The teen showed up today. She handed Bea the notebook, saying, “I talked to you in here.” And so Bea read, and responded, while I hid under my blanket.
I wonder, what would you have done with me? What would you do if teen me walked into your office today?
You would have known the diagnosis of bulimia, cutting, and anxiety. You probably would have been told I was resistant to treatment. You would have known I was from a good family. That I got good grades, was well liked, participated in school activities like cheerleading and newspaper and that I was active in my church.
“Well, I would think that what was going on underneath– the cutting, the bulimia, the suicide attempts– didn’t match the picture I was being presented. I would be curious about that, about what that meant.”
You would have met a quiet polite girl. I would have willingly discussed school, church, friends, cheerleading. Anything else you brought up would be likely to make me ignore you, to go quiet and zone out.
What would you have done?
“So, that is lots of teens. I would try to get you to play a board game or to do some art with me. I would make sure that you knew I was aware there was more going on than you were saying. I wouldn’t push you to tell me, just make sure that you knew I knew there was something that was triggering the cutting, the bulimia.”
Kathy talked about normal things, and then would try to get me to talk about food, or maybe my feelings. She would try, and I would tune her out. But then, a few months after I had been seeing her, I went to that party and my whole world fell in on itself. Everything was was just one big mess and I couldn’t make sense of it, I thought I was going crazy.
Things got worse. I was cutting more, throwing up more.
I got caught cutting, and my mom called Kathy. I ended up seeing her that night. Mom wanted Kathy to “talk some sense into me” but that’s not what she did.
She asked if she could see what I had done, and I showed her. She was kind and understanding. Sitting on the floor, side by side, she looked at the cuts, new cuts, old cuts healing, scars. She said, “You must have been hurting really bad for a really long time.”
I said, “No, I’m fine. Everything is okay.”
She said, “Your words say you are okay, but your cutting tells me something else. It tells me you are hurting.”
I denied it, and she told me it was okay to not be okay, that in her office, I didn’t have to be okay. She talked about people cutting themselves to feel pain physically because they couldn’t feel it emotionally.
I told her that wasn’t right, that I had cut to make it stop.
She wanted to know, “To make what stop?”
But I didn’t tell her. Not then. Not that day. But that was the day I started to trust her. She was so understanding, and not mad, and she didn’t need me to be okay, and she acted like she really cared about me.
We had sat on the floor that day, side by side, and she didn’t try to fix me. She just sat next to me and tried to understand.
“She did see you, didn’t she? It sounds like she was very attunted. That she realized the cutting was because of something. It makes sense that you would trust her.”
And things went like this. Talking, slowly about feelings, about numb, about cutting, about throwing up. And she was always Kathy, always caring, always okay with what I said or did.
So, months later, I told her about the party. She had been my therapist for close to a year then. So, I told her. She didn’t believe me. I’d trusted her, I’d thought she was on my side, and she did not beleive me.
Nothing was okay. Nothing at all. I was crazy. And so I tried to die. And my mother fired Kathy and I never saw her again.
“This is painful. It is painful to read.” Bea’s voice has tears in it.
“I’m sorry.” I don’t want my words to cause her pain.
“You don’t need to be sorry, I just want you to know I feel how painful this is. A year of building trust, to have it end like that. It’s so hurtful. She really did so much damage. It’s really to bad there wasn’t the opportunity for a repair.”
So, I wonder. What would you have seen? What would you have said or done— in the beginning when I wouldn’t talk, and the night my mother wanted my therapist to talk sense into me, and the day I told you about the party? How would you have responded?
She diagnosed me with borderline personality disorder. I was 13, 14. What would you have said, done, believed back then? What would you say, do, believe if you met me now, in present day?
