My joyous optimism, my sense of professional accomplishment, my feeling that I was reaching a full embodiment and expression of myself all withered when I established my private practice and met my first patient. I visited him in the hospital where he had been living for a month, awaiting diagnosis and undergoing treatment for what turned out to be stomach cancer. He was terrified. He felt betrayed by his body, threatened by his mortality, overwhelmed by the uncertainty and loneliness of illness. And I couldn’t reach him where he was. All of my skill in establishing a climate of warmth and trust, in building a bridge between me and my patient, had disappeared. I felt like a child dressed up in a doctor’s white coat. A fake. My expectations of myself were so high, my fear of failure so toppling, that I couldn’t see past my own self-absorption to reach the man who was asking for my help and my love. “Will I ever be healthy again?” he asked, and my mind flipped like a Rolodex, spinning through theories and techniques, my eyes pointed at the wall, trying to mask how nervous and scared I was. I was of no help to him. He didn’t invite me back. I realized, as I had when I met Tom, the paraplegic veteran, that my professional success had to come from a deeper place within me—not from the little girl trying to please others and win approval but from my whole and authentic self, the one who was vulnerable and curious, who was accepting of herself and ready to grow.
In other words, I began to formulate a new relationship with my own trauma. It wasn’t something to silence, suppress, avoid, negate. It was a well I could draw on, a deep source of understanding and intuition about my patients, their pain, and the path to healing. My first years of private practice helped me to reframe my wound as something necessary and useful, and to shape and develop my most enduring therapeutic principles. Often the patients I worked with mirrored my own discoveries about the journey to freedom. Equally often they taught me that my search for freedom wasn’t complete—and they pointed me in the direction of further healing.
* * *
Although Emma was the identified patient, I met her parents first. They had never spoken to anyone, least of all a stranger, about the secret in their family: Emma, their oldest child, was starving herself to death. They were private, reserved people, a conservative German American family, their faces creased with worry, eyes filled with fear.
“We’re looking for practical solutions,” Emma’s father told me that first visit. “We have to get her to start eating again.”
“We heard that you’re a survivor,” Emma’s mother added. “We thought Emma could learn something from you, that you might inspire her.”
It was heartbreaking to see their panic for Emma’s life, to see their shock. Nothing in life had prepared them for a child with an eating disorder; they had never considered that something like this could happen to their daughter and their family, and none of their existing parenting tools was having a positive effect on Emma’s health. I wanted to reassure them. I wanted to ease their distress. But I also wanted them to begin to see a truth that might be even more painful for them to acknowledge than Emma’s illness—that they had a part in it. When a child is grappling with anorexia, the identified patient is the child, but the real patient is the family.
They wanted to tell me every detail of Emma’s behaviors that concerned them: the food she refused to eat, the food she pretended to eat, the food they would find tucked inside napkins after family meals, the food they discovered stuffed into her dresser drawers, the ways she pulled away from them and retreated behind closed doors, the terrifying changes in her body. But I asked them instead to talk about themselves, which they did with obvious discomfort.
Emma’s father was short and compact—he was a soccer player, I learned. He looked a little like Hitler, I realized with unease—he had a thin mustache and dark, pressed hair, and a way of barking when he talked, as though behind every communication was the insistence on not being ignored. Later I would have individual sessions with each of Emma’s parents, and I would ask her father how he had decided on his career as a police officer. He told me that as a boy he had walked with a limp, and his father had called him Shrimpy-Limpy. He chose to be a police officer because it required risk taking and physical strength; he wanted to prove to his father that he wasn’t a shrimp or a cripple. When you have something to prove, you aren’t free. Even though I didn’t yet know anything about his childhood during our first visit, I could tell that Emma’s father was living in a prison of his own making—he was living within a limited image of who he should be. He behaved more like a drill sergeant than a supportive husband or concerned father. He didn’t ask questions; he ran an interrogation. He didn’t acknowledge his fears or vulnerabilities; he asserted his ego.
His wife, who wore a tailored cotton dress with buttons down the front and a thin belt, a look that was both timeless and no-nonsense, seemed hyperattuned to his tone and speech. He talked for a few minutes about his frustrations at work when he was skipped over for a promotion, and I could see her searching for a careful balance point between affirming his indignation and stoking his anger. She had clearly learned that her husband needed to be right, that he couldn’t handle being confronted or contradicted. In our private session, I would be impressed by her resourcefulness—she mowed the lawn and did many of their home repairs, she made her own clothes—and the seeming contradiction between her skills and the power she gave over to her husband, the price she paid to keep the peace. Her habit of avoiding conflict with her husband at all costs was as damaging to her daughter’s health and their family dynamic as were his domineering behaviors. They were partners in making control—not empathic connection, not unconditional love—the language of the family.
