The Southeast Florida Association for Psychoanalytic Psychology (SEFAPP)

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  • 03/27/2017 8:07 PM | Anonymous

    “I’m considering getting a divorce,” 52 year old Evelyn says, starting the session.

    Although her marriage has been rocky for some time, this pronouncement surprises me given that her husband recently had a heart attack and by-pass surgery. She seemed genuinely concerned about him and committed to helping him through the rehabilitation process. I remain silent.

    “I was listening to this program on NPR, On Point, and there was this doctor on who wrote a book about solving medical mysteries. I don’t remember his name, but it was interesting.”

    I heard a small part of that program too, but I wait to hear what led Evelyn from that program to her considering divorce.

    “There was a man who had a heart attack who’d had a bad heart so his heart attack was no surprise, kind of like Jack. But then the doctor went on to say that like the very next day or something like that, his wife had a heart attack too. And she had been perfectly healthy. And the doctor said it was the stress, almost like being too close to her husband and having to have a heart attack just like him. Well, I don’t want that to be me. I know this might sound awful, but Jack’s not worth my health. He hasn’t been a good enough husband for me to lay down my life for him.”

    Feeling unsure what to say, I continue to remain silent.

    “Do you think I’m awful?” Evelyn asks.

    “No, of course not, but I am a little confused. I heard a small part of that program too…”

    “Do you remember the doctor’s name? I thought I could get his book.”

    “No, I didn’t hear much of the program, but what I remember is that he was talking about a couple that was extremely loving and close and that it was that closeness that led to the wife’s distress and her perhaps unconscious need – those are my words, not his – to identify with her husband and go through the same experience he had.”

    “Well I guess if that was true, I wouldn’t have to worry about that.”

    “Evelyn, am I mistaken or do you feel particularly angry today?”

    She shrugs. “I guess.”

    “Can you say what’s going on?”

    “I’ve been busting my butt taking care of Jack and do you think I even get so much as a thank you?!” All he does is bitch and complain – I’m in so much pain, I’m scared, what if this happens again, why does my right arm still hurt. Complain, complain, complain. I’m sick of it.”

    Jack has definitely been a less than ideal husband - inattentive, otherwise preoccupied and, most likely, unfaithful. Still, Evelyn has stayed with him, continually hoping that she could make him different, just as she longed to do with her absent and eventually abandoning father. Still, right after a major scare and trauma seems an unusual time to be considering divorce. Then a thought comes to me.

    “Evelyn, do you think this time you especially thought it would be different? Jack was scared and vulnerable. Maybe he’d need you in a different way? Maybe he’d let you in as he hadn’t before?”  

    Evelyn hangs her head. “Stupid of me, wasn’t it,” she says, her anger now turned on herself.

    “No, definitely not stupid. It was you hoping again, hoping you – or something – could make Jack different, just as you hoped with your father.”

    “But it is stupid! How many times do I have to go through the same thing to know it’s not going to work? It’s like continually hitting my head against the same brick wall.”

    “It’s hard to give up hope. It’s hard to mourn what never was and never will be.”

    “I can’t stand when you talk about mourning. Who wants to mourn, who wants to be sad all the time?”

    “So you’d rather be angry.”

    “Damn straight.”

    “Well, it’s reasonable to be angry, but if you’re only angry you can’t ever finish the process of letting go.”

    Evelyn’s eyes pierce me with fury.

    “And,” I continue, “to end up being angry at everyone – yourself, me, your children, your friends - that doesn’t lead to a very fulfilling life.”

    “So should I stay with Jack?”

    “That’s a decision only you can make, Evelyn. But I do know regardless of what decision you make, you will have to mourn the impossible.”
  • 01/20/2017 1:06 PM | Anonymous

    “It’s been a while,” says Delores. “I appreciate your seeing me so quickly.”

    “My pleasure,” I respond, truthfully. I always liked Delores, a spunky, vibrant woman who was in her late 60s when I last saw her.

    “This time it’s actually not an emergency. Not like last time. I was such a mess. Losing Marvin so unexpectedly was devastating. I just wasn’t prepared. And having him be the third husband I lost, well, that was all way too much.” She sighs. “But I guess that is part of why I’m here. I’m trying to figure out if I dare do it again. After Marvin I said never again, no more men. And now, now I just don’t know.”

    I certainly remember Delores’ trauma at losing Marvin. I myself was a relatively recent widow, Delores’ pain clearly reverberating with my own. And the fact that she had lived through two other such losses felt truly overwhelming. I can certainly understand her reluctance to take the risk again.

    “Is there a specific man?” I ask. 

