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An Afternoon in My Other Counseling Office

male-purple-finch-perched-on-branch

Photo credit here.

The air is dead with offgassing carpets, cleaning products, and layering, lingering camouflage. Makeup, perfume, deodorant, shampoo, aftershave, and gum conceal souls ashamed to show their bruising. Souls afraid to own their splendor.

The light is dead as well. Unnatural light emitted by glowing tubes which draw from a source inadequate to supply true illumination. It reveals the glistening scalp under the expensive coif. It corners the man who must hide his face or else betray his sorrow.

It tells all: Charlie has combed his hair but he has not bathed for a week.

It tells nothing: This cool, reptilian light does not warm. It does not heal.

So many voices. I am at once numbed and enamored, lacerated and reassured. I escape the contrived comforts of my outpatient surgery to shake off the smothering accumulation.

I walk the property in slow circles. Goodness and mercy follow me as I gulp the sunshine in slow, steady breaths. A purple finch perches atop the rusted fence. A cow lows in in the distance. The light enters at my invitation and pools in my recesses.

I return to the well-appointed office donated by the well-appointed church made up of well-appointed congregants who trust that I am versed in the art of swallowing light.

Here is a post I wrote some time ago about an afternoon in my urban counseling office.

 

 

 

 

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The View from the Gristmill

watermelon

Watermelon image courtesy of purpleslog

 

“I spent all yesterday putting together holiday gift bags and had one left over.”

“I bought you this restaurant gift card to express my thanks for the consultation.”

“I just finished making cookies, and so I brought a few for you.”

Every now and then a client presents me with a gift. I debate instituting an official No Gifts policy to avoid the therapeutic work these offerings demand. On the other hand, these moments can open a window for me to model healthy boundaries or discuss the meanings behind the gifts in ways which provide grist for good therapy.

Don’t be fooled by this fancy-sounding talk. I am a chicken. Sometimes I want to be an ostrich. As much as I would like to be a peacock, I know these presents are not always an indication of my stellar counseling abilities; and I try to overcome my fear of ruffling feathers for the good of my counselees.

I realize that some offers are uncomplicated gestures of thanks. But many are not. Some represent a discomfiting gesture of familiarity. Other times, the giving is an attempt to seek my reassurance or trap me in a tacit contract. Use your imagination, and you will be spot on.

The art of discernment is one I will never completely master.

She–and it is usually a she–may be asking if I like her. Is she is special to me? Will I will think about her when she is not before me? Do I love her? Do I love, love her?

She may not believe she alone is enough to hold my interest. Or what if she has to soften my burden in trying to help someone so defective? Is money enough to make her tolerable?

Is she is just a paycheck to me?

She may be trying to secure a better outcome…Will I work harder if she provides me with added incentive? Maybe I’ll work on commission. Can she extract more-more-more benefit faster-faster-faster if I feel beholden?

It could be that she doesn’t even see me as a real person with feelings (yet?) but experiences a self-absorbed need to give, perhaps compulsively or lavishly, to maintain her fragile belief in her own goodness. Or maybe she needs to remind me that I am a subordinate, a sort of emotional manicurist whose services she can take or leave.

This week I was offered the following:

1. A single, perfect melon from a client who works 80 hours a week to pay off her children’s gambling debts.

2. A gift-wrapped calendar, printed from home, whose artwork had been created by one half of a couple in long-term therapy to manage anxiety and depression without drug dependency and codependency. The creator of the calendar expressed surprise coupled with approval at his wife’s presentation of this gift.

3. A ticket to a motivational speaking event from a client who came to therapy to work on her painful relationship with her adult daughter and who moves to capture me in a hug at the end of every session. She and her spouse are the featured speakers.

I won’t disclose how I handled each instance of gifting. I will leave it to your imagination.

I will say that I have accepted a hand-knit scarf, a tangerine, and some amazing whiskey-infused brownies. I will also say that I have declined a zebra print makeup bag, a silk scarf; and, session after session, the most fraught offer of a stick of gum in the history of mankind.

I am curious. What would you have done?

This post belongs in the series Therapy Tales.

90834

Image credit here.

Image credit here.

“He used to let me do everything for him.”

