I can also imagine the appeal of saying you’re leaving therapy if you were inexplicably left in the waiting room. Has Charlotte been planning to leave, or is this an impulsive reaction to the primal fear she felt a few minutes ago? I wonder if she’s drinking again. Sometimes people drop out of therapy because it makes them feel accountable when they don’t want to be. If they’ve started drinking or cheating again—if they’ve done or failed to do something that now causes them shame—they may prefer to hide from their therapists (and themselves). What they forget is that therapy is one of the safest of all places to bring your shame. But faced with lying by omission or confronting their shame, they may duck out altogether. Which, of course, solves nothing.
“I decided before I came in today,” Charlotte says. “I feel like I’m doing well. I’m still sober, work is going fine, I’m not fighting as much with my mom, and I’m not seeing the Dude—I even blocked him on my phone.” She pauses. “Are you mad?”
Am I mad? I’m certainly surprised—I thought she’d moved past her fear of being addicted to me—and I’m frustrated, which I admit to myself is a euphemism for mad. But underneath the anger is the fact that I worry for her, perhaps more than I should. I worry that until she has had practice being in a healthy relationship, until she can find more peace with her dad than bouncing between pretending he doesn’t exist and becoming devastated when he shows up and inevitably disappears again, she’ll struggle and miss out on much of what she wants. I want her to work through this in her twenties rather than her thirties; I don’t want her to squander her time. I don’t want her to one day panic, Half my life is over. And yet I also don’t want to discourage her independence. Just as parents raise their kids to leave them one day, therapists work to lose patients, not retain them.
Still, something feels rushed about this decision and perhaps comfortably dangerous for her, like jumping out of a plane with no parachute.
People imagine they come to therapy to uncover something from the past and talk it through, but so much of what therapists do is work in the present, where we bring awareness to what’s going on in people’s heads and hearts in the day-to-day. Are they easily injured? Do they often feel blamed? Do they avoid eye contact? Do they fixate on seemingly insignificant anxieties? We take these insights and encourage patients to practice making use of them in the real world. Wendell once put it this way: “What people do in therapy is like shooting baskets against a backboard. It’s necessary. But what they need to do then is go and play in an actual game.”
The one time Charlotte got close to having a real relationship, about a year into her therapy, she abruptly stopped seeing this guy but refused to tell me why. Nor would she tell me why she didn’t want to talk about it. I was less interested in what had happened than in what made this—of all the things she’d told me about herself—the Thing That Cannot Be Discussed. I wonder, today, if she’s leaving because of that thing.
I remember how she’d wanted to hold on to this Thing—to say no to my request. “It’s hard for me to say no,” she explained, “so I’m practicing in here.” I told her that regardless of whether she talked about the breakup, I thought it was equally hard for her to say yes. The inability to say no is largely about approval-seeking—people imagine that if they say no, they won’t be loved by others. The inability to say yes, however—to intimacy, a job opportunity, an alcohol program—is more about lack of trust in oneself. Will I mess this up? Will this turn out badly? Isn’t it safer to stay where I am?
But there’s a twist. Sometimes what seems like setting a boundary—saying no—is actually a cop-out, an inverted way of avoiding saying yes. The challenge for Charlotte is to get past her fear and say yes—not just to therapy, but to herself.
I glance at the bees pressed up against the glass and think of my father again and how once, when I was complaining about the way a relative would try to make me feel guilty, my father quipped, “Just because she sends you guilt doesn’t mean you have to accept delivery.” I think about this with Charlotte: I don’t want her to feel guilty for leaving, to feel that she has let me down. All I can do is let her know that I am here for her either way, share my perspective and hear hers, and set her free to do as she wishes.
“You know,” I tell Charlotte as I watch some of the bees begin to disperse, “I agree that things are better in your life, and that you’ve worked hard to make that happen. I also have the sense that you’re still struggling with getting close to people and that the parts of your life that might be related to this—your dad, the conversation about the guy that you don’t want to have—feel too painful to talk about. By not talking about them, part of you might believe that you can still hold out hope that things might be different—and you wouldn’t be alone in that way of thinking. Some people hope that therapy will help them find a way to be heard by whoever they feel wronged them, at which point those lovers or relatives will see the light and become the people they’d wished for all along. But it rarely happens like that. At some point, being a fulfilled adult means taking responsibility for the course of your own life and accepting the fact that now you’re in charge of your choices. You have to move to the front seat and be the mommy dog driving the car.”
Charlotte has been looking at her lap while I speak, but she sneaks a glance at me during that last part. The room is brighter now, and I notice that most of the bees have left. Just a few stragglers remain, some still on the glass, others circling each other before flying away.
“If you stay in therapy,” I say softly, “you might have to let go of the hope for a better childhood—but that’s only so that you can create a better adulthood.”
Charlotte looks down for a long time, then says, “I know.”
We sit together in the silence.
Finally she says, “I slept with my neighbor.” She’s talking about a guy in her apartment building who had been flirting with her but also said that he wasn’t looking for anything serious. She’d decided she was only going to date men who were looking for a girlfriend. She wanted to stop dating emotional versions of her dad. She wanted to stop being like her mom. She wanted to start saying no to those things and yes to becoming neither parent but instead the person she has yet to discover.
