But then we get licensed, people come to seek our counsel and . . . we still go to therapy. Not continuously, necessarily, but a majority of us sit on somebody else’s couch at several points during our careers, partly to have a place to talk through the emotional impact of the kind of work we do, but partly because life happens and therapy helps us confront our demons when they pay a visit.
And visit they will, because everyone has demons—big, small, old, new, quiet, loud, whatever. These shared demons are testament to the fact that we aren’t such outliers after all. And it’s with this discovery that we can create a different relationship with our demons, one in which we no longer try to reason our way out of an inconvenient inner voice or numb our feelings with distractions like too much wine or food or hours spent surfing the internet (an activity my colleague calls “the most effective short-term nonprescription painkiller”).
One of the most important steps in therapy is helping people take responsibility for their current predicaments, because once they realize that they can (and must) construct their own lives, they’re free to generate change. Often, though, people carry around the belief that the majority of their problems are circumstantial or situational—which is to say, external. And if the problems are caused by everyone and everything else, by stuff out there, why should they bother to change themselves? Even if they decide to do things differently, won’t the rest of the world still be the same?
It’s a reasonable argument. But that’s not how life generally works.
Remember Sartre’s famous line “Hell is other people”? It’s true—the world is filled with difficult people (or, as John would have it, “idiots”). I’ll bet you could name five truly difficult people off the top of your head right now—some you assiduously avoid, others you would assiduously avoid if they didn’t share your last name. But sometimes—more often than we tend to realize—those difficult people are us.
That’s right—sometimes hell is us.
Sometimes we are the cause of our difficulties. And if we can step out of our own way, something astonishing happens.
A therapist will hold up a mirror to patients, but patients will also hold up a mirror to their therapists. Therapy is far from one-sided; it happens in a parallel process. Every day, our patients are opening up questions that we have to think about for ourselves. If they can see themselves more clearly through our reflections, we can see ourselves more clearly through theirs. This happens to therapists when we’re providing therapy, and it happens to our own therapists too. We are mirrors reflecting mirrors reflecting mirrors, showing one another what we can’t yet see.
Which brings me back to John. Today, I’m not thinking about any of this. As far as I’m concerned, it’s been a difficult day with a difficult patient, and to make matters worse, I’m seeing John right after a young newlywed who’s dying of cancer—which is never an ideal time to see anyone, but especially not when you haven’t gotten much sleep, and your marriage plans have just been canceled, and you know that your pain is trivial compared to that of a terminally ill woman, and you also sense (but aren’t yet aware) that it’s not trivial at all because something cataclysmic is happening inside you.
Meanwhile, about a mile away, in a quaint brick building on a narrow one-way street, a therapist named Wendell is in his office seeing patients too. One after another, they’re sitting on his sofa, adjacent to a lovely garden courtyard, talking about the same kinds of things that my patients have been talking to me about on an upper floor of a tall glass office building. Wendell’s patients have seen him for weeks or months or perhaps even years, but I have yet to meet him. In fact, I haven’t even heard of him. But that’s about to change.
I am about to become Wendell’s newest patient.
2
If the Queen Had Balls
Chart note, Lori:
Patient in her mid-forties presents for treatment in the aftermath of an unexpected breakup. Reports that she seeks “just a few sessions to get through this.”
It all starts with a presenting problem.
By definition, the presenting problem is the issue that sends a person into therapy. It might be a panic attack, a job loss, a death, a birth, a relational difficulty, an inability to make a big life decision, or a bout of depression. Sometimes the presenting problem is less specific—a feeling of “stuckness” or the vague but nagging notion that something just isn’t quite right.
Whatever the problem, it generally “presents” because the person has reached an inflection point in life. Do I turn left or right? Do I try to preserve the status quo or move into uncharted territory? (Be forewarned: therapy will always take you into uncharted territory, even if you choose to preserve the status quo.)
