• 10/04/2016 2:25 PM | Anonymous
    “I never thought I’d be seeing a therapist. And certainly not for this! After all, it isn’t a problem. It’s what everyone does. Everyone my age, anyway. But here I am,” Samantha says, looking at me expectantly, brushing her straight blonde hair away from her face.  

    She’s been speaking at me rapidly for several minutes although I still have no idea to what she’s referring. I look back at her and wait.

    She sighs deeply. “This is harder than I thought. I guess it kind of feels like talking to my Nana. Don’t get me wrong, I love my Nana but …”

    I smile inwardly. “But you wouldn’t want your Nana to know about whatever this is. ‘

    “Exactly,” she says brightly.

    “Well, I’m not your Nana, but it would be helpful if I knew what’s troubling you or, if it’s easier, you can tell me a little about yourself.” 

    “I’m 20, a sophomore in college, actually born in Florida, from Daytona. I have two younger brothers. My parents are divorced. My Mom’s a nurse, my Dad owns a car dealership. I told them I wanted to go into therapy because school has me stressed. Which is kind of true.” Pause. “That’s about it. So I guess I better tell you.” She takes a deep breath. “I assume you know about hooking up, where you just go on your phone and make a date to meet for sex, no strings attached?”

    “Certainly,” I say nodding.

    “Well, I do it quite a bit. Started in high school, much more in college.  Like I said, no big deal, just lots of fun. Sometimes great sex, sometimes just so-so, but it’s a fantastic way to get lots of experience without having to worry about it getting messy.”

    I now feel like Samantha’s Nana. It’s hard for me to imagine the pleasure involved in totally anonymous sex. But I hope to keep my judgment to myself. “So what about hooking up is becoming a problem for you?”

    “I can’t not do it.”

    “What do you mean?”

    “Well, used to be I’d only do it on the weekend, sometimes with four or more guys, but still only Saturday and Sunday. Then it was also Friday night. And then maybe a couple of other nights during the week. But now I can’t not do it! I can’t sleep if I haven’t hooked up with at least one guy, sometimes more. Sometimes I try. I pace the floor, I drink some wine, I take a Xanax. Nothing works. Sometimes I end up hooking up at 3, 4 in the morning. I’m driven. And I know, it’s like being an addict and no kind of addict is good. My Dad’s an alcoholic and my Mom used to be addicted to pills. She’s clean now. But I know. It’s not good. Right?”

    “No, Samantha, it’s not good.” Corroborating Samantha’s assessment doesn’t feel judgmental, but rather supportive of the stronger, less impulsive part of her. “But tell me what hooking up does for you? What about it makes you feel relaxed when nothing else works?”

    “Like you said, it relaxes me. I guess part of it is just the physical release. Although I know that can’t be all of it, because it doesn’t work if I … uh … if I do it myself.” Pause. “I guess it fills me up, makes me feel less alone. And I like being wanted. Like the guy can’t have enough of me. Or the guys. They just all want me. It’s a high. Just talking about it makes me want to run out and do it.”

    “And if you don’t. If you sit with your feelings right now?”

    “I guess I feel blah. Yeah, blah. I feel ordinary, like a nobody, kind of lonely, like no one wants me. Yuk! I don’t like it. I don’t want to feel like that.”

    “Can I ask you, Samantha, are the feelings you just described familiar? Did you feel them when you were a child?”

    “For sure! First there were the two younger kids, boys at that. Then there was the booze and the pills and the screaming and the divorce and more screaming. I thought they might fight about who had to take us, but I guess that was the one non-issue. My Mom got us, no questions asked. Except they kept screaming because my Mom wanted more money, my Dad said no way. I don’t have much of a relationship with my Dad. He has lots of women. We kind of get in his way.”

    There are so many interpretations to be made here, all related to Samantha’s feeling unimportant and insignificant, whether in relation to her brothers, her father, her father’s women or her parent’s involvement with their own lives and addictions. But there’s no rush. If she can tolerate her feelings, I suspect Samantha will be in treatment for some time.   
  • 10/04/2016 2:21 PM | Anonymous

    I open my waiting room door to meet James Harrison for the first time. He rises, hand outstretched to shake mine. I’d guess he’s in his mid-forties. A good-looking man, tall, thin, seemingly comfortable in his own skin. We make the brief walk to my office and I gesture him to the sage chair across from mine.

    “So,” he says, “Why should I be here?”

    I inadvertently jerk my head back while, at the same time, stifling the urge to laugh. He’s certainly wasted no time throwing down the gauntlet. Still, it’s so startling, that I find it almost funny. Perhaps that’s a defensive reaction on my part.