“I figured if I left therapy, I could just keep sleeping with him,” she says.
“You can do whatever you want,” I say, “whether you’re in therapy or not.” I watch her hear what she already knows. Yes, she has given up drinking and the Dude and has begun to give up the fight with her mom too, but the stages of change are such that you don’t drop all of your defenses at the same time. Instead, you release them in layers, moving closer and closer to the tender core: your sadness, your shame.
She shakes her head. “I just don’t want to wake up five years from now and never have had any kind of relationship,” she says. “Five years from now, a lot of people my age won’t be single anymore, and I’ll be the girl who hooks up with a guy in the waiting room or her neighbor and then tells the story at a party like it’s just another adventure. Like I don’t even care.”
“The cool girl,” I say. “The one who has no needs or feelings and just goes with the flow. But you do have feelings.”
“Yeah,” she says. “Being the cool girl feels like shit.” She’s never admitted this before. She’s taking off her beekeeper suit. “Is ‘like shit’ a feeling?” she asks.
“It sure is,” I say.
And so it begins, at last. Charlotte doesn’t leave this time. Instead, she stays in therapy until she learns to drive her own car, navigating her way through the world more safely, looking both ways, making many wrong turns but finding her way back, always, to where she truly wants to go.
47
Kenya
I’m getting a haircut and telling Cory my news about canceling my book contract with the publisher. I explain that now I might spend years repaying the publisher its money, and I might not be able to get another book contract after backing out of this
one so late in the game, but I feel like an albatross has been removed from around my neck.
Cory nods. I see him check out his tattooed biceps in the mirror.
“You know what I did this morning?” he says.
“Hmm?” I say.
He combs out my front layers and checks that they’re even. “I watched a documentary on Kenyans who can’t get clean water,” he says. “They’re dying, and many of them are traumatized by war and sickness, and they’re being thrown out of their homes and villages. They’re wandering around just trying to find some water to drink that won’t kill them. None of them go to therapy or owe their publishers money.” He pauses. “Anyway, that’s what I did this morning.”
There’s an awkward silence. Cory and I find each other’s eyes in the mirror, and then, slowly, we begin to laugh.
We’re both laughing at me, and I’m laughing too at the ways people rank their pain. I think about Julie. “At least I don’t have cancer,” she’d say, but that’s also a phrase that healthy people use to minimize their own suffering. I remember how, initially, John’s appointment was scheduled after Julie’s and how I regularly made an effort to remember one of the most important lessons from my training: There’s no hierarchy of pain. Suffering shouldn’t be ranked, because pain is not a contest. Spouses often forget this, upping the ante on their suffering—I had the kids all day. My job is more demanding than yours. I’m lonelier than you are. Whose pain wins—or loses?
But pain is pain. I’d done this myself, too, apologizing to Wendell, embarrassed that I was making such a big deal about a breakup but not a divorce; apologizing for suffering from anxiety about the very real financial and professional consequences of an unmet book contract but that, nonetheless, were in no way as serious as the problems facing, well, the people in Kenya. I even apologized for talking about my health concerns—like when a patient noticed my tremor and I didn’t know what to say—because, after all, how bad was my suffering if I didn’t even have a diagnosis, much less a diagnosis that ranked high on the “acceptable problems to suffer from” scale? I had an unidentified condition. I didn’t—knock on wood—have Parkinson’s. I didn’t—knock on wood—have cancer.
But Wendell told me that by diminishing my problems, I was judging myself and everyone else whose problems I had placed lower down on the hierarchy of pain. You can’t get through your pain by diminishing it, he reminded me. You get through your pain by accepting it and figuring out what to do with it. You can’t change what you’re denying or minimizing. And, of course, often what seem like trivial worries are manifestations of deeper ones.
“You still doing Tinder therapy?” I ask Cory.
He rubs some product into my hair. “Hell, yeah,” he says.
48
Psychological Immune System
“Congratulations, you’re not my mistress anymore,” John says dryly as he walks in carrying a bag with our lunches.
I wonder if this is his way of saying goodbye. Has he decided to stop therapy right when we’ve just genuinely begun?
He walks to the couch and makes a show of silencing his cell phone before tossing it onto a chair. Then he opens the takeout bag and hands me my Chinese chicken salad. He reaches in again, pulls out some chopsticks, and holds them up: Want these? I nod: Thanks.
Once we’re settled, he looks at me expectantly, tapping his foot.
“Well,” he says, “don’t you want to know why you’re no longer my mistress?”
I look back at him: I’m not playing this game.
“Okay, fine.” He sighs. “I’ll tell you. You’re not my mistress anymore because I came clean to Margo. She knows that I’m seeing you.” He takes a bite of his salad, chews. “And you know what she did?” he continues.
I shake my head.
“She got mad! Why would you keep this a secret? How long has this been going on? What’s her name? Who else knows? You’d think you and I were fucking or something, right?” John laughs to make sure I know how outlandish he considers that possibility.
“To her, it might feel like that,” I say. “Margo feels left out of your life and now she’s hearing that you’ve been sharing it with somebody else. She craves that closeness with you.”
