(or In Session, with Cancer)
The long-awaited text had finally arrived. “Can you do Tues at 1:00?”
The text had been sitting on my phone for more than two hours before I saw it. I stared at it for several minutes, trying to make sense of what I was reading, trying to get my brain to take in what this really meant. I checked my calendar, then responded “Sure.” It was the only answer I could give that captured my mixed-up feelings of anticipation and dread. I wasn’t feeling a “yes” or “absolutely” or “I’ll be there.” I definitely wasn’t feeling anything punctuated with an exclamation point.
I had been waiting for weeks for this moment to occur. Of course I would be happy and relieved to see my therapist, but I was also feeling anxious and sad and scared and overwhelmed. I hate it that our relationship has to be confined to the four walls of her office. And that the only way I get to make physical contact with her is in that space.
About 30 minutes before I needed to leave for my session, a headache emerged. My entire head hurt, as if some invisible and unrelenting force was pushing down squarely on the top of my head, but also down the back near my neck and towards my forehead. I probably should have taken something before I left my office, but I was hoping it would pass. On the subway ride downtown, the pain intensified, my head hurting more with each jerk of the train. By the time I arrived, I was in full-on headache mode. Not the best way to arrive at a long over-due therapy session.
I knew my therapist wasn’t going to be on top-form. And now nor was I – not mentally, not physically.
“How are you?” she asked more than once.
“My head hurts” was all I could muster.
“Do you have any questions for me?”
What I should have said was “I don’t have any questions that I feel would be appropriate to ask you.” When a few hours later, perhaps after my headache subsided, a list of questions popped into my mind in quick succession, I thought it was okay to ask. I sent an email, with genuine questions – questions that had more to do with her caseload than her. Questions I needed to ask only so that I could calibrate my own experience against the only other people going through the same thing. I realize now that my first instinct was correct. It’s better that I just keep my questions to myself. I need to learn to live without the answers, in a state of not knowing.
So we talked a bit. I wouldn’t call it “therapy.” It was really just an opportunity to see each other face-to-face. A chance to try to convince each other that we are both still intact, although I suspect some camouflaging on both sides. Neither wants to burden or stress out the other.
It’s hard enough to fit all that transpires in three weeks into 45 minutes. Add in the shocking news, the immediate reaction, the gradual processing, the fallout from your therapist having cancer – well, I don’t know how much time would be required to process all of that. Considerably more than 45 minutes.
Some things were said. Much was left unsaid.
I went in knowing full well that I wasn’t going to get all that I needed. I think that was the source of most of my reluctant anticipation and stress. The relationship I need isn’t available to me right now.
She is the one with cancer. Her life is careening down one path, my life is traversing another. No longer is she able to be my companion on this journey. The roads have diverged.
She can’t be my therapist. She can’t be a confidant, a fellow warrior, a sounding board, a support, a saving grace. So many other relationships can continue to exist right now. This, sadly, is not one of them, not in its former state at least. It’s been put on hold, indefinitely. It may never resume as it was before.
The sooner I resign myself to these facts, and accept and surrender to this fate, the better off I’ll be, I suspect.
Other relationships may need to adjust too, but I predict those relationships will be able to mold and adapt more easily. Can a therapeutic alliance survive cancer and come out the other side intact? I’m not sure. I desperately want to believe that it can but I fear I am only setting myself up for disappointment.
If the situation was reversed I would hope that she would continue to be a supportive presence in my life. It saddens me greatly that I can’t do the same for her. Even if she would let me in to that space, I’m not sure I’d be able to keep my shit at bay. Therapists spend years learning to compartmentalize their feelings and emotions. We’ve spent the last four years trying to get me to stop compartmentalizing my feelings and emotions, to give her all that I hold inside, so that I don’t have to hold it alone. But now she can’t serve that function, and I don’t know how to be in her presence and repress those reflexes.
Her current mantra is “be brave, be good.” I am trying but I fear I am failing on both accounts. I’ve never felt brave, and I surely don’t now. I feel scared and overwhelmed and abandoned. I try to put on a brave face, but it’s just a mask. I’m not sure I’m being very good either. Perhaps the best way I can be helpful is to just get out of the way entirely. Disconnect and take my shit somewhere else, far away, where it will not be burdensome or draining to her. I’m the last thing she needs right now.
I’m worried either of us might cause irreparable damage. I’m worried that all we’ve worked to build will just self-destruct.
Maybe some space is what is required. Over time I’ve gradually migrated across the couch in her office. In the beginning I would sit at the end of the couch closest to her. Then I slowly started moving away, to my current position on the other end of the couch near the window. It’s the spot farthest away from her in the room while still sitting on the couch. I want to be close and connected, but apparently not too close. As our therapeutic journey started to go deeper, I guess a part of me needed some space in our togetherness. I needed to always keep some distance, physical as well as emotional.
I thought about sitting closer this time, but when I arrived I forgot that plan and let habitual patterns unconsciously take over.
I spent most of the session with my gaze averted, unable to make eye contact. Now I wish I had spent more time looking directly at her, trying to take in every bit of her essence.
I desperately wanted to walk away feeling connected and restored and relieved. But I was more affected than I had anticipated. A wave of overwhelming sadness washed over me and I found myself in a flood of tears, unable to catch my breath between the unrelenting sobs.
With the joy came grief, with the connection came isolation, with relief came paralyzing fear.
I want to be stronger than I am. I wanted to be able to survive this disruption. I wanted to have enough in me to get by, to get through. But I don’t. Additional supports are going to have to be called in. I am going to have to surrender.
I live under a cloud of despair that every interaction might be our final one. I try to be the good, perfect, grieving patient and I’m just not. This is not how I want her to remember me. This is not how I want it all to end. Therapy promises to give you the chance at one good ending in your life, a carefully coordinated goodbye. I’m angry that I might not get that. The fruits of my labor might just be one final explosion.
We struggled for a long time after her sabbatical in the spring. She challenged me with this: “You have felt disconnected. I have felt like I am working hard to be close to you, but have been closed out without any way to know where you are.”
I had to remind her that “I spent 25 days building a wall while you were gone. I guess it will take time to dismantle it.”
I know walls are a lousy way to keep people out. So this time I’m building a cocoon, trying to insulate myself from the storm gathering around me. A cocoon where I can’t hurt anyone and I can’t get hurt either. I want to be dormant, I want to conserve my energies, I want to be still and not be noticed. I seek protection in the form of a warm encasing. Maybe this will be a moment of transformation. Maybe I will emerge into grace when this is all over, no matter the ending. Maybe that’s the best I can hope for.