    I think about commenting on his provocativeness, but decide that would only escalate what is already a fencing match between us.  “Well, since I’ve never laid eyes on you before,” I respond, “I have no idea why you should be here. Perhaps it would be helpful if you told me.” Too hostile, I tell myself. It’s hard not to meet aggression with aggression.

    “At least you didn’t go into that bullshit about everyone can benefit from therapy, it’s always good to understand yourself better, etc., etc.”

    Do I need this? I think to myself. We haven’t even said hello and we’re already adversaries. Actually that’s not a bad interpretation. “Mr. Harrison, I wonder why we’re already adversaries. As far as I know you voluntarily came into my office. I’m not forcing you to be here. There must be some reason you’re seeking the help of a therapist.”

    “Ah ha. So you’re the try the gentle approach type of therapist.”

    I am definitely getting pissed. Which must be what he wants. “I suspect it’s important for you to keep relationships on an adversarial basis. Perhaps that’s why you’re seeking therapy. Perhaps you have difficulty getting along with people.”

    “Perhaps,” he says grudgingly.


    “OK. So now what?” he challenges.

    I really do not need this. I want to tell this man that I don’t think we should work together, that I’m not the best person for him. Maybe that too would be a good interpretation. Or would it just be acting-out on my part?

    “Why don’t you tell me a little about yourself?”

    “Why would I want to do that if we’re not going to work together?”

    “Have you decided that we’re not going to work together?” I ask.

    “Have you?” is the rejoinder. 

    “I don’t know,” I answer truthfully. “I do know that I’m not willing to spend every session fighting with you when I have no understanding of why you need to fight. And I’m also not prepared to convince you that you should be in therapy with me.”

    “But you do think I should be in therapy?”

    “Yes,” I reply definitively.


    “Because you are clearly someone who needs to fight which means that you either have a lot of anger or need to keep people at a very far distance or both.”

    “You see. You were able to tell me why I needed to be here.”

    “And I suspect that you could have told me that yourself far more quickly.”

    “But then I wouldn’t have known if you’re smart enough to handle me.”

    “So I suppose I should assume that you’re going to be continually testing me?”


    “Mr. Harrison…”


    “James, I do know that how you are in the world, is how you are in here with me, but I want to again say that I think it is very unhelpful for us to be continually sparring and that one of my goals for you, is going to be to find the James Harrison behind your defensive posturing.”

    “You don’t like me much, do you?”

    “I would say that you insure that no one likes you much. But I would very much like to learn to like you. And I hope you’ll allow that to happen.”


    I groan internally and wonder why I didn’t refuse to take him on as a patient. “Can you tell me what you’re feeling, James?”

    “Satisfied. I think you’re the right person for me.”

    “Can you say how you felt when I said I thought you insured that no one liked you, but that I’d like to learn to like you?”

    “I told you, satisfied.”       

    “Did you feel anything else? Hurt? Relieved? Angry?”

    “No. Just satisfied. I accomplished what I wanted to accomplish.”

    “So you feel satisfied with yourself. Do you have any feelings about me?”

    A slow smile spreads across his face. “I’ll tell you what came to mind. That’s what I’m supposed to do, right?”

    I nod.

    “I feel you’re a worthy opponent.”

    Perhaps, I think to myself, this treatment will be about whether a worthy opponent can become a stalwart ally. If so, it’s going to be a slow slog through.
  • 10/04/2016 2:12 PM | Anonymous

    “I had a dream about all these disasters last night,” Jenny says. “It was frightening. There was one disaster after another. I mean I know there have been lots of disasters – floods, hurricanes, earthquakes, tornados – but it was strange for me to be dreaming of them. I don’t know if I was in the disaster or watching the disaster or helping at the disaster. It was weird.”

    Jenny‘s a young medical student. I wonder if, at a surface level, she’s anxious about how she will handle her responsibilities as a physician. I remain silent, waiting to see where Jenny’s thoughts will take her.

    “My mother called last night. She was complaining about my step-father for a change, about this step-father, just like she complained about all the others. I don’t know why she keeps marrying them, always sure this one will be her most perfect love. I think I’ve even lost count of what number she’s up to. Ugh. I don’t think I ever want to get married. Or not until I’m really, really sure. I guess I see her as a disaster. That’s sad to say about your own mother. I joke with my friends that she’s my negative role model. I want to be everything she’s not and not be anything she is. Sad.”

    “Did you feel that way as a child?” I ask.

    “Maybe not as a small child, but before I became a teen-ager for sure. Our house was a revolving door. At least she was smart enough not to have any more kids, except that there were always the so-called Dad’s kids who revolved through and then disappeared forever.”