“This is a waste of time,” Emma’s father finally said during our first visit, after answering my questions about his job, their family routines, how they celebrated holidays. “Just tell us what to do.”
“Yes, just tell us how we can get Emma to come to the table at mealtime,” her mother begged. “Tell us how we can make her eat.”
“I can see how worried you are about Emma. I can see how desperate you are for answers and fixes. And I can tell you that if you want Emma to get well, your first job is to understand that with anorexia, the issue isn’t only what Emma eats; it’s also about what’s eating her.” I couldn’t just fix her and send her back, her healthy self, I told them. I invited them to help me, to be my cotherapists, to observe their daughter, but not with the agenda of making her do or be anything different, just paying attention to her emotional states and behaviors. Together we could build a clearer picture of her emotional landscape and get more familiar with the psychological aspects of the disease. By enlisting their help and cooperation, I hoped to lead them toward an understanding of their part in her illness. I was nudging them toward taking responsibility for the way they contributed to what was eating Emma.
The following week, I met Emma for the first time. She was fourteen years old. It was like meeting my own ghost. She looked like I had at Auschwitz—skeletal, pale. She was wasting away. Her long, stringy blond hair made her face look even thinner. She stood in the doorway of my office, her too-long sleeves pulled all the way down over her hands. She looked like a person with a secret.
With any new patient, it’s important to be sensitive to his or her psychological boundaries from the very first moments of our initial encounter. I must intuit immediately if this is a person who wants me to take her hand or keep my physical distance, if this is a person who needs me to give him an order or a gentle suggestion. For a patient with anorexia—a disease that is all about control, about relentless rules for what and when you eat or don’t eat, for what you reveal or conceal—these first moments are critical. For one thing, anorexia has an inescapable physiological dimension. Because of the lack of nutrients entering the body, and because the bulk of the few calories consumed go to autonomic functions (breathing, elimination), the brain is deprived of blood flow, and this leads to distorted thinking and, in severe cases, paranoia. As a psychologist beginning a therapeutic relationship with a person with anorexia, I have to remember that I’m communicating with a person who likely has distorted cognitive functioning. It’s easy for a habitual gesture—putting a hand on someone’s shoulder as I guide her to a comfortable chair, for example—to be misinterpreted as threatening or invasive. As I greeted Emma for the first time, I tried to simultaneously warm and neutralize my body language. Because someone with anorexia is an expert at control, it’s important to disarm her need for control by offering freedom. At the same time, it’s vital to create a structured environment where there is safety in clear rules and rituals.
Having met her parents, I knew that the home language was full of criticisms and blame, so I began our session with a compliment. “Thank you for coming,” I said. “I’m so happy to finally meet you. And thank you for being right on time.”
When she had chosen a seat on the couch, I told her that anything she told me was confidential—unless her life was in danger. And then I made a soft, open-ended invitation. “You know, your parents are so worried about you. I’m interested to know the real story. Is there anything you’d like to tell me?”
Emma didn’t respond. She stared at the carpet, tugging her sleeves even farther over her hands.
“It’s okay to be silent,” I said.
More silence stretched between us. I waited. I waited some more. “You know,” I said after a while, “it’s fine for you to take as long as you need. I have a little paperwork I need to do. I’m going to go work in the other room. When you’re ready, let me know.”
She eyed me suspiciously. In a home with punitive discipline, children grow accustomed to hearing threats, and these threats can escalate quickly or, at the other extreme, prove empty. Although I was speaking kindly, she was looking to see if my words and tone were going to escalate into an angry criticism or admonition, or if I wasn’t really going to leave the room, if I was just a pushover.
I think she was surprised when I simply stood up, crossed the room, and opened the door. Only then, my hand on the doorknob, did she speak.
“I’m ready,” she said.
“Thank you,” I said, returning to my chair. “I’m happy to hear that. We have forty minutes left. Let’s use them well. Is it okay if I ask you a couple questions?”
She shrugged.
“Tell me about a typical day. What time do you wake up?”
She rolled her eyes, but she answered my question. I continued in this vein. Did she have a clock radio, or an alarm clock, or did her mother or father come to wake her up? Did she like to lie in bed for a while under the covers, or did she jump right out of bed? I asked her mundane questions, getting a sense of her daily life—but none of my questions had anything to do with food. It is so hard for someone with anorexia to see anything in life outside of food. I already knew from her parents that her focus on food was controlling her family, that all of their attention was consumed by her illness. I had a feeling she expected me, too, to be interested only in her illness. With my questions I was trying to shift her attention to other parts of her life, and to dismantle or at least soften her defensive structures.
When I had worked through a day in her life, I asked her a question that she didn’t know how to answer. “What do you like to do?” I asked.
“I don’t know,” she said.