But people don’t care about inflection points when they come for their first therapy session. Mostly, they just want relief. They want to tell you their stories, beginning with their presenting problem.
So let me fill you in on the Boyfriend Incident.
The first thing I want to say about Boyfriend is that he’s an extraordinarily decent human being. He’s kind and generous, funny and smart, and when he’s not making you laugh, he’ll drive to the drugstore at two a.m. to get you that antibiotic you just can’t wait until morning for. If he happens to be at Costco, he’ll text to ask if you need anything, and when you reply that you just need some laundry detergent, he’ll bring home your favorite meatballs and twenty jugs of maple syrup for the waffles he makes you from scratch. He’ll carry those twenty jugs from the garage to your kitchen, pack nineteen of them neatly into the tall cabinet you can’t reach, and place one on the counter, accessible for the morning.
He’ll also leave love notes on your desk, hold your hand and open doors, and never complain about being dragged to family events because he genuinely enjoys hanging out with your relatives, even the nosy or elderly ones. For no reason at all, he’ll send you Amazon packages full of books (books being the equivalent of flowers to you), and at night you’ll both curl up and read passages from them aloud to each other, pausing only to make out. While you’re binge-watching Netflix, he’ll rub that spot on your back where you have mild scoliosis, and when he stops, and you nudge him, he’ll continue rubbing for exactly sixty more delicious seconds before he tries to weasel out without your noticing (you’ll pretend not to notice). He’ll let you finish his sandwiches and sentences and sunscreen and listen so attentively to the details of your day that, like your personal biographer, he’ll remember more about your life than you will.
If this portrait sounds skewed, it is. There are many ways to tell a story, and if I’ve learned anything as a therapist, it’s that most people are what therapists call “unreliable narrators.” That’s not to say that they purposely mislead. It’s more that every story has multiple threads, and they tend to leave out the strands that don’t jibe with their perspectives. Most of what patients tell me is absolutely true—from their current points of view. Ask about somebody’s spouse while they’re both still in love, then ask about that same spouse post-divorce, and each time, you’ll get only half the story.
What you just heard about Boyfriend? That was the good half.
And now for the bad: It’s ten o’clock on a weeknight. We’re in bed, talking, and we’ve just decided which movie tickets to preorder for the weekend when Boyfriend goes strangely silent.
“You tired?” I ask. We’re both working single parents in our mid-forties, so ordinarily an exhausted silence would mean nothing. Even when we aren’t exhausted, sitting in silence together feels peaceful, relaxing. But if silence can be heard, tonight’s silence sounds different. If you’ve ever been in love, you know the kind of silence I’m talking about: silence on a frequency only your significant other can perceive.
“No,” he says. It’s one syllable but his voice shakes subtly, followed by more unsettling silence. I look over at him. He looks back. He smiles, I smile, and a deafening silence descends again, broken only by the rustling sound his twitching
foot is making under the covers. Now I’m alarmed. In my office I can sit through marathon silences, but in my bedroom I last no more than three seconds.
“Hey, is something up?” I ask, trying to sound casual, but it’s a rhetorical question if ever there was one. The answer is obviously yes, because in the history of the world, nothing reassuring has ever followed this question. When I see couples in therapy, even if the initial response is no, in time the true answer is revealed to be some variation of I’m cheating, I maxed out the credit cards, my aging mother is coming to live with us, or I’m not in love with you anymore.
Boyfriend’s response is no exception.
He says: “I’ve decided that I can’t live with a kid under my roof for the next ten years.”
I’ve decided that I can’t live with a kid under my roof for the next ten years?
I burst out laughing. I know there’s nothing funny about what Boyfriend has said, but given that we’re planning to spend our lives together and I have an eight-year-old, it sounds so ridiculous that I decide it has to be a joke.
Boyfriend says nothing, so I stop laughing. I look at him. He looks away.
“What in the world are you talking about? What do mean, you can’t live with a kid for the next ten years?”