    “Was that hard? Forming an attachment to these father figures or siblings and then having them disappear?”

    She shrugs. “I don’t know. Maybe. Or maybe I just learned to do my own thing, be involved with my schoolwork, with my friends. I liked being alone.”

    Despite the matter-of-factness in Jenny’s tone, I find myself becoming sad. I wonder about her desire for aloneness as a defense against loss. And I think again about her dream, since disaster almost always involves loss.

    “When did you last see your own Dad?”

    “Who knows. He vanished a long time ago. Every so often he’ll make an appearance, but I certainly wouldn’t want to count on him.”

    “I wonder if it’s possible for you not to feel sad about all these losses, Jenny?”

    “I’m too busy.”

    To avoid sadness, I think to myself. I ask, “What were the disaster survivors doing in your dream?”

    “I was going to say they were doing what disaster survivors always do, dig through their houses looking for stuff, try to find things that are important to them. But I don’t think so. I don’t remember seeing people. It was like one of those apocalyptic novels. Maybe there were a few people, I don’t remember, but basically it was empty, barren.”

    “Sounds really sad.”


    “I just had a weird thought. I wonder if it wasn’t me in all those disasters, but you. Like I was the observer, but you were the one who was there. I wonder what that would mean,” she muses. “I could get it if you’re the one who’s trying to help in the disaster. But would that mean I’m the disaster? I don’t feel like a disaster. So am I trying to reduce you, to make you like me, so I don’t feel like so much of a disaster?” Pause. “I guess that’s possible.”

    “Are you saying, Jenny, that it feels like a disaster to need people, to need help, to not want to be all alone in the world?”

    “It is a disaster to need people. No one is ever there. You can’t count on anyone. Not your mother, not your father …” Her voice trails off.

    “Were you going to say, ‘not your therapist’?”

    “Yes,” Jenny says looking down. “I mean I know you’ve been there for me, but you’re only my therapist. Eventually this relationship will end. And then what? Then I’ll be alone. Again. Just like always.”

    “It’s hard for you to imagine that even when we do end – which we certainly don’t have to do until you’re ready – that you will take me with you, as part of you, just as a part of you will remain with me.”

    “I don’t know if I believe that,” she says. A moment letter, Jenny is crying. “And I’m not sure I even want to believe it,” she says between sobs. “What would that mean, that I would stay with you when my parents could discard me so easily?”

    “It would mean that you are loveable and that it was your parent’s great loss that they weren’t able to cherish you as you needed and deserved to be cherished.”
  • 08/31/2016 4:12 PM | Anonymous

    “I really appreciate your seeing me again,” Estelle Peterson says wringing her hands. I had previously seen Mrs. Peterson for a number of years. Although we made some progress in curbing her anxiety, she remained a constant worrier.

    “My daughter’s pregnant,” she says.

    “Congratulations. I remember you were afraid you’d never have a grandchild.”

    “Yes, yes, that’s true,” she says dismissively. “But she lives in Florida.”

    “And that means?”


    “Oh, you’re worried about her getting the Zika virus.” Concern about  Zika is certainly understandable, but I suspect it will only fuel Mrs. Peterson already considerable anxiety.

    “And having a deformed child! I can’t imagine anything worse. I told her she has to leave Florida. Right now. Right away. She doesn’t have to worry about me, but she has to take care of her baby! I told her to go stay with her sister in Connecticut.”

    “And she said?”

    “That it wouldn’t be a practical. That she and Jonathon have jobs. That they just couldn’t pick up leave.”

    “I told she could just quit her job and Jonathon can stay here, that she’d be all right with her sister. Then she got mad at me and told me to stop it. I told her I couldn’t stop it, that I couldn’t bear to spend the next six months worrying about her baby. They hadn’t even told me right away, so I’ll probably worry anyway, worry if one of those mosquitos got her early on. But she won’t listen to me. I don’t know what I’m going to do. How am I going to get through her pregnancy?”

    “How’s your daughter feeling about being pregnant?”

    “What? Oh, she’s pretty good. She said that some of her morning sickness was pretty bad, but I told her not to worry about that, that was to be expected. I remember when I was pregnant with her and her sister. I thought I would die. But I didn’t. And she won’t die either. But I might die of a heart attack if I have to worry about the baby for six months.”  

    I remember now. It wasn’t only Estelle’s constant worrying that was so difficult, but also her need to make everything about herself. Everyone’s pain becomes her pain. She sees herself as being constantly worried about others, but really she’s concerned about dealing with her own anxiety and discomfort.

    “So how can we help you to survive the next six months?”

    “No, you have to help me convince Diana. Tell me what I can say to her to make her leave?”

