a therapist reflects on and uses her angry feelings towards her patient to work more effectively with that patient and to help her patient understand her use of anger as a defense.
Not Again
As Cynthia sits scowling from the chair diagonally across from me, I remember why I was both surprised and less than thrilled to have her call and ask to return to treatment.
After several minutes of us staring at each other I say, “What prompted your wanting to return to therapy with me?”
“The New Year,” she says curtly, as if that provides an adequate explanation.
“And…?” I ask, prodding.
“What the fuck! You know people make resolutions about what they’re going to do to improve their lives. As if January 1 was the magic date.”
“That would imply there were things in your life you wanted to improve.”
“Of course! You know anyone who doesn’t want to improve their life!”
“This all feels very familiar Cynthia. You say you want to improve your life, you asked to come back into therapy with me, yet you’re immediately attacking everything I say.”
“What? You can’t take somebody challenging you?”
“Okay,” I say, hoping I’m hiding my desire to strangle her. “Let’s look at that last comment: You can’t take somebody challenging you. What impelled you to make that particular statement?”
“What? How should I know. It seemed like a good response to your dumb ass comment.”
Silently counting to 10, I reflect on how uncomfortable it is to be angry and to have to contain it. “Okay,” I say. “We already know you’re angry. And we know you have good reason to be angry. But would I be making a wild guess to say that perhaps one of the ways you’d like to make your life better is to be less angry?”
She shrugs.
We again sit in silence, but this silence feels a bit more comfortable, not as raw, not as challenging.
She mumbles something.
“I’m sorry,” I say, “I didn’t hear you.”
“It’s not a good way to make friends,” she says, barely over a whisper.
“True. In fact I think that sometimes you use your anger to keep people away.”
“Why would I want to do that?” she asks, the edge back in her voice.
“I wasn’t criticizing you when I said you use your anger to keep people away. I was making a comment that, if correct, might help you to think about when and why you try to keep people away and when you you’d like a person to be closer.”
“I never know,” Cynthia says, again barely above a whisper. “I do want more people in my life. But when they come at me, I don’t know, I just can’t take it.”
“Interesting choice of words, Cynthia – when they come at me – like when your parents came at you to punish you, beat you, hurt you.”
She nods, dropping her head. “Yeah.” Pause. “People aren’t safe.”
“Some people are safe.”
“You can always get them mad.”
“I guess you’re saying YOU can always get them mad by prodding and poking and challenging. Or by running away.”
“Who says I run away?!”
“There’s that edge again, Cynthia. I say you run away. If you didn’t run away you’d have more people in your life. You’d be less lonely.”
“I never said I was lonely!”
“You didn’t imply it?” I ask gently.
She shrugs. Pause. “I guess.” Pause. “I don’t want people getting too close. I could get hurt.”
“I understand that, but I wonder if you’re also saying it feels really scary to want people, to need them. Like it feels really scary to need me, to say you want to be here, that you need to be here.”
“Go fu…” Pause. “I was just going to tell you to go fuck yourself, but then that seemed like exactly what you were saying, that I use my anger to keep people away and maybe it’s because I don’t want to need any of those fucking people who are just going to hurt me again and again.”
“I’m impressed, Cynthia, that you were able to catch that yourself, reflect on it and keep yourself from giving an automatic angry response.”
“Yeah. I guess that was pretty good.”
I smile. “I’m glad you were able to take in a positive comment about yourself and accept it.”
“I guess.”
“Now don’t get too enthusiastic,” I say teasingly.
“I… I’m glad I came back.”
“Thank you, Cynthia,” I say. “I’m really, really glad you came back too.”