    “Oh yes, Harry. A friend of mine kept asking me to go out with him. She said he was a widower, a friend of the man she dates, a good bridge player and an all-around nice guy. I said ‘no’ for quite a while. Then one day I felt lonely and they were going to a movie I wanted to see, so I said, why not, it’s just one date. That was three months ago. And now, well, it’s going to go one way or the other. I either have to stop seeing him or take the plunge.”

    I certainly understand Delores’ conflict. Harry perhaps offers a more fulfilling, richer life, but certainly raises the specter of another devastating loss. I’ve lived my life believing that it’s “better to have loved and lost, than never to have loved at all,” but perhaps there’s a limit to the number of excruciating losses any person can sustain. Fortunately I don’t have to make Delores’ decision for her.

    “So, what are your thoughts?” I ask.

    “Well, I’ve thought of all the obvious things – he’s older than me, although only by a couple of years; he has prostate cancer but they’ve been watching it for years and it’s never gotten worse; he’s also had a lot of skin cancer, but that seems under control as well; no heart disease, but Marvin supposedly didn’t have heart disease either, until he keeled over dead. I go round and around in my head about all that. But what’s really odd, is that I keep thinking about my father, dreaming about him too.”

    I remain silent, giving Delores time to reflect.

    “My father’s been dead for almost 50 years. It was very traumatic for me when he died. I felt like an orphan, even though I was in my 20s. My mother had been dead since I was 10, so it had been just me and my Dad for a while.” Pause. “But I don’t know why I’m particularly thinking of my Dad now. He didn’t come up for me when Marvin died, or any of my other husbands either if I remember correctly. No, that’s not true. John, my first, died not that long after my Dad. I wasn’t 30 yet and I remember then thinking of my Dad a lot. There were so many losses. I could cry just thinking about it.”

    “I’m sure that’s true.”

    “So do I want another one? I mean, I know no one ever knows, that I could drop dead tomorrow, especially since I don’t exactly have longevity in my family, but I guess my experience is always that the men go first.”

    “Except not for your mother. She died first.”

    “That’s true,” Delores says pensively. “I wonder what that meant for me. This is a crazy thought, but I wonder if I expected my Dad to live forever. I mean I knew he couldn’t, but still …”

    “Was that a wish, Delores? As in you wanted your Dad to live forever because you couldn’t face another loss.”

    “I’ve certainly faced lots of them.” She chuckles. “I wonder if I keep looking for the one who’ll live forever. Just kidding.”

    “Maybe you’re not kidding. Maybe you keep looking for the man who won’t abandon you, who will live to be there for you, unlike either of your parents.”

    “That’s deep. My unconscious would have to be real smart to think that one up.”

    “Perhaps it’s that the child part of you is still yearning for the safety and security that was so absent in your childhood.”

    “Perhaps. But I don’t know if that helps me figure out what to do about Harry. I’ll have to think about it during the week and see what my unconscious comes up with.”

    “Sounds good.”  

  • 01/10/2017 1:00 PM | Anonymous

    “I’m really glad you’re back,” Christine says, her eyes filling with tears. “I know you were only gone a week, but it’s been a hard week. I thought I was more prepared, more ready to deal with my parents this time, but I don’t know, I guess it was the holidays. It was awful. I felt sorry for my girls. They were so looking forward to Nana and Poppy coming for Christmas and it was such a disaster. My parents never stopped fighting, my mother never stopped telling me what I was doing wrong, most particularly as a mother and, of course, as someone who couldn’t keep my husband from straying and my father just got more and more depressed.”

    “I’m sorry, Christine. It does sound awful and so disappointing.”

    “Yes, that’s exactly right, terribly disappointing. I guess I thought since we’d been working so much on my parents these days, I’d be able to handle them differently or be less affected by them or something.”

    “So it sounds as though you’re saying that you’re disappointed in me too, in our work together.”

    “No. I don’t think so. I was disappointed that you weren’t here to bounce things off of, to maybe give me some ideas of how to handle things differently.”

    Although Christine’s denial doesn’t convince me, I let it go for the moment. “For example,” I say. “Can you give me an idea of what you thought you could have handled differently?”

    “There are so many things. How I could have gotten them to stop fighting. How I could have stopped my mother from being so critical of me. How I could have stopped her from being critical of my girls.”

    “All right, let’s look at those three things which don’t all strike me as the same. Could you have gotten them to stop fighting? If I’m not mistaken you’ve been trying unsuccessfully your whole life to get them to stop fighting.”

    Christine looks startled. “Oh, right. One of the things I need to give up on. I forgot. I can’t keep hoping for what will never be. I need to accept my powerlessness. I knew you should have been here. But why did I forget? I feel ashamed of myself. Why couldn’t I hold onto that?”

