Client Stories

DEPRESSION

Mary’s Story

Mary, a middle aged woman sought therapy for depression that had gone on for 5 years, on and off. She was married with three children. A multigenerational family history and diagram revealed that the depressions were worse in the late summer and that her mother had experienced a similar pattern. Mary became weepy, experienced severe PMS, and withdrew from family and friends.

Careful history taking found that she had an abortion 9 years prior to seeking therapy, because her husband had threatened to leave if she carried the baby to term. Her mother had a miscarriage a year before Mary’s birth, and it seemed, never been able to deal with that loss and had held Mary very close to her, even as an adult. Mary was compliant and avoided conflict, eager to please those around her.

Mary was open to my suggestion to actively grieve for her unborn baby. With coaching, Mary was able to look at the anger she felt towards herself for going along with her husband’s threat, as well as express, in a constructive manner, her anger at him for the ultimatum.

I usually see parents or spouses early in the therapy in order to get as much information and to connect with them in a supportive way. I had met Charles, her husband, during the second meeting. He was unaware that she harbored any grief or anger, having assumed that Mary was either going through menopause or had a chemical imbalance.

Mary’s depressions lifted and after 8 months in therapy, she experienced her first depression-free late summer. Neither she nor Charles wished to take a closer look at their marriage and so ended therapy at that point.

Alan’s Story

Alan’s wife made the initial call after he was “downsized” out of his executive position in a high tech firm. He was convinced that he had failed his family, and with his oldest daughter going off to college, he was feeling desperate to find new employment. Alan was also overwhelmed by the fear that he was “too old” to keep up in his field and had taken to spending his days on the golf course, playing and drinking with retired buddies rather than looking for another position.

His wife, Theresa, was furious with his behavior and also felt betrayed by his lack of interest in finding work. An older sister, she had gotten a plan mapped out for Alan to work with executive search firms, take some courses to build his skills, and had reduced the family budget to a fraction of what it had been. He claimed that he was too overwhelmed to do anything and said sooner or later, before his severance pay ran out, something would come up.
Alan’s family doctor had prescribed an antidepressant but it didn’t seem to be working. I saw the Alan and Theresa together and also separately. I helped Theresa to back off; after a couple of months she ended up taking a part-time accounting job that paid well and kept her focus off of her husband to some extent. As Theresa made it more clear over time that it was his life, his success or his failure, Alan started to take more responsibility for his career.
It was somewhat disorienting for Alan not to have a woman telling him what to do-his mother had raised four children, and as her “baby” she had taken special care to see that he never had to worry too much about anything. This of course increased his father’s tendency to be somewhat harsh and demanding, which increased his mother’s solicitude.

Alan seemed to measure far short of the goals he had set for himself. Over time, he learned to set more realistic goals, to learn from Theresa how to get himself organized, and eventually found a new position. She continues to consult with me on a monthly basis.

ANXIETY

Tom’s Story

Tom, a truck driver, had been having anxiety attacks that also involved acute stomach pains. His physician referred him to me after finding no physical reason for the pain. I suggested that he collect information about the timing of these attacks. After tracking the incidents of stomach pain for two weeks, he identified a pattern: The stomach attacks that were likely to be the most debilitating happened when he was about to leave town for a day trip to deliver goods to a large city.

His wife, who attended most of the sessions, agreed that this seemed to be a part of the situation, but added that he was often anxious when she left for work at the nursing home on weekends. Tom, who was forty years old, had been abandoned by alcoholic parents when he was about 18 months old. I asked what he thought about abandoning a baby and he said the very idea made his stomach hurt.

While he was not particularly interested in going through a long course of therapy-too painful he said-he was able to acknowledge that his early childhood experiences might be connected to the anxiety and stomach pain. After a few months, he was able to reduce the frequency of anxiety attacks and the stomach pains ceased.

ANGER AND MARITAL CONFLICT

Mike and Jenny’s Story

Mike started therapy after his wife Jenny brought a restraining order against him for hitting her numerous times while drunk. Both of their first marriages ended in divorce and each had two children; Mike rarely saw his own kids and emotionally abused Jenny’s kids. He was also distant from his own parents, who were financially well off but alcoholics who had also appeared to write him off when he refused to build a house near theirs.

