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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.

 

 

 

 

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.

Petunia

Image credit here.

Image credit here.

I wrote this in Fall, 2013, while slogging through my therapeutic writing about the infamous Summer of 2012 and its aftermath.

My brain is fully of heavy thoughts, and it is time to take a break.

I thought it would only be fair to devote a page to Petunia, a crucial but heretofore overlooked player in that summer’s drama. Who the heck is Petunia, you ask? Why my old pink laptop, of course!

I am writing on her at this very moment!

Incredibly, she is still alive. She still boots but her disk drive is broken. Her backup service has inexplicably failed. Several of her programs have mutinied and refuse to run. I have repaired her frayed cord twice—once with blue painter’s tape and now with purple duct tape. (She says the latter is much cooler.) She peppers me with countless error messages each day but I can see that she is trying to hang on for my sake, and I appreciate her for it.

Though Petunia should be past menopause by now, she still overheats and shuts herself down about every 30 minutes. But take heart! I am close to perfecting the solution. As I write this, she is propped up on my daughter’s pink and green polka-dotted eraser (It should come as no surprise that she is please with my choice.) and a packet of wooden chopsticks I found in the utensil drawer. She is being ventilated by a fan sitting on my big yellow Langenscheidt dictionary, which is in turn sitting on the white plastic Ikea chair across the kitchen table from me. It is October, and I’m getting a wee bit chilly….

I could use a cup of coffee but then I’d have to unplug something.

I am not making this up.

This is part of The Story of Hanna. For the previous installment, click here. For the next installment, click here.

How?

Photo credit here.

Photo credit here.

How do I continue this story?

When Hanna and her husband Niko headed back to Germany after their ill-fated visit, there was silence. Ok, Hanna did let us know they had arrived safely and that they would be in touch. The message was curt. I wasn’t terribly surprised.

It was clear from the outset that we had considerable work ahead of us. I had actually shown my best friend the door. That is a euphemism. After a month of hell, I had more or less pushed her through it.

Those weeks in the summer of 2011 were the most stressful I had ever experienced. Within a few days of their arrival, the shower drains began clogging with hair. We were all—literally—losing it. But our friendship was so deep and so wide. We had a commitment and history most married couples would envy. As horrible as the month had been, I rested in the belief that after we licked our wounds and got some rest, sanity would return. We would talk things through to resolution.

I was wrong.

I waited to hear from Hanna, figuring she needed some down time. I knew I did.

After a while, I sent some chatty emails. I got no response. Then I sent letters. And more letters. Too many letters.

First my tone was optimistic: “Whew, that was rough, wasn’t it? I look forward to talking when you are rested.” Then the protective numbness began to crumble.

I made rational appeals. I begged. I pointed the finger, too. I followed up with conciliatory tomes. Nothing. All the while, I believed—then convinced myself to keep believing–that after all our years “for better,” our little marriage would undoubtedly survive “for worse.” It took 5 months for the Dear John letter to arrive. It was not gentle.

I had no recourse. Hanna had cut me off at the knees. She let me know she had not read anything I had sent. She pronounced us dead without trying to see matters through my eyes.

I had no recourse, so I began to write. I needed some outlet, if only my creaky old laptop, through which to vent my regret, anger, despair. I really needed Hanna but she wouldn’t have me.

Hanna and I used to process everything together with our one big brain. She was the right hemisphere, and I was the left. Or visa versa. I was inconsolable. My husband was incredible but he had a lot of thinking to do himself. My other friends were great. Still, there is a limit to how much one can unload, even to the most loving of friends, day after day; week after week; month after month. I was clinically depressed.

Tapping the bones of this story into Petunia, my decrepit but faithful pink Dell, was therapy. She gave me the voice I needed. If you’ve been reading my blog, you may understand the desperation I can feel when I am unheard*.

It’s been a few years since things blew up, and I think I’ve worked through the experience thoroughly enough to share it.

Here is my concern: What if I discover, in stirring up and fleshing out the story, that the embers are not as cold as I believe? I could end up with a flash fire. I have worked through all the predictable stages of grief, but feelings have their own logic and are rarely processed to completion. I know better than to believe they will remain quiet after a firm jab with the old poker. Yes, that concerns me.

I don’t hold out much hope that I will hear from Hanna again but I can’t know that. I still think of her often and consider her and Niko friends dear to my heart. I still love her so much. She never did tell her family anything, and I have occasional contact with her parents. I’ve known her brother Torsten since he was about 5, and he is a good friend, a brother. Maybe, just maybe….

I want to write as though she will read these words. I must do it this way or not at all.

This is a tall order, and I hope I am up to the task.

This is the second installment in The Story of Hanna. Click here for the third installment.

*This post and this post deal with not feeling heard.

Rule # 16: Sing When You Feel Like Crying

Photo credit here.

Photo credit here.

My father taught me to sing as a cure for a disturbing condition–a condition disturbing to him.

I’m surprised that I never developed a distaste for singing. On the contrary! I have loved to sing since I was tiny. I sang songs when- and wherever I felt the urge. And I contentedly tried out funny noises just to hear how they sounded. One day, while riding home in the back seat of our station wagon and looking out the window, I caught myself vocalizing and felt sudden shame. I looked around furtively to see if anybody had observed me–whew!–and I made a mad grab for a fig leaf. The seeds of adolescent self consciousness had been sown but singing remained joyous.

After that day in the car, I generally sang in private or with others. As a second grader, I loved to sit on my carport alone and sing from those little booklets used by carolers. I didn’t understand that music gave me direct access to my feelings and helped me to process. I just knew it felt good. Yes, it helped me to process them during periods when I was either too young or too lacking in insight to consciously address my inner state.

I was never a great singer, and at this point in my life, those muscles are shot. My singing voice is growing croaky from disuse. I could make the effort and revive it but these days I am more likely to write. Nevertheless, I can’t shake the sense that the gift of song was delivered in secret to help preserve and protect me. The idea makes me smile. A friend I didn’t know had filled my cup with chocolate milk while my head was turned. A friend I hadn’t yet met had draped a fluffy quit across my sleeping frame.

I sang in choirs as a child and adolescent. As an adult, I did a longish stint as a vocalist in a band. The feeling in my body—both the sound and the vibration—brought deep, visceral comfort. The eerie moments when surrounding voices interlocked with mine to create a perfect Summ* achieved a temporary rapture for which words could not suffice. I had to close my eyes and disappear into it.

My father never liked it when I cried. I’m going to go as far as to say he didn’t tolerate it. He never said outright that it was a bad thing but that is the message I received.

When I was upset and tried to speak to him through my tears, he would say, “Stop whining. I can’t understand you while you are crying.” His attempts to manage me made me cry harder to be heard, and this made matters worse. To have a voice, I had to give up my voice.

My father approached crying as though it were an inconvenient medical condition, such as hiccups, or a pathology in need of treatment. It was disconnected from its origins rather than treated as a symptom of a larger problem. It certainly had nothing to do with him. He decided to help me get over it anyway.

My father shared his tried-and-true cure. He declared with medical certainty that it was physically impossible to sing and cry at the same time. I believed him, and I believe he believed himself. The cure for crying was to sing. It just now occurs to me to ask how he had learned this remedy and what had necessitated it.

So I sang. And now I write.

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

*I had to use this German word, which means humming or droning because the sound of word will make you feel what I am saying. Summen recalls the sound of bees happily at work in the wisteria arbor above your head. Say the s like a z and the u like the u in the English word put. Say it out loud. Emphasize the first syllable and feel the zzzzzzz. Listen to it here

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