Anna

"Run your fingers through my soul. For once, just once, feel exactly what I feel, believe what I believe, perceive as I perceive, look, experience, examine, and for once; just once, understand."

Ever known a beautiful woman who had no idea she was beautiful? If so you know a woman like Anna. When she walked into my office for the first time she was biting her nails and shuffling her feet back and forth, but clearly behind the nervous façade there was a truly beautiful woman. Still, as a therapist it wasn’t my job to worry about what she looked like, and I asked her to sit down so we could se what it is she wanted to accomplish.

She immediately told me that she didn’t think this was going to work. I felt like I was on a first date, and she had rejected me after just one look. Wow, my own substitute feelings were getting activated here, and I reminded myself to calm down and remain in therapist mode.

Eventually we did settle into a comfortable conversation, and she told me she had to constantly fight feelings of inadequacy. She felt she was ugly, overweight, not smart enough, and that people were constantly looking at her and judging her.

This is not an uncommon sort of therapy problem, and my training immediately started filling in pieces of her background. Probably an overbearing, perfectionistic mother in this story, who had stripped away at her daughter’s self-esteem for most of her life. Most likely she constantly talked to herself in a negative matter, and thoughts became feelings which then affected her behavior as well as her perception of the world around her. Boom, I has solved the case, I was the therapist of the year….

But I was wrong.

Her description of her childhood was pretty normal. She was an only child of parents who had doted on her a bit, but what she described was far from a standard overbearing childhood. Her parents were a bit older, and she had always wanted brothers and sisters growing up, but really what she described was far from what I expected.

No what she described was a kind of longing. She described walking past people’s houses at Christmastime and feeling a kind of penetrating sadness about something she thought she was missing out on. It was sad, sweet, and very touching.

So I could immediately go to the idea that perhaps being an only child filled Anna with a kind of pervasive loneliness that cast a long shadow over her entire life. This was partially correct, and Anna did have a kind of private internal world that was very difficult to penetrate. This is not uncommon with only children, as the lack of siblings often makes them turn inward, as they miss out on a lot of the socialization that comes from kicking, screaming, and laughing with brothers and sisters who are fighting for the same space.

But this wasn’t the whole story either.

I told Anna about the substitute theory and she immediately felt like it described her perfectly. She knew on some level that she was a perfectly attractive person, but emotionally she just never quite felt like she belonged. The idea of belonging is so powerful in psychotherapy, and finding out how someone belongs in the world is often one of the most important pieces of the therapeutic puzzle.

But substitute people often belong only partially. All the facts of their lives usually look just fine. They went to prom, weren’t picked last for the team, and fit in just fine with nearly everyone. This was true with Anna as well, everything she described about her life seemed remarkably normal.

So we kept coming back to how she felt about herself. One would have thought just from her sheer beauty she would have been reinforced over and over again in her life, but that wasn’t her experience at all. I walked a fine line with her in therapy. I could tell her she was beautiful, but really, if that didn’t match with her experience, than that’s a poor therapeutic intervention. No it was more important for me to try and feel how she felt and perhaps help her find her way towards her best self. And in the meantime,

Do it for myself as well…..

So as time passed we talked a lot about this feeling. I told her a little about my own personal journey, but was also careful not to make the sessions about me, although I was I’m sure learning as much from her as she was from me. Maybe more. We explored this topic together, and I asked me to teach me about her inner world, which she agreed to do with great relish. Somehow teaching someone who understood was very empowering to her, and she walked me through some of the earliest memories of her life right up to the present day.

They key to our relationship was that after many months of talking, she began to feel understood, which is not only a goal of therapy, but an important consideration in any human interaction. Eventually, through telling me her story, something slowly started to change. There was more of a strut in her step, and even the way she walked across a room seemed to be different. She had found her confidence by talking about how unconfident she was, and paradoxically left therapy a much more self-assured woman.

Although I would like to take credit for this wonderful therapeutic accomplishment, it was actually me who was in a sense getting therapy from her. I had watched her transformation, and contributed when I could by empathizing and listening and trying to understand. When therapy works best this is what it is, a process of watching someone find their way back to themselves. It was incredibly powerful, and a perfect example of how really listening is often the best tool a therapist really has.