather than coming in and telling me what you decided and allowing us time to say good-bye.”

“I’m sorry,” she says quietly.

“I’m sorry too. But I want you to know that anger doesn’t have to be destructive and that I wish you the very best.”

If Looks Could Kill

Marlene glares at me as I open the door to the waiting room. My customary smile freezes on my face. I’ve been seeing Marlene for over three years now and her connection to me is quite intense. As we walk toward my office I ask myself if there was there anything notable about our last session. I didn’t announce an upcoming vacation. I don’t recall a therapeutic breach. We talked about her father, a man she has been loath to take off his pedestal. 

Marlene drops into the chair, crosses her arms and legs and pointedly looks out the window, avoiding my eyes. She’s a tall, blonde woman in her mid-thirties who came into treatment because of repeatedly failed relationships she described as filled with betrayal and abandonment.   

We sit in silence for several minutes as Marlene’s anger fills the room. I’m becoming increasingly uncomfortable. Is that because I want to avoid getting caught in a power struggle? Or does Marlene’s anger feel too big to me, triggering my own discomfort with intense rage? I can’t tell. But I know I’m going to break the silence.

“You’re obviously really angry with me, Marlene. Can you tell me why?”

“I hate you!” Marlene spits at me.


Over the years, I’ve certainly had patients tell me they hate me. But the venom behind Marlene’s words is frightening to me, especially since I have no idea what’s fueling it. I do know her anger is triggering me, reminding me of the irrational, explosive rage of my father, but that awareness doesn’t assuage my anxiety.
  
“You’re just like my fucking mother! All you want to do is take him away from me. I can’t say you want him all to yourself, you’re too much of an old bag for Daddy, but you probably just want me to be as miserable as you.”

I’m getting a glimmer of what’s going on. That helps. But the paranoia behind Marlene’s words is still discomforting. 

“So in our last session you felt I was trying to take your father away from you.”

“I didn’t ‘feel it,’ you were. Telling me he never loved me!”

I feel I’m walking through a land mine. If I dispute Marlene’s account of what I said, we’ll only end up arguing about who said what. Yet I’m not comfortable allowing what I see as Marlene’s distortion to exist as fact. I decide to try to go underneath the rage and paranoia. 

“So if I was trying to take your father away from you I can certainly understand your feeling enraged at me. But what if in the course of our discussion you found yourself having some doubts about your father …”

“Never, bitch! You see. You’re doing it again.”

My anxiety is moving towards anger, just as Marlene’s anger covers her fear and vulnerability.

“Marlene,” I say with more determination. “There’s a lot going on here today. Even the intensity of your rage and your unwillingness to hear me out, speaks to your covering over lots of feelings. Something clearly got triggered in our last session. I’ve become the enemy. I wasn’t your enemy before and I’m not your enemy today. If you feel I was too harsh about your father, I apologize. But no father is perfect, no father can be 100% available and loving. And I think you got scared about losing your perfect father. Perhaps having him be less than perfect feels like he’s not there at all, sort of like with me going from friend to enemy, he went from being 100% there to being 100% absent and that was too painful to bear.”

Once again there is silence, but this silence feels more tolerable.

“I don’t know,” Marlene finally says in barely a whisper. “If I believe you, I lose him. If I stay with him… I don’t know. Does that mean I lose you?”

“The world isn’t so black and white, Marlene. You don’t have to choose between us, even though I know that is how it often felt with your parents. Neither your father nor I are perfect, but our lack of perfection doesn’t mean that you’re abandoned and alone. It means you get to take what you can from each of us imperfect people and that you can also look beyond us for close, meaningful relationships.”

“I don’t know. I don’t know what to think.”

“What is it that you feel right now?
”
“Confused.”

“Anything else?”

“Kind of empty. It’s like I was filled with rage when I came in and now that rage is gone, but I’m not sure what’s there in its place.”

“I understand. We’ll continue to talk about it next time.”

Taking a Break

“I know we only have a few minutes left in our session,” Martha says interrupting her complaints about her work and her marriage, “But I wanted to tell you I’m planning on taking a break from therapy.”

Feeling immediately angry at this sudden pronouncement with almost no time to discuss it, I ask, “What led you to that decision?”

“I’ve been thinking about it for a while. We just don’t seem to be getting anywhere. I come in every week and complain about either Mitchell or my boss, my boss or Mitchell. It doesn’t change anything.”

I happen to concur with Martha’s assessment, but my sense is that my attempts to engage Martha in greater self-reflection, as opposed to her litany of complaints, has been mostly unsuccessful. 

“Martha, could you at least come for one more session to talk about what you think hasn’t worked and why, as well as giving us a chance to say good-bye should you decide to end.”

“I’m not ending. Just taking a break. Besides, I’m on vacation the next two weeks.”

Another surprise. Martha obviously had planned her leave-taking for a while, even neglecting to mention her upcoming vacation.

Aware we have no time left this hour I say, “Well, what if you come in three weeks from today so that we have a chance to talk and in the meantime maybe we can both think about why you chose to tell me about your break at the very end of a session right before you were going on vacation?”

Martha sighs. “I guess. This seemed like a natural break point, but if you want me to come in once more I guess I can do that.”
“Thank you. I’ll see you in three weeks and have a good vacation.”

I am definitely annoyed, feeling dismissed and discarded. I have no idea whether Martha will show for her session in three weeks and whether or not she’ll continue. I feel obliged to keep Martha’s time available even though she’s made no commitment to the continuation of our relationship. 

Martha does show in three weeks. She is, however, uncharacteristically late, leaving me again off-balance and unsure of her intentions.

“Well, I’m here,” she says. “What do you want to talk about?”

“Maybe we should start by talking about your anger at me,” I suggest.

“I’m not angry at you. I just don’t think we’re getting anywhere.”

“You tell me the last few minutes of an hour that you’re leaving, you’re late to this session and you seem annoyed about being here.”

She shrugs.

Here I am again, angry. My anger. Her anger. My anger. Her anger. Maybe that’s what’s going on.

“You know, Martha, I think what you’ve been trying to do – unconsciously of course – is help me to feel your level of anger, dissatisfaction, and powerlessness, whether those feelings are directed towards me, your husband, or your boss. Things aren’t going the way you want them to in any aspect of your life and you feel powerless to change them.”

“That’s exactly right!” Martha says brightening.

“But I wonder if you’re really as powerless as you feel,” I continue. “Or if you don’t know how to ask for what you want or don’t know how to make it happen. For example, I want you to stay in treatment. I do understand that simply complaining about what’s not working in your life isn’t helpful; that we have to figure out ways in which you can get what you need here as well as in other parts of your life.”

“But how am I supposed to know what I need? You’re the doctor, you’re supposed to know.”

“There’s an awful lot in what you just said, Martha. First, there’s a request to be taken care of and anger at not being taken care of. But there’s also a lot of passivity in your statement which only increases your feelings of powerlessness and makes you less likely to get what you want.”

“But I don’t know what I want! I just know I’m not getting it.”

“That’s a great insight, Martha. And it makes a lot of sense. When you were a kid, no one cared what you wanted. They were too busy with what they wanted. You don’t know what you want. But you do know you feel dissatisfied. And when you’re dissatisfied you complain or leave. I’d say we know what we need to work on, assuming you’re willing to stay and work on it.”

“I was sure I was going to take a break. But, yeah, I’m willing to give it another try.”

“Good,” I say smiling.