A patient and therapist struggle to help the former realize her potential despite fears of envy and retaliation.

“I’ve decided to write a book,” Karen announces at the beginning of her of session. Dressed in casual jeans, no make-up with her hair pulled back in a ponytail, Karen looks younger than her 48 years.

Although her declaration leads me to think, ‘Oh no, not another idea that goes nowhere,’ I take a more supportive approach. “In art history?” I ask, Karen’s area of specialty.

“I don’t know. I haven’t decided yet. I have to do something. I can’t go on just being Dr. Thomas Hartfield’s wife. It’s too boring. I don’t want to have to get all dressed up and hang out at the club playing bridge, gossiping with the women.”

“Weren’t you recently talking about wanting to open an art gallery?”

“Yes. I still think that’s a good idea, but I don’t know, there’d have to be so many people involved, people I’d have to manage. It seems overwhelming. Writing is something I can do on my own, at my own time, in my own space.

“Of course, I haven’t written anything since I was in college. I was pretty good back then. I think I considered majoring in English. But then again I thought about majoring in lots of things. I’m not even sure how I ended up with a major in art history. I guess because I hung around college for so long and had so many credits, they told me it was time for me to graduate and art history was it.”

“So it seems, Karen, we’re back to talking about how difficult it is for you to make a decision and to carry a plan through to fruition.”

She sighs. “You don’t think I’d write that book do you?”

“Well, I don’t have a crystal ball, but when you say that you don’t  know what you want to write about, it seems you could get stuck right there. I’d be concerned you could think endlessly about what you did or didn’t want to write and never be able to move beyond that point.”

“How did you know what you wanted to write?” Karen asks me.

I don’t introduce my book into my therapy sessions, but many patients Google me and find it online. Now I wonder if there’s some relationship between my book and Karen’s sudden interest in writing. “Before I answer that question, Karen, can I ask you how you feel about my having written a book?”

“Envious. You were able to follow through and do it. But maybe also inspired, like if you can write a book maybe I can too.” She hesitates.

“What just happened there?”

“Nothing. I guess I got anxious. There are so many choices. I don’t know how anyone ever decides on one path over another. I don’t know how you pick. I don’t know how you pick one and give up the others. So how did you decide what to write about?”

I wonder about Karen’s anxiety. Does she worry I’d feel angry or vindictive if she wrote a book? Does making one choice over others bring up fear of loss? Keeping these questions in mind, I answer Karen. “I felt compelled to write about my relationship with my late husband. I think there’s often an emotional press in writing; you have something you have to say. It’s like being in therapy. It’s sharing a vital part of yourself that you want to be known.”    

“Do you think I don’t want to be known?”

“That’s a very interesting question. What do you think?”

“Well declaring myself, taking path A rather than path B would be a way of being more known.”

I’m silent, intrigued by Karen’s train of thought.

“But why wouldn’t I want to be known?”

“I was just asking myself the same thing.”

Silence.

“Weird. The words, ‘You’re a moving target’ just went through my head.” Pause. “Who did I think would shoot me?”

I wonder if it’s me, but I remain silent.

“My oldest sister for sure. She was horribly jealous of me. I was the pretty one, although I made myself as unattractive as possible until she left for college. She’d cut up my clothes, steal all my panties. One time she even cut off part of my hair in the middle of the night.”

“That’s called abuse, Karen,” I say, surprised by this revelation I had not previously heard.

“You think?”

“Definitely. What did your parents do?”

“I don’t know. I don’t remember telling them. Maybe I did. Maybe they said we had to work it out. That part of my childhood is a bit fuzzy.” Pause. “Do you think this is relevant?”

“I definitely think this is relevant, Karen. We have to stop now, but we definitely need to spend more time understanding how your sister affected your life.”