“What are your hobbies? What do you like to do in your free time?”
“I don’t know.”
I walked over to the whiteboard that I keep in my office. I wrote, I don’t know. As I asked her more questions about her interests, her passions, her desires, I put a check mark for every time she said, “I don’t know.”
“What are your dreams for your life?”
“I don’t know.”
“If you don’t know, then guess.”
“I don’t know. I’ll think about it.”
“A lot of girls your age write poems. Do you write poems?”
Emma shrugged. “Sometimes.”
“Where would you like to be in five years? What kind of a life and career appeal to you?”
“I don’t know.”
“I’m noticing that you say these words a lot: I don’t know. But when the only thing you can think is I don’t know, that saddens me. It means you’re not aware of your options. And without options or choices, you aren’t really living. Can you do something for me? Can you take this pen and draw me a picture?”
“I guess.” She walked to the board and pushed her thin hand out from her sleeve to take the pen.
“Draw me a picture of yourself, right now. How do you see yourself?”
She uncapped the pen and drew quickly, her lips pursed. She turned so I could see her drawing: a short, fat girl with a void, blank face. It was a devastating contrast—skeletal Emma beside a blank, fat cartoon.
“Can you remember a time when you felt different? When you felt happy and pretty and fun loving?”
She thought and thought. But she didn’t say, “I don’t know.” Finally she nodded her head. “When I was five.”
“Could you draw me a picture of that happy girl?”
When she stepped away from the board, I saw a picture of a dancing, twirling girl in a tutu. I felt my throat catch, a spasm of recognition.
“Did you take ballet?”
“Yes.”
“I’d love to hear more about that. How did you feel when you were dancing?”
She closed her eyes. I saw her heels pull together in first position. It was an unconscious motion, her body remembering.
“What are you feeling right now as you remember? Can you give that feeling a word?”
She nodded, her eyes still closed. “Free.”
“Would you like to feel that way again? Free? Full of life?”
She nodded. She put the pen on the tray and tugged her sleeves down over her hands again.
“And how does starving yourself get you closer to this goal of freedom?” I said it as warmly, as kindly as I could. It wasn’t a recrimination. It was an effort to bring her into an unflinching awareness of her self-sabotage and of how far she had taken it. And it was an effort to help her answer the most important questions at the outset of any journey toward freedom: What am I doing now? Is it working? Is it bringing me closer to my goals, or farther away? Emma didn’t answer my question in words. But in her teary silence I could sense her recognizing that she needed and wanted to change.
When I met with Emma and her parents all together for the first time, I greeted them with enthusiasm. “I have very good news!” I said. I shared with them my hope, my confidence in their ability to work as a team. And I made my own participation in the teamwork conditional upon their agreeing that Emma would also be in the care of the medical staff at an eating disorder clinic, because anorexia is a serious, potentially fatal condition. If Emma ever got below a certain weight, which would be determined in consultation with the staff at the clinic, she would have to be hospitalized. “I can’t risk you losing your life over something that can be prevented,” I told Emma.
A month or two after I started working with Emma, her parents invited me to their home for a family meal. I met all of Emma’s siblings. I noticed that Emma’s mother introduced each of her children with qualifiers: this is Gretchen, the shy one, and Peter, the funny one, and Derek, the responsible one. (Emma had already been introduced to me: the sick one.) You give children a name, and they play the game. This is why I find it useful to ask my patients, “What was your ticket of admission in your family?” (In my childhood, Klara was the prodigy, Magda was the rebel, and I was the confidante. I was most valuable to my parents when I was a listener, a container for their feelings, when I was invisible.) Sure enough, at the table Gretchen was shy, Peter was funny, Derek was responsible.
I wanted to see what would happen if I broke the code, if I invited one of the children into a different role. “You know,” I said to Gretchen, “you have such a beautiful profile.”
Their mother kicked me under the table. “Don’t say that,” she admonished me under her breath. “She’ll end up conceited.”
After dinner, while Emma’s mother cleaned up in the kitchen, Peter, who was still a toddler, was pulling on her skirt, asking for her attention. She kept putting him off, and his attempts to get her to stop what she was doing and pick him up became more and more frantic. Finally he toddled out of the kitchen and went straight for the coffee table, where there were some porcelain knickknacks. His mom ran after him, swooped him up, spanked him, and said, “Didn’t I tell you not to touch those?”
The spare-the-rod-spoil-the-child approach to discipline had created a climate in which the children seemed to get only negative attention (bad attention, after all, is better than no attention). The strict environment, the black-and-white nature of the rules and roles imposed on the children, the palpable tension between the parents—all made for an emotional famine in the home.
I also witnessed the highly inappropriate attention that Emma’s father paid her. “Hey there, Hottie,” he said to her when she joined us in the living room after dinner. I saw her shrink into the couch, trying to cover herself. Control, punitive discipline, emotional incest—no wonder Emma was dying in the midst of plenty.
