But I’m wrong. Today Charlotte believes that I’m going to kill her because as she was leaving her finance job last night to head out for her very first Alcoholics Anonymous meeting, some coworkers invited her to join them for drinks and she said yes, because she thought it would be a good networking opportunity. Then she tells me, without a trace of irony, that she drank too much because she was upset with herself for not going to the AA meeting.
“God,” she says. “I hate myself.”
I was once told by a supervisor that every therapist has the experience of seeing a patient with whom the similarities are so striking that this person feels like your doppelgänger. When Charlotte walked into my office, I knew she was that patient—almost. She was the twin of my twenty-year-old self.
It wasn’t just that we looked alike and had similar reading habits, mannerisms, and default ways of thinking (over- and negative). Charlotte came to me three years after she had graduated from college, and while everything looked good on the outside—she had friends and a respectable job; she paid her own bills—she was also unsure of her career direction, conflicted about her parents, and generally lost. Granted, I didn’t drink too much or sleep with random people, but I’d moved through that decade just as blindly.
It may seem logical that if you identify with a patient, it will make the work easier because you intuitively understand her, but in many ways, this kind of identification makes things harder. I’ve had to be extra-vigilant in our sessions, making sure that I’m seeing Charlotte as a separate person and not as a younger version of myself that I can go back and fix. More so than with other patients, I’ve had to resist the temptation to jump in and set her straight too quickly when she plops down in her chair, tells a meandering anecdote, and finishes with a demand couched in a question: “Isn’t my manager unreasonable?” “Can you believe my roommate said that?”
At twenty-five, though, Charlotte has pain but not significant regret. Unlike me, she hasn’t had a midlife reckoning. Unlike Rita, she hasn’t damaged her children or married someone abusive. She has the gift of time, if she uses it wisely.
Charlotte didn’t think she had an addiction when she first entered treatment for depression and anxiety. She drank, she insisted, only “a couple of glasses” of wine each night “to relax.” (I immediately applied the standard therapeutic calculation used when somebody seems defensive about drug or alcohol use: whatever the total reported, double it.)
Eventually I learned that Charlotte’s nightly alcohol consumption averaged three-quarters of a bottle of wine, sometimes preceded by a cocktail (or two). She said that she never drank during the day (“except on weekends,” she added, “because hashtag brunch”) and rarely appeared drunk to others, having developed a tolerance over the years—but she did sometimes have trouble recalling events and details the day after drinking.
Still, she believed there was nothing unusual about her “social drinking” and she obsessed about her “real” addiction, the one that increasingly plagued her the longer she stayed in therapy: me. If she could, she said, she’d come to therapy every day.
Each week after I’d indicate that our time was up, Charlotte would sigh dramatically and exclaim with surprise, “Really? Are you serious?” Then, very slowly, while I stood at the open door, she’d gather her scattered belongings one by one—sunglasses, cell phone, water bottle, hair band—frequently leaving behind something that she’d have to come back for later.
“See,” she’d say when I’d suggest that her leaving items behind was her way of not leaving her session. “I’m addicted to therapy.” She’d use the generic term therapy rather than the more personal you.
But as much as she disliked leaving, therapy was the perfect setup for somebody like Charlotte, a person who craved connection but also avoided it. Our relationship was the ideal combination of intimacy and distance; she could get close to me but not too close because at the end of the hour, whether she liked it or not, she went home. During the week, too, she could get close but not too close, emailing me articles she read or one-liners about something that had happened between sessions (My mom called and acted crazy, and I didn’t yell at her), or photos of various things she found amusing (a license plate that read 4EVJUNG—not taken, I hoped, while she was inebriated behind the wheel).
If I tried to talk about these things during our sessions, Charlotte would brush them off. “Oh, I just thought it was funny,” she said about the license plate. When she sent an article on an epidemic of loneliness among her age group, I asked about its resonance for her. “Nothing, really,” she replied with a perplexed look on her face. “I just thought it was culturally interesting.”
Of course, patients think about their therapists between sessions all the time, but for Charlotte, keeping me in mind felt less like a stable connection and more like a loss of control. What if she relied on me too much?
To deal with that fear, she’d already left our therapy and returned twice, always struggling to stay away from what she called her fix. Each time, she quit without notice.
The first time, she announced in session that she “needed to quit and the only way I’ll do it is if I leave quickly.” Then she literally got up and bolted from the room. (I’d known something was up when she hadn’t unpacked the contents of her bag onto the armrests and left the blanket draped over the chair.) Two months later, she asked if she could come back “for one session” to discuss an issue with her cousin, but when she arrived, it was apparent that her depression had returned, so she stayed for three months. Just as she started feeling better and began to make some positive changes, an hour before her session, she sent me an email explaining that once and for all, she needed to quit.
Therapy, that is. The drinking continued.
Then one night Charlotte was driving home from a birthday party and crashed into a pole. She called me the next morning, after the police had issued her a DUI.
