A patient turns her pain and anger on herself.
“Bill broke up with me Saturday night,” says 28 year old Chelsea in her Monday session, looking as though she may not have slept or bathed since then.
“I’m so sorry…” I begin.
“You didn’t call me back. I called and called and called.”
“I’m sorry, Chelsea, but when I called on Sunday I explained I was at a very long play, didn’t check my phone and got home way too late to call. Did you get my message?”
“It was too late,” Chelsea says, rolling up the left hand sleeve of her blouse.
Always a bit queasy, I resist the urge to look away, her left arm filled with red gashes from what I assume are self-inflicted cuts from a razor blade. “Oh, Chelsea,” I say, “It’s been years since you felt the need to cut yourself. I guess you were mad at both Bill and me.”
“You abandoned me. I couldn’t stand the pain.”
“What made the pain so unbearable?”
“What?” she asks, becoming angry. “That’s a stupid question. The two most important people in my life abandon me and you ask what made the pain so unbearable?”
“You’re definitely angry with me.”
“But why did you need to turn the anger on yourself, why cut yourself, why not be angry at me, at Bill?”
“What was I supposed to do, go to your house and kill your dog?”
“Was that a fantasy you had on Saturday night?” I ask, hoping I sound calmer than I feel internally.
“What if it was?”
“You know, Chelsea, it’s always all right to have whatever fantasy you have, as long as it stays a fantasy.”
“Hah! Scared you, didn’t I?”
“It’s a scary fantasy, but the pleasure you took in scaring me indicates just how angry you are at me. I guess what you’re saying is that you felt afraid you couldn’t contain your rage, so had to turn in on yourself.”
“I wanted to kill you! I wanted to kill Bill. I did start swinging at him, but he just pushed me away and told me that’s why he had to get away from me and literally ran out the door.”
“I am sorry, Chelsea. I know you loved Bill and really wanted this relationship to work out.”
“Why don’t they? Why don’t any of my relationships work out?” Chelsea says, starting to cry.
Although we have dealt with the responses to those questions many times over the years – because you’re demanding and needy, because one moment you love the person and the next you hate him, because you can’t tolerate even brief separations without feeling enraged or terrified or both - I also know this is not the time to revisit them.
“When I didn’t call you back on Saturday, what did you think? Why did you think I didn’t call? And what did you think when I called on Sunday?”
“I felt you were just like Bill. That you didn’t care about me, that you were sick of me just like him, that you wanted to be rid of me.”
“I understand that’s what you felt, Chelsea, but I was asking something a little different. I was asking what you thought. If you thought there might have been a reason I didn’t call you back that might have had nothing to do with you, like maybe I lost my phone or forgot it.”
“But you didn’t. You chose not to call me back.”
“So it would have felt better for you if I’d called after midnight?”
“It would have felt better, but it still would have been too late.”
Only Chelsea’s feelings exist for her at this moment. “You’re caught up in so many painful feelings, Chelsea - hurt, loss, rage, abandonment – that from this place it’s impossible for you to step outside your feelings and try to reflect on them. So maybe it would be better if we focused on helping you not to turn all those feelings on yourself and hurt yourself. Can we do that?”
“I kinda liked doing it, it was like going back to an old friend.”
“I’m sorry to hear that. So are you saying that you think you’re going to start cutting again?”
Chelsea smirks. “That made you angry, didn’t it?”
“You know, I wasn’t aware of feeling angry, but you’ve always been incredibly sensitive and now that you mention it, perhaps that’s true.”
“And that’s one thing I’ve always appreciated about you, your honesty and your willingness to own your own shit.”
“Thank you. So maybe from there we can work on repairing our relationship and move forward.”
“Maybe,” Chelsea says with considerable hesitation.
“I understand. Right now repair feels difficult.”
“Yes, it does.”