“Life was so good,” she sighs, “until the accident.” She wasn’t even sure how it had happened. Sherry recalled having felt out of sorts that day. She had asked Marco to put an extra shot in her Americano but the creeping nausea had caused her to reconsider. She had broken the rules and stolen a few moments on the cool leather couch in the women’s lounge off limits to staff. But in the end, she had thought it better to get up and push through. Sherry had been an athlete, and she understood this paradox: the cure for too much activity is more activity.

She had finished her shift at the restaurant, pulled out into traffic, and come close to waking up in the afterlife. Instead, she had come to in a hospital room, awakened by the sound of her own breathing. Her first thought: “And I didn’t even finish ironing John’s shirts.”

Sherry’s heart attack had left her with one good eye, one good arm, and one shiny blue wheelchair. “Cobalt,” she smiles, “I thought it would bring out my eyes. John always did like my eyes. He used to tell me what to wear and how to do my hair so I’d look like a million bucks.”

Past tense.

John had visited Sherry in the hospital. Once. After that, their conversations had taken place through attorneys. However, Sherry is not one to dwell on her misfortunes. She understands his wanting to protect his assets–what, with her care being so costly–and she doesn’t take it personally. “He is very, very close to his mother,” she confides, “and it seems only fair that he should have her money to himself once she’s gone.”

Sherry is a mite disheartened that John has not returned her calls. A few times she has used a paratransit service to organize a ride to his new condo. One time, a woman answered the door. “The cleaning service, I guess.”

Sherry doesn’t mind living with her mother for now. Not really. She had been disappointed to learn that she would not be able to return to the cape cod she had shared with John. She had had little choice but to go from the rehab facility back to her childhood home. The house isn’t fully accessible but she manages well enough with help from mother–though she is sometimes impatient and rough. Sherry imagines her mother’s disappointment at spending her golden years negotiating ostomy bags, and she forgives her.

“Now that the divorce has been final for a few months, we should be able to get back together. What’s a piece of paper, after all? I know John has been holding off to be sure all the legal stuff has settled.”

I take a deep breath, blink, and lick my lips, as I buy a moment to formulate my response. Before I can speak, Sherry continues.

“So do you think I should try calling this time or just show up?”

90834 is the billing code for a 45 minute individual counseling session. This is the code most commonly approved by Medicaid for individual therapy. You can find another post about a therapy experience here.

90837

Image credit here.

Image credit here.

I have known Avril for precisely 203 hours. I have known Avril for 8 days and 11 hours.

I have known Avril one hour at a time for 6 years and 8 days. She was barely out of childhood when we started our secret meetings. She had to sneak around so that her grandma wouldn’t learn about me and kick her out of the house. Now she is a career woman, a single parent, and a home owner. I am her therapist.

Today when Avril left my office, I dashed for the ladies room in the darkened part of the building. My swollen heart was near bursting. I drew a few quaking breaths, grabbed it in both hands, and wrung. When just enough of it had squeezed out my eyes to ensure that it would fit back into my chest until lunch, I allowed myself one luxurious minute more. Maybe two. Another client was on her way. I dabbed my kohl and returned to my post.

I was not sad. The culprit was gratitude. It had been welling and swelling all morning, and Avril’s face had set me off.

Four weeks ago, Avril had returned after a six-month break. She was aware she was starting to falter. I had held up the mirror and shown her how far she had come. She had curled into herself:

“Stop!” she had cried, “Stop it now!”

Two weeks ago, she knew was flirting with disaster. She was scared because she had stopped feeling scared. Would she grasp for the help she needed before she was all used up? Avril had been taught that depression is not real, that medication is an affront to Jesus. She had gutted it out before–but the stakes had seemed smaller back then.

Avril was but a nub that day. Her face was stony, her voice a near monotone. I thought I spied a spark of “Fuck You” simmering behind her eyes but I couldn’t be sure. It both reassured and alarmed me. The starving, the cutting, all those games.…These had been her tools, both comforting and despised, to secure her care. They had been friends once upon a time. Now they fit her like a too-small skin. Weary from trying so hard to embrace her new size, she sought solace in the familiar. She panicked when she realized she couldn’t go back, and this made her strain even harder. In trying to force matters, she had nearly done herself harm.

