Truth Beyond Words

Session One

I entered the waiting room and encountered a goddess. Even from a distance, I could tell that she was extraordinary. She appeared to be blissfully unaware of the impact she might have on mere mortals.

She wore a snow white summer dress that provided breath-taking contrast to her near- tropical tan. Long, wavy auburn hair and red lipstick rounded out the stunning visual palette. Since she appeared to be absorbed in a magazine, I allowed my eyes to feast for an instant before approaching her. I knew that I was indulging myself, but the only women I'd ever seen who compared had been projected safely on a silver screen.

Linda? I inquired in a cool, professional voice that belied my pounding heart. Won't you come this way?

As she led the way in the direction indicated, I couldn't help but notice the rippled musculature of her sculpted legs. Fantasies erupted, and I gave myself a mental slap.

She sat gracefully and crossed her legs. That simple action threw me off stride, and I began rather abruptly by inquiring, What brings you here?

She wasn't quite ready for the direct approach and wanted to test the waters. I've had some things going on in my life lately, and a friend suggested that it might help to talk with someone.

In a gentle attempt to begin mapping the way to her pain, I asked, Would you mind telling me about some of these recent events?

Well, she said with some embarrassment, I guess everyone has problems of one sort or another. Compared to a lot of people, I've got it pretty good. I really don't want to be wasting your time.

A little token resistance, so I decided to go with a process response. You're feeling unsure about your decision to meet with me?

Well, my friend insisted that you could help.

As I entered the therapeutic world, I began to see past her beauty. She was quite guarded and stiff. I needed to make it easy for her. Rather than prying further, I provided her with some nonthreatening information. Most of the people I see have rather ordinary life problems. That doesn't mean that their suffering is ordinary. Neither does it mean that they are abnormal. It's not the easiest thing in the world to make an appointment with a psychologist. Your being here suggests that you are motivated to deal with something that is troubling you.

As a reward for my gentle and reassuring tone, she looked at me directly for the first time and smiled tentatively. It would be so easy to get lost in her hazel eyes, and I again had to remind myself not to go there.

She said softly, I really don't know what's wrong with me. I've got the kind of life I always dreamed of, but it doesn't seem to matter. Nothing seems to matter. Pretty crazy, huh?

Time for a nonjudgmental, reflective statement, so I responded, You succeeded in creating the life you thought you wanted only to find that it isn't what you had hoped.

A tiny tear in the corner of her eye suggested that she was beginning to give me a glimpse beyond her nearly perfect façade. There was more than a little bitterness in her voice as she said, I've been a good girl all my life. I made top grades in school. I was a cheerleader. I married the captain of the football team who is now a successful attorney. I've got it all, but feel like I might as well have nothing.

She needed to know that I understood her predicament; so I said, It must be frustrating and terribly disappointing to have worked so hard to have created the life you thought you wanted only to find that you can't enjoy it.

We were moving in the right direction as evidenced by a timid smile. She was beginning to believe that I wasn't going to judge her or tell her how she should feel.

Her sense of frustration was reflected in her next question. Why can't I be like my friends? They all seem so together. When I say anything about how I feel, they just change the subject.

As a gentle probe, I said, It must be difficult to have your friends ignore your pain. How do you feel when they don't seem to want to listen?

The tears now started to trickle. With a suppressed sob, she said, It hurts. In fact it hurts like hell! I feel so alone. My friends don’t care. To make matters worse, I've got this great husband; but he's the last person who wants to hear how I feel.

She had lowered her barriers and needed to know that I was with her. You are obviously a very accomplished person. It's not at all surprising that the emptiness and sadness you feel has led you to question your life.

She turned her frustration on me and challenged, But why do I feel this way?

This was a critical moment. Depending on my response, she would either continue the journey or decide I wasn't worthy of her trust. It would be safe to provide an erudite answer, but that would have been the end of therapy and the start of counseling.

I ventured, You feel cheated by life and don't know whom to blame. You can't blame your friends because they seem happy with their choices. You can't blame your husband because he is successful and satisfied. Where does that leave you?

