Charlotte is late for today’s appointment because somebody hit her car as she was pulling out of the parking lot at work. She’s fine, she says, it was a minor fender-bender, but it caused the steaming coffee in her cup holder to spill onto her laptop on which she’d composed her presentation for tomorrow and which she hadn’t backed up.
“Do you think I should tell them what happened or just pull an all-nighter?” she asks. “I want it to be good, but I don’t want to seem flaky.”
The prior week, at the gym, she’d accidentally dropped a weight on her toe. The bruise had gotten worse, and she was still in pain. “Do you think I should get it x-rayed?” she asked.
Before that, her favorite college professor had died in a camping accident (“Do you think I should fly to the funeral, even though my boss will be mad?”), and before that, her wallet had been stolen and she’d spent days combating identity theft (“Should I keep my driver’s license locked in the glove compartment of the car from now on?”).
Charlotte believes she’s been hit with a wave of “bad karma.” It seems as if, every other week, there’s another crisis—a traffic violation, an incident with her sublet—and while at first I felt bad for her and tried to help her cope, gradually I noticed that we’d stopped doing any therapy at all. And how could we? By focusing on one external calamity after another, Charlotte has been distracting herself from the real crises in her life—the internal ones. Sometimes “drama,” no matter how unpleasant, can be a form of self-medication, a way to calm ourselves down by avoiding the crises brewing inside.
She’s waiting for me to advise her on what to do about her presentation, but she knows by now that I don’t tend to give prescriptive advice. One of the things that surprised me as a therapist was how often people wanted to be told what to do, as if I had the right answer or as if right and wrong answers existed for the bulk of choices people make in their daily lives. Taped up next to my files is the word ultracrepidarianism, which means “the habit of giving opinions and advice on matters outside of one’s knowledge or competence.” It’s a reminder to myself that as a therapist, I can come to understand people and help them sort out what they want to do, but I can’t make their life choices for them.
When I first started out, though, occasionally I’d feel pressure to give advice of the benign (or so I believed) sort. But then I realized that people resent being told what to do. Yes, they may have asked to be told—repeatedly, relentlessly—but after you comply, their initial relief is replaced by resentment. This happens even if things go swimmingly, because ultimately humans want to have agency over their lives, which is why children spend their childhoods begging to make their own decisions. (Then they grow up and plead with me to take that freedom away.)
Sometimes patients assume that therapists have the answers and we simply aren’t telling them—that we’re being withholding. But we aren’t out to torture people. We hesitate to give answers not only because patients don’t really want to hear them, but also because they often misconstrue what they hear (leaving us thinking, for instance, I never suggested you say that to your mother! ). Most important, we want to support their independence.
But when I’m in Wendell’s office, I forget all this, along with everything else I’ve learned about advice-giving over the years: that the information the patient presents to you is distorted through a particular lens; that the presentation of the information will change over time as it becomes less distorted; that the dilemma may even be about something entirely different that has yet to be uncovered; that the patient is sometimes gunning for you to support a particular choice and this will become more clear as your relationship develops; and that the patient wants others to make decisions so that she doesn’t have to take responsibility if things don’t work out.
Here are some questions I’ve asked Wendell: “Is it normal for a fridge to break after ten years? Should I keep this one longer or pay to repair it?” (Wendell: “Are you really here to ask me something you can ask Siri?”) “Should I choose this school for my son, or the other one?” (Wendell: “I think you’ll benefit more from understanding why this decision is so hard for you.”) Once he said, “I only know what I would do. I don’t know what you should do,” and instead of absorbing his meaning, I replied, “Okay, then, just tell me—what would you do?”
Behind my questions lies the assumption that Wendell is a more competent human being than I am. Sometimes I wonder, Who am I to make the important decisions in my own life? Am I really qualified for this?
Everyone wages this internal battle to some degree: Child or adult? Safety or freedom? But no matter where people fall on those continuums, every decision they make is based on two things: fear and love. Therapy strives to teach you how to tell the two apart.
Charlotte once told me about a commercial she saw on television that made her cry.