    “Even if I could do that, which I can’t, it seems to me we both need to respect your daughter as an adult, to respect her decisions and to try to be as supportive of her as you can.”

    “How can I respect her decision when it’s endangering her child, when it will leave me, her mother, a nervous wreck until the baby is born?”

    “Do you generally respect your daughter’s decisions? Did you respect her decision to marry her husband, to become a teacher, to move to Florida?”

    “I definitely wanted her to move to Florida. I wanted to keep an eye on her. Becoming a teacher was okay, although I wondered if she couldn’t do better. I guess that was true of Jonathon too, but he worked out pretty good.”

    Knowing that I am most likely talking to myself, I continue on, “Mrs. Peterson, respecting your daughter’s decisions means recognizing that she’s an adult apart from you who has a right to make a decision even if it is different from the one you’d make.”

    “Even if it endangers her child? No, I can’t respect her decision.”

    And I don’t respect Mrs. Peterson’s way of being in the world, making it difficult for me to espouse respect when I don’t feel it myself. Perhaps I can try to accept Mrs. Peterson for who she is, and thereby move us both towards a more tolerant view of others.

    “Mrs. Peterson. I suspect that you’re not going to change your daughter’s mind about not leaving Florida. Perhaps I can help you to accept that fact and perhaps we can work on managing your anxiety.”

    “You’re not being helpful.”

    “Sorry. I can only do what I can do.”

    “You used to say that to me all the time, that I had to accept my limitations, that I couldn’t control everything, that I could only do what I could do.”

    “Yes, that’s true.”

    “But maybe this time I can do more.”

    “I guess we’ll continue this discussion next week.”

  • 08/31/2016 3:47 PM | Anonymous
    “What brings you here?” I ask Peter, a handsome young man I am seeing for the first time.

    “My father.”

    I wait for further elaboration. He offers none.

    “Can you say more?” I ask.

    “Nothing more to say. I’m here because of my father.”

    “So I gather you don’t want to be here.”

    “You got that right.”

    “And you don’t feel you need to be in therapy.”

    “Right again.”

    “And you’re angry that your father insisted you come.”

    “You’re batting a thousand.”

    Ignoring his sarcasm, I ask, “So why did you feel you had to do what your father wanted?”

    He snickers. “You don’t know my father.”

    “That’s true. Why don’t you tell me about him?”

    He snickers again. “Sneaky. You’re going to get me to talk. Okay, might as well. My father’s paying for it. My father pays for everything. He’s rich. Developed his own company. Made a fortune. And never lets anyone forget it. He’s smart, a good businessman. My brother works with him. Me, I can’t imagine sitting in an office all day. Just like I can’t sit in class all day. I’m 24 and still bouncing from one college to another. I guess that’s why my father wants me in therapy. He wants you to motivate me.”

    “Are you angry with your father?”

    “Yeah, I guess you could say that. He’s always on my case. Always wants something more from me. Always bugging me to make something of my life.”

    “And what do you want for your life, Peter?” He shrugs. “Don’t know. Don’t know why I have to want anything. I like hanging out with my friends, surfing, hang gliding, sitting around getting high. Why should I have to work? Daddy will leave me more than enough money.”

    I find myself empathizing more with my patient’s father than with Peter himself, making me uncertain how to respond, concerned that I will sound critical, like his father. I decide further exploration is preferable to any comment about the patient’s current life. “Did you always feel this way, Peter? What about in grade school or even before?”

    Peter sits silently, but exudes less defiance. “My Dad was my hero,” he finally says. “He played baseball with us, took us to games. And even when he stared making money, and wasn’t around as much, I knew that he was doing it for us. And then he started making more money. And there were stories about him, interviews with him, he was making a big name for himself. And there was me. My brother was a straight A student. I couldn’t measure up. I never liked to read. I was lousy in math. There was nothing I was good at. Except baseball. And I wasn’t good enough at that. My father climbed up and up and I went nowhere but down. So I gave up. Why bother.”

    “Sounds pretty sad.”

    “I guess,” he says, shrugging, his defensive tone returned.

    “Where was your mother in all this?”

    “That’s another story. Nothing was ever enough for my mother. She criticized all of us – especially my father. I never understood why he took it, why he didn’t get out. I thought he probably had women on the side – who could blame him – but I don’t know that for sure. I once asked him. He slapped me across the face.”

    “Was that typical of him? To hit you?”

    “So when you feel angry, you turn yourself off, you ‘stop caring.’”

    “I guess.”

    “I wonder if the problem with that Peter is that without being able to tap into your anger, your aggression, it’s very hard to find your competitive spirit, your desire to win, perhaps even your desire to beat your father.”