“I’m sorry,” he says.
“Sorry for what?” I ask, still catching up. “You mean you’re serious? You don’t want to be together?”
He explains that he does want to be together, but now that his teenagers are leaving for college soon, he’s come to realize that he doesn’t want to wait another ten years for the nest to be empty.
My jaw drops. Literally. I feel it open and hang in the air for a while. This is the first I’m hearing of this, and it takes a minute before my jaw is able to snap back into position so I can speak. My head is saying, Whaaaaaat? but my mouth says, “How long have you felt this way? If I hadn’t just asked if something was up, when were you going to tell me?” I think about how this can’t possibly be happening because just five minutes ago, we picked our movie for the weekend. We’re supposed to be together this weekend. At a movie!
“I don’t know,” he says sheepishly. He shrugs without moving his shoulders. His entire body is a shrug. “It never felt like the right time to bring it up.” (When my therapist friends hear this part of the story, they immediately diagnose him as “avoidant.” When my nontherapist friends hear it, they immediately diagnose him as “an asshole.”)
More silence.
I feel as though I’m viewing this scene from above, watching a confused version of myself move at incredible speed through the famous stages of grief: denial, anger, bargaining, depression, and acceptance. If my laughter was denial and my when-the-hell-were-you-going-to-tell-me was anger, I’m moving on to bargaining. How, I want to know, can we make this work? Can I take on more of the childcare? Add an extra date night?
Boyfriend shakes his head. His teenagers don’t wake up at seven a.m. to play Legos, he says. He’s looking forward to finally having his freedom, and he wants to relax on weekend mornings. Never mind that my son plays independently with his Legos in the mornings. The problem, apparently, is that my son occasionally says this: “Look at my Lego! Look what I made!”
“The thing is,” Boyfriend explains, “I don’t want to have to look at the Legos. I just want to read the paper.”
I consider the possibility that an alien has invaded Boyfriend’s body or that he has a burgeoning brain tumor of which this personality shift is the first symptom. I wonder what Boyfriend would think of me if I broke up with him because his teenage daughters wanted me to look at their new leggings from Forever 21 when I was trying to relax and read a book. I don’t want to look at the leggings. I just want to read my book. What kind of person gets away with simply not wanting to look?
“I thought you wanted to marry me,” I say, pathetically.
“I do want to marry you,” he says. “I just don’t want to live with a kid.”
I think about this for a second, like a puzzle I’m trying to solve. It sounds like the riddle of the Sphinx.
“But I come with a kid,” I say, my voice getting louder. I’m furious that he’s bringing this up now, that he’s bringing this up at all. “You can’t order me up à la carte, like a burger without the fries, like a . . . a—” I think about patients who present ideal scenarios and insist that they can only be happy with that exact situation. If he didn’t drop out of business school to become a writer, he’d be my dream guy (so I’ll break up with him and keep dating hedge-fund managers who bore me). If the job wasn’t across the bridge, it would be the perfect opportunity (so I’ll stay in my dead-end job and keep telling you how much I envy my friends’ careers). If she didn’t have a kid, I’d marry her.
Certainly we all have our deal-breakers. But when patients repeatedly engage in this kind of analysis, sometimes I’ll say, “If the queen had balls, she’d be the king.” If you go through life picking and choosing, if you don’t recognize that “the perfect is the enemy of the good,” you may deprive yourself of joy. At first patients are taken aback by my bluntness, but ultimately it saves them months of treatment.
“The truth is, I didn’t want to date somebody with a kid,” Boyfriend is saying. “But then I fell in love with you, and I didn’t know what to do.”
“You didn’t fall in love with me before our first date, when I told you I had a six-year-old,” I say. “You knew what to do then, didn’t you?”
More suffocating silence.