Like all families, Emma and her family needed rules, but very different ones from those they were operating under. So I helped Emma and her parents to make a family constitution that they would help one another to enforce, a list of family rules that would improve the climate in their home. First, they talked about the behaviors that weren’t working. Emma told her parents how much hearing them yell and blame frightened her, and how resentful she felt when they changed the rules or expectations at the last minute—what time she had to be home, what chores she had to finish before she could watch TV. Her father talked about how isolated he felt in the family—he felt like the only one disciplining the kids. Interestingly, Emma’s mother said something similar, that she felt like she was parenting all alone. From the list of hurtful habits and behaviors—the things they wanted to stop doing—we built a short list of things they agreed to start doing:
1. Instead of blaming others, take responsibility for your own actions and speech. Before you say or do something, ask, Is it kind? Is it important? Does it help?
2. Use teamwork to reach common goals. If the house needs cleaning, each member of the family has an age-appropriate job. If the family is going out to a movie, choose together which movie to see, or take turns getting to choose. Think of the family as a car where all the wheels are integrated and work together to move where it needs to go—no one wheel takes control, no one wheel bears all the weight.
3. Be consistent. If curfew has already been established, the rule can’t change at the last minute.
In general, Emma’s family’s constitution was about giving up the need to control someone else.
I treated Emma for two years. In that time she completed the out-patient program at the eating disorder clinic. She stopped playing soccer—something her father had forced her into when she started middle school—and went back to ballet class (and then on to more dance classes: belly dancing, salsa). The creative expression, the pleasure she took in moving to the music and rhythm, led to an enjoyment of her body, which gave her a healthier self-image. Near the end of our time together, when she was sixteen, she met a boy in school and fell in love, and this relationship gave her another motivation to live and to be healthy. By the time she stopped working with me, her body had filled out and her hair was thick and shining. She had become the present-day version of her picture of the twirling, dancing girl.
The summer after Emma’s junior year of high school, her family invited me to a barbeque at their house. They put out a wonderful spread—ribs, beans, German potato salad, homemade rolls. Emma stood with her boyfriend, filling a plate with food, laughing, flirting. Her parents, siblings, and friends sprawled on the lawn and in folding chairs, feasting. Food was no longer the negative language of the family. Emma’s parents, though they hadn’t completely transformed the tone of their parenting or their marriage, had learned to give Emma what she had learned to give herself—the space and trust to find her way toward the good in life. And without having to live consumed by their fear of what might happen to Emma, they had grown free to live their own lives. They had a weekly bridge night with a group of friends and had let go of much of the worry and anger and need to control that had poisoned their family life for so long.
I was relieved and moved to see Emma restored to Emma. And her journey also prompted me to reflect on me. Edie. Was I at one with my own inner dancing girl? Was I living with her curiosity and ecstasy? Around the same time that Emma left my practice, my first grandchild, Marianne’s daughter, Lindsey, began a toddler ballet class. Marianne sent me a picture of Lindsey in a little pink tutu, her sweet chubby feet tucked into a pair of tiny pink slippers. I wept when I saw the picture. Joyful tears, yes. But there was also an ache in my chest that had more to do with loss. I could picture Lindsey’s life spreading out from this moment—her performances and recitals (sure enough, she would continue to study ballet and perform in The Nutcracker every winter of her childhood and adolescence)—and the happiness I felt for her in anticipation of all she had to look forward to could not be uncoupled from the sorrow I felt at my own interrupted life. When we grieve, it’s not just over what happened—we grieve for what didn’t happen. I housed a year of horror within me. And I housed a vacant, empty place, the vast dark of the life that would never be. I held the trauma and the absence, I couldn’t let go of either piece of my truth, nor could I hold either easily.
* * *
I found another mirror and teacher in Agnes, a woman I met at a spa in Utah where I was speaking to breast cancer survivors about the importance of self-care to promote healing. She was young, in her early forties, her black hair pulled back in a low bun. She had on a neutral-colored smock dress buttoned up to her neck. If she hadn’t been the first in line for a private appointment in my hotel room after my talk, I might not have noticed her at all. She kept herself in the background. Even when she stood in front of me, her body was barely visible beneath her clothes.
“I’m sorry,” she said, when I opened my door to invite her in. “I’m sure there are other people who deserve more of your time.”
I showed her to the chair by the window and poured her a glass of water. She seemed embarrassed by my small caretaking gestures. She sat on the very edge of her chair and held the water glass stiffly in front of her, as though to take a sip would be an imposition on my hospitality. “I don’t really need a whole hour. I just have a quick question.”
“Yes, honey. Tell me how I can be useful.”
