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Maggie's Story

Nothing in the human psyche is more powerful than the desire to be loved. And at no time is that desire stronger than in childhood.

One of my patients, a thirty-seven-year-old single woman named Maggie is a good example. She came to see me after losing her job as an executive at a clothing company barely a year after being hired. She'd never been fired before and said she felt "humiliated." The stress of starting a job search with a black mark on her resume, she said, was keeping her up at night and preventing her from concentrating during the day. Her migraines, which she hadn't had since she was a teenager, were back.

"It would be one thing if I'd hated this woman from Day One," Maggie said of her boss Elizabeth. "But I liked her. I trusted her. And she totally used me." She paused. "I thought I knew people. I was really stupid."

Maggie looked genuinely hurt. "How did she 'use' you?" I asked.

"I left a really, really good job at my last company because she recruited me. She was always telling me at trade shows how talented I was and how she'd love to work with me. Then she made me an offer. I took it. I poured my whole heart into her company. I definitely put in more time than I ever had before--eighty, ninety hours a week, traveling to Europe and China and everywhere else. It was non-stop for thirteen months. And then all of a sudden she's like, 'This isn't working out."

"Did she say why?"

"Ridiculous stuff," Maggie said. "My attitude. Shipping glitches, which I had zero control over." She paused. "From what I hear, this is just Elizabeth's thing. It happened to two other people who had the job before me. One lasted a year, the other one a year-and-a-half. She gets nervous someone will take over or something."

"When did you find out about these other people?" I asked.

"People at the company told me before I signed on," she said. "I just thought it would be different with me."

"Why?"

"She said they acted like landing the job meant they didn't have to be hands-on, anymore--like they could just sit back and delegate. And I pride myself on never asking anyone who works under me to do more than I do. Plus, I had this connection with her. Or I thought I did."

"What sort of connection was that?" I asked.

"She seemed to want to help me get to the next level," Maggie said. "I've never worked directly for a woman before. I've always thought it would be the best situation for me." She sighed. "Dumb."

"Not dumb," I assured her. "You wanted a mentor."

She shrugged. "I've just never felt completely comfortable with the men I've worked for. Maybe it's the glass ceiling thing. Or maybe it's me. I don't know. It's been hard for me to trust men."

"Why is that?"

"Because my dad was an asshole."

That sounded pretty straightforward. "How so?"

"The usual way," she said. "He screwed around on my mother."

"Did they divorce?"

"When I was eleven. But that was after putting my mother through hell for years."

"You knew about your dad's infidelity?" I asked.

"My mother and I don't keep secrets from one another."

"She told you?"

"I knew the minute she did. I remember her screaming at him that he couldn't come to my seventh birthday party because she'd found a girl's number in his pocket." She smiled. "Sandra."

"Why are you smiling?" I asked.

She shrugged. "I just think it's funny I never forgot her name. The others are a blur."

The fact that Maggie had never forgotten the name of her father's first known lover isn't funny at all, of course. "You're not angry about what happened?" I asked.

Her smile disappeared. "At him, nobody else. I hardly speak to him."

That made sense. At that age, Maggie would have been attached to her father in complex ways, including (at least according to Sigmund Freud) unconscious fantasies about becoming the sole focus of her father's affections, in place of her mother. The fact that she had had to acknowledge, at the age of seven, that her father was apparently passionate about a third woman--a stranger--would have made her feel jealous and enraged.

But Maggie's words told me more than that. She seemed intent on my hearing that she was angry "only at" her father. And that didn't make sense to me. It felt like a barrier she was constructing to keep herself--and me--from the truth. After all, two people had hurt Maggie: Her father had done it by being careless and callous enough to disclose his sexual indiscretions. Her mother had done it by sharing highly charged information with Maggie when she was clearly incapable of understanding it. From the moment her mother learned of her father's infidelity, she had apparently used Maggie as a pawn to get back at him, barring him from showing up at her seventh birthday party.

But Maggie couldn't have allowed herself to feel angry at both her parents. That would have made her feel too alone. Knowing that her father could leave for another woman, she would have needed to believe that someone would protect and love her forever. She turned to her mother, even though it didn't sound to me like her mother had earned her confidence.

"You're very close with your mom?" I asked.

"She's my best friend," Maggie said. "We've been through everything together."