    “I could never beat my father. I could never even come close.”

    “The problem, Peter, is that you gave up trying. You were so sure you’d lose, that you’d never come close, that you were defeated before you began.”

    “But I couldn’t come close.”

    “Maybe. Maybe not. I wonder what you might be able to accomplish if you didn’t feel so defeated, so shut down. I hope you’ll give yourself and us the chance to find out.”

  • 08/08/2016 11:21 AM | Anonymous

    Mrs. Cortez settles herself uncomfortably in the chair across from me, fidgeting nervously with her fingers. “I never expected to be in a therapist’s office,” she says. “Especially not for this.”

    I smile at her. “Take your time. I can see you’re anxious,” I say reassuringly.

    She sighs deeply. “My husband and I came from Mexico a long time ago. We wanted to have children in a place where they’d have more opportunity. We’ve done well. I’m the office manager of a large cardiologists’ office, my husband drives for FedEx. My daughter graduated from college. My son’s in college now.” She looks down at her hands. “It’s about my son,” she says, barely audible. “He…he told me he was gay.”

    She glances up at me.

    “It was after the Orlando killings, in the… the nightclub. He said he couldn’t stay silent. He couldn’t keep hiding who he was. He cried like a baby. I was shocked. I held him, told him I loved him, that I loved him whoever he was. But it’s so confusing to me. It’s against my religion. It’s against my culture. I know Pope Francis said who are we to judge and I’m trying not to, but it feels so unnatural to me. And he’s afraid to tell my husband, which I understand. But now I have this secret from my husband and I don’t like that either.”

    “I can see how much pain you’re in, Mrs. Cortez.”

    “Please call me Daniella. I just told you the biggest secret of my life, Mrs. Cortez is much too formal.”

    “Of course, Daniella,” I respond. I like this woman. Although we come from vastly different backgrounds with vastly different values, I appreciate both her pain and her conflict. From a place of love, she’s struggling to take in a new reality, to expand her view of what’s acceptable, to integrate her new information about her son – her gay son – with who she always understood him to be.

    “I know it’s hard,” I say, “But your son isn’t a different person from who he was before he told you he was gay.”

    “It feels like he is. I look at him and I wonder…” Pause. “I imagine… I wonder who he’s been with and how. It kind of makes me sick. My son? How could my son kiss another man? Could he put another man’s… No, I can’t say it. I can’t even think it.” Pause. “I haven’t been to church since he told me.”


    “I have all these impure thoughts, all these images. If I go to confession, what will I say? I don’t want to tell the priest.”

    “I thought you said Pope Francis said who are we to judge.”

    “That’s Pope Francis. Not all priests are like that.”

    “So you’re afraid the priest will condemn your son, just like you’re afraid your husband will.”

    “Yes. If I’m having all these problems, my husband is so much more traditional. And he’s a man. I know what men say about gays. All those jokes. And that’s something else. I worry about my son. He’ll have such a harder life. And Mexicans aren’t having such an easy time in this country right now. Then you add being gay. I’m scared for him.”

    “Daniella, this may seem like an odd question, but can you say what you are hoping to get from therapy?

    “I needed to tell somebody. It’s been such a burden.” Pause. “And I guess I want you to help me accept my son.” She cries silently. “He’s a good boy. I love him. I keep wishing this was a dream. That it will go away. But I know it won’t. I know I won’t change him. I want to accept him. And I want to figure out how to tell my husband.”

    “Do you feel ashamed that your son is gay, Daniella?” I ask.

    She nods. “I know you’re supposed to be born that way. But I keep wondering if it was something I did, something my husband did. Did I keep him too close, was my husband too strict?”

    “There are no answers to those questions. But I wonder if we can understand how shame came to play such an important role in your life.”

    She looks down. “I’ve always felt ashamed. Ashamed of my background, my poverty, my alcoholic father. Ashamed of being different, of not being born in this country. I always wanted to fit in. And now there’s my son. Another difference – for him and for me.”

    “So hopefully as we talk about these issues and you find more peace, you’ll also be able to be more accepting of your son.”   

  • 06/29/2016 6:05 PM | Anonymous

    “I won’t be here next week,” Mona begins. “I’m going fishing with my parents.”

    I feel disappointed for Mona. I’ve been seeing her for a little under a year, working on her need to separate from her parents. A 30 year old paralegal, Mona works in the law firm where her mother was once senior partner and lives in a house her extremely successful father bought for her. Although Mona was raised by a series of nannies during her early years - her parents busy building a business and developing a career – they now crave her time and attention.

    “I know,” she continues. “We’ve talked about it and talked about it. No, I don’t really want to go. No, I don’t like to fish. Yes, it’s awful being stuck on a boat with my folks for a week. Yes, I wanted to save my vacation time so I could go to Europe.” 