She had not yet become small enough for me to intervene. I was worried but I would not mother her. Avril had become a woman, and she had to choose for herself.

Today, Avril arrived with a gaunt face, a giant mug of tea, and no hello. She started talking and left me to fill in the blanks:

“The medication is making me really tired. But I stopped trying to avoid food. I know my appetite will come back if I wait.”

Her face was soft and almost shy.

90837 is the billing code for a therapy session lasting 53-60 minutes.

Full Plate

Image credit here.

Image credit here.

I created a rule for myself called “One Friend at a Time.” I had to.

This is one of the junctures. It’s one of the joints where Family Rules and The Story of Hanna dovetail. They lean against each other like a house of cards.

I have explained trying, and failing, to create closeness and safety within my family of origin. You can go back and read about it if you want but I’ll sum up here: I was never going to get everyone in my family to get along at the same time AND the effort was taxing AND I kept trying. Just call me Sisyphus.

This dynamic is one I have played out many, many times: finding, or happening, or arranging myself between two individuals–or as a hub for several–who then begin to relate to one another through me. I try to be all things to all people. I don’t do it on purpose. At this point, I have become so conscious of this trap that I rarely get too far into it before I smack myself silly.

I see my counselees doing this all the time: they unknowingly recreate their painful pasts in the hope that their story will eventually end happily. This madness even has a name: repetition compulsion. ‘Round and ’round and ’round she goes. Where she stops, nobody knows….It can’t be an accident that I sought specialty training in couples therapy. At least now I use my damage for good. And in most cases, we all get a better outcome.

Back to the rule.

I knew how to be a friend. That wasn’t the problem. I just had a hard time being friends with more than one person at a time. I sought one-on-one interactions because they were the safest. Being with one person made it less likely I’d disappoint, annoy, or get stuck in a triangle in which I had to manage more than one relationship at once. I do mean manage. Parties gave me palpitations well into my 30’s. I had to have a single neat box for each friendship. On my plate, the peas; carrots; and mashed potatoes weren’t supposed to touch. Mixing them could get too messy.

The best way to work the one-at-a-time method was to have only one really close friend. I took the title “best friend” as gospel. I had to find one person—Karen was my first best friend–and squeeze close enough so that we practically heard each other’s thoughts.

I don’t think I would have betrayed my family in any serious way; but in in day-to-day matters, I chose my best friend over my family every time. When Karen came over, I played cruel pranks on my sister and made rude gestures at my mother’s back while she stood at the kitchen sink. When Karen went home, I behaved differently. My conscience troubled me but my best friend thought I was funny; and securing her was paramount. I needed a sure thing.

Hanna was my last best friend. I am no longer willing to use that designation for anyone except my husband. I’ve retired her jersey.

I always said my husband was my best friend because that is what wives are supposed to say. I’m not sure I was completely truthful. Maybe I crossed my fingers behind my back because he was my best male friend and there was no competition.

Hanna and I had been “family” for over a decade by the time I met Henry, and it was as though we agreed to shove over a bit and make room on the plate. Did I love him? Yes! Did I want to want to spend the rest of my life with him? Yes! Did I want to have his babies? Oooooooh, yes! He was and is the only guy for me. But did I actually leave and cleave?

Well.

Yes.

It just took me decades to complete the process.

I’ve had a lot of time to reflect on the trouble this hanging chad has caused. Maturity came late in this area of my life. I’m glad I’ve grown up a bit but the collateral damage has been considerable.

This post belongs both to Family Rules and The Story of Hanna. You can find the prior post in the Family Rules series here and the next post in the series here. You can find the prior post in The Story of Hanna series here and the next post in the series here.

Growth Pains

Photo credit here.

Photo credit here.

This is the first installment in The Story of Hanna

October, 2011

I’m still feeling a bit wobbly following my surgery this summer. It was unexpected, it was rough, and it happened without the benefit of anesthesia. I lost an important part of myself, and my wounds have not yet closed. As a counselor, I’m always helping others deal with enmeshment and individuation. I get this stuff. I was surprised at some things I learned when I had to look in the mirror.