It turned out, in fact, that Maggie had signed on with her mother for war after war. There were her father's repeated infidelities. There was her parents' divorce. Then there were the half-dozen or so tumultuous romances her mother suffered through, each of them ending with the discovery that her boyfriend was either married or addicted to drugs or seeing other women.

In turn, Maggie's mom had come to her defense each of the times Maggie chose a man "unworthy" of her trust or affection. And that happened a lot. Even at work her male bosses always seemed to be egotists, predators, or frauds. And her mother was always there, a shoulder to cry on.

I knew that challenging Maggie's belief that her mother was beyond reproach would connect her with early and intense feelings of fear and betrayal. I would be asking her to feel all the pain she would have felt at seven had she admitted to herself that neither her father nor her mother was able to put her first, that she wasn't that well-loved by anyone. To a child, that would have felt like the whole world could fall apart at any time, that her very survival was in question. And part of Maggie was still that child.

I also knew, though, that Maggie had come to therapy after her female employer disappointed her. And she had come to me--a man--for help. That told me she might be ready to abandon the gender stereotypes and family myths that were keeping her from seeing the true nature of her predicament as a child--and moving beyond it.

"Why wasn't your mother more careful to keep what she found out about your father to herself?" I asked Maggie during our next session.

She squinted at me in disbelief. "You're joking, right?"

"Not at all."

She stood up. "This is ridiculous. How can you be taking his side?"

"I'm not," I said. "I'm taking yours."

She started toward the door.

I wanted to make sure Maggie understood that I believed her leaving would be a form of denial. "You can't avoid the truth forever," I said.

She turned back to me. "It was her job to cover for him?" she seethed.

"That's not what I'm saying," I said gently. I motioned toward Maggie's seat, hoping she'd take it again.

She didn't move.

"It was her job to protect your relationship with him, even after he violated theirs," I said.

"There was nothing to protect."

"Maybe not," I allowed. I paused. "Do you remember anything about your dad from when you were, say, five or six?"

"Nothing good," she said.

I nodded, but stayed silent. Several seconds passed.

"What are you getting at?" Maggie asked. "I mean, he took me to the park and stuff. What father doesn't? But when it came to ..."

Plenty of fathers don't. "What sort of park?" I asked.

"A park. I don't know. It wasn't anything special. It had this really high slide and swings and rides, or whatever."

"What did you like to do there?"

That was a simple question, but it opened up memories that Maggie had shut down in order to maintain a version of her life story that was partly fiction: that her father was the enemy and her mother was her only ally.

She rolled her eyes. "I don't know why this matters."

"Tell me, anyhow."

She sighed. "The slide, okay? You went up a ladder that must have had about twenty steps and . . ." She stopped herself. "What does this have to do with . . .?"

I thought of my own daughter, six years old at the time. I could picture her at the top of a slide like the one Maggie had described, half-excited, half-petrified. "Did he tell you you'd be alright sliding down?" I asked Maggie. "Did he wait for you at the bottom?"

She just looked at me. Her eyes filled with tears. She wiped them, then shook her head. "Why are you doing this?"

I pressed forward. "What else did you two do together?"

A tear rolled down Maggie's cheek. "He drove me to school every day."

"Did you like that?"

Another tear. "Stop," Maggie said. She finally sat down.

I did stop, but her tears didn't--for half a minute, maybe more.

During our next meeting I pressed Maggie to remember more of the good times she had had with her father. I also started helping her more realistically evaluate her mother's behavior. "Did you think your mom had bad luck choosing men?" I asked. "Or bad judgment?"

"How was she supposed to know if some guy was a loser?"

"Guy after guy?"

"She's supposed to be a mind-reader?"

"No, just a mother. And that means being careful who she includes in her daughter's life."

Maggie looked me straight in the eye, as if deciding whether she could really trust me. "I guess I would have been more careful if I were her," she said, finally, just above a whisper.

It didn't take more than a few hours for Maggie to make the connection between her mother having selected one damaged man after another and her own habit of doing the same. Not only was she deprived of the love of her father from a young age, she never learned how to include a worthy man in her life.

I remembered Maggie telling me her reasoning for thinking that a female employer would be the right fit for her. I've just never felt really comfortable with the men I've worked for.

Is that any wonder? Having seen her father unmasked as a philanderer and then portrayed as a pure scoundrel, then having witnessed the predictable results of her mother continuing to favor broken, unreliable men, was there any chance that Maggie would come to any conclusion other than that all men were untrustworthy, even her male employers? Why would she have ever looked to one of them for nurturance or mentoring?