She said, rather contritely, I guess I'm mad at myself. And then a little stronger, But that doesn't make any sense. What have I done wrong?

Linda, I responded, it's time to take a fresh look at the world in which you live. Is it possible that no one has done anything wrong? You were brought up with a belief that if you achieved certain things you would be successful and that would result in happiness. Since you aren't happy, you’re questioning everything about your life. And maybe that's good because it will allow us to take a look at thoughts and beliefs that are standing in your way. But rather than invalidating your entire existence, let's start by examining the things that are bothering you.

Oops! She wasn't responding. I got a little too windy. In order to keep her involved, I decided to provide some encouragement. There are many people in pain who decide that it's easier and safer to keep trudging through life instead of facing up to what's bothering them. I'm glad that you were strong enough to take that chance, and I'm also glad to have the opportunity to work with you.

She needed a little ray of sunshine, and her demeanor lightened. So there is some hope for me?

The worst thing I could have done would have been to tell her that everything was going to be okay. Instead, I said, It's clear that you have a lot going for you. In most ways, you have your life pretty well put together. It's also obvious that there are some pieces that don't quite fit.

I will agree that something isn’t quite right. What can I do about it?

Are you willing to take a good, hard look at your life?

I think I've already done that, she objected. It hasn't seemed to help.

For a minute, she had made it look like it was going to be easy. Now it was clear that her defenses were strong, even with her unhappiness. I decided to change direction and said, It must be frustrating for you.

She hadn't anticipated that response and had to think for a moment. Well, I guess you could call it frustrating. I just want to know what to do about it.

I knew that was BS, so I forged ahead. Linda, you are obviously an intelligent woman. Do you think there is a simple answer to your rather complex problem?

She appeared to feel flattered as she said, I don't know that I'm really that complex.

We were starting to waste time, so I decided to force her hand and asked more emphatically, Linda, are you willing to take a hard look at your life?

She started to repeat what she had said earlier then stopped herself. I guess what I said was a cop-out. I'm here to learn, even if it makes me uncomfortable.

Now that was what I wanted to hear. I was relieved that we weren't going to have to tap dance through a few weeks before really getting to work. I said, I appreciate your honesty and openness. If there were a simple answer, you would have already found it. But if you're willing to work with me, I'm confident that we can get moving in the right direction.

It appeared that we had settled on an appropriate tone for our work as she said, I’m here for a reason, and I don't give up easily.

I said, Let's meet again next week, and we can really get down to business. I would just like to ask just a few questions before you go. How is your appetite?

It's fine, she replied. I guess I'm lucky because I never seem to gain or lose weight.

Have you been sleeping too much or too little lately?

Just the usual seven to eight hours a night, she responded.

Do you have any significant health problems?

No, she smiled. I'm as healthy as a horse.

For your protection, it would be helpful if I knew of any potential legal issues in your life.

Other than being married to an attorney, I try to stay away from the legal system.

Just one more thing. Have you had any thoughts of harming yourself?

No, I'm not that depressed, she exclaimed with some apparent relief that I had even asked the question.

I smiled in response and said, As we discussed over the phone, I charge $120 per hour and expect payment at the end of each session. In order to protect your privacy, I don't participate in any managed care plans. I also won't allow a case manager who doesn't know you to dictate the course of our work. On another subject, I would recommend that you keep a journal to record how you are feeling and what is happening in your life.

She leaned over to get her purse. Before I could avert my gaze, I was treated to a glimpse of alabaster skin untouched by sunlight. She looked up at me perfectly composed as I attempted to mask my discomfort.

In a rather shallow attempt at nonchalance, I said, See you next week, and looked away to begin writing my treatment notes.

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Linda's Journal

March 3

I finally got around to seeing a shrink. My life just seems so dull, but I really don't see how this nerdy guy is going to help. He was nice enough and seemed to understand what was bothering me. I just don’t know how he could challenge me enough to make a difference.