“I didn’t see it at all,” she told me after she arrived wearing a cast. “And I don’t just mean the pole.” Her car had been totaled but, miraculously, she’d ended up with just a broken arm.
“Maybe,” she said, for the first time, “I have a drinking problem, not a therapist problem.”
But she was still drinking a year later, when she met the Dude.
29
The Rapist
At John’s appointment time, my green light goes on. I walk down the hall to the waiting room, but when I open the door, the chair John usually takes is empty, save for a bag of takeout. For a minute I think he might be in the restroom down the hall, but the public key is still hanging on the hook. I wonder if John’s running late—after all, presumably he ordered the food—or if he’s decided not to come today because of what happened last week.
That session had started off uneventfully. As usual, the delivery guy brought our Chinese chicken salads, and after John complained about the dressing (“too saturated”) and the chopsticks (“too flimsy”), he got right down to business.
“I was thinking,” John began, “about the word therapist.” He took a bite of his salad. “You know, if you break it in two . . .”
I knew where this was going. Therapist is spelled the same way as the rapist. It’s a common joke in the therapy world.
I smiled. “I wonder if you’re trying to tell me that sometimes it’s hard to be here.” I’ve certainly felt that with Wendell, especially when his eyes seem to bore into me and there’s no place to hide. By day, therapists hear people’s secrets and fantasies, their shame and their failures, invading the spaces they normally keep private. Then—boom—the hour’s over. Just like that.
Are we emotional rapists?
“Hard to be here?” John said. “Nah. You can be a pain in the ass, but this isn’t the worst place to be.”
“So you think I’m a pain in the ass?” It took some effort not to emphasize the I, as in “So you think I’m a pain in the ass?”
“Of course,” John said. “You ask too many
damn questions.”
“Oh? Like what?”
“Like that.”
I nodded. “I can see how that might annoy you.”
John brightened. “You can?”
“I can. I think you’d rather keep me at a distance when I’m trying to get to know you.”
“And heeeeeere we go again.” John rolled his eyes dramatically. At least once a session, I bring up our pattern: my trying to connect with him; his trying to flee. He may be resistant to acknowledging it now, but I welcome his resistance because resistance is a clue to where the crux of the work lies; it signals what a therapist needs to pay attention to. During training, whenever we interns felt frustrated by resistant patients, our supervisors would counsel, “Resistance is a therapist’s friend. Don’t fight it—follow it.” In other words, try to figure out why it’s there in the first place.
Meanwhile, I was interested in the second part of what John had said. “Just to be more annoying,” I continued, “I’m going to ask you another question. You said this isn’t the worst place to be. What’s the worst?”
“You don’t know?”
I shrugged. No.
John’s eyes bugged out. “Really?”
I nodded.
“Oh, come on, you know,” he said. “Just guess.”
I didn’t want to get into a power struggle with John, so I took a guess.
“At work when you don’t feel that people understand you? At home with Margo when you feel you’re disappointing her?”
John made the sound of a game-show buzzer. “Wrong!” He took a bite of salad, swallowed, then lifted his chopsticks into the air to punctuate his words. “I came here, you may or may not remember, because I was having trouble sleeping.”
I noticed his dig: May not.
“I remember,” I said.
He let out a huge sigh, as if summoning the patience of Gandhi. “So, Sherlock, if sleeping is a problem for me, where do you think it’s hard for me to be right now?”
Here, I wanted to say. You’re having trouble being here. But in good time, we’ll talk about that.
“Bed,” I said.
“Bingo!”
I waited for him to elaborate, but he went back to his salad. We sat together while he ate and swore at his chopsticks.
“Aren’t you going to say anything?”
“I’d like to hear more,” I said. “What are you thinking about as you’re trying to fall asleep?”
“Jesus Christ! Is something wrong with your memory today? What do you think I’m thinking about—everything I come in here telling you each week! Work, my kids, Margo—”
John went on to relate an argument he’d had with Margo the night before about whether their older daughter should get a cell phone for her eleventh birthday. Margo wanted her to have it for safety, now that Grace was going to be walking home from school with her friends, and John thought that Margo was being overprotective.
“It’s two blocks!” John said he told Margo. “Besides, if someone tries to kidnap her, it’s not like Grace is going to say, ‘Hey, excuse me, Mr. Kidnapper, let me just pause here for a second, get my phone out of my backpack, and call my mom!’ And unless the kidnapper is a complete idiot—which he could be, okay, but he’s probably just a sick motherfucker—the first thing he’s going to do if he steals someone’s kid is look in her backpack for a cell phone and dump it or destroy it so we can’t track her location. So what’s the point of the phone?” John’s face had turned red. He was really worked up.
Since our Skype call the day after Margo had insinuated that she might leave, things between them had calmed down. As John described it, he tried to listen more. He tried to get home from work earlier. But really, it seemed to me that he was, as he said, “appeasing her,” whereas what she likely wanted was the very thing John and I struggled with together: his presence.
John packed the remnants of his lunch into the takeout bag and tossed it across the room, where it landed with a thud in the trash can.