I didn't even have to ask Maggie the question most directly related to her having misjudged the character of the woman who hired her away from her prior job, encouraged her to work 90 hours a week, then summarily fired her, apparently for no good reason. Maggie asked that question herself. "You know, I never even considered believing that Elizabeth had fired two other people for no reason. Do you think," she wondered aloud, "that wanting to see my mother as perfect meant I couldn't really see Elizabeth for who she was?"

The key word there was couldn't. Maggie couldn't let herself see the truth about Elizabeth because it was linked to core truths she was denying about her mother. "It feels to me like you wanted very badly to believe a woman would protect and nurture you, because that's what you wanted to believe as a little girl."

The unconscious life story link between Maggie's childhood and adulthood was the reason her being fired had kept her up at night, rekindled her migraines, stolen her concentration, and made her feel humiliated.

Now, as an adult, Maggie could finally afford to see that truth, to feel it and to stop limiting herself by trying to avoid it.

She stopped thinking of her mother as her only friend and beyond reproach and began seeing her as a complex person with both strengths and weaknesses. And while that caused a temporary rift in their relationship, it made it real and laid the foundation for it to grow in even more honest directions in the future.

Maggie's next position was as a vice president at a clothing company with a man at the helm. But unlike every other man she had worked for, she checked his reputation for integrity extensively before signing on. She told him she was looking for more than a job, that she wanted a mentor. She guarded against her predictable tendency (rooted in her childhood experiences) to write him off as duplicitous, insincere, or arrogant. And she found what she would have sworn didn't exist in the world: a man who actually ended up coming through for her.

Her luck in romance eventually changed, too. Knowing that she might unconsciously choose men with character flaws (because they were the kind of men she had watched her mother date) she intentionally slowed down her next few relationships until she could feel more certain she was with someone reliable--or she'd walk away. She actually avoided one man who was very handsome and had led a very exciting life (and had been married twice before) because, as she put it, "I'm mesmerized by trouble--at the beginning. Later on, it's a nightmare." And she met someone who initially bored her, but eventually won her heart by being passionate, yet trustworthy.

The stereotypes of her father and mother that Maggie had clung to like a life raft as a child had become an anchor weighing her down in adulthood. Now, having let go of them, far from drowning, she found herself free. Back to top

Sandra's Story

Sandra was a forty-six-year-old woman going through a contentious divorce. She told me, within a few minutes of meeting me, that she had graduated from Harvard (she wore a Harvard class ring) and had landed a position at a major accounting firm. I noted her clothing: elegant, serious, with designer insignia in plain view.

When someone volunteers how strong or smart or lucky or wealthy he or she is, you begin to wonder why they feel the need to tell you that.

"I feel like I'm at war," she said. "I'm not sleeping. I'm not eating. I can't concentrate. I mean, I'm a Harvard grad. I work at one of the biggest accounting firms in the world. And I can't balance a set of books to save my life. I'm out of balance. This divorce has taken over my life."

"Why is the divorce so contentious?" I asked Sandra.

"It wasn't at the beginning," she told me. "We were using a mediator to split our assets down the middle and set up joint custody of our two kids. When that didn't work, we went out and got killer lawyers."

"Who gave up on mediation first?"

"I did. I had no choice."

"What happened?"

"My husband owns a manufacturing company that's worth at least thirty percent more than he was claiming it was," she said. "The way he was valuing it made no sense, whatsoever. And he knew it. But he had the gall to just say, 'Hey, you're okay with this, right?' Like I'm an idiot. I called a lawyer five minutes later."

"Your 'killer' lawyer," I said. "You were really angry."

"Beyond angry."

"Did you try to convince the mediator your husband was lying?"

"Why bother?" she said. Every trace of indecision, anxiety, and sadness left her voice. "I don't like being made a fool of."

Who does? But Sandra hadn't even tried to use her considerable skills as an accountant to get a fair settlement. Something about having her intelligence questioned had triggered powerful, buried emotions. "Do people generally think they can pull the wool over your eyes?" I asked. "You're obviously very smart, and your education speaks for itself."

"Nobody really goes there, anymore," she said. "Maybe that's why I reacted the way I did when he tried."

Anymore. "Who used to 'go there'?" I asked.

She laughed. "No one. I mean, not since my brothers."

