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In our first clinical encounter, by zoom, my patient Carine looked me squarely in the face and asked whether I had “at least a doctorate.” She’d already fired a string of therapists as no one made her feel better. For good measure, she added that I didn’t even look like a proper therapist. Clearly, I had my work cut out for me.
Carine had experienced devastating early abandonment. Her parents had moved to the US with her older siblings, leaving her in the care of an abusive aunt who beat her and locked her in a dark room. She was blamed for her parents not sending money for her care, called stupid, dull, not smart enough for her family to take with them. Seven years passed before they finally sent for Carine. She finally arrived in the US at fourteen – a teenager who’d spent her childhood waiting.
I felt deep empathy for Carine. She was determined and resilient. She’d graduated college and co-founded a successful company. According to her, she’d forgiven her parents, and even took care of them financially. Yet she was combative, constantly on edge and felt miserable most days. Her rage often erupted toward me. Some days, I was “doing nothing useful,” or “asking inane questions.” Sometimes she’d abruptly end Zoom meetings. Sessions with her left me drained and frustrated. Yet she never missed a session.
I could hear her rejecting parents and cruel aunt, as well as the forlorn, abandoned and abused little girl who couldn’t be soothed. Carine’s devastating abandonment and mistreatment had imprinted in her that she was not good enough. The internal message was one of unworthiness and that vocabulary became her own. She was not just the cast-aside and hurt child, but the rejecting adult who inflicted pain. This gave her a sense of control in the internal chaos and rage she felt. She needed to not need for her own survival.
How do you help someone who’s actively trying to destroy you? Was she testing me to see if I could withstand her aggression and not collapse or retaliate?