“Well, first of all, you shouldn’t have been daignosed with anything like that, not at your age. Secondly, BPD is just trauma. If someone comes to me with that diagnosis, I see trauma. That’s all. I do think that in the 90’s, anytime cutting was a symptom, BPD was considered. It was….well, that was how things were viewed then. Be it the knowledge we had, or cultue, or what, cutting was often viewed as manipulation.” She tells me about when she was doing internships, how therapists, psychologists, doctors would talk about BPD patients, and how it made her cringe. She tells me how not everyone agreed with the old school viewpoint, even at that time.
Did Kathy just pretend? Was it all an act to make me trust her? Was it just her doing her job? If it wasn’t, then what happened when I told her about the party? Why did she change, why was she so not caring? Why wasn’t she the therapist I knew and trusted that day?
“I don’t think she was pretending. You are too sensitive to changes in people around you, to people being fake, that you wouldn’t have trusted her if she weren’t being real. She clearly wasn’t very attuned that day. Was she asking questions kindly, like, just trying to understand?”
I shake my head. “No. No, it was….like she was interrogating me, like she…..she thought I had done something wrong or was lying….it…she just wouldn’t stop questioning me. She wasn’t Kathy.”
“Maybe she was triggered, maybe something about your story brought something up for her. Maybe she was having a very off day. Therapists make mistakes. We screw up. And we forget how important we are, that we matter.”
“The first thing….the first response I have is to say, she wasn’t important, she doesn’t matter. But she did matter.” I start to cry again.
“Yeah, she did matter. She was important. This was a loss, and painful. So much pain.”
“I needed her. I was going crazy, and I….she was the only person I had to talk to, and I talked to her and she didn’t beleive me. And then there was nothing, and I had no one, and I couldn’t handle it anymore, I just needed it to stop and it wouldn’t and I couldn’t even trust my own mind, I wasn’t sure what was true anymore, and it was all just too much. So I…I tried to end it.”
“You really did feel all alone. Abandoned and let down. Of course it hurt. I wish you had gotten to go back, to see her again, to maybe repair the relationship and not be alone with all of this.”
“I wouldn’t have talked to her anyway,” I say, angrily.
“Maybe not. But she could have talked.” Bea counters.
“My mother made that choice, not me.”
“True. That doesn’t mean Kathy didn’t want to see you again.”
I guess I can’t know if she wanted to see me again, or what my mother even told her.” I say.
“No, you can’t know.”
“My mom was mad. Kathy wasn’t doing her job of fixing me because I was still trying to kill myself. She might have told her just that.”
Bea sighs. “If that were me, I would have done everything I could to get your mom to let you come back to me. I woild have talked to her about repair, and relationship, I would have asked her to come in so we could talk.”
“You would have?”
“Yes. I would have wanted to repair things,” she assures me.
“I guess there is no way of knowing.” I shrug.
I think for a while. “What would you have done if that was you, and I came back?”
“Well, I would probably cry. I would feel really terrible that I had missed the mark so horribly, and caused you more pain. I’d tell you that and say that I want to find a way to repair the damage I had done.”
“I probably would come into your office mad.”
“Would you be able to tell me that you were mad, or would that have felt too threatening to risk having me be on an opposite side?” When Bea asks this, I feel touched that she remembers how hard it was for me to be mad at her because I didn’t want us to be on opposite sides. That was before I learned, and experienced, that people can be mad at each other and still care and work together on the same side to repair the rupture.
“No, I would tell you because it wouldn’t matter to me. You would already be gone, not on my side.”
“Then I would start with the mad; I’m glad you came back, even if you are mad at me. I’m glad you can tell me you are mad. I understand something really upset you last time. Can you tell me what that was?”
“No. I’m not talking to you about this. Not ever again.” My tone says that this is final, that I am angry and hurt.
“We were talking about the party, and I clearly missed something. I hurt you, because I missed something. I’m sorry.” Bea says softly.
“I don’t care,” I say in my coldest, angriest voice.
“And then I would just stay with that,” Bea tells me. “I would wait and carefully bring up the party and my clear misattunement, and wait until you were ready to respond.”
“Just like that? You would wait? How long?” I ask. I don’t beleive she would wait until I were ready to talk.