"Your brothers?"

"Trust me: It's ancient history. It's nothing, really."

It's no big deal. It's nothing. It's ancient history. These are self-soothing phrases people use to try to talk themselves out of their pain. "Tell me, anyhow," I said.

Sandra suddenly looked pained. "It was just kid's stuff. They're both smarter than I am . . . by a lot. They were constantly setting me up to take the fall for them with my dad. He was pretty strict."

"Setting you up . . . how?"

"Blaming me for every dumb thing they did. Leaving toys outside. The house being a mess. They stole money from his wallet once and put it in my room."

"Your dad didn't know they were lying?" I asked.

She shook her head. "They were good. It got to where I didn't know who was lying. I remember thinking, 'Wait, maybe I did forget to lock the front door.' 'Maybe I took money from his wallet by accident, somehow.'"

I wondered how closely the divorce mediation mimicked the times during her childhood when she'd tried to explain the truth to her strict father. "Was your mediator a man?" I asked.

"Yes," Sandra said. "Why?"

"Older than you?"

"Much. A retired judge, like a lot of them. He had to be my father's age, at least."

Sandra's unresolved pain at being an easy mark for her brothers seemed not only to be involved in her holding forth a shield of credentials with me so early in our meeting, but to have short-circuited a mediation process she might otherwise have been able to use effectively, sparing her the emotional and financial costs of a protracted legal battle.

Had Sandra been living the truth she might have addressed the mediator this way: "I hope you'll understand that when my husband feels free to present figures that so clearly undervalue his business it makes me wary of trusting this process. If I seem upset, that's why. Having the wool pulled over my eyes--especially by someone I've shared so much of my life with--is very painful for me."

If Sandra had expressed her vulnerability, instead of flashing her Harvard credentials, she would have stood a much better chance of encouraging the mediator to be fair to her. But Sandra hadn't been able to show her vulnerability. She was busy covering it up, acting more like the girl she was at home with her brothers and father than the woman she had become in the world.

Once Sandra recognized the way buried parts of her past were determining the way she responded in the present, she began to choose how to respond. She didn't need to over-react whenever she sensed someone challenging her intellect, because she was no longer automatically tapping into hidden feelings from childhood. Her new self-awareness allowed her to put the past back where it belonged and to see herself for what she now was: a competent, creative woman. Back to top

Tom's Story

Tom was 44-years-old when he first came to see me. He felt stuck. He managed a car dealership and made a good living but hated his work.

"I've been with the same dealership fifteen years," he told me. He rubbed his tired-looking eyes. "I started selling cars there and got promoted to assistant manager, then manager. It's been the same routine since then, going on six years now. I get there at eight in the morning and leave at nine or ten at night, usually six days a week. And there isn't an hour when I don't feel like I'm wasting my life."

I knew from other patients of mine in the car business that salespeople and managers tend to move frequently from dealership to dealership. "It's unusual to be at one shop for fifteen years, isn't it?" I asked Tom.

"Basically, unheard of," he said. "Anyone else would be general manager of a group of dealerships by now."

"Why not you?" I asked.

"My dad always asks me the same question. I've had offers. But it never seemed like the right time. First it was that I was getting married and didn't want another big change in my life at the same time. Then it was having my son. Then my daughter." He sighed. "The truth is I'll always find some reason to stay put."

"Even though you hate it there . . ."

"I'm not sure it would be any different at another shop," he said. "I hate the work, not the place." He shook his head. "I pretty much hate myself at this point."

"Or maybe you just aren't yourself," I said. "Is there something you'd rather be doing with your life?"

"You mean, like a dream job?" He looked at me almost timidly, as if simply uttering the words filled him with anxiety.

I nodded.

"If I could do anything in the world, I'd open a restaurant. I've got a great idea for one. Honestly, I think that's what's kept me going the past ten years." He shook his head. "Not that I'd ever actually do it."

"Are you worried you wouldn't be good at it?"

Tom smiled. He suddenly looked much more energized. "I'm not worried about that. I'm a very good cook and a really good manager," he said. "Cooking's my only hobby. It's the only thing I read about. The only TV. I watch is the Food Channel." He paused. "I think I could be great."

I could tell from Tom's voice and his eyes that he meant what he was saying. "Is it the financial risk, then?" I asked.