I could tell that he was really attracted to me. I knew that he was checking me out in the waiting room. I could almost feel him watching me as I led the way to his office. When I bent over to get my purse, I thought his eyes were going to pop out of his head. I'll have to admit, it feels good to be wanted after all the years of inattention from Rick.

At least he seemed to take my unhappiness seriously. It was kind of funny how he asked me about suicidal thoughts. I don't think he was comfortable with it, but I give him credit for asking anyway.

He was certainly right about one thing. There just has to be more to life than this. You might say that I'm sick and tired of feeling sick and tired. Nothing excites me anymore. I never look forward to anything. It just seems like, why bother?

I think I'll give him a try. He seems nice enough, and I think he has good intentions. I just wish he were a little stronger and more dynamic. I guess it's not easy to find a shrink like that.

When Rick belittled me for seeing him, I nearly hit the roof. Where does he get off criticizing me? He expects me to be a perfect Stepford wife with no purpose in life other than to please him. It's almost funny that he complained about my wasting money seeing a psychologist considering the way that he throws money away on his toys. It's obvious that he could care less about what's important to me.

Session Two

Sure it was a warm day, but I didn't know they even made shorts that short. Warning bells the size of Big Ben were clanging. I needed all the self-discipline I possessed to keep my eyes from luxuriating in her exquisite form. The sad truth was that a female like Linda wouldn't give me the time of day under any other circumstance. And I was lonely, single, and vulnerable.

Putting that train of thought aside, it was time to focus on her and her needs. How have you been since our last session?

With a somewhat exasperated look, she commented, I almost didn't come back today. I just don't see how talking with you like this is going to do any good.

I held my gut reaction in check. This was not the time to get defensive. Instead, I needed to give her room to express and explore her doubts. It's not clear to you at this point how we can make your life better simply by talking.

Well, she sighed, I did feel a little better after the last time we met. But my husband made light of it, and I’ve been wondering if I shouldn't be able to feel better on my own.

An important clue had surfaced, but I needed to resist the urge to jump on it. From what you have told me, you’ve been success driven all your life. Is it surprising that any criticism causes you to engage in doubts and feelings of inadequacy?

She wrinkled her brow and exclaimed in a rather forced voice, I’ve relied on myself throughout my life. My parents are quite successful, and they always encouraged me to depend on myself and no one else.

And how have you felt in the past when you accomplished things without help? I queried.

After a brief pause, she replied, Happy, strong, and proud. I can remember things like being chosen as a cheerleader and making an 'A' in a tough math course. I felt so good at those times.

It would be a brief detour from where we needed to go, but it was important to know if she could access those emotional states. Not only would it help gauge the depth of her depression, but it might also allow us to build associations between positive feelings and healthy thoughts. So I remarked, As you were telling me how well you felt, it seemed like you were not only remembering what happened, but also experiencing the feelings you had at the time.

Well, yes I was, she said with some surprise in her voice. That was the closest I’ve felt to feeling good in quite a while.

I decided that the immediate priority was anchoring those feelings in order to provide her some relief. I also wanted to promote the hope that she could get better. I wasn't totally sure that we had established sufficient trust, but decided to go for it. I would like to do a little exercise that will help us understand your feelings. Would that be okay with you?

What kind of exercise? she asked cautiously.

You've already shown a remarkable ability to associate feelings with memories and that's something we should be able to build on.

It's fascinating how defenses lower in response to genuine compliments, and she rewarded me with a shy smile. I explained, It's very simple. Just sit back in your chair and take a few slow, deep breaths.

After about thirty seconds, some of her tension seemed to be lifting. I continued, I'll bet that there are some experiences that stand out for you so distinctly that you can actually picture them in your mind's eye. To help you do that, I would like for you to close your eyes while continuing to take deep, calming breaths.

Her eyelids began fluttering, and I didn't want her to go too deep at this point. I decided to ground her by asking her to picture herself as she got up in the morning and prepared to come to the session. I asked her to describe each step of her morning routine. As she talked, my attention wandered to those incredible legs. I literally gave myself a pinch as a reminder that it was totally unethical to take advantage of her trust and vulnerability.

