I Can't Stand It! | by Linda Sherby, Ph. D, ABPP

02/04/2022 6:52 PM | Anonymous

"I Can't Stand It!" starts with a patient's anger and despair about covid19 and ends with a surprise for the therapist.



“I can’t stand this anymore!” Karen shrieks. On my video screen I watch a usually attractive 35 year old woman grimace and pull at her hair. “When, when is it going to end?”

“I don’t know the answer to that, Karen. It’s a pandemic and the virus will do what it’s going to do.”

“But we can’t plan anything. We don’t know from one moment to the next what’s going to be happening. How many times have we gone back and forth from being in the office and back on video? I can’t stand it! I feel as though I’m going crazy.”


“The uncertainty is difficult for everyone, Karen. And I do understand that going back on video after a few weeks in the office is very disconcerting.”

“And then there’s your vacation! How could you leave in the middle of all this?! What if you got sick? What if you died? Would I even know? Would anyone tell me?”

“I understand your feeling angry with me for abandoning you.”

“But answer my question. Would anyone tell me if you died or would I just be wondering forever?”

“Yes, a colleague would contact you if I died. But I wonder if your worrying about my dying came from your feeling so unsafe without me. My absence has always been understandably frightening to you and certainly with Covid raising everyone’s anxiety, it’s easy to see how you’d fear losing me forever.”

“You mean like when I was a kid and my mother went away leaving me with my insane father?” Pause. “Yes, that was terrifying. It was always terrifying, even when she was there, but when she was gone that was really, really terrifying. I never knew what to expect. Truthfully, my mother was useless at preventing my father’s explosions, but it still felt a bit safer when she was there. He was so unpredictable. You just never knew what would set him off: a book left on the kitchen table, the dog barking, my clattering a dish. It was so scary. And I could never understand why she had to go away. What was so much more important than me?!”

“The pandemic replicates your childhood experience in so many ways: you never know what’s going to happen next and, just like your mother, even when I’m here I’m pretty ‘useless’ to change the reality of the pandemic, just like she couldn’t prevent your father’s explosions.”

“But why did you have to go away? She went away for business, although as a kid I never knew what that meant. She went away to see her parents, but I didn’t understand why she couldn’t take me with her. I guess my Dad would say we couldn’t afford it, but I didn’t understand that either.”

“I don’t think, Karen, anything your Mom told you about why she went away would have felt like a good enough reason to you and I’m sure that’s true of me as well. You’d always feel you weren’t important enough, that you were being left for something more important than you.”

“You’re not going to tell me, are you? You’re not going to tell me why you went away.”

“I don’t think the reason I went away would make any difference to you. As I said, it wouldn’t make you feel any less left or abandoned.”

“But it might make me feel like I mattered enough for you to tell me.”

“Did you have any thoughts, ideas of why I went away?”

“Well that’s an obvious therapist trick! I won’t play!”

“What I think is happening now is that you’re finding something to fight with me about, as opposed to us dealing with your anger about my leaving, and perhaps also the fear and sadness you felt underneath.”

“Why won’t you tell me?!”

“Because no matter what I say, I will have left you for someone or something else and it’s those feelings we need to deal with, not the specifics of where I went or why. Your mother told you why she went away and it never made a difference to you.”

“Tell me.”

I struggle to decide how to respond. I’m beginning to feel angry, which I know is also what Karen feels. I don’t think an endless power struggle between us will be helpful. And I also don’t think my telling her will change her feelings. I finally say, “I went to attend a friend’s special birthday.”

“You told me! I won!”

I’m startled.

“Yay!! You didn’t expect me to react like that. This was great. I feel powerful! And way less scared.”

“That’s true, Karen, that’s not how I expected you to react. You feel as though you won and therefore you’re no longer the scared child, but rather the powerful adult.”

“Yes.” Pause. “And you’re right, I still feel you put someone else above me. But it doesn’t hurt nearly as much.”

“There’s a lot to process here. We’ll have to continue next session.”


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