“As long as you needed. I would do art, and plah games, take walks with you, and make sure you knew that I knew there was a lot going on that you weren’t saying, and that I was just waiting for you to be ready to work on repair.”
“Will you wait for the teen to be ready to talk? To trust you?” I ask.
“Yep. I’ll wait. And I think the teen is doing a great job talking in her own time. And I will just keep waiting, trusting that she will know when it is time to talk more.”
“You are good at waiting,” I tell her. “You waited four years for the filter to be removed.”
“I did. That had to happen in your time, not mine.”
Somehow we get to discussing Kathy, and if she had kids, or was married, how old she was. I have no answers. I only know she was mom-age, but older than my mom, more like the age of my friend’s moms. “She didn’t tell me stuff about herself,” I say.
“She had some firm boundaries, not like your self disclosing therapist.” Bea laughs.
“I wouldn’t have been able trust you if you didn’t tell me about you, if you weren’t real.”
“I know. And really, I shouldn’t say that. The old school of thought was that therapy should be single person; meaning the therapist is a blank slate. But there is also 1 1/2 person therapy, where the therapist gives some feedback, maybe shows emotions, that sort of thing, but leaves out anything personal about herself. Then there is 2 person therapy, meaning the therpaist shares more of herself, shows her feelings, discusses her reactions to things, and the relationship is more collaborative and that of working side by side. Sharing things about myself is only being a bad therapist if I were sharing things that were me wanting you to take care of me. Or if you didn’t want to know about me. I have people who don’t want to know anything about me, and so they don’t know anything. You need to know about me, to know that I’m real, that I am not pretending to be something I’m not. You need that to feel safe, to know that I’m just me. Honestly, you probably know more of me than anyone else I see, because you need that.”
I laugh. “I never thought you were doing anything wrong. Different than therapists in my past, yes. But not wrong. And it helped me. You being real means I can talk about things, that it is safe. I mean, with the teen present, there is no way I would have been able to trust you, not after…..well, the story abour Kathy became that she pretended to care, she acted one way to make me trust her, and then she got what she wanted, and she hurt me.”
“Now, what does that parallel?” Bea asks.
I think for a minute. Feeling shame, guilt, apprehension, I say, “What the teen thinks about you?”
“Well, yes. But also, Kenny.”
“Oh. Oh, yeah. It does.” I’m surprised. Does this mean something? I don’t know.
We talk a little more, mainly about trust, and the teen, and how it makes perfect sense to Bea that the teen would struggle with not wanting to be alone, but being so afraid to trust Bea.
As my sessions is ending, Bea says, “Everything we have talked about today reminds me, I have a conference for new therapists, and interns I’m to attend, to do a presentation about therapy relationships and not rushing the process when working with trauma, with sexual abuse. What I keep hearing from more experienced therapists is that the newer therapists and interns are rushing things, pushing to rush things.” She pauses, and then says, “I was going to use the story of a person I saw long ago, but your story fits the topic better. You reminded me how we did just follow the process and really let things unfold.” She says the next part slowly, carefully, “Would you let me use your story— our therapy story– to talk about these things?”
Surprising myself, I say, “You could do that.” And then I add, “You should tell them about Kathy.”
“Yes, I could do that.”
“They need to know how much hurt they can cause, how much power they have,” I say softly.
“They do need to know that. And you could write about your therapy experience then, and your therapy experience now. If you wanted to, that is.”
“I would like to do that,” I tell her. “Maybe…..if I can, I mean, it’s not good that this happened to me, but maybe if my story can help therapists help someone like me, then that is a good thing. Isn’t it?”
“Yes, it is a good thing. A very good thing.” She pauses after she says this, and adds, “You know you don’t have to let me share your story, or talk about our relationship, or write anything to share. You can tell me no.”
I pull the blanket off my head. “I know. But I wanted to say yes.”
“Okay. Then we will decide what to share, together. Okay?”