She said she had been interested in something I’d said in my talk. I’d shared an old Hungarian saying I learned as a girl: Don’t inhale your anger to your chest. I had given an example of the self-imprisoning beliefs and feelings I had held on to in my life: my anger and my belief that I had to earn others’ approval, that nothing I did would be good enough to make me worthy of love. I’d invited the women in the audience to ask themselves, What feeling or belief am I holding on to? Am I willing to let it go? Agnes asked me now, “How do you know if there’s something you’re holding on to?”
“It’s a beautiful question. When we’re talking about freedom, there’s no one-size-fits-all. Do you have a guess? Does your gut tell you that there’s something inside that’s trying to get your attention?”
“It’s a dream.” She said that ever since her cancer diagnosis a few years ago, and even now that her disease was in remission, she’d been having a recurring dream. In it she is preparing to perform surgery. She puts on blue scrubs and a face mask. She tucks her long hair inside a disposable cap. She stands at a sink, scrubbing and scrubbing her hands.
“Who’s the patient?”
“I’m not sure. It’s different people. Sometimes it’s my son. Sometimes it’s my husband or my daughter, or someone from the past.”
“Why are you performing the surgery? What’s the patient’s diagnosis?”
“I don’t know. I think it changes.”
“How do you feel when you’re performing the operation?”
“Like my hands are on fire.”
“And how do you feel when you wake up? Do you feel energized, or tired?”
“It depends. Sometimes I want to go back to sleep so I can keep working, the surgery isn’t finished yet. Sometimes I feel sad and tired, like it’s a futile procedure.”
“What do you think this dream is about?”
“I used to want to go to medical school. I thought about applying after college. But we had to pay for my husband’s business degree, and then we had kids, and then the cancer. It was never the right time. That’s why I wanted to talk to you. Do you think I’m having this dream because I should pursue medical school now, this late in my life? Or do you think I’m having this dream because it’s time to finally put the fantasy of becoming a doctor to rest?”
“What appeals to you about medicine?”
She thought before she answered. “Helping people. But also finding out what’s really going on. Finding out the truth. Finding what’s under the surface and fixing the problem.”
“There aren’t absolutes in life—or in medicine. As you know, diseases can be difficult to treat. Pain, surgery, treatments, physical changes, mood swings. And there’s no guarantee of recovery. What has helped you live with cancer? What truths or beliefs are you using to guide you through your illness?”
“Not to be a burden. I don’t want my pain to hurt anyone else.”
“How would you like to be remembered?”
Tears sprang into her light gray eyes. “As a good person.”
“What does ‘good’ mean to you?”
“Giving. Generous. Kind. Selfless. Doing what’s right.”
“Does a ‘good’ person ever get to complain? Or be angry?”
She reminded me of myself, before the paraplegic veteran had brought me to an encounter with my own rage. “Anger isn’t a value,” I told Agnes. “It’s a feeling. It doesn’t mean you’re bad. It just means you’re alive.”
She looked skeptical.
“I’d like you to try something. An exercise. You’re going to turn yourself inside out. Whatever you usually hold in, you’re going to get out, and whatever you usually get rid of, you’re going to put back in.” I took the pad of hotel stationery off the desk and handed it to her with a pen. “Each person in your immediate family gets one sentence. I want you to write down something you haven’t told that person. It might be a desire or a secret or a regret—it might be something small, like, ‘I wish you’d put your dirty socks in the laundry.’ The only rule is it has to be something you’ve never said out loud.”
She smiled faintly, nervously. “Are you going to make me actually say these?”
“What you do with them is entirely up to you. You can tear them up like confetti and flush them down the toilet, or set them on fire. I just want you to get them out of your body by writing them down.”
She sat in silence for a few minutes and then began to write. Several times she crossed something out. Finally she looked up.
“How do you feel?”
“A little dizzy.”
“Topsy-turvy?”
“Yes.”
“Then it’s time to fill yourself back up again. But with the things you usually give to other people. You’re going to put all that love and protection and nurturing back inside.” I asked her to picture herself getting very small, so tiny that she could climb inside her own ear. I told her to crawl down the canal, and down her throat and esophagus, all the way to her stomach. As she journeyed within, I asked her to put her tiny loving hands on each part of her body that she passed. On her lungs, her heart. On her spine, along the inside of each leg and arm. I coached her to lay her compassionate hands on each organ, muscle, bone, vein. “Bring love everywhere. Be your own unique, one-of-a-kind nurturer,” I said.
It took awhile for her to settle in, to let her attention move away from the surface experience. She kept shifting in her chair, brushing a stray hair away from her forehead, clearing her throat. But then her breathing deepened and slowed, her body became still. She grew deeply relaxed as she ventured within, her face looked untroubled. Before I guided her back out through her ear canal, I asked if there was anything she wanted to tell me about what she had felt or discovered inside.