“And that’s why I couldn’t sleep,” he went on. “Because an eleven-year-old doesn’t need a cell phone and you know what? She’ll get one anyway because if I put my foot down, Margo will sulk and tell me in some passive-aggressive way that she wants to leave again. And you know why that is? Because of her IDIOT THERAPIST!”
Wendell.
I tried to imagine Wendell hearing Margo’s version of this story: We were talking about getting Grace a cell phone for her birthday and John just went ballistic. I pictured Wendell in position C, wearing his khakis and cardigan, giving Margo the head-tilted look. I imagined him asking a Buddha-like question about whether she might be curious why John had had such a strong reaction. I figured that by the time their session was over, Margo would have a slightly different take on John’s motives, just as I had come to see Boyfriend’s actions as less than sociopathic.
“And you know what else she’s going to tell her idiot therapist?” John continued. “She’s going to tell him that her fucking husband can’t fucking have sex with her, because when I got in bed at the same time she did instead of finishing up my emails—another thing I’m doing to make her happy, by the way—I was so pissed off that I wouldn’t have sex with her. She approached me but I told her I was tired and didn’t feel well. Like a housewife in the fifties with a headache. Jesus Christ, right?”
“Sometimes our emotional states can really affect our bodies,” I said, trying to normalize this for John.
“Can we keep my penis out of this? That’s not the point of the story.”
Sex comes up with almost every patient I see, the same way that love does. Earlier on, I’d asked John about his sex life with Margo, given the difficulties in their relationship. It’s a common belief that people’s sex lives reflect their relationships, that a good relationship equals a good sex life and vice versa. But that’s only true sometimes. Just as often, there are people who have extremely problematic relationships and fantastic sex, and there are people who are deeply in love but who don’t click with the same intensity in the bedroom.
John had told me then that their sex life was “okay.” When I’d asked what “okay” meant, he said that he was attracted to Margo and enjoyed sex with her but that they went to bed at different times so it was less frequent than in the past. But often he contradicted himself. At one point he said that he tended to initiate sex but Margo didn’t want it; another time he said that she often initiated “but only if I do what she wants during the day.” Once he said that they’d talked about their sexual desires and needs; another time he said, “We’ve been having sex with each other for over a decade. What’s there to talk about? We know what the other person wants.” Now I got the sense that John was having trouble getting an erection and that he felt humiliated.
“The point of the story,” John went on, “is that there’s a double standard in our house. If Margo’s too tired to have sex one night, I let it go. I don’t corner her with a toothbrush in her mouth the next morning and say”—here he did the Oprah impression again—“‘I’m sorry you weren’t feeling well last night. Maybe we can find some time to connect tonight.’”
John looked up at the ceiling and shook his head.
“Men don’t talk like that. They don’t dissect every little thing and think it has ‘meaning.’” He made air quotes when he said the word meaning.
“It feels like picking a scab instead of letting it be.”
“Exactly!” John nodded. “And now I’m the bad guy unless she gets to make all the decisions! If I have an opinion, I’m not ‘seeing’”—more air quotes—“what Margo’s ‘needs’ are. So then Grace gets into this and says that I’m being unreasonable, that ‘everyone’ has a phone, and that it’s two to one, girls win! She actually said that: ‘Girls win.’”
He lowered his arms now that he was done with the air quotes. “And that’s when I realize that part of what’s driving me nuts and making it hard to sleep is that there’s too much estrogen in the house and
nobody understands my perspective! Ruby’s starting elementary school next year but already acts like her older sister. And Gabe’s getting so emotional, like a teenager. I’m outnumbered in my own home and everyone wants something from me every minute and nobody understands that I might need something too—like peace and quiet and some say in what goes on!”
“Gabe?”
John sat up. “What?”
“You said Gabe was getting so emotional. Did you mean Grace?” I did a quick memory check: his four-year-old’s name was Ruby and his older daughter was Grace. Didn’t he just say Grace wanted a phone for her birthday? Or did I have that wrong? Was it Gabriella? Gabby shortened to Gabe, the way some girls named Charlotte are called Charlie nowadays? I’d once confused Ruby with Rosie, their dog, but I was pretty sure I had Grace’s name right.
“I did?” He seemed flustered but recovered quickly. “Well, I meant Grace. Obviously I’m sleep-deprived. Like I told you.”
“But you know a Gabe?” Something about John’s reaction made me suspect that this wasn’t just about insomnia. I wondered if Gabe was somebody significant in his life—one of his brothers, a childhood friend? The name of his father?
“This is an idiotic conversation,” John said, looking away. “I meant Grace. Sometimes a cigar is just a cigar, Dr. Freud.”
We both sat there.
“Who’s Gabe?” I asked gently.
John was quiet for a long while. His face went through a series of expressions in rapid succession, like a time-lapse video of a storm. This was new; he generally had two modes, angry and jokey. Eventually he looked at his shoes—the same checkered sneakers I’d seen on our Skype call—and shifted into the safest gear, neutral.
Maybe You Should Talk to Someone Page 21