Back on track, I asked, Now let's go back to one of those pleasant memories. I would like for you to pick out one that seems especially vivid and real.

After a few seconds, her face brightened. I took an advanced placement calculus class in high school. My friends thought I was crazy, and my parents thought I might be taking on too much with all my other activities. I nearly killed myself studying for the final, but it was all worth it when I got the top grade in the class.

Most memories are nothing more than words summarizing something that happened. It's much more powerful to remember something by re-experiencing it in the present. Clients with posttraumatic stress disorder suffer from break through memories that make it seem as if a terrible event were happening all over again. For them, my job is to remove the affective intensity of the memory so that it can safely be stored in words.

In Linda's case, I wanted instead to enhance the recollection as a real time event. I said, Tell me what you notice around you as you are receiving your grade. Really tune in to any sights, sounds, or smells that you can recall.

She continued to smile contentedly as she responded, It was a sunny day, and I can remember the feel of the sun coming through the window. It was really strong, and it somehow made me feel happy and warm. The teacher was very strict and rarely gave compliments. When he told me how impressed he was, I thought I was going to explode.

I was flowing with her and inquired, And how are you feeling now?

It was good that she stayed in the memory rather than intellectualizing. I feel happy and warm. I even hear birds singing outside.

In order to anchor the place, I said, It may sound a little silly, but I would like for you to touch the back of your left hand with your right index finger as you are experiencing these positive feelings. You are in a space that is very real, and you can learn to return to it anytime you want. All you will have to do is touch your hand just as you are doing. Now I would like for you to slowly open your eyes.

She looked around the room as if she had never seen it before. Wow! I feel like you gave me some sort of drug. I felt lousy when I came in, but now I feel better than I have in years.

It's a very positive sign that you are able to access such positive feelings. What did you learn from the exercise?

With some enthusiasm, she responded, I don't have to rely on other people to tell me what to do or how to feel. I've been so caught up in doing what I thought I was supposed to do that I was starting to lose myself.

So tell me what that insight does for you.

She brightened, saying, I feel free. I can't believe that I let myself get so tied up in knots.

I was pleased to see her relief, but wanted to make sure she could do something with what she had learned. I persisted, Now that you have that insight, are there situations or circumstances in which you might act differently?

I'm sure there are. For the moment, I'm just blown away by realizing how dumb I've been.

She certainly wasn't going in the direction I had hoped. I asked, Do you want to use this information to punish yourself?

She smiled and shook her head. That was pretty silly of me. You know, I just thought of that old saying about casting pearls before swine. But I certainly don't think of myself as a pig. I've gotten the message. There is no need for me to continue being a compulsive people pleaser.

In wrapping up the session, I said, Over the next week, I would like for you to observe yourself as you interact with other people. It's important that you not judge yourself. Just watch and learn. As you go through the week, think about the things you do and how they fit into your life. It's not time to make any big changes. Let's just see what we can learn about Linda.

––––––––

Linda's Journal

March 10

After our session, I was genuinely feeling lighter. In fact, I felt better than I had in a long time. I still had some doubts that this shrink was strong enough to help me, but he did seem to know what he was talking about.

He did some sort of hypnosis thing that was just great. I've been practicing it several times a day and, to my amazement, it seems to work. It's great to know that I have something I can use to get me through the tough times.

I did have a bit of a breakthrough when I realized how much I had lived my life according to what other people expected of me. It feels strange to look back on all the choices that I've made that weren't really my choices at all.

It's sad to think that no matter how much I work to improve myself I will never meet the expectations of my husband and my parents. They are just so judgmental. I feel like I'm doomed to living my life as a failure in their eyes.

Since having dinner with my parents, I've been feeling like a complete loser. It doesn't really make sense, but I feel like I’ve let them down. I was given an assignment to watch myself go through each day. I hate to say it, but I've been totally disgusted by what I've seen.

I'm having serious second thoughts about going back to see the shrink. I guess I should be able to get over it on my own. It's really kind of silly of me. I've got everything I could ever ask for. What's wrong with me? That's funny. That's the same question I started with.