“I thought it would be so dark in here,” she said. “But there’s so much light.”
A few months later she called with devastating news: Her breast cancer was no longer in remission. It had returned and was spreading rapidly. She said, “I don’t know how long I have.” She told me she planned to do the inside-out exercise every day so that she could empty herself of the inevitable anger and fear she felt, and fill herself back up with love and light. She said that, paradoxically, the more honest she was with her family about her more negative feelings, the more grateful she became. She told her husband how resentful she had been that his career had taken priority. Telling him openly made it easy to see that holding on to the resentment served nobody, and she found she could see more vividly all the ways he had supported her throughout their marriage. She found she could forgive him. With her teenage son, she didn’t mask her fears about death, she didn’t give him the reassurances that left no room for doubt. She talked openly about her uncertainties. She told him that sometimes we just don’t know. To her daughter, who was younger, in middle school, she expressed how angry she was about the moments she would miss—hearing about her first dates, seeing her open her college acceptance letters, helping her put on her wedding dress. She didn’t repress her rage as an unacceptable emotion. She found her way to what was beneath it—the depth and urgency of her love.
When her husband called to tell me Agnes had died, he said he would never get over the grief, but that her passing was peaceful. The quality of love in their family relationships had deepened in her last months of life. She had taught them a truer way of relating to one another. After I hung up the phone, I wept. Through no one’s fault, a beautiful person was gone too soon. It was unfair. It was cruel. And it made me wonder about my own mortality. If I died tomorrow, would I die at peace? Had I really learned for myself what Agnes had discovered? Within my own darkness, had I found the light?
* * *
Emma helped me question how I was relating to my past. Agnes helped me confront how I was relating to my present. And Jason Fuller, the catatonic army captain who came to my office for the first time one hot afternoon in 1980, who sat silent and frozen for long minutes on the white couch, who obeyed the order I finally gave him to come to the park with me to take my dog for a walk, taught me how to face a decision that would determine my future. What I learned from him that day would affect the quality of my life in all of my remaining years, and the quality of the legacy I have chosen to pass on to my children, grandchildren, and great-grandchildren.
As we walked around the park, Jason’s gait loosened. So did his face, every step bringing more color and softness. He looked younger all of a sudden, less hollowed out. Still, he didn’t talk. I didn’t plan ahead for what would happen when we returned to my office. I just kept us moving, breathing, every minute that Jason stayed with me an indication that if he felt safe enough, he might be reached.
After one slow loop around the park, I led us back to my office. I poured us some water. Whatever lay ahead, I knew it couldn’t be rushed. I had to provide a place of absolute trust, where Jason could tell me anything, any feeling, where he knew he was safe, where he knew he wouldn’t be judged. He sat on the couch again, facing me, and I leaned forward. How could I keep him here with me? Not just physically in my office. But ready for openness, for discovery? Together, we had to find a way to move toward insight and healing, a way for Jason to flow with whatever emotions and situations were overwhelming him into catatonia. And if I was to guide him toward wellness, I couldn’t force him to talk. I had to flow with his current state of mind, his current choices and conditions, and stay open to opportunities for revelation and change.
“I wonder if you can help me,” I finally said. This is an approach I sometimes take with a reluctant patient, a tough customer. I take the attention away from the patient’s problem. I become the one with the problem. I appeal to the patient’s sympathy. I wanted Jason to feel like he was the one with strength and solutions, and I was just a person, curious and somewhat desperate, asking to be helped. “I really want to know how you want to spend your time here with me. You’re a young man, a soldier. I’m just a grandmother. Could you help me out?”
He started to speak, but then his throat clotted up with emotion and he shook his head. How could I help him to stay with whatever external or internal turmoil existed without running away or shutting down?
“I wonder if you could help me understand a little better how I could be useful to you. I’d like to be your sounding board. Would you please help me a little?”
His eyes cinched up as though he was reacting to a bright light. Or clenching back tears. “My wife,” he finally said, his throat closing down again around the words.
I didn’t ask in what way his wife was troubling him. I didn’t ask for the facts. I went straight for the feeling under his words. I wanted him to take me directly, deeply, to the truth in his heart. I wanted him to be the person I trusted he was capable of being—a person who could unfreeze and feel. You can’t heal what you can’t feel. I had learned this the hard way, after decades of choosing to be frozen and numb. Like Jason, I had bottled my feelings, I had put on a mask.
What was under Jason’s mask, his frozenness? Loss? Fear?
“It looks like you’re sad about something,” I said. I was guessing, suggesting. Either I was right, or he would correct me.
“I’m not sad,” he muttered. “I’m mad. I’m mad as hell. I could kill her!”
“Your wife.”