As you’ve probably guessed, this conversation goes nowhere. I try to understand if it’s about something else—how could it not be about something else? After all, his wanting his freedom is the ultimate “It’s not you, it’s me” (always code for It’s not me, it’s you). Is Boyfriend unhappy with something in the relationship that he’s afraid to tell me about? I ask him calmly, my voice softer now, because I’m mindful of the fact that Very Angry People aren’t Very Approachable. But Boyfriend insists that it’s only about his wanting to live without kids, not without me.
I’m in a state of shock mixed with bewilderment. I don’t understand how this has never come up. How do you sleep soundly next to a person and plan a life with her when you’re secretly grappling with whether to leave? (The answer is simple—a common defense mechanism called compartmentalization. But right now I’m too busy using another defense mechanism, denial, to see it.)
Boyfriend, by the way, is an attorney, and he lays it all out as he would in front of a jury. He really does want to marry me. He really does love me. He just wants much more time with me. He wants to be able to leave spontaneously together for the weekend or come home from work and go out to eat without worrying about a third person. He wants the privacy of a couple, not the communal feel of a family. When he learned I had a young child, he told himself it wasn’t ideal, but he said nothing to me because he thought he could adjust. Two years later, though, as we’re about to merge our homes, just as his freedom is in sight, he’s realized how important this is. He knew things had to end, but he also didn’t want them to—and even when he thought about telling me, he didn’t know how to bring it up because of how far in we were already and how angry I’d likely be. He hesitated to tell me, he says, because he didn’t want to be a jerk.
The defense rests and is also very sorry.
“You’re sorry?” I spit out. “Well, guess what. By trying NOT to be a jerk, you’ve made yourself into the world’s BIGGEST jerk!”
He goes quiet again, and it hits me: His eerie silence earlier was his way of bringing this up. And although we go round and round on this until the sun peeks through the shutters, we both know in a bone-deep way that there’s nothing else to say.
I have a kid. He wants freedom. Kids and freedom are mutually exclusive.
If the queen had balls, she’d be the king.
Voilà—I had my presenting problem.
3
The Space of a Step
Telling somebody y
ou’re a psychotherapist often leads to a surprised pause, followed by awkward questions like these: “Oh, a therapist! Should I tell you about my childhood?” Or “Can you help me with this problem with my mother-in-law?” Or “Are you going to psychoanalyze me?” (The answers, by the way, are “Please, don’t”; “Possibly”; and “Why would I do that here? If I were a gynecologist, would you ask if I was about to give you a pelvic exam?”)
But I understand where these responses come from. It boils down to fear—of being exposed, of being found out. Will you spot the insecurities that I’m so skillful at hiding? Will you see my vulnerabilities, my lies, my shame?
Will you see the human in my being?
It strikes me that the people I’m talking to at a barbecue or dinner party don’t seem to wonder whether they might see me and the qualities I, too, try to hide in polite company. Once they hear that I’m a therapist, I morph into somebody who might peer into their psyches if they aren’t careful to deflect the conversation with therapist jokes or walk away to refill a drink as soon as possible.
Sometimes, though, people will ask more questions, like “What kind of people do you see in your practice?” I tell them I see people just like any of us, which is to say, just like whoever is asking. Once I told a curious couple at a Fourth of July gathering that I see a good number of couples in my practice, and they proceeded to get into an argument right in front of me. He wanted to know why she seemed so interested in what a couples therapist does—after all, they weren’t having problems (uncomfortable chuckle). She wanted to know why he had no interest in the emotional lives of couples—after all, maybe they could use some help (glare). But was I thinking about them as a therapy case? Not at all. This time, I was the one who left the conversation to “get a refill.”
Therapy elicits odd reactions because, in a way, it’s like pornography. Both involve a kind of nudity. Both have the potential to thrill. And both have millions of users, most of whom keep their use private. Though statisticians have attempted to quantify the number of people in therapy, their results are thought to be skewed because many people who go to therapy choose not to admit it.
Maybe You Should Talk to Someone Page 2