    “Seems like you said a lot there, Christine. First, I think you are angry with me for not being here. Then I think you got uncomfortable with your anger and felt ashamed instead. And, I agree we should look at why it’s easier for you to hold onto your feelings of hopelessness and powerlessness when I’m here.”

    “I do feel ashamed of myself. We’ve talked and talked about my needing to give up hope with my parents and I just can’t seem to do it.”

    “Well, it’s very painful. It means you can never have the parents you want or wanted either now or in the past. It involves mourning for what never was and never can be.”

    “I know. I guess that’s why it’s harder to do when you’re not here. If you’re not here and I don’t have my parents – and I sure don’t have my ex any more – I feel all alone. Except for the girls of course, but that’s different.”

    “That’s a great insight, Christine.”

    “Thanks. But what about the other two things I mentioned, why did you feel they were different?”

    “The second one might not be all that different, getting your mother not to be critical of you, but I guess I wondered what it is that you felt when your mother’s so critical.”

    “I do feel angry, but I try to pretend it doesn’t bother me and just ignore her.”

    “Because?”

    “Confronting her only makes it worse.”

    “And when she attacks your girls?”

    “I guess I do about the same thing.”

    I am annoyed by Christine’s passivity. I feel she is leaving her daughters unprotected, just as I felt unprotected by my mother in relation to my explosive father. I tread lightly. “I wonder what message you give your girls when you don’t stick up for them.”

    “But I thought I’m supposed to give up hope of ever changing her,” she says plaintively.

    “This could just be me, Christine, but I think there’s a difference between accepting there’s no way you’re ever going to change your mother and still giving your girls the message that it’s not okay with you for her to attack them, or you for that matter.”

    “That’s confusing.”

    “It’s like saying, you know you’re not going to change her behavior but you’re still going to let her – and your girls – know her behavior isn’t acceptable.”

    “It scares me.”

    “What scares you?”

    “I guess her anger.”

    “I get that. And perhaps your anger as well.”

    “I don’t like all this talk about my anger.”

    “I believe you.”

  • 10/29/2016 2:36 PM | Anonymous

    “I got a great idea after our last session,” 30 year old Melinda says enthusiastically.

    I remain silent.

    “You know how we’re always arguing about whether or not you care about me? Well, I figured out how you can prove it to me.”

    Oh my, I think to myself. Whatever’s coming can’t be good.

    “You can stop charging me for some period of time we agree on. That way I’d believe you cared about me and weren’t just in it for the money.”

    I feel as though I’m going to be walking through a field full of land mines. Other than agreeing to Melinda’s request which I know I’m not going to do, whatever I say has the very likely potential of a large explosion. I’m also aware of feeling angry and put upon. Hmm, I think to myself, I bet at some level Melinda could have anticipated that would be my reaction. 

    “When you came up with this idea, Melinda, how did you think I’d respond?”

    “I don’t know. How should I know how you’d respond?”

    “Well, we’ve worked together for about three years, you might have some thoughts about what I would or would not say or would or would not do.”

    “You’re not going to do it, are you? You’re just stalling, playing games,” she says, her anger building. 

    “Is that what you would have expected?” I ask.

    Melinda crosses her arms over her chest and glares at me. “I’m not saying another work until you answer me directly.”

    I sigh inwardly. Melinda and I have frequently found ourselves in these kinds of power struggles. I can refuse to say anything, at which point she will indeed not say another word until she storms out at the end of the session. Or I can submit to her demand that I answer her, which feels to me like an uncomfortable submission. Or perhaps, just perhaps, I can try and interpret what’s happening between us. Melinda’s mother died when she was nine, leaving her to be raised by her distant, authoritarian father, who she rebelled against while desperately wanting his love and approval. In her interaction with me, Melinda can take the role of her authoritarian father who tries to force me to be as she wants me to be. Or she can be the needy, demanding child who wants both to win her father’s love, while insuring that her mother will not abandon her.

    “So I’m going to run a few assumptions by you and you can tell me what you think. First, I think you knew – if only unconsciously – that I would not agree to your request, that it would stretch the boundary of our relationship in a way that would not be acceptable to me. Second, the reason you find it so difficult to believe – and accept, I might add – my caring is that you felt abandoned by your mother and rejected and criticized by your father. It’s also easy for you to become your father in this room with me and just as you refused to bow to your father’s demands, at some level you know that I will not bow to your demands either.”

    “It wasn’t a demand, it was a compromise, a negotiation.”

    “I’m not sure about that Melinda. I think you came prepared to fight with me. And that’s probably the most interesting question. Why is it that you want to fight with me?”

    “I don’t want to fight with you. I fight with you because you won’t give me what I want.”

    “Which was exactly your relationship with your father.”

    “I guess,” Melinda says reluctantly.

    “But I think that as much as you say you want my caring, you often do things that prevents your getting exactly what you say you want, which leads me to wonder if you need to reject my caring.”