“That bitch is cheating on me!” There. The truth was out. It was a beginning.
“Tell me more,” I said.
His wife was having an affair, he told me. His best friend had tipped him off. He couldn’t believe he had missed the signs.
“Oh God,” he said. “Oh God, oh God.”
He stood. He paced. He kicked at the couch. He had broken through his rigidity and was now becoming manic, aggressive. He pounded the wall until he winced in pain. It was as though a switch had been hit, the full strength of his emotion surging on like floodlights. He was no longer sealed off and contained. He was explosive. Volcanic. And now that he was thrashing around unprotected in all that hurt, my role had changed. I had guided him back into his feelings. Now I had to help him experience them without drowning in them, without totally losing himself in the intensity. Before I could say a word, he stiffened in the middle of the room and yelled, “I can’t take it! I’m going to kill her. I’ll kill both of them.”
“You’re so mad you could kill her.”
“Yes! I’m going to kill that bitch. I’m going to do it right now. Look what I’ve got.” He wasn’t speaking hyperbolically. He meant it quite literally. From under his belt he pulled a handgun. “I’m going to kill her right now.”
I should have called the police. The warning sirens I had felt in my gut when Jason first walked through the door had not rung false. And now it might be too late. I didn’t know if Jason and his wife had children, but what I pictured as Jason brandished the gun was the children crying at their mother’s funeral, Jason behind bars, the children losing both of their parents in the heat of one moment’s impulse for revenge.
But I didn’t call the police. I didn’t even call my assistant to let her know I might need help. There wasn’t time.
I wouldn’t shut him down. I would ride the wave of his intention to its consequence. “What if you kill her right now?” I said.
“I’m going to do it!”
“What will happen?”
“She deserves it. She’s got it coming. She’s going to regret every lie she ever told me.”
“What will happen to you if you kill your wife?”
“I don’t care!” He was pointing the gun at me, right at my chest, gripping it with both hands, his finger frozen near the trigger.
Was I a target? Could he take his rage out on me? Pull the trigger by mistake, send a bullet flying? There wasn’t time to be afraid.
“Do your children care?” I was acting on instinct.
“Don’t mention my children,” Jason hissed. He lowered the gun a fraction. If he pulled the trigger now he would shoot my arm, my chair, not my heart.
“Do you love your children?” I asked. Anger, however consuming, is never the most important emotion. It is only the very outer edge, the thinly exposed top layer of a much deeper feeling. And the real feeling that’s disguised by the mask of anger is usually fear. And you can’t feel love and fear at the same time. If I could appeal to Jason’s heart, if I could get him to feel love for even a second, it might be long enough to interrupt the signal of fear that was about to become violence. Already his fury was on pause. “Do you love your children?” I asked again.
Jason wouldn’t answer. It was as though he was stuck in the cross-hairs of his own competing feelings.
“I have three kids,” I said. “Two daughters, one son. What about you?”
“Both,” he said.
“A daughter and a son?”
He nodded.
“Tell me about your son,” I said.
Something broke loose in Jason. A new feeling. I saw it pass over his face.
“He looks like me,” Jason said.
“Like father, like son.”
His eyes were no longer focused on me or the gun, his vision was someplace else. I couldn’t tell what the new feeling was yet, but I could sense that something had shifted. I followed the thread.
“Do you want your son to be like you?” I asked.
“No!” he said. “God, no.”
“Why not?”
He shook his head. He wasn’t willing to go where I was leading him.
“What do you want?” I said it quietly. It was a question that can be terrifying to answer, a question that can change your life.
“I can’t take this! I don’t want to feel like this!”
“You want to be free from pain.”
“I want that bitch to pay! I’m not going to let her make a fool of me.” He raised the gun.
“You’ll get your life back in control.”
“Damn right I will.”
I was sweating now. It was up to me to help him drop the gun. There was no script to follow. “She did you wrong.”
“Not anymore! It ends now.”
“You’ll protect yourself.”
“That’s right.”
“You’ll show your son how to handle things. How to be a man.”
“I’ll show him how to not let other people hurt him!”
“By killing his mom.”
Jason froze.
“If you kill his mother, won’t you be hurting your son?”
Jason stared at the gun in his hand. In visits to come, he would tell me what filled his mind at this moment. He would tell me about his father, a violent man who beat into Jason, sometimes with his words, sometimes with his fists, that this is what a man does: A man is invulnerable; a man doesn’t cry; a man is in control; a man calls the shots. He would tell me that he had always intended to be a better father than his father had been. But he didn’t know how. He didn’t know how to teach and guide his children without intimidation. When I asked him to consider how his choice to seek revenge would affect his son, he was suddenly compelled to search for a possibility that, up until then, he hadn’t been able to summon. A way to live that didn’t perpetuate violence and insecurity, that would bring him—and his son—not to the imprisoning seduction of revenge but to the wide open sky of his promise and potential.
