Today's blog, "In A Quandary," focuses on a patient who returns to treatment to deal with the stresses imposed by Covid19, stresses that necessarily tap into past conflicts and issues.

“It’s kind of weird starting therapy on FaceTime,” my new patient, Leah, begins. “But I’m a therapist myself, getting used to working virtually, so I figured it was time to get myself back into treatment. I certainly could use the help.”

“And how can I help you?”

“I guess the big push for me to start treatment again is my father, but of course like everyone else in the world, I have problems and problems and more problems.” She sighs. “I’m 45. I’m married, my husband, Ed, is an IT guy working from home. I have two kids, girls, 12 and 14, who are in school virtually. So there we all are at home, each in a separate room, learning, seeing patients and solving computer problems. Sometimes it works, sometimes it doesn’t. It’s a problem if one of my girls doesn’t understand something she’s being taught and thinks she can just interrupt me in a middle of a session. I’ve tried to explain she can’t just do that, but if she goes to Ed, well, he just doesn’t have the patience, so she’ll end up interrupting me anyway. I’ve tried locking my door, but Elisa – she’s my youngest – gets really scared if I do that, so that doesn’t work either.”

“Sounds like you’re being pulled in every direction.”

“That’s for sure. And then there’s my father. My Mom died three years ago and at first I thought my Dad would be okay but now I can see he’s starting on the road to dementia – actually getting worse faster than I would have expected - and I’m worried about him being alone. Sometimes he calls again and again to ask the same question. He told me he’s burned a couple of pots forgetting he had the fire on. He’ll sometimes forget which apartment is his. And, of course, like many people during Covid, he’s lonely and, because he’s who he is, he’s angry. So I’m trying to decide if I should move him into the house with us.”

“Wow! Sounds like you have a tremendous amount on your plate.”

“Yeah. And the added problem is that I don’t like my Dad. I mean I love him – I guess – but I don’t like him. He’s angry, opinionated, narcissistic, dogmatic and intrusive. And that was all my life, not just since my Mom died or since the dementia.”

“So what was it like for you growing up?”

“Well, I’m a therapist, that should give you a big hint,” she says with a small smile. “It was hard. I was the oldest of three girls. My Mom was this really sweet person who didn’t have a backbone. She accepted anything and everything my father did, worshipped him really, and left us to fend for ourselves. Which usually meant I was the one arguing with him. My middle sister was the good girl, kind of like my mother, and my youngest sister just sort of floated through life, which is kind of what she’s still doing. I think she just ended marriage number three and career number … I don’t know. Too many to remember.”

“So what do you think it would be like with your father in the house?”

“Awful. I know it would. My youngest daughter is scared of him, always has been; and my oldest, at 14, she’d probably be arguing with him just like I used to. But I don’t know how they’d do with his dementia.”

“You haven’t said much about your husband.”

“I know,” Leah says sighing. “It’s hard. I mean I love Ed and I know he loves me, but even after all my previous therapy, I still think I married my father. No, that’s not really fair. Ed isn’t an angry bully like my father. But he is self-centered and not inclined to go out of his way to be patient or helpful, like I was saying before about his not helping my youngest with her schoolwork.”

“I notice you keep referring to your children as ‘yours’ rather than ‘ours.’

“That’s true. They’re very much my responsibility. I mean he loves them and he’s great about playing with them as long as it’s something he enjoys. But he’s definitely the fun parent and I’m the one who keeps after them to do their homework, pick of their rooms and so forth.”   

“So you always end up in the role of the responsible one. Any idea why?”

“First response, I was the oldest. Second, it’s the only way I’m sure things will get done.” Pause. “Maybe it’s the only way I feel safe.”

“There’s certainly a lot there for us to explore there.”

“I want to ask you before we stop if I should take my father in, but I know you can’t answer that.”

“Maybe we first need to look at why you only feel safe when you carry all the weight of responsibility.”