Impasse: A Tale in 3 Acts

(or When an Unstoppable Force Meets an Immovable Object)

Prologue: At the heart of every good therapeutic alliance there is an impasse – some insurmountable challenge that must be negotiated between client and therapist before the real work begins.  I know, from my own experience, that being in the depths of an impasse is intolerable.  It takes all the courage and energy you can summon to engage in the battle, to fight the good fight.  I share these stories because it helped me to know how others in my own therapeutic lineage tackled these ruptures, and because I hope my own impasse story gives others hope that there is a way through.  It’s messy and terrifying and may never be fully resolved, but it doesn’t have to spell the end.  It is, in fact, often just the beginning.

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Real

(or Questioning Everything I Once Held to Be True About the Therapeutic Alliance)

“What is REAL?” asked the Rabbit one day, when they were lying side by side near the nursery fender, before Nana came to tidy the room. “Does it mean having things that buzz inside you and a stick-out-handle?”

“Real isn’t how you are made,” said the Skin Horse. “It’s a thing that happens to you. When a child loves you for a long, long time, not just to play with, but REALLY loves you, then you become Real.”

“Does it hurt?” asked the Rabbit.

“Sometimes,” said the Skin Horse, for he was always truthful.

~ Margery Williams, The Velveteen Rabbit

There have been several occasions when I have had to remind my therapist that therapy isn’t real.  She always takes offense at my insistence that therapy is actually an alternate, concocted, manufactured universe that doesn’t even come close to approximating reality.  If all the people in my life were as compassionate and empathic and understanding and able to listen and willing to negotiate and able to engage in conflict and open to change, not to mention be completely focused on me, as my therapist is, then I wouldn’t have a need for therapy!

I know that therapy is meant to be a petri-dish, where you get to test and experiment and fail in safety with a dedicated guide and cheerleader right there by your side.  It’s a chance for a dress-rehearsal, to try things out before you have to do something out there, in the real world.  But it is an artificial construct, with carefully appointed boundaries and roles and responsibilities.  The real world doesn’t work in the same way.  I wish it did, but sadly, it doesn’t.

I also know that what my therapist is really reacting to is my suggestion that the relationship between us isn’t real.  She will counter that the relationship we have is indeed very real, and intimate and loving and supportive and everything you’d hope to find in another person you can relate to.

Sometimes in the past I had allowed myself to believe this, to be pulled into the notion that what we had between us was more than a business transaction.

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Holiday Wish

(or Guilt in a Box)

A few weeks ago a colleague asked me “How was your Thanksgiving?”  I replied by letting out an audible groan, to which he laughed and replied “You are the first person to respond that way.”  And in that moment I realized that not everyone sees the holidays as a detonated minefield ready to explode.

For me, the holidays highlight loss.  I become acutely aware of what I’ve had to sever in order to stay true to myself.  I have a heightened sensitivity to people who are no longer in my life – either by death or estrangement.  I look wistfully at friends and neighbors, who seem surrounded by family and who never have to contemplate the question of where or how to spend the holidays.  Of course they will be with family, of course everyone will get together to celebrate.  I live in hope that we will find a “chosen” family of our own, but it never seems like there is anyone around us who is also family-less.

And yet, I find myself trapped in the traditions of my childhood, unable to completely let go and forge a new set of traditions for my family.  The past is hard enough to shake free from, under normal circumstances.

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Out of Control

(or More Tantrums Required?)

Our 4 year old is currently in a battle for control, or lack thereof really.  He will launch into these emotional tantrums and irrational tirades, seemingly over nothing at all.  Or perhaps they are over everything.

Which is how we found ourselves at the beach at few months ago, on a mid-September day, with our son in his pajamas.  When he has these fits, if we can even figure out what he is upset about, we do our best to concede some point or decision to him.  The director of a local preschool advised parents not to fight their children on what they wear to school.  She even suggested that if they want to show up naked, that was perfectly fine – and that after that one time, they wouldn’t try that antic again.  I’m not sure I support the peer shaming of preschoolers to get them to conform to societal norms, so I’m okay with most things as long as there is no inherent danger present, physical or emotional.  Pajamas on the beach seemed to pass that test.

Since it was mid-September, we were just planning on sitting on the beach.  It was a clear, sunny day, but not the beach weather of the height of the summer.  We had left behind our beach umbrella, our sand toys, even our swimsuits.  But sure enough, our son in his pajamas wanted to go into the water.  I said we could go dip our toes in the water, certain that it would be too cold for much else.

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Raw

(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.

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Left Behind

(with Unfinished Business)

It’s been 15 days (and counting) since I last saw my therapist.  The last time I saw her I was still functioning under the illusion that she and her doctors were working, slowly, methodically, through a long diagnostic process.  Initial signs, along with a family history, pointed to MS, but in order to diagnose, they had to work down the MS rule out list.  There was a long list of possibilities to test for and that would take time to get through.  I did not sense any urgency.  It seemed sensible to remain calm and carry on with these rule-out tests.  Cancer was in the mix, and mentioned, along with the caveat that it seemed unlikely.  At one point, less than a month ago, there was even talk of just needing back surgery, with a mere 10 days to recuperate.

So I wasn’t worried.  And I wasn’t prepared when the very next day, the cancer diagnosis was made.  I had no time to prepare.  I didn’t know we’d be heading into a long, traumatic break.  When she took a 3-week break last spring, we had time to prepare and plan and find ways to explicitly stay connected.  This time, the bottom just fell out.

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Fill It Up Again

(or You Can’t Always Get What You Want Need)

One of the ideas rattling around in my head before the election madness took over had to do with routines and the impact of disruption to these orienting, centering, reliable constructs that make up most of our lives.  As a parent, I know I bemoan any disruption in my children’s routine, be it a snow day, a holiday break, summer vacation, even the weekend.  We all know that children usually thrive on routine, when they are fully aware of plans and timings and expectations and what comes next.

I suspect many adults also function better on routines, but for some reason we aren’t allowed to openly admit that.  As adults we are somehow expected to better withstand the changes in routine, to be able to adjust the sails and keep the boat from capsizing.  Even if it’s a tricky maneuver, we must try to make it look easy and effortless, even in the face of gale-force winds.

I’m likewise certain that the recent election results are unsettling to so many precisely because we are entering unchartered waters, and have no idea of where we are going, or how we will get there or what the ultimate outcome will be.  The routine of life as we know it has been completely disrupted and we may never settle into a new, predictable routine again.  Responding to rapid changes may become the new norm.

For me, the theme of therapy this year has been disruption in routine.  It started back in April when my therapist took a much-needed sabbatical abroad.  I didn’t begrudge her (too much) this time away, but I did anxiously count down the 25 days she was gone.  Then we ran into a 21 day stretch at the end of June when I was away and another 20 day stretch at the end of the summer when our vacations misaligned.

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