Unrequited

"With Longing" found here

Friday morning on the way to work, my drive took me past a large medical office complex. As I sat at the red light, a familiar form hurried through the crosswalk. A 20-something young woman was on her way inside to work. Because it was raining, her head was tucked down into her chest and the hood on her coat hid her face. But I knew it was her.

She had the same profile when she was sitting on my couch, her head tucked into her chest, tears rolling down her face. "I don't know what to say to him," she had said over and over. Her black hair falling over her eyes, her mouth flexing open and closed as she sobbed.

She ended up leaving her husband after coming to terms with his cheating on her. She came to therapy for almost a year and a half, "just to get my feet under me," she apologetically said. She didn't think she could have made it otherwise, she said.

I hadn't seen her for a good six months since we ended our work together. We had said our goodbyes--she looked so victorious and happy when she left. I told her how much I had learned about courage, perseverance, and hope from her. I felt honored to share her struggle and victory. She left, smiling. I had a lump in my throat as I finished the paperwork for her file.

I remembered all of this, sitting in my car at the crosswalk. I wondered how she was doing. Had she ever garnered support from her critical parents? Or did they still attribute the divorce to her refusal to behave like a Southern belle? Had she gotten up the courage to start going to church alone? Or start volunteering at the tutoring center like she always wanted to? Had she been able to hold firm to her boundaries with her ex-husband? Was she happier now? There was no way to know. I couldn't exactly call her to find out what was going on in her life now. I was just grateful to get a glimpse of her again.

Most people think therapists sit back in their chairs, adjust their glasses, and think of questions to ask like, "What do you think of that?" "Is that okay with you?" "How is that for you?" and, "Can you say more about this?" Many therapists, however, move the conversations along in ways that get to the crux of the issues, knowing that the questions they ask will bring temporary discomfort to the clients whom they love.

Love. Not in a forbidden, romantic, sense. Rather, as new stakeholders in our client's wellbeing.

"Healing occurs in the in-between." This, from Gestalt literature that informs us that healing and growth depends on the quality and strength of the relationships we form with our clients. Some therapists put on "therapist face" every time they enter the therapy room. But some of us take a moment to check our hearts to be sure we are capable and eager to emotionally connect with our clients before we see them. We enter into their experiences with them. We hear things that they can tell no one else--things that make them feel terrified, dirty, faint, ill. Even though we don't necessarily focus on the magnitude of pain so much as the moving along of growth and change, our hearts are wrung at times, as they only can be, so close to rawness of lived experience. We also enter into their terror, shame, overwhelm. We bring all that we can muster to the job of working through unpleasantness and challenge. We become closer to our clients than any other soul can be at times. It is emotionally expensive sometimes. It is also a sacred privilege. It just doesn't last.

Nor should it. When our clients either feel they have gotten what they came to therapy for, or we mutually decide that it's time for them to move on, we part ways. Hopefully, we both have good memories of hard work and that slow, almost imperceptible emotional and mental shift that happens as the clouds begin to lift and life's path is more clear. They move out of our offices, off our schedules, and into lives that are hopefully more ordered and liveable than when they first came to see us. We stay behind, wondering and hoping that they have received enough to help, and that they will make good choices with the tools offered in therapy. That they will realize that someone, somewhere, believed in them and thinks of them warmly. It's just that we seldom ever know for sure, what happens in the long run.

My therapy students struggle with this. There have been many times when, after saying goodbye to a long-term client or family, they have returned to the supervision room and broken down. "I learned so much from that family!" "Do you think they are ready to stop coming here?" "Isn't there any way I can ever see them again?" We talk about legal and ethical principles that we adhere to and how we can't intrude on our clients to check in with them, nor can we even acknowledge, in a public place, that we know who they are. Otherwise, their friends will ask, "How do you know her?" and the confidentiality that we guarantee our clients will be compromised. We do our best with the time we have and the motivation our clients bring. It is often a crapshoot, what will happen. But we are obligated to bring the best of who we are and what we know to the table. Then, it is time to let go, to give our clients wings and send them off with a sense of accomplishment. Students aren't so sure. They had no idea that they could feel so strongly about clients who may have driven them crazy with resistance or the "yes-but" syndrome. And now that they are gone, the student may be surprised by the strength of their feelings of loss.

"We are paid intimates," I hear myself telling students over and over. People pay us to listen and understand them. To walk through a period of life with them and help sort through emotional and social issues. But mostly, to be on their side and to engage with them. It is a silent care that is part respect, part hope, part protectiveness, part admiration and part fondness. All together, it feels like altruistic love. Many clients we become attached to of in spite of our objective detachment. But most of the goodbyes are forever.

So our responsibility, I tell students, is to be sure we have people in our personal lives whom we can love openly, with abandon. People who don't come and go--who we talk to as much as we listen, and who are more intimate with us than our clients are. People who share our homes with us, rub our backs at night, share all our secrets, fears, and hopes (but nothing about our clients!). They are our anchors and we can't do our job without them.

Sitting at the crosswalk, the faces of many clients moved across my mind: Sal, who had been inappropriate with a young man at work; Julie, whose husband was an utter brute; Linda, who was so ill that I didn't know how long she could keep going; Mel, whose affairs left him guilty, ashamed, and still unable to find love in the right places. I cared deeply for all of these people. Only, they will never know it.

Maybe they did know and that's why they kept coming.

The grey hoodie of my former client bobs through the crowd of medical staff going through the front doors. I watch until I can't see her any more. Traffic begins to move and I drive on through the intersection. There are new people in and out of my office doors every week. I step on the gas. I have a 9:00 appointment and I don't want to be late.