    “That doesn’t make sense. Why would I do that? I think you’re just playing therapist tricks, trying to get away from your not caring about me.”

    I choose to ignore Melinda’s last provocation. “Melinda, if you accepted my caring you would be saying that you were a person who deserved caring about. And if you allow that in, then you’re left with the realization that you are indeed loveable and that no matter what you did – or do – you couldn’t keep your mother from dying and you can’t keep your father from being a cold, critical person. And that leaves you feeling powerless and helpless and we know how awful those feelings are for you.”

    “Is there any way you’d consider my suggestion?”

    So much for interpretations, I think to myself. What I say is, “Now I know you know the answer to that question, so I guess you’re saying you’re mad at me.”

    “Yeah. I think you should have to do something to prove your caring.”

    “I guess we’ll continue talking about this next time.”  

  • 10/04/2016 2:25 PM | Anonymous
    “I never thought I’d be seeing a therapist. And certainly not for this! After all, it isn’t a problem. It’s what everyone does. Everyone my age, anyway. But here I am,” Samantha says, looking at me expectantly, brushing her straight blonde hair away from her face.  

    She’s been speaking at me rapidly for several minutes although I still have no idea to what she’s referring. I look back at her and wait.

    She sighs deeply. “This is harder than I thought. I guess it kind of feels like talking to my Nana. Don’t get me wrong, I love my Nana but …”

    I smile inwardly. “But you wouldn’t want your Nana to know about whatever this is. ‘

    “Exactly,” she says brightly.

    “Well, I’m not your Nana, but it would be helpful if I knew what’s troubling you or, if it’s easier, you can tell me a little about yourself.” 

    “I’m 20, a sophomore in college, actually born in Florida, from Daytona. I have two younger brothers. My parents are divorced. My Mom’s a nurse, my Dad owns a car dealership. I told them I wanted to go into therapy because school has me stressed. Which is kind of true.” Pause. “That’s about it. So I guess I better tell you.” She takes a deep breath. “I assume you know about hooking up, where you just go on your phone and make a date to meet for sex, no strings attached?”

    “Certainly,” I say nodding.

    “Well, I do it quite a bit. Started in high school, much more in college.  Like I said, no big deal, just lots of fun. Sometimes great sex, sometimes just so-so, but it’s a fantastic way to get lots of experience without having to worry about it getting messy.”

    I now feel like Samantha’s Nana. It’s hard for me to imagine the pleasure involved in totally anonymous sex. But I hope to keep my judgment to myself. “So what about hooking up is becoming a problem for you?”

    “I can’t not do it.”

    “What do you mean?”

    “Well, used to be I’d only do it on the weekend, sometimes with four or more guys, but still only Saturday and Sunday. Then it was also Friday night. And then maybe a couple of other nights during the week. But now I can’t not do it! I can’t sleep if I haven’t hooked up with at least one guy, sometimes more. Sometimes I try. I pace the floor, I drink some wine, I take a Xanax. Nothing works. Sometimes I end up hooking up at 3, 4 in the morning. I’m driven. And I know, it’s like being an addict and no kind of addict is good. My Dad’s an alcoholic and my Mom used to be addicted to pills. She’s clean now. But I know. It’s not good. Right?”

    “No, Samantha, it’s not good.” Corroborating Samantha’s assessment doesn’t feel judgmental, but rather supportive of the stronger, less impulsive part of her. “But tell me what hooking up does for you? What about it makes you feel relaxed when nothing else works?”

    “Like you said, it relaxes me. I guess part of it is just the physical release. Although I know that can’t be all of it, because it doesn’t work if I … uh … if I do it myself.” Pause. “I guess it fills me up, makes me feel less alone. And I like being wanted. Like the guy can’t have enough of me. Or the guys. They just all want me. It’s a high. Just talking about it makes me want to run out and do it.”

    “And if you don’t. If you sit with your feelings right now?”

    “I guess I feel blah. Yeah, blah. I feel ordinary, like a nobody, kind of lonely, like no one wants me. Yuk! I don’t like it. I don’t want to feel like that.”

    “Can I ask you, Samantha, are the feelings you just described familiar? Did you feel them when you were a child?”

    “For sure! First there were the two younger kids, boys at that. Then there was the booze and the pills and the screaming and the divorce and more screaming. I thought they might fight about who had to take us, but I guess that was the one non-issue. My Mom got us, no questions asked. Except they kept screaming because my Mom wanted more money, my Dad said no way. I don’t have much of a relationship with my Dad. He has lots of women. We kind of get in his way.”