“It was for a car,” she said, then added dryly, “I can’t remember which car, so clearly the commercial wasn’t very effective.”
The ad, she said, is set at night, and there’s a dog at the wheel. We see the dog driving through a suburban neighborhood, and then the camera pans to the interior, in the back, where there’s a puppy in a car seat, barking away. Mommy Dog keeps driving, glancing in the rearview mirror, until the smooth ride lulls the puppy to sleep. Mommy Dog finally pulls into her driveway, lovingly gazing at her sleeping pup, but the second she kills the motor, the puppy wakes up and once again starts barking away. With a resigned look on her face, Mommy Dog turns the car back on and starts driving again. We get the sense she’ll be driving around the neighborhood for quite a while.
By the time Charlotte got to the end of this story, she was sobbing, which was unusual for her. Charlotte generally betrays little, if any, real emotion—her face is a mask, her words, diversions. It’s not that she’s hiding her feelings; it’s that she can’t access them. There’s a word for this kind of emotional blindness: alexithymia. She doesn’t know what she’s feeling or doesn’t have the words to express it. Praise from her boss will be reported in a monotone, and I have to probe . . . and probe . . . and probe, until I finally get to a hint of pride. A sexual assault in college—she was drinking, found herself at a party in a strange dorm room, naked, in a bed—will be reported in that same monotone. A retelling of a chaotic conversation with her mom will sound like she’s reciting the Pledge of Allegiance.
Sometimes people can’t identify their feelings because they were talked out of them as children. The child says, “I’m angry,” and the parent says, “Really? Over such a tiny thing? You’re so sensitive!” Or the kid says, “I’m sad,” and the parent says, “Don’t be sad. Hey, look, a balloon!” Or the child says, “I’m scared,” and the parent says, “There’s nothing to be worried about. Don’t be such a baby.” But nobody can keep profound feelings sealed up forever. Inevitably, when we least expect it—seeing a commercial, for instance—they escape.
“I don’t know why this makes me so sad,” Charlotte said about the car commercial.
Watching her cry, I understood not just her pain but the reason she constantly pushed for me to make her decisions. For Charlotte, there had been no Mommy Dog in the driver’s seat. With Mom immersed in her depression, taking to her bed between bouts of inebriated late-night partying; with Dad frequently out of town for “business”; with two chaotic parents who argued with abandon and liberal strings of expletives, sometimes so loudly that the neighbors complained—Charlotte had been forced to act as a grownup prematurely, like an underage driver navigating her life without a license. She rarely got to see her parents acting like adults, like her friends’ parents.
I imagined her as a child—What time should I leave for school? How do I deal with a friend who said something mean today? What should I do when I find drugs in my dad’s desk drawer? What does it mean when it’s midnight and my mom isn’t home? How do I apply to college? She’d had to parent herself, and her younger brother too.
Children, however, don’t like having to be hyper-competent. So it’s not surprising that Charlotte wants me to be the mother for her now. I can be the “normal” parent who safely and lovingly drives the car, and she can have the experience of being taken care of in a way she never has before. But in order to cast me in the competent role, Charlotte believes she has to cast herself as the helpless one, letting me see only her problems—or, as Wendell once put it in relation to what I do with him: “seduce me with her misery.” Patients often do this as a way to ensure that the therapist won’t forget about their pain if they mention something positive. Good things happen in Charlotte’s life too, but I rarely hear about them; if I do, it’s either in passing or months after they occurred.
I think of this misery-seduction dynamic between Charlotte and me, and between a younger Charlotte and her parents. No matter what Charlotte did—getting drunk, staying out late, being promiscuous—it didn’t have the desired effect. This went wrong. That went wrong. Pay attention to me. Can you even hear me?
Now, after the questions about the laptop and the spilled coffee, Charlotte is asking what she should do with the Dude from the waiting room. She hadn’t seen him for a few weeks, then he came with the girlfriend, and today he came alone again. A few minutes ago, in the waiting room, he asked her on a date. Or at least she thinks it’s a date. He asked her to “hang out” tonight. She said yes.