"No," Tom said, "I'm a mess, not my finances. I've put away a little dough. And if I opened a place and it went belly up I could get a job managing another dealership in no time at all. My dad always tells me I should just go for it, but for some reason I can't pull the trigger."

That was the second time Tom had mentioned his father. "Sounds like your dad really believes in you," I said.

"He believes in himself," Tom said. "That's the difference between us. He has more courage in his little finger than I have in my whole body."

The fact that Tom had sidestepped my statement about his father believing in him told me to dig deeper into their relationship. "Tell me more about him," I said.

"He has courage," Tom said. "If he has a hunch he follows it."

"Such as?"

"Google," Tom said.

"Google?" "He mortgaged his house to invest in Google when it went public. It went to the moon. Now, he's living large."

Tom's dad mortgaging his house to invest in the IPO of an Internet stock sounded more impulsive to me than courageous. "Is that the first time he's laid everything on the line for what he believed in?" I asked.

"He's always been that way," Tom said with pride. "As long as I can remember."

When I dug deeper, though, it became clear that some of what Tom remembered about his dad wasn't anything to be proud of. When he was nine years old his father invested almost everything the family owned on developing, patenting, and trying to market an invention designed to make cars more fuel-efficient. When it turned out the technology didn't work well enough to interest any of the automakers, his father had to sell their home and move the family into his own parents' house for two years while he got back on his feet by working as an insurance agent. Six years later, he left that job to partner with friends in Texas who were convinced a large piece of land for sale there included vast deposits of gold. When none were found, he declared bankruptcy, and told Tom he no longer had the money to pay for his college education. So Tom dropped out during his first semester and never went back.

"Were you very upset with him?" I asked Tom.

"Not for a second," Tom said without hesitation. "My father gave us all the courage we needed. He told us not to worry about a thing, that he'd make everything back, and more. And, ultimately, he did exactly what he said he would."

"With the Google investment?" I asked.

Tom nodded.

"That was a long time after your college years."

Tom chuckled. "He didn't say when he'd make it back."

Tom was using humor to distance himself from the reality that his father had squandered the chance for him to go to college. And humor was only one of his defenses against that fact. His view of his father as a courageous man with complete confidence in himself shielded him from a realization that would have been utterly terrifying to him as a boy: that his father was a self-involved gambler with terrible judgment who was willing to risk his family's financial well-being, including their home and his child's education, to indulge his narcissistic fantasies of unlimited wealth.

Once I saw how Tom was fictionalizing his father, it was easy to understand why he had never pursued his own genuine dream of opening a restaurant. In his mind, following his heart was unconsciously connected with being just like his "courageous" dad--reckless, insensitive to the needs of his family, bankrupt, and homeless. He had courage all mixed up with chaos because he was still too afraid to dig down to the truth and see his father for who he really was.

"You know I was thinking about something you told me," I said during our next session. "When you listed the reasons you hadn't switched dealerships and taken a job as a general manager, the first reasons on your list related to making sure your marriage and your children stayed secure."

"Excuses," Tom said.

"But good ones, as excuses go," I said. I wanted to challenge Tom to think about his father in a more honest light. "You didn't want your kids to have to go through what you did with your own father."

"We ended up doing great."

"Really?" I said. "You hate your work and you won't take the risk to do what you love."

"That has nothing to do with my father."

I kept pressing. "You're saying you wouldn't feel guilty if you lost your house and couldn't send your kids to college?"

"Of course I would. I mean . . ."

"Do you think your father felt guilty?"

"I don't know. I mean . . ."

"Did he tell you he did?"

"Well, no, but some things speak for . . . "

"Did you ever see him cry over it?"

Tom stayed silent.

"Sleepless nights? Anything?"

Tom looked away. "He was a tough guy," he said softly, as though barely clinging to his fiction.

"And you had to pretend to be one," I said. "At nine." I paused. "Where do you think all your fear went?"

"I guess I kept it."

"Exactly. But when you keep fear bottled up, denying it even exists, it takes more and more of your energy, until it paralyzes you completely." I waited a few moments, then made my point. "When your dad followed his dreams, other people got badly hurt, including you. But you're not nine, anymore. You could pursue your dream without turning it into anyone else's nightmare. Worse comes to worst, the restaurant closes and you go back to work at a car dealership. You still keep your house and put your kids through school. You've earned that safety net by working sixteen hour days for fifteen years. There's no shame in that."