Most of his childhood memories centered on the emotional and physical abuse he endured from his father. His mother privately sided with Mike but did nothing to stop the abuse. Mike denied that this had much of an impact on him, saying that he was “a bad kid and that’s how parents are.” He knew there was a connection between is own anger (and depression) but didn’t know what to do about it.

Mike continued to deny that he had been hurt in any way by the childhood abuse. After Jenny decided to move out, he fell into a serious depression; eventually he was able to deal with the profound sadness and the anger he had towards his parents. He reestablished contact with them, slowly, as he did with Jenny and his children. Although they divorced, they began dating again shortly afterwards. They planned to remarry as soon as Jenny succeeded in learning how to remain calm when Mike occasionally exploded at her. Each of them is still consulting with me about these issues.

TEENAGE AGGRESSION

Justin’s Story

Justin, a 16 year old boy, was referred to me by his probation officer. Justin had hit another boy at school during a basketball game, been suspended, and the boy’s parents had pressed charges after the emergency room physician found evidence of a skull fracture.

Justin was the only child; his mother Elaine and father Bob worked in a family business that was constantly on the verge of collapse. The “crib” death of a premature sibling, a sister before Justin.

Elaine treated Justin as though he were a child, and coddled and spoiled him, while overtly and covertly rejecting her husband. Bob retaliated by taking out a great deal of frustration on Justin, to the point of constant criticism and ridicule, while ruling with a very firm hand. Justin had developed a pattern of letting other boys pick on him in school, which neither of his parents knew about. Over time, as he grew older and stronger, he adopted the pattern of bullying that he had experienced first hand at home and at school.

Elaine was the one in the family who was most frustrated and the most eager to see what she could do differently. She began to look at her own functioning relative to Bob, and we had several couple sessions that were focused on their relationship and the triangle that had formed around Justin.

I also coached Justin about ways to reduce his father’s negative focus on him and to put some breathing room between him and his mother. He was an apt pupil who learned a great deal about triangles and his role in keeping the negativity going between himself and his father.

After several months of therapy, they dropped out when Justin’s probation was over. I recently received a call from Elaine asking to set up an appointment. With Justin now out of the house (he attends a college nearby), their marriage was in a crisis. Since Bob does not want to participate in therapy, I will work with her for the time being; perhaps he will change his thinking over time.

POST TRAUMATIC STRESS DISORDER

Judy’s Story

Judy, a 25 year old computer consultant, called to set up an appointment because her family doctor had refused to continue prescribing anti-anxiety medication unless she entered therapy. She had been injured in an automobile accident the previous winter and was anxious about driving in rain or snowy weather. The woman whose car she had hit, had run a stop sign. The woman was unable to walk and facing permanent partial paralysis.
Judy also found herself weeping “over nothing” and taking great pains to avoid the section of the city where the accident occurred. Her guilt about the accident was overwhelming. She had started and stopped a series of relationships with young men on whom she relied so heavily that they retreated from her dependency on them.
Her physician and I both agreed that Judy was experiencing posttraumatic stress disorder. I suggested that she systematically deal with the losses and trauma associated with the accident. For example, her physical activity was hampered by ongoing back pain. Her concentration was poor, and she had lost several accounts due to expensive mistakes she had made and her travel limitations also resulted in lost business opportunities.

Judy’s father, a very successful computer expert himself, had been rebuffed in his efforts to help her reestablish herself professionally since the accident. (Her parents divorced while she was in college and her mother lived almost 2000 miles away in the same town as her older daughter.) He agreed to come in to meet with me and Judy to discuss ways in which he might support Judy.

During one session, while discussing the divorce, it became clear that Judy believed she had caused her parents’ divorce by her choice to major in computer science rather that art, her mother’s field. The divorce had been ugly, with accusations on both sides about third parties being involved, the sale of the family home, and even the death of Judy’s much loved pet dog.

The parallels between her parents’ marital problems (“It just blew up”) and the accident (“I ‘m a terrible driver, it was all my fault.”) became clear. In neither case was Judy responsible for the outcome. Over time, Judy resolved both of these traumatic events. She “gave” responsibility for her parents’ marriage back to them, visited the woman from the accident in the rehab center to discuss the accident. Judy worked with her father to reestablish her career. She reconnected with her mother and older sister and was able to function quite well without the anti-anxiety medication. She has scheduled a few appointments each winter since then to stay on track with the progress she made several years ago.