I look at Charlotte. Why on earth would you think that’s a good idea?
Okay, I don’t say this out loud. But sometimes, and not just with Charlotte, I’ll hear something a patient is saying—some self-destructive course of action she’s taken or is about to take (for instance, telling her employer how she really feels in the service of “being authentic”)—and I’ll have to suppress the urge to blurt out, No! Don’t do it!
But I can’t just bear witness to a train wreck either.
Charlotte and I have talked about anticipating the outcome of her decisions, but I know this is more than an intellectual process. Repetition compulsion is a formidable beast. For Charlotte, stability and its attendant joy isn’t to be trusted; it makes her feel queasy, anxious. When you’re a child and your father is loving and playful, then disappears for a while, and later comes back and acts as if nothing happened—and does this repeatedly—you learn that joy is fickle. When your mother emerges from her depression and suddenly seems interested in your days and acts the way you see other kids’ moms acting, you don’t dare feel joy because you know from experience that it will all go away. And it does. Every single time. Better to expect nothing too stable. Better to “hang out” with the guy in the waiting room who either still has a girlfriend or no longer does but flirted with you when he did.
“I don’t know what his deal with the girlfriend is,” Charlotte continues. “You think this is a bad idea?”
“How do you feel about it?”
“I don’t know.” Charlotte shrugs. “Excited? Scared?”
“Scared of what?”
“I don’t know. That he won’t like me outside of the waiting room or that I’m his rebound after his girlfriend. Or that he’s fucked up because he was having problems with his girlfriend in the first place. I mean, why else would they be coming to therapy?”
Charlotte starts fidgeting, playing with her sunglasses on the arm of the chair.
“Or,” she goes on, “what if he’s still with his girlfriend and this isn’t a date but just a friend thing, and I didn’t realize that, and then I have to see him again in the waiting room each week?”
I tell Charlotte that the way she speaks about the Dude reminds me of how she’s described her state of mind before interactions with her parents, not just as a child, but now, as an adult. Will it go well? Will they behave themselves? Will we get into an argument? Will my dad show up or cancel at the last minute? Will my mom act inappropriately in public? Will we have fun? Will I be humiliated?
“Yeah,” Charlotte says. “I won’t go.” But I know she will.
When our time is up, Charlotte goes through her ritual (expressing disbelief that the hour is over, slowly packing up her belongings, stretching languidly). She ambles toward the door but stops at the threshold, as she often does to ask me a question or say something she should have said during the session. Like John, she’s prone to what we call “doorknob disclosures.”
“By the way,” she begins casually, although I have a feeling that whatever comes next will be anything but an offhand aside. It’s not uncommon for patients to go through an entire session talking about this or that, only to spill something important in the last ten seconds (“I think I’m bisexual,” “My biological mother found me on Facebook”). People do this for a variety of reasons—they’re embarrassed, they don’t want you to have a chance to comment, they want to leave you feeling as unsettled as they do. (Special delivery! Here’s all my turmoil; sit in it all week, will you?) Or it’s a wish: Keep me in mind.
This time, though, nothing comes out. Charlotte just stands there. I wonder if she’s thinking about something particularly hard for her to address—her drinking, or her hope that her father will pick up the phone when she calls on his birthday next week. Instead she blurts out: “Where did you get that top?”
It seems like such a simple question. I’ve had an Uber driver, a barista at Starbucks, and a stranger on the street all ask me the same question about this new top—one of my favorites—and each time, I answered without a hint of hesitation. “Anthropologie, on sale!” I’d reply, proud of my good taste and good fortune. But with Charlotte, something stops me. It’s not that I’m worried she’ll start to dress exactly like me (as one of my patients did). It’s that my gut tells me why she’s asking; she wants to get it and wear it on her date with the Dude—the date that she’s supposedly not going on.
“Anthropologie,” I say anyway.
“It’s cute,” she says, smiling. “See you next week.”
And off she goes, but not before I meet her eyes for a split second and she looks away.
We both know what’s about to happen.