“I knew as soon as I saw your hair and clothes.” Hanna had said, unable to fully articulate what had begun to go wrong between us the moment she and her husband arrived from Germany for a month-long visit. This was their first visit in five years. I had finished my graduate work and taken a job in my field. I wasn’t sure what taboo I had broken. What had I done to trigger such feelings of loss and betrayal?

Hanna and I met when we were assigned to the same fifth grade class in XCity, Germany. We were classmates for four years before I returned to the U.S. I was the pig-tailed American girl with the Ranger Rick backpack and the bad John Denver habit. She was the quiet, white-haired kid who wore traditional leather pants and carried a pocket knife. I thought she was a boy. It wasn’t until our early teens that our best-friendship became firmly cemented.

By ninth grade, Hanna had become a star athlete and a Beauty. Her looks and effortless air of mystery caused boys to pine and become irrational in her presence. I, on the other hand, had followed my family blueprint to become a gangly, pimple-faced Nerd. In my presence, boys experienced…nothing. They didn’t notice I was alive unless they needed help with their homework.

Steadfast through the decades, we visited back and forth and were in frequent touch in between. Despite our outward differences and our geographic separation, we were, as Hanna’s father often joked, “ein Kopf und ein Arsch.” A head and a tail. A single creature. Though he meant to tease us, he had hit upon the truth: We were so close that we hardly knew where she ended and I began.

Hanna and I understood one another intuitively and profoundly. Our enmeshment worked unbelievably well. In fact, I believe it saved us from childhoods which could have undone us.

Hanna came from a family in which feelings were poorly tolerated. She grew up without hearing the words, “I love you”; and when she showed emotion, she was criticized as mentally unstable and threatened with boarding school. Invalidated and undervalued, she could easily have gone for broke and self destructed.

My family was equally dysfunctional. We were just as well versed in passive aggression but it was located within a larger arsenal of weapons intended to help us bite and scratch ourselves to the top of the family heap. Punishment came frequently and unpredictably, and nobody wanted to be the one in the crosshairs when Dad was in one of his moods. I became observant and stoic. I distrusted and ignored my own feelings. I could easily have gone on to become an abuser or else continued to withdraw until I lost touch with myself altogether.

I know Hanna’s love and support made me more resilient and allowed me to hold my head a little higher. I conjured her presence to help me when I felt clumsy shopping for clothes, and I imagined myself in her skin to give myself the courage to take risks. I later learned that she had carried me in her heart in much the same way. Admiring my dispassion and logic, she imitated me when she needed to think her way through difficulties without becoming overwhelmed by her emotions.

Our outward experiences were always very different. I was a goody-goody; she experimented. I accepted Christ; she remained skeptical. I went to college and became an athlete at about the same time she retired from athletics and moved to a small town to apprentice as a goldsmith. I dated little, married young, and couldn’t wait to have babies. She traveled the world and dated a series of colorful characters. Nevertheless, we always shared intimately and without judgment.

We each made an important decision around the year we turned 40. I returned to school to pursue my M.S. in Pastoral Counseling. After making progress towards an undergraduate degree in Psychology, Hanna dropped out of college to become partner to a man with a serious and chronic health condition. We did not realize that the cord which had kept us connected for so long was about to fray.

My grad school experience was arduous and protracted. Family responsibilities resulted in my taking over six years to finish; but stretching out the timeline had gifted me with the opportunity to deeply contemplate and assimilate the material. The program required more of me than the memorization of facts and the writing of research papers. I was challenged at every turn to reflect with honesty upon my faith and my life, past and present. I experienced anger and sadness, joy and gratitude as God used this time as the crucible for a work of healing and enormous growth.

It was suggested this summer that I had changed, that I had become “other.” It was hinted that I had become less. Less hospitable, less authentic, less available. I disagree. I know have become more.

Somewhere along the way, I grew my own head, heart, and lungs without even realizing it. My brain thinks clearly, my heart beats confidently, and my soul expands with every breath. I love Hanna, and I want her friendship just as much as I always have. I simply no longer require her. In time, I believe I will be able to feel the profound beauty of this truth.

We are not yet at the end of the story, and I do not know how it ends. What if I survive the surgery, and Hanna does not? What if we both survive the surgery but the friendship cannot be resuscitated?

The wait is painful and uncertain.

To follow this thread, please click on the tab for The Story of Hanna or find second installment here.