    There are so many interpretations to be made here, all related to Samantha’s feeling unimportant and insignificant, whether in relation to her brothers, her father, her father’s women or her parent’s involvement with their own lives and addictions. But there’s no rush. If she can tolerate her feelings, I suspect Samantha will be in treatment for some time.   
  • 10/04/2016 2:21 PM | Anonymous

    I open my waiting room door to meet James Harrison for the first time. He rises, hand outstretched to shake mine. I’d guess he’s in his mid-forties. A good-looking man, tall, thin, seemingly comfortable in his own skin. We make the brief walk to my office and I gesture him to the sage chair across from mine.

    “So,” he says, “Why should I be here?”

    I inadvertently jerk my head back while, at the same time, stifling the urge to laugh. He’s certainly wasted no time throwing down the gauntlet. Still, it’s so startling, that I find it almost funny. Perhaps that’s a defensive reaction on my part.

    I think about commenting on his provocativeness, but decide that would only escalate what is already a fencing match between us.  “Well, since I’ve never laid eyes on you before,” I respond, “I have no idea why you should be here. Perhaps it would be helpful if you told me.” Too hostile, I tell myself. It’s hard not to meet aggression with aggression.

    “At least you didn’t go into that bullshit about everyone can benefit from therapy, it’s always good to understand yourself better, etc., etc.”

    Do I need this? I think to myself. We haven’t even said hello and we’re already adversaries. Actually that’s not a bad interpretation. “Mr. Harrison, I wonder why we’re already adversaries. As far as I know you voluntarily came into my office. I’m not forcing you to be here. There must be some reason you’re seeking the help of a therapist.”

    “Ah ha. So you’re the try the gentle approach type of therapist.”

    I am definitely getting pissed. Which must be what he wants. “I suspect it’s important for you to keep relationships on an adversarial basis. Perhaps that’s why you’re seeking therapy. Perhaps you have difficulty getting along with people.”

    “Perhaps,” he says grudgingly.

    Silence.

    “OK. So now what?” he challenges.

    I really do not need this. I want to tell this man that I don’t think we should work together, that I’m not the best person for him. Maybe that too would be a good interpretation. Or would it just be acting-out on my part?

    “Why don’t you tell me a little about yourself?”

    “Why would I want to do that if we’re not going to work together?”

    “Have you decided that we’re not going to work together?” I ask.

    “Have you?” is the rejoinder. 

    “I don’t know,” I answer truthfully. “I do know that I’m not willing to spend every session fighting with you when I have no understanding of why you need to fight. And I’m also not prepared to convince you that you should be in therapy with me.”

    “But you do think I should be in therapy?”

    “Yes,” I reply definitively.

    “Why?”

    “Because you are clearly someone who needs to fight which means that you either have a lot of anger or need to keep people at a very far distance or both.”

    “You see. You were able to tell me why I needed to be here.”

    “And I suspect that you could have told me that yourself far more quickly.”

    “But then I wouldn’t have known if you’re smart enough to handle me.”

    “So I suppose I should assume that you’re going to be continually testing me?”

    “Perhaps.”

    “Mr. Harrison…”

    “James.”

    “James, I do know that how you are in the world, is how you are in here with me, but I want to again say that I think it is very unhelpful for us to be continually sparring and that one of my goals for you, is going to be to find the James Harrison behind your defensive posturing.”

    “You don’t like me much, do you?”

    “I would say that you insure that no one likes you much. But I would very much like to learn to like you. And I hope you’ll allow that to happen.”

    “Touche!”

    I groan internally and wonder why I didn’t refuse to take him on as a patient. “Can you tell me what you’re feeling, James?”

    “Satisfied. I think you’re the right person for me.”

    “Can you say how you felt when I said I thought you insured that no one liked you, but that I’d like to learn to like you?”

    “I told you, satisfied.”       

    “Did you feel anything else? Hurt? Relieved? Angry?”

    “No. Just satisfied. I accomplished what I wanted to accomplish.”

    “So you feel satisfied with yourself. Do you have any feelings about me?”

    A slow smile spreads across his face. “I’ll tell you what came to mind. That’s what I’m supposed to do, right?”

    I nod.

    “I feel you’re a worthy opponent.”

    Perhaps, I think to myself, this treatment will be about whether a worthy opponent can become a stalwart ally. If so, it’s going to be a slow slog through.
  • 10/04/2016 2:12 PM | Anonymous

    “I had a dream about all these disasters last night,” Jenny says. “It was frightening. There was one disaster after another. I mean I know there have been lots of disasters – floods, hurricanes, earthquakes, tornados – but it was strange for me to be dreaming of them. I don’t know if I was in the disaster or watching the disaster or helping at the disaster. It was weird.”

    Jenny‘s a young medical student. I wonder if, at a surface level, she’s anxious about how she will handle her responsibilities as a physician. I remain silent, waiting to see where Jenny’s thoughts will take her.

