Jacob, a tall, thin, awkward-looking 21 year old, enters my office for the first time.
“My mother thinks I should be in therapy,” he begins.
“And what do you think?”
“I guess. Well, I sorta like talking. But they always dismiss me. I’ve seen seven therapists and they all say that I’m fine, that I don’t have to come any more.”
I’m appalled. How is it possible that so many therapists would dismiss a patient who wasn’t ready to end? “I won’t do that,” I blurt out. “I won’t tell you to leave until you feel ready.” But then I have a second thought. It does seem unlikely that so many therapists would react in the same manner unless the patient was contributing to the perception that he was “fine.” Definitely something to keep in mind as the treatment progresses.
I stand with my sister behind our locked bedroom door, while my brother rages on the other side, beating his fists and throwing his body against it. It bucks and shudders in its frame, until the doorframe cracks. But the door holds.
It turned out to be one of many doors that held.
Though I came from an educated family, the first time I heard about therapy was when I went to boarding school. I stood on the deck of the library during a party talking to my Spanish teacher and a dark-haired girl who was known to be troubled. Fir trees loomed overhead. When the girl said she was in therapy, I said something like, “I’d be interested in trying that, but I don’t think I’m crazy enough.” She closed her lips and looked down. My Spanish teacher said, “You just told her she was crazy.” Shame swallowed me up.
William lived with his mother. His adoptive mother, technically, and not the first. From his sixth week of life to his second year, someone other than his real mother had taken care of him. But that first adoption didn’t take, and one day he found himself alone, hungry, and afraid, until someone picked him up and took him to the place where his present mother had chosen him and taken him home. He didn’t know why he had been abandoned, had no sense of how long he’d been on the street. He knew only that he had hated that place–the smell of dog and other cats, the cage that trapped him between his litter and his food, the noise–and that now he was somewhere safe, somewhere quiet, with snug spaces to nestle in and nap on, high places from which to surveille, low, cool, dark hollows for hiding, and a tiny patch of outside where he could sun himself or stalk prey.
Therapists rely on the sixth sense, broadly defined as intuition. What of the other senses? Bypassing thought, the senses assimilate unconscious information before words are found. Feeling at sea with three patients, I tune into sensory experiences and begin to write.
Today Daniel is a man. The August break has been good to him. When I saw him last month this 40 year old was a boy slumped over by depression. Now there is a new weather system in the consulting room.
I don’t quite recognize this Daniel and I am thrown off my game. He has biceps. His hair is tousled in that bed head way. He takes command of the chair that previously engulfed him. He seems more masculine. Sexy. He is smiling. Buoyed by his new role as father, Daniel expresses surprise at his capacity to nurture.
Marcia died on Monday, asphyxiated by pneumonia, afflicted by brain cancer. She was beautiful, intelligent, 38 years old. I wonder how Marcia felt as life eased out of her body. Her body: cut, sutured, shunted, intubated and bruised. Did she find peace in dying or did she rage her final breath?
Grief and awe compel me to write about our relationship. I was Marcia’s therapist for ten years. We met weekly. She described herself to friends as “upbeat.” She aspired to her childhood nickname “Susie Sunshine” with her bright outlook and spunkiness, but in the privacy of my office, Marcia relinquished her burden of confidence, optimism, and enthusiasm. With shame, she showed me the sad and lonely Marcia hidden from her friends. In the privacy of my office, Marcia allowed herself to express her longings for romance and intimacy.
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