If I understand anything about that afternoon, about the whole of my life, it’s that sometimes the worst moments in our lives, the moments that set us spinning with ugly desires, that threaten to unglue us with the sheer impossibility of the pain we must endure, are in fact the moments that bring us to understand our worth. It’s as if we become aware of ourselves as a bridge between all that’s been and all that will be. We become aware of all we’ve received and what we can choose—or choose not—to perpetuate. It’s like vertigo, thrilling and terrifying, the past and the future surrounding us like a vast but traversable canyon. Small as we are in the big scheme of universe and time, each of us is a little mechanism that keeps the whole wheel spinning. And what will we power with the wheel of our own life? Will we keep pushing the same piston of loss or regret? Will we reengage and reenact all the hurts from the past? Will we abandon the people we love as a consequence of our own abandonment? Will we make our children pick up the tab for our losses? Or will we take the best of what we know and let a new crop flourish from the field of our life?
Craving revenge, holding a gun, picturing himself in his son’s face, Jason was suddenly able to see the choices available to him. He could choose to kill or choose to love. To vanquish or to forgive. To face a grief, or to pass the pain on, again and again. He dropped the gun. He was crying now, huge, rippling sobs, waves of sorrow crashing over his body. He couldn’t stand with the immensity of the feeling. He fell to the ground, to his knees, he bent his head. I could almost see the different feelings breaking over him in waves, the hurt and shame and broken pride and ruined trust and loneliness, the image of the man he couldn’t be and would never be. He couldn’t be a man who had never lost. He would always be a man whose father beat and humiliated him when he was young, whose wife cheated on him. Just as I will always be a woman whose mother and father were gassed and burned and turned to smoke. Jason and I would always be what every person is, someone who will bear suffering. We can’t erase the pain. But we are free to accept who we are and what has been done to us, and move on. Jason knelt, crying. I joined him on the floor. The people we loved and relied on had disappeared or let us down. He needed to be held. I held him. I pulled him to my chest and he sank into my lap and I held him and we cried until our tears had soaked my silk blouse through.
* * *
Before Jason left my office, I demanded that he give me the gun. (I would hang on to the gun for years, so long that I forgot it was still in my closet. When I was packing my office in preparation for my move to San Diego, I would discover the gun, still loaded, in the drawer of a filing cabinet, a reminder of the volatility and pain we often choose to hide away, the potential for damage that persists until we consciously face and dismantle it.) “Are you safe to leave now?” I asked him. “Are you safe to go home?”
“I’m not sure.”
“It’s going to be uncomfortable for you without a gun. Do you have somewhere else to go if the rage comes back? If you feel like you have to hurt or kill someone?”
He said he could go to his friend’s house, the one who had told him about the affair and advised him to see me.
“We need to practice what you will say to your wife.” We made a script. He wrote it down. He would tell her, “I feel so sad and upset. I hope we can find a time to talk about it tonight.” He wasn’t allowed to say more until they were alone together, and only then if he could communicate with words instead of violence. He was to call me immediately if he felt incapable of going home. If the homicidal feelings came back, he was to find a safe place to sit down or take a walk. “Close the door. Or go outside. Be by yourself. Breathe and breathe and breathe. The feelings will pass. Promise me you will call me if you start to feel out of control. Get yourself out of the situation, make yourself safe, and call me.”
He started to cry again. “No one ever cared about me like you do.”
“We’re going to be a good team together,” I told him. “I know you’re not going to let me down.”
Jason came back to my office two days later, and so began a therapeutic relationship that would last for five years. But before I knew how his story would turn out, I had a turning point of my own to confront.
Once Jason left and I had stowed the gun and sat down in my chair, breathing deeply, slowly, regaining my calm, I sorted through the mail my assistant had given me just before Jason’s unexpected arrival. And there I found another letter that changed the course of my life. It was from U.S. Army chaplain David Woehr, a former colleague at William Beaumont, who was then heading the Religious Resource Center in Munich, where he was responsible for administering clinical training to all of the U.S. Army chaplains and chaplain’s assistants currently serving in Europe. The letter was an invitation to address six hundred chaplains at a workshop Dave would be leading in a month. In any other circumstance, I would have accepted, would have been honored and humbled to be of use. Because of my clinical experience at William Beaumont, and my success in treating active-duty personnel and combat veterans, I had been asked a number of times to speak to larger military audiences and had always felt that it was not just an honor but also my moral obligation—as a former prisoner of war, as a person liberated by U.S. soldiers—to do so. But Dave’s workshop was scheduled to meet in Germany. And not just anywhere in Germany. In Berchtesgaden. Hitler’s former retreat in the mountains of Bavaria.