"I guess not," Tom said, his voice suddenly less stressed. "I just never looked at it that way." We sat in silence for several moments. "So now that you've got the safety net," I said, "it's time for a leap of faith. My guess: The safety net never gets used."

Tom opened his restaurant about a year later. And while there were moments he was certain he would fail, that he should retreat back to the car business before losing everything, he stayed the course. Because he understood most of his fear of chaos was coming from being powerless when he lost his home at nine years old and when he lost his chance for a college education at seventeen.

His restaurant eventually began to thrive. Back to top

Nicole's Story

Four months before she came to see me, Nicole, 46, would have said her life was very nearly perfect. She had been married nineteen years and had a healthy daughter, 17, and son, 14. She worked part-time as the office coordinator for her husband Grant, a successful realtor. She was in close touch with her sister, 40, and both her parents. She had friends, a dog, two cats, and a Volvo SUV.

Sure, she sometimes wondered whether drinking a glass of wine or two to get to sleep could be a problem, but plenty of people didn't sleep well and plenty of people enjoyed their wine. There was also the way she went on shopping sprees to lift her mood when she felt down for more than a day or two, but a few extra dresses or pairs of shoes didn't seem like the end of the world. Even the fact that she didn't have much interest in sex anymore didn't seem so weird. After all, she'd lived and worked with the same man for nearly two decades--not exactly the ultimate recipe for passion.

Then, shortly after her daughter Kelley was accepted to a nationally recognized design school, Nicole's mood really started slipping. She was thrilled to see Kelley pursuing her dream, so she couldn't understand why she wasn't on Cloud Nine with her. She remembered feeling the same way after her wedding, when the ceremony and celebration and honeymoon were over.

However, her mood continued to slip. Despite Kelley's growing excitement about going to college, Nicole found herself tearful at times. She felt exhausted and couldn't concentrate at work. She began arguing more with her husband, especially when he bothered her about her drinking. She was up to three glasses of wine at bedtime. She had no sexual desire, whatsoever. In dark moments after midnight, she even doubted whether life was worth living.

She began to wonder whether her real problem might be her marriage. She certainly didn't feel anything like romantic love, anymore. She probably hadn't for many years. But she didn't want to think about it.

By avoiding the pain in her life, Nicole was no different from most of us. Human beings have a reflex reaction to psychological pain no different from our reaction to physical pain. We withdraw from it. We try to avoid thinking not only about the painful aspects of our lives today, but those in the past, all the way back to childhood.

We accept the notion that the mind uses many "defense mechanisms" to distance us from bitter realities. Chief among these mechanisms is denial. Denial can make us "look the other way" in the face of evidence that our spouses are unfaithful or our children have turned to drugs. It can make us immune to feedback from friends and loved ones who warn us about our addictions or other self-defeating behaviors.

Nicole might never have come to see me, in fact, were it not for her fourteen-year-old son Nathan. Nate was a high school football player and all-around jock, not one to talk about his feelings, so when he got choked up and told Nicole he felt like he had "lost his mother," she decided it was high time she tried to "find herself."

The first time we met I could see Nicole wasn't just well-put-together; she was perfectly-put-together. Everything was in its place--her designer clothes, her jewelry, her makeup, her hair. She was physically fit and looked younger than 46. But she also looked worried. She avoided eye contact. And more than once, she clenched and unclenched her fists, as though to wring the tension from her hands.

I nodded at them. "You're having a hard time," I said.

She looked down at her hands and let out a long breath. "I never thought I'd be saying this," she told me, "but I think I may need something."

"You mean, a medicine?"

"My sister's on Zoloft. She says it helps her."

I knew why Nicole was asking for Zoloft right off the bat: Part of her was still searching for some way to cover up the trouble in her life, instead of getting to the bottom of it.

"Zoloft might be part of the answer," I told her, "but I'd have to understand much more about you and your life to know."

She clenched her fists, again.

I leaned toward her. "Tell me what's wrong," I said.

That was enough to make her eyes fill up. "Nothing," she said. She twisted her engagement ring back and forth. "My marriage. The way I am around my kids . . . losing my temper. I'm a complete mess."

"You're a person," I said, "That's always messy."

She looked directly at me for the first time.

"What's happening in your marriage?" I asked.