    “And I’m going fishing.”

    “Do you have a sense of why you made that decision?”

    “The consequences of not going are too great.”

    “And those consequences are?”

    “My house. My job. Little things like that.”

    “Do you think your parents would take away your house or your job if you said you didn’t want to go fishing with them?”

    “It’s important to them. If I can make them happy, why not?”

    “What about what makes you happy?”

    “Oh yes. There is that I suppose.”

    “What would make you happy, Mona?”

    “Being on a desert island somewhere, all by myself.”

    “Is that true?” I ask.

    “Yes and no I guess. In some ways it would feel like I felt as a kid – alone and adrift – surrounded by my books instead of water. There were times that felt welcoming, peaceful. Other times I felt so, so lonely. All I wanted was Mommy or Daddy to come home and be with me. But even when they were home they weren’t with me. And that was worse.”

    “So now Mommy and Daddy have come home to be with you.”

    “I suppose.”


    “You know, I’m not sure that’s true,” Mona says. “I mean, yes, they’re always there. I can’t get rid of them. But I’m the Mommy and the Daddy. I have to take care of them.”

    “So you’re still not getting what you need. And you’re certainly not getting what you needed as a child.”

    “That’s for sure.”

    “But I wonder, Mona, if you keep trying, if you keep trying to get what needed from them. If you keep trying to get them to take care of you as you hadn’t felt taken care of as a child.”

    “No doubt. Look what I chose as a profession, a paralegal. Not putting paralegals down or anything, but I know I’m smart, I know I could have been anything I wanted to be – a doctor, a lawyer, CEO of a corporation. But, no, I’m a paralegal and Mommy and Daddy get to take care of me forever.”

    “That’s really sad, Mona. You’re saying that you kept yourself from realizing your full potential in your attempt to get what you never got from your parents in the past.”

    “It’s worse than that. Because what I get from them now are the same things I was able to get from them as a kid – material things. I never wanted for anything materially. But what I wanted was their time and attention. And, yeah, I suppose I do get that now, but it’s really all about them. I don’t even know why I keep trying.”

    “I think you do know why, Mona. You keep trying because inside you there’s a needy dependent little girl who yearns for Mommy and Daddy to be home taking care of you.”

    “I suppose that’s true.”

    “The problem is that you can never make up for that, Mona. The past is past and however much you as that little girl might long for and deserve to have loving, attentive parents, there’s no way to redo that.”

    “That’s charming. So what do I do?”

    “You - and we - have to work on helping you to mourn that which you never had. It’s hard. It means feeling sad and angry, sad and angry, sad and angry, until you can get to a place of acceptance.”

    “Doesn’t sound pleasant.”

    “No, it’s a long, difficult process.”

    “Meanwhile it will have to wait. I’m going fishing.”

  • 06/15/2016 6:01 PM | Anonymous

    “I still can’t believe it,” Marcy says, tears streaming down her face, her hands clenched into fists. “

    I can’t believe my big brother is dead. In an instance. He’d just played racket ball that morning. To die just like that. No sign of any heart problems. I can’t believe it.”

    “I’m so sorry, Marcy. I know how important your brother was to you, almost like a stand-in father.”

    Marcy nods, sobbing, unable to speak.

    “And his sudden death must bring up all the feelings you had as a child when your father died so suddenly.”

    March nods again, reaches for a tissue and blows her nose. “That’s why I know Dave did everything he could not to repeat our father’s history, not to leave a wife and young kids. He never smoked, didn’t eat red meat, exercised. And he barely made it into his fifties. It’s so unfair,” she says. “Life is so God damn unfair!”

    Silence. Marcy looks up at me and says, “You look so sad yourself.”

    Marcy has read me correctly. I reverberate with her pain. Although I never had a brother and my father didn’t die young, I’ve had my share of losses. The intensity of Marcy’s pain brings back the feelings of agonizing loss, of emptiness, of disbelief at knowing you will never again see the one you loved. That life is unfair goes without saying. I no longer rail against that indisputable reality. Loss is a necessary part of love and life. And life without love isn’t worth living.

    I respond honestly. “Yes, Marcy. I am. I feel the depth of your loss, your sadness and just as your brother’s death brings up past feelings about your father’s death, it also stimulates feelings about my past losses.”

    “I’m sorry. I didn’t mean to make you sad,” she says, immediately illustrating the problem of a therapist being self-revealing.

    “That’s perfectly okay, Marcy. You don’t have to take care of me. You have more than enough to do right now taking care of your own feelings. And, besides, although your pain now feels overwhelmingly agonizing, I know that you wouldn’t have given up having your brother in your life. And that’s true for me and my losses as well.”

