Patients Who Haunt the Therapist

It’s almost Halloween. Time to talk of a patient who haunts me.

I put her in the category of Greek tragedy. After you do therapy for a while, you get a sense of a singular place called “Grim Future;” and a person, admirable in many ways, whose tragic flaw will take her there. Usually, you only witness the first few acts of the drama.

But you are certain, even though the data say therapists are flawed predictors.

These are the patients with whom you are powerless. Not a good thing for a peculiar profession, one hoping to prevent disaster, enable happiness.

She was a university student. Her parents actually did the leg-work to find a therapist to “fix” her. I came recommended, though an odd choice for a family steeped in “hellfire and brimstone” faith, the folks who strangle nearby innocents with certainty of the right and wrong of everything. Their rigidity frightened me, people who sat so tightly wound in my office I thought they might vaporize. Hisssssssssssssssss!

I’d be seeing the daughter, however, I said to myself. I told them she would be my patient, not they; once I evaluated her and assuming I believed good might be done. I “would not, could not” (as Dr. Seuss says) report back to them; short of imminent risk of self-harm or danger to someone else. They seemed to agree.

She walked in and springtime came with her. A silvery thing, she lit the room, though I cannot explain how. A “presence.” Therapists take in everything or try to.

This young woman was tall, perhaps 5’10” and willowy; black hair against porcelain skin, a pleasant face. Her complexion was so fair I could almost see through her. Someone else had, I suspected, and seen there was no will in her to resist much of anything.

She was not the most expressive person I ever treated, more sadly placid. Not serene, but the kind of calm derived from having the fight drained from you. Almost weary. Her parents had sucked the life out of her. Think vampires. The wind would take her where it chose. Right now she had youth and beauty, but as they say about the short careers in the National Football League (NFL), the three initials really mean “not for long.” Of course, I didn’t understand all this immediately.

Her parents wanted her to follow some “serious,” academic track. She was a dancer. They wanted her earthbound. She wished to leap. Bad combination.

Many of us try to get the love we couldn’t get at home, don’t we, at least for a while? My patient was looking for such affection. Her folks didn’t like her boyfriend: he was not a member of their suburban, uppity class, and worse (to them) freighted with a minority heritage. But before you feel too sympathetic toward him, you must learn more.

I discovered he had introduced her to cocaine, which he also used: a drug, for her, like a key for her internal lock. There she found release, relief, and ecstasy. There, she was no longer anyone’s hostage. But, of course, she’d simply gone from being her parents’ chattel to that of the boyfriend and the drug.

Treatment didn’t go on for long. The job of freeing a person from parental dominance or a lover’s grip must wait if simply getting through the day is difficult.  I explored addiction treatment with her. I don’t recall if she began or not, but her interest was only dutiful. Soon enough her parents discovered her use and blamed me for not telling them. Therapy ended.

The character of Alfieri, in Arthur Miller’s A View From the Bridge, says the following:

There are times when you want to spread an alarm, but nothing has happened. I knew, I knew then and there – I could have finished the whole story that afternoon. It wasn’t as though there was a mystery to unravel, I could see every step coming, step after step, like a dark figure walking down a hall toward a certain door. I knew where (she) was heading for, and I knew where (she) was going to end. And I sat here many afternoons asking myself why, being an intelligent man, I was so powerless to stop it. And I even went to a certain old lady in the neighborhood, a very wise old woman, and I told her, and she only nodded and said, ‘Pray for (her) …’

The cynics say counselors are only interested in money, making a fine living off the pain of others. Well, some few are, but most of us want the best for everyone, not just our patients. We are rewarded by human contact and flourishing.

Yes, we cannot help without a therapeutic distance. The invisible boundary doesn’t inoculate us all the time. People we know, in and out of therapy, get inside. It happens to us as to you. We are not sculpted from stone.

Halloween is an odd day to be thinking of prayer, but apt perhaps. This year, when you tuck your candy-buzzed child into bed, and after all your treats have been gobbled up by greedy little monsters, sit back and rest and be grateful if no ghosts haunt you. Then, if you have a picture of this fragile creature because my story was well-told, pray for the (now, no longer young) woman, if she lives.

And for your counselor. This, from an ex-therapist who doesn’t believe in God.

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The top painting is Marie, by Peder Severin Krøyer. The second image is The Ghost, by Tsukioka Yoshitoshi. Both are sourced from Wikimedia Commons.