She smiled at the same time as a tear escaped her eye. She wiped it away. "Not a lot--which is kind of the problem. We're . . . existing." She shook her head, as though trying to stop herself from saying more. The impulse to keep one's truth--especially one's pain--secret is among the most common, powerful, and toxic elements of human nature. "Grant is a wonderful person," she said. "He's been a great provider for almost twenty years. He's never hurt me."

If all my years as a practicing psychiatrist have taught me one thing, it's this: Listen for what people do not say. All Nicole could say at the moment about Grant was that he made money and wasn't abusive. That left out a lot of other desirable qualities.

I knew Nicole needed permission to tell me what she was really feeling. And since she had already hinted at her reality, I gave her an opening. "He's wonderful, but...," I said.

"But I'm bored to tears," she said flatly.

"And have been for how long?"

"Honestly?"

I waited.

"Probably since I've known him."

Nicole had come in asking for a prescription, maybe thinking that she had slid into a depression over the course of a few months, and we were already journeying back twenty-three years, to when she first met Grant. "What did you think of him when you met him?" I asked.

"That he was a real gentleman," she said. "That he would make a good husband and father--even if he was pretty, well, predictable. I'd been through a really bad breakup just before I met him," she said. "I wanted someone stable."

"Who had you broken up with?" I asked.

"Oh, God." She laughed and actually blushed--over twenty years later. So much for those who would deny the power of the past. "He was a complete mess."

A complete mess. Those were the same words Nicole had used to describe herself just moments before. And that was no coincidence: Listening carefully to Nicole had led me to my questions, which had led directly to the unconscious connection she now felt with her lover from decades before. "What kind of mess?" I asked.

"The worst kind," she said. Her expression brightened, and she suddenly looked ten years younger. "A troubled artist. Your typical bad boy."

"'Bad,' meaning ...?"

"You know: Wine, women. Not to mention the fact he was broke."

"You weren't about to go there," I said.

She chuckled, shook her head. "I'd already been there."

"How so?"

"With my dad."

Nicole had come in for what she thought would be a quick fix--Zoloft--and come face-to-face with unresolved feelings about her father. We had traveled thirty or more years in about thirty minutes.

"Your dad?" I asked.

"Ancient history," she said. She looked away, again.

"Doesn't sound like it," I said. "Here we are talking about him."

"What can I say? He was a lot more interested in his scotch, the track, and other women than he was in my mother, my sister or me."

Nicole told me the rest during a few more sessions. Her father would disappear for days at a time. Other women would call the house, setting the stage for screaming matches and occasionally even physical fights between her parents. Sometimes, her dad gambled away everything he made as a laborer, leaving the family without food.

Once I knew that "ancient history," I knew why it seemed so important to Nicole to look perfect. She felt anything but perfect inside. Part of her was still the little girl whose father might be sober one night, drunk the next, smiling and generous when he came home from the track a winner, violent when he had lost everything. No wonder Nicole would have traded passion with a troubled artist for the predictability and stability Grant offered. And that's one reason she would have felt somber after exchanging marriage vows; those vows were motivated partly by fear. They were partly about living life and partly about avoiding it.

"It doesn't help anything," Nicole said, "that I work with Grant and live with him. We're together twenty-four, seven."

"Why did it turn out that way?" I asked.

She shrugged. "He needed the help, and I didn't have much of a plan," she said. "I mean, I had fantasies about interior design or whatever, but I had no training or anything." She laughed. "I figured I'd at least know where he was all the time."

"Unlike your father," I said.

She stopped laughing. "I suppose," she said.

"Did you ever pursue your love of design?" I asked.

"Just stuff in our house," she said. "I'll leave the rest to Kelley."

My skin turned to goose flesh, as it does whenever the past becomes palpable in the present. It was clear to me now why Kelley leaving for design school had triggered Nicole's depression. Kelley was living out dreams that Nicole had once had for herself, dreams she had buried in order to create the safe family life she craved. Now, with her daughter off to design school, where she might even fall head over heels for an artistic, romantic, unpredictable man, Nicole was feeling the loss of what she had given up in exchange for stability--pieces of herself.

I wanted to bring Nicole face-to-face with the truth she had run from her whole life. Only that kind of reckoning with the early chapters in her life story could leave her free to imagine, and then live, wonderful chapters in the future. "So what do you think your dad loved more," I asked her, "the gambling, girls and booze . . . or you?"

She sat in silence for several seconds. Her eyes filled with tears, again. "Not me," she said finally. "I guess I never really wanted to admit