    “Oh no! I would never have given up having him in my life. Not for a moment. I literally don’t know what I would have done without him as a kid.” Pause. “But I’m still going to miss him,” she adds plaintively. “I feel like a kid when I say that,” she says between sobs.

    “We all carry the child part of us along with our adult self, so I’m sure both the adult you and the child you will miss him. Very much.”


    “You know what you said about my not having to take care of you?”

    “Right. You don’t.”

    “I was thinking how different that was than when my father died. I was only six, but I felt that I had to take care of my mother. I was supposed to be the one to make her feel better. And I couldn’t do that. She felt bad for a long, long time. I can feel how I felt as that child. That long, long time felt like forever. And while I tried to take care of her, she wasn’t so good at taking care of me. Good thing my brother was 18, or who knows what would have happened to me. Probably shipped off to some aunt I hardly knew. My brother tried hard. But sometimes my clothes didn’t match or my hair was all messy. I don’t remember the other kids making fun of me. They mostly felt sorry for me, but that didn’t feel so good either.”

    “It all sounds terribly painful, Marcy. So hard for you.”

    “And now I’m back at it again. Trying to make Mom feel better. But it always seems reasonable. First she loses her husband, now her son. What could be worse than that? But I don’t want in that role again. It’s such a burden.”

    “Are you concerned, Marcy, that you will need to take care of me, too?”

    “No,” she says hesitantly.

    “You don’t sound too sure.”

    “Well, you don’t seem depressed and you’re certainly functional.” Pause. “But maybe making you feel sad worries me. Like I’m not supposed to do that.”

    “I understand, Marcy. We should continue to look at that. And maybe looking at your feelings of needing to take care of me, will help you work through some of the past issues with your mother and free you from the burden of feeling responsible for her happiness.”

  • 05/31/2016 5:49 PM | Anonymous

    “I’m kind of in a state of shock,” Sheila begins. “My sister was arrested for shoplifting. A lipstick for heaven sakes! She could have bought a million lipsticks! I don’t get it. And she doesn’t seem to be able to explain it. At least not to me.”

    “You’ve never talked much about your sister,” I say to Sheila. “What’s your relationship like?”

    Sheila sighs. “Pat’s two years younger than me, 36. I guess we’ve never been close. Not as kids, not now when we live less than a half hour apart. She was always difficult, always getting into trouble, creating some drama in the house. She’s very pretty. My father liked that. I guess I was jealous of her. I was the good girl, the one who always did well in school, the one who obeyed the rules. I got points for that, but her looks made her popular with the “in” girls and always got her dates with the most desirable boys. And then she married Cliff, married into all that wealth. She calmed down after that. I thought she was happy. Who knew?”

    “Do you still feel jealous of your sister?”

    “I guess. It seemed she was always creating problems, but still got everyone to love her. But I don’t know about this time. My parents are definitely not happy. And I can only imagine how Cliff’s family will react.”

    “Does that bring you some satisfaction?”

    “I wouldn’t say that to anyone but you, but yes, it does. Except she’ll probably get out of this too. And I really shouldn’t complain. I have a great career, a wonderful husband and a lovely daughter. You can’t ask for much more than that.”

    “Do you feel less than your sister?”

    “That’s a good question. It’s like if I think about my adult self and my adult life, I have absolutely no reason to feel less than Pat – except for her money, but that’s really not the issue for me. It’s these feelings from the past that creep in and suddenly I’m the one who gets to stay home on Saturday night, who watches my father look adoringly at my sister and, yes, I feel less than. Silly, right?”

    “Not silly at all, Sheila. Our unconscious is timeless and the experiences and feelings we had at five and ten and fifteen, are as much with us, as our present day experiences and feelings.”

    “Makes sense.”

    “You haven’t talked at all about your mother’s feelings about you or your sister.”

    “I guess that’s because I never knew how my mother felt. About anything. She was always efficient and proper and did the things she needed to do, including taking care of us, and I suppose loving us, but there was a shallowness to her feelings. Or maybe it’s that feelings were too messy. She did what she needed to do, her feelings on the shelf.”

    “So in relation to your mother, your sister and you were equal, neither of you getting very much.”

    “Oh, I wouldn’t say that. I mean we may have been equal, but it’s not that we didn’t get very much.”


    “Are you saying you think we were emotionally deprived?”

    “You were the good girl, your sister acted out. Maybe you were both trying to get more love and attention.”


    “I wonder if that’s why I sometimes get depressed out of the blue. It’s like everything is going along fine and suddenly there’s this black cloud.”