Rule # 9: I Know You Better Than You Know Yourself

Photo courtesy of TMAB2003

Photo courtesy of TMAB2003

I think I was my father’s little boy.

I say this tentatively and with an apology to my younger brother Will. Both because I may have misunderstood–and that makes me sound queasily grandiose–and because it might sound like I am blaming him for not being chosen as heir. Maybe I should apologize to Gwen as well. If one daughter could be his son, why not the other? I believe it had little to do with our individual merits.

Maybe birth order is to blame since both my siblings are loveable and gifted individuals. Looking through my adult vantage point and my therapist goggles, I see that my father was prone to bending logic when it suited him. It is deforming to spoil, provoke, or ignore a child into brazenness, neediness, or despair and then point at that child’s behavior to justify your concerns about his or her goodness or stability.

The fact that I learned to negotiate the shifting shoals is both an achievement and a source of shame and guilt. I rarely ran aground in any obvious way. While I was astute enough to figure out and operate within the rules of engagement, I did not save or defend my siblings when I might have. Instead, I stood quietly by and watched as they were branded with various labels and then punished for bearing them. Older and stronger, I sometimes even threw them under the bus.

I know, I know. I was just a kid. But it still feels bad sometimes. Back and forth, back and forth I go. Was I a victim or an accomplice? This is how I wear my damage. They wear theirs differently.

Allowing myself to contemplate my brokenness brings self loathing. If I claim I am damaged, I selfishly compete for balm at the expense of those who need it more. I have shown I can manage. If I claim I am undamaged, I smell superior and condescending. There is no way out. Thankfully, the reverberations have become dampened over time. I don’t spend a lot of time or tears on this matter. It generally stays in the back of my mind, held comfortably in check by God’s cleansing and my adult logic.

Occasionally old feelings still build and threaten. Writing this–right in this moment–I feel the edges of madness pressing in. That slow sinking. Eyelids falling shut. Bad Jane, bad Jane. Time to take a break…

…The brands I received were different but no less constricting. Though I never struggled with sexual preference or identity, being Junior and being entrusted with my father’s inside views on my mother’s shortcomings caused me to associate my womanly emotional makeup with weakness and disown it as inferior. I was just as uncomfortable with my body.

I got to be the Good Student, the Responsible One, the Dutiful One. Whoop dee do. These labels came with the designations Stoic One and Stick In The Mud. I think in time I also got Sneaky One, and sometimes that one fit.

Gwen got to be the Feminine One, the Cute One, and the Artistic One. Sigh. Sadly, those were padlocked to the brands Dramatic One (never to be taken seriously, even in extremis) and Messy One (“She can’t help herself. It’s because of her artistic temperament.”). How would you like to labor under those prophetic burdens? And what do you think happens when two girls, so differently regarded and so close in age, have to share a single small room? This was not a recipe to cultivate sibling love.

Will had other brands but those escape me now. The comparison between me and Gwen was sharpest given our 18-month age difference.

Dad labeled me because he knew he knew me and what I was about. Looking at me was looking in the mirror. It was a Fun House mirror–wavy and distorted–but only one of us seemed to realize it. I was supposed to be an engineer like him. He knew it was a fit for me. I knew I would never, ever, do it. Even the thought of it made me clammy.

I stood up to him about the engineering major but compromised by giving in to his expectation that I enroll in 21 credits my first semester in college. He had done it. No problem! Never mind that I was participating as a scholarship athlete on a Division I sports team. I lasted a few weeks before quietly adjusting my schedule and doing my own thing. To his credit, he was entirely supportive. This marked the start of a better phase in our relationship. On the cusp of my adulthood, I began to understand him differently. I came to view his behavior as motivated more by a lack of insight than a spoiling for malice. More on that soon.

I ended up studying Bio and German. I said I might try for medical school though I knew I never would.

In retrospect, this may have been the most Jane I was able to be at this time in my life. The finding of Jane has been a molasses-slow and ongoing process. Bio was not my thing. German, I love, but not as a profession. Years later, I ended up in counseling and then in grad school for counseling. It’s a great fit.

As for writing? Too artistic for me to even contemplate.

This post is part of Family Rules. For the prior post in the series, click here. For the next post, click here.

 

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