    “My mother called last night. She was complaining about my step-father for a change, about this step-father, just like she complained about all the others. I don’t know why she keeps marrying them, always sure this one will be her most perfect love. I think I’ve even lost count of what number she’s up to. Ugh. I don’t think I ever want to get married. Or not until I’m really, really sure. I guess I see her as a disaster. That’s sad to say about your own mother. I joke with my friends that she’s my negative role model. I want to be everything she’s not and not be anything she is. Sad.”

    “Did you feel that way as a child?” I ask.

    “Maybe not as a small child, but before I became a teen-ager for sure. Our house was a revolving door. At least she was smart enough not to have any more kids, except that there were always the so-called Dad’s kids who revolved through and then disappeared forever.”

    “Was that hard? Forming an attachment to these father figures or siblings and then having them disappear?”

    She shrugs. “I don’t know. Maybe. Or maybe I just learned to do my own thing, be involved with my schoolwork, with my friends. I liked being alone.”

    Despite the matter-of-factness in Jenny’s tone, I find myself becoming sad. I wonder about her desire for aloneness as a defense against loss. And I think again about her dream, since disaster almost always involves loss.

    “When did you last see your own Dad?”

    “Who knows. He vanished a long time ago. Every so often he’ll make an appearance, but I certainly wouldn’t want to count on him.”

    “I wonder if it’s possible for you not to feel sad about all these losses, Jenny?”

    “I’m too busy.”

    To avoid sadness, I think to myself. I ask, “What were the disaster survivors doing in your dream?”

    “I was going to say they were doing what disaster survivors always do, dig through their houses looking for stuff, try to find things that are important to them. But I don’t think so. I don’t remember seeing people. It was like one of those apocalyptic novels. Maybe there were a few people, I don’t remember, but basically it was empty, barren.”

    “Sounds really sad.”

    Silence.

    “I just had a weird thought. I wonder if it wasn’t me in all those disasters, but you. Like I was the observer, but you were the one who was there. I wonder what that would mean,” she muses. “I could get it if you’re the one who’s trying to help in the disaster. But would that mean I’m the disaster? I don’t feel like a disaster. So am I trying to reduce you, to make you like me, so I don’t feel like so much of a disaster?” Pause. “I guess that’s possible.”

    “Are you saying, Jenny, that it feels like a disaster to need people, to need help, to not want to be all alone in the world?”

    “It is a disaster to need people. No one is ever there. You can’t count on anyone. Not your mother, not your father …” Her voice trails off.

    “Were you going to say, ‘not your therapist’?”

    “Yes,” Jenny says looking down. “I mean I know you’ve been there for me, but you’re only my therapist. Eventually this relationship will end. And then what? Then I’ll be alone. Again. Just like always.”

    “It’s hard for you to imagine that even when we do end – which we certainly don’t have to do until you’re ready – that you will take me with you, as part of you, just as a part of you will remain with me.”

    “I don’t know if I believe that,” she says. A moment letter, Jenny is crying. “And I’m not sure I even want to believe it,” she says between sobs. “What would that mean, that I would stay with you when my parents could discard me so easily?”

    “It would mean that you are loveable and that it was your parent’s great loss that they weren’t able to cherish you as you needed and deserved to be cherished.”
  • 08/31/2016 4:12 PM | Anonymous

    “I really appreciate your seeing me again,” Estelle Peterson says wringing her hands. I had previously seen Mrs. Peterson for a number of years. Although we made some progress in curbing her anxiety, she remained a constant worrier.

    “My daughter’s pregnant,” she says.

    “Congratulations. I remember you were afraid you’d never have a grandchild.”

    “Yes, yes, that’s true,” she says dismissively. “But she lives in Florida.”

    “And that means?”

    “Zika!”

    “Oh, you’re worried about her getting the Zika virus.” Concern about  Zika is certainly understandable, but I suspect it will only fuel Mrs. Peterson already considerable anxiety.

    “And having a deformed child! I can’t imagine anything worse. I told her she has to leave Florida. Right now. Right away. She doesn’t have to worry about me, but she has to take care of her baby! I told her to go stay with her sister in Connecticut.”

    “And she said?”

    “That it wouldn’t be a practical. That she and Jonathon have jobs. That they just couldn’t pick up leave.”

    “I told she could just quit her job and Jonathon can stay here, that she’d be all right with her sister. Then she got mad at me and told me to stop it. I told her I couldn’t stop it, that I couldn’t bear to spend the next six months worrying about her baby. They hadn’t even told me right away, so I’ll probably worry anyway, worry if one of those mosquitos got her early on. But she won’t listen to me. I don’t know what I’m going to do. How am I going to get through her pregnancy?”