“Yeah,” John says, and he seems lost in thought for a bit. He takes more bites of his salad, looks at the floor, then rubs his forehead as if whatever’s going on in there is draining him. Finally he looks up.
“We talked about Gabe,” he says quietly. And then he starts crying, a guttural wail, raw and wild, and I recognize it instantly. It’s the sound I heard in the ER back in medical school from the parents of the drowned toddler. It’s a love song to his beloved son.
I have a flash to another ER, on the night when my son was a year old and he had to be rushed by ambulance to the hospital after he spiked a fever of 104 and began seizing. By the time the paramedics arrived at my house, his body was limp, his eyes closed, and he was unresponsive to my voice. As I sit with John, I feel again in my body the terror of seeing my son lifeless, me on the gurney with him on my torso, the EMTs flanking us, the sirens a surreal soundtrack. I hear the sound of him howling for me as they strapped him into the x-ray contraption, forcing him to be still, his eyes open now, terrified, beseeching me to hold him as he squirmed violently to reach me. His screams, in their intensity, sounded much like John’s wail now. Somewhere in the hospital’s hallway, I remember seeing what looked like an unconscious child—or a dead one—being wheeled by. This could be us, I thought at that moment. This could be us by the morning. We could be leaving here like this too.
But it wasn’t us. I got to go home with my beautiful boy.
“I’m sorry, I’m sorry, I’m so, so sorry,” John is saying through his tears, and I don’t know if he’s apologizing to Gabe or Margo or his mother—or to me, for his outburst.
All of the above, he says. But mostly, he’s sorry that he can’t remember. He wanted to block out the unfathomable—the accident, the hospital, the moment he learned that Gabe had died—but he couldn’t. What he’d give to forget hugging his son’s dead body, Margo’s brother pulling them both away, and John punching him, screaming, “I will not leave my son!” How he’d like to erase the scene of telling his daughter that her brother had died and of the family’s arrival at the cemetery, Margo falling to the ground, unable to walk in—but those memories, unfortunately, remain vividly intact, the stuff of his waking nightmares.
What’s fuzzier, he says, are the happy memories. Gabe in his twin bed in his Batman pajamas (“Snuggle me, Dada”). Rolling around in wrapping paper after opening his birthday presents. The way Gabe strode confidently into his preschool class like a big kid, only to turn around at the door and blow a furtive kiss. The sound of his voice. I love you to the moon and back. The smell of his head when John bent down to kiss him. The music of his giggle. His animated facial expressions. His favorite food or animal or color (Was it blue or “rainbow” before he died?). All of these memories feel, to John, as if they’re fading into the distance—that he’s losing the details of Gabe, much as he wants to hold on to them.
All parents forget these details about their kids as they grow, and they mourn that loss too. The difference is that as the past recedes in their memories, the present is right in front of them. For John, the loss of his memories brings him closer to the loss of Gabe. And so at night, John tells me, while Margo seethes, assuming that he’s working or watching porn, he’s hiding out with his laptop watching videos of Gabe, thinking about how these are the only videos he’ll ever have of his son, just as the memories John has of Gabe are the only memories he’ll ever have. There will be no more memories made. And while the memories might get blurry, the videos won’t. John says that he’s watched these videos hundreds of times and can no longer tell the difference between his actual memories and the videos. He watches obsessively, though, “to keep Gabe alive in my mind.”
“Keeping him alive in your mind is your way of not abandoning him,” I
say.
John nods. He says that he pictures Gabe alive all the time—what he would look like, how tall he would be, what interests he’d have. He still sees the neighbor boys who were Gabe’s friends as toddlers and imagines Gabe hanging out with them now in middle school, having crushes on girls, eventually shaving. He also imagines the possibility that Gabe would have gone through a phase of butting up against John, and when John hears other parents complain about their high-schoolers, he thinks about what a luxury it would be to have the chance to nag Gabe about his homework or find weed in his room or catch him doing any of the pain-in-the-ass things that teens tend to do. He’ll never get to meet his son the way other parents meet their kids at different stages along the way, when they’re the same people they’ve always been but both thrillingly and sadly different.
“What did you and Margo talk about?” I ask.
“When Margo was interrogating me about therapy,” he says, “she wanted to know why. Why I was here. Was it about Gabe? Did I talk about Gabe? And I told her that I didn’t come to therapy to talk about Gabe. I was just stressed out. But she wouldn’t let it go. She was incredulous. ‘So you haven’t talked about Gabe at all?’ I told her that what I talked about was private. I mean, can’t I talk about what I want in my own therapy? What is she, the therapy police?”
“Why do you suppose it’s important to her that you talk about Gabe?”
He considers this. “I remember after Gabe died, Margo wanted me to talk about Gabe and I just couldn’t. She didn’t understand how I could go to barbecues and Lakers games and seem like a normal person, but that first year I was in shock. Numb. I told myself, Keep moving, don’t stop. But the next year, when I woke up I’d want to die. I kept my game face on but I was bleeding internally, you know? I wanted to be strong for Margo and Gracie, and I had to keep a roof over our heads, so I couldn’t let anyone see the bleeding.
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