    “That a great insight, Sheila. What you’re saying is that those childhood feelings we were talking about earlier catch up with you and suddenly you’re a kid again feeling needy and ungiven to and depressed.”

    “That’s exactly right!” She pauses. “You know, that also makes me feel more sympathy towards my sister. I like that. It’s a new feeling.” Another pause. “Do you think she shoplifted because she felt needy and thought the lipstick would make her feel better?”

    “You’re saying she was trying to nurture herself with a material object, because she didn’t feel given to emotionally. That’s certainly a possibility. And I imagine there’s some anger thrown in there as well. Probably for both of you.”

    “Hmm. I’ve never seen myself as an angry person, but I guess we’ll have to talk about that next time.”

    “Okay. We will.”

  • 04/27/2016 2:14 PM | Anonymous

    Belinda glares at me silently, arms crossed in front of her chest. “Look at you,” she says finally, “Sitting there so innocently, like you’re not about to shirk your responsibility and abandon us all.”

    Finding myself more amused than angry, I wonder if Belinda is less distressed about my upcoming vacation than her words seem to imply. I’ve seen Belinda for a number of years now and watched her grow from a woman who was unable to feel much of anything, to someone who is more in touch with her emotions and more able to connect to others. But anger is her usual defense when she feels particularly vulnerable. “So you’re feeling angry about my being away for two weeks,” I say.

    “Duh! Yeah, you could say that, great clinician that you are.”

    I’m less amused. She may be angrier than I thought.

    “This may seem like a silly question, but why? Why are you so angry?”

    “That’s not silly, it’s stupid. Answer it yourself!”

    “Belinda, what’s going on here? You’ve never liked when I’ve gone on vacation, but you seem particularly angry today.”

    “All that talk about your being here for me, about my needing to take you with me, about my needing to rely on you. Great! So what happened to all that?”

    “None of that has changed.”



    “Say something,” she demands.

    I consider remaining silent and decide that would only escalate the confrontation. “I think you’re trying to provoke me, Belinda, and I’m not sure why that is.”


    “Do you feel anything besides anger about my being away for two weeks? Do you feel scared? Sad?”

    “You’d like that wouldn’t you? You’d like me to be crying like a baby. Make you feel important. Like I couldn’t live without you.”

    “You can live without me, Belinda, but that doesn’t mean you can’t have feelings about my being gone.”

    “Why are you the one who decides when you get to leave? Why don’t I have a say in the matter? Why don’t your other patients?”

    An image of my patients voting on when I should go on vacation floats through my mind and I again find myself amused. But then I wonder why I am being amused by Belinda’s anger today. Is it my defense? Is Belinda’s anger frightening me and am I trying to minimize it by finding it amusing? Or perhaps she’s the one who’s frightened of her anger. 

    “Well?” she asks challengingly.

    “Are you afraid of how angry you are, Belinda?” I ask.

    “Are you?” is her retort.

    “I don’t know,” I reply. “I didn’t think I was, but then I wondered if I was minimizing your anger and if that meant I was afraid of it. And then I wondered if you were afraid of your anger.”

    Belinda’s face softens. She looks almost like she might cry. She shakes her head. “I can’t believe it. I was sure I’d never let you in today. I was sure I’d hold onto my anger. I was sure I wouldn’t tell you. I cut myself last night.”

    My stomach turns over. “Why?” I asked, shocked. As far as I knew Belinda was never a cutter.

    “I just felt so angry you were leaving me. I didn’t know what to do with all the feelings. I tried screaming and hitting the wall but it didn’t help. So I took a knife and cut myself. Not much, truthfully. It was just a little nick. I don’t much like blood. I thought if I could really hurt myself, I’d probably feel better, but I couldn’t do it. And then I got even madder that you had that much power over me.”  

    “I’m glad you didn’t really hurt yourself, but inflicting pain on you in any way is really scary, Belinda. I’m sorry you didn’t call me and try and talk about your feelings.”  

    “That makes me mad too. Why would I call you and be even more dependent on you when there’s no way I’m going to be able to call you for two weeks?”

    “It’s true, Belinda. I’m not going to be available for two weeks. But that doesn’t mean I stop existing for you or that you stop existing for me. We’re in each other’s lives; we’re in each other’s head. Our connection doesn’t vanish. And, yes, you can be angry that I’m going. And you can also feel sad and scared. And we can talk about all those feelings. But neither of us can or should try to take the feelings away or make light of them. You’re feelings always matter, because you matter.”

    “I was about to say I wish you didn’t matter to me, but I guess that’s really not true.”

    “I’m glad. We still have one more session before I leave, so let’s continue talking about this. And no cutting.”

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