Session Three

It was a despondent young lady who dragged in 5 minutes late. As soon as we were seated, I asked, What's wrong?

Everything, she muttered. It's been a terrible week.

I hadn't warned her that highs and lows are to be expected when a person begins a change process. You left here feeling on top of the world. Can you tell me when things started to go wrong for you?

In a wooden voice, she said, I had my parents over for dinner after our last session. I was really looking forward to it, and that's unusual for me. Before we finished the salad, my husband, Rick, announced that I was seeing a shrink. He sounded so condescending that I felt like all the air had been let out of my balloon.

What happened after his statement?

She looked rather dazed as she said, There was dead silence for what seemed like forever. During that time, I got to thinking about how my parents had always taught me to be self-reliant. I went from being on top of the world to feeling like a total failure.

I commented, Rick pushed a button that made all the old doubts and bad feelings re-appear.

Yes, and my parents' silence confirmed what I was feeling.

It was fascinating that a person so talented and accomplished could so easily relinquish her self-confidence. I realized that I was facing a delicate dilemma. It was important that she continue to rely on me at this point, but I didn't want her to feel weak and helpless. Rather than being sympathetic, I needed to push her to defend herself.

I delicately challenged, So you allowed them to invalidate you.

She looked up and asked, What do you mean?

I didn't want to make it too easy for her, so I said, What do you think I mean?

After a brief pause, she responded, Oh. I guess I did let them wreck how I was feeling.

I'll bet if you look back you can remember other times the same sort of thing happened.

She wrinkled her brow as if deep in thought. You know, you're right. As I think about it, there were times when I rushed home excited to tell my parents about something I had done. Their reaction was always something to the effect of 'so what?' Especially with my father, it seemed like nothing I did ever quite measured up. It feels funny to say that because I've always thought of them as such good parents.

In a reassuring tone, I said, You're not saying that they are bad people or bad parents, but you are starting to realize a pattern of behavior involving you and your parents that has had a profound effect on you.

There was no need to turn her against her parents, so I didn't mention the fact that withholding praise is a powerful, though destructive way to control a child. I didn't want to make Rick the bad guy either, but needed for her to pull it all together. Can you think of times as an adult when you allowed someone to have a similar effect on you?

She jumped on that question. Boy, can I! It seems like nothing I do is ever good enough for Rick. I work all day cleaning the house, and he comes home and finds something out of place. I cook a great meal, and the only comments he makes belittle my efforts. I hate to admit it, but one of the things bothering me is a question that has always in the back of my mind. How could I be married to such a wonderful man and not be happy? Until now, I've always assumed there was something wrong with me.

I wanted her to release the burden she had been carrying, but not by finger pointing. Rather than thinking about individual people in your life, let's examine the recurring pattern.

You know, she chuckled, it's really funny. All this time I've thought of myself as strong and independent. And I was really looking for someone to tell me that things were okay...that I was okay.

It was an important insight, and I wanted to make sure she got it and knew what to do with it. Has it been just anyone? Or did you allow certain people that control because you admired them or saw them as more powerful than you?

She looked down, deep in thought. Suddenly, she raised her head and exclaimed, What an ass I've been! I’ve deluded myself about being in charge of my own life. But what I've really been doing is trying to prove myself to my father and Rick. It's like if I did enough or accomplished enough then they would love me and then I would be okay.

Now we should be able to bring it home. I asked, And what happens when you try to please them?

With more than a touch of bitterness, she replied, At best, nothing. At worst, they point out how I should have done better.

I wanted to make sure she could benefit from what she had learned without turning it against the people she loved. Until now, were you aware of this pattern?

Of course not, she replied. Do you think I'm such an idiot that I would keep doing something so pointless?

And your father and Rick, do you think they are aware of the pattern?

Absolutely, it's how they have controlled me.

It was an expected conclusion. Now it was critical that she be able to put things in perspective. "It's very common for people to have patterns of relating, especially with those they care about, that are totally automatic and unconscious. Unfortunately,