    “How’s your daughter feeling about being pregnant?”

    “What? Oh, she’s pretty good. She said that some of her morning sickness was pretty bad, but I told her not to worry about that, that was to be expected. I remember when I was pregnant with her and her sister. I thought I would die. But I didn’t. And she won’t die either. But I might die of a heart attack if I have to worry about the baby for six months.”  

    I remember now. It wasn’t only Estelle’s constant worrying that was so difficult, but also her need to make everything about herself. Everyone’s pain becomes her pain. She sees herself as being constantly worried about others, but really she’s concerned about dealing with her own anxiety and discomfort.

    “So how can we help you to survive the next six months?”

    “No, you have to help me convince Diana. Tell me what I can say to her to make her leave?”

    “Even if I could do that, which I can’t, it seems to me we both need to respect your daughter as an adult, to respect her decisions and to try to be as supportive of her as you can.”

    “How can I respect her decision when it’s endangering her child, when it will leave me, her mother, a nervous wreck until the baby is born?”

    “Do you generally respect your daughter’s decisions? Did you respect her decision to marry her husband, to become a teacher, to move to Florida?”

    “I definitely wanted her to move to Florida. I wanted to keep an eye on her. Becoming a teacher was okay, although I wondered if she couldn’t do better. I guess that was true of Jonathon too, but he worked out pretty good.”

    Knowing that I am most likely talking to myself, I continue on, “Mrs. Peterson, respecting your daughter’s decisions means recognizing that she’s an adult apart from you who has a right to make a decision even if it is different from the one you’d make.”

    “Even if it endangers her child? No, I can’t respect her decision.”

    And I don’t respect Mrs. Peterson’s way of being in the world, making it difficult for me to espouse respect when I don’t feel it myself. Perhaps I can try to accept Mrs. Peterson for who she is, and thereby move us both towards a more tolerant view of others.

    “Mrs. Peterson. I suspect that you’re not going to change your daughter’s mind about not leaving Florida. Perhaps I can help you to accept that fact and perhaps we can work on managing your anxiety.”

    “You’re not being helpful.”

    “Sorry. I can only do what I can do.”

    “You used to say that to me all the time, that I had to accept my limitations, that I couldn’t control everything, that I could only do what I could do.”

    “Yes, that’s true.”

    “But maybe this time I can do more.”

    “I guess we’ll continue this discussion next week.”

  • 08/31/2016 3:47 PM | Anonymous
    “What brings you here?” I ask Peter, a handsome young man I am seeing for the first time.

    “My father.”

    I wait for further elaboration. He offers none.

    “Can you say more?” I ask.

    “Nothing more to say. I’m here because of my father.”

    “So I gather you don’t want to be here.”

    “You got that right.”

    “And you don’t feel you need to be in therapy.”

    “Right again.”

    “And you’re angry that your father insisted you come.”

    “You’re batting a thousand.”

    Ignoring his sarcasm, I ask, “So why did you feel you had to do what your father wanted?”

    He snickers. “You don’t know my father.”

    “That’s true. Why don’t you tell me about him?”

    He snickers again. “Sneaky. You’re going to get me to talk. Okay, might as well. My father’s paying for it. My father pays for everything. He’s rich. Developed his own company. Made a fortune. And never lets anyone forget it. He’s smart, a good businessman. My brother works with him. Me, I can’t imagine sitting in an office all day. Just like I can’t sit in class all day. I’m 24 and still bouncing from one college to another. I guess that’s why my father wants me in therapy. He wants you to motivate me.”

    “Are you angry with your father?”

    “Yeah, I guess you could say that. He’s always on my case. Always wants something more from me. Always bugging me to make something of my life.”

    “And what do you want for your life, Peter?” He shrugs. “Don’t know. Don’t know why I have to want anything. I like hanging out with my friends, surfing, hang gliding, sitting around getting high. Why should I have to work? Daddy will leave me more than enough money.”

    I find myself empathizing more with my patient’s father than with Peter himself, making me uncertain how to respond, concerned that I will sound critical, like his father. I decide further exploration is preferable to any comment about the patient’s current life. “Did you always feel this way, Peter? What about in grade school or even before?”

    Peter sits silently, but exudes less defiance. “My Dad was my hero,” he finally says. “He played baseball with us, took us to games. And even when he stared making money, and wasn’t around as much, I knew that he was doing it for us. And then he started making more money. And there were stories about him, interviews with him, he was making a big name for himself. And there was me. My brother was a straight A student. I couldn’t measure up. I never liked to read. I was lousy in math. There was nothing I was good at. Except baseball. And I wasn’t good enough at that. My father climbed up and up and I went nowhere but down. So I gave up. Why bother.”

    “Sounds pretty sad.”

    “I guess,” he says, shrugging, his defensive tone returned.

    “Where was your mother in all this?”

    “That’s another story. Nothing was ever enough for my mother. She criticized all of us – especially my father. I never understood why he took it, why he didn’t get out. I thought he probably had women on the side – who could blame him – but I don’t know that for sure. I once asked him. He slapped me across the face.”

    “Was that typical of him? To hit you?”

    “So when you feel angry, you turn yourself off, you ‘stop caring.’”

    “I guess.”

    “I wonder if the problem with that Peter is that without being able to tap into your anger, your aggression, it’s very hard to find your competitive spirit, your desire to win, perhaps even your desire to beat your father.”

    “I could never beat my father. I could never even come close.”

    “The problem, Peter, is that you gave up trying. You were so sure you’d lose, that you’d never come close, that you were defeated before you began.”

    “But I couldn’t come close.”

    “Maybe. Maybe not. I wonder what you might be able to accomplish if you didn’t feel so defeated, so shut down. I hope you’ll give yourself and us the chance to find out.”

  • 08/08/2016 11:21 AM | Anonymous

    Mrs. Cortez settles herself uncomfortably in the chair across from me, fidgeting nervously with her fingers. “I never expected to be in a therapist’s office,” she says. “Especially not for this.”

    I smile at her. “Take your time. I can see you’re anxious,” I say reassuringly.

    She sighs deeply. “My husband and I came from Mexico a long time ago. We wanted to have children in a place where they’d have more opportunity. We’ve done well. I’m the office manager of a large cardiologists’ office, my husband drives for FedEx. My daughter graduated from college. My son’s in college now.” She looks down at her hands. “It’s about my son,” she says, barely audible. “He…he told me he was gay.”

    She glances up at me.

    “It was after the Orlando killings, in the… the nightclub. He said he couldn’t stay silent. He couldn’t keep hiding who he was. He cried like a baby. I was shocked. I held him, told him I loved him, that I loved him whoever he was. But it’s so confusing to me. It’s against my religion. It’s against my culture. I know Pope Francis said who are we to judge and I’m trying not to, but it feels so unnatural to me. And he’s afraid to tell my husband, which I understand. But now I have this secret from my husband and I don’t like that either.”

    “I can see how much pain you’re in, Mrs. Cortez.”

    “Please call me Daniella. I just told you the biggest secret of my life, Mrs. Cortez is much too formal.”

    “Of course, Daniella,” I respond. I like this woman. Although we come from vastly different backgrounds with vastly different values, I appreciate both her pain and her conflict. From a place of love, she’s struggling to take in a new reality, to expand her view of what’s acceptable, to integrate her new information about her son – her gay son – with who she always understood him to be.

    “I know it’s hard,” I say, “But your son isn’t a different person from who he was before he told you he was gay.”

    “It feels like he is. I look at him and I wonder…” Pause. “I imagine… I wonder who he’s been with and how. It kind of makes me sick. My son? How could my son kiss another man? Could he put another man’s… No, I can’t say it. I can’t even think it.” Pause. “I haven’t been to church since he told me.”

    “Because?”

    “I have all these impure thoughts, all these images. If I go to confession, what will I say? I don’t want to tell the priest.”

    “I thought you said Pope Francis said who are we to judge.”

    “That’s Pope Francis. Not all priests are like that.”

    “So you’re afraid the priest will condemn your son, just like you’re afraid your husband will.”

    “Yes. If I’m having all these problems, my husband is so much more traditional. And he’s a man. I know what men say about gays. All those jokes. And that’s something else. I worry about my son. He’ll have such a harder life. And Mexicans aren’t having such an easy time in this country right now. Then you add being gay. I’m scared for him.”

    “Daniella, this may seem like an odd question, but can you say what you are hoping to get from therapy?

    “I needed to tell somebody. It’s been such a burden.” Pause. “And I guess I want you to help me accept my son.” She cries silently. “He’s a good boy. I love him. I keep wishing this was a dream. That it will go away. But I know it won’t. I know I won’t change him. I want to accept him. And I want to figure out how to tell my husband.”

    “Do you feel ashamed that your son is gay, Daniella?” I ask.

    She nods. “I know you’re supposed to be born that way. But I keep wondering if it was something I did, something my husband did. Did I keep him too close, was my husband too strict?”

    “There are no answers to those questions. But I wonder if we can understand how shame came to play such an important role in your life.”

    She looks down. “I’ve always felt ashamed. Ashamed of my background, my poverty, my alcoholic father. Ashamed of being different, of not being born in this country. I always wanted to fit in. And now there’s my son. Another difference – for him and for me.”

    “So hopefully as we talk about these issues and you find more peace, you’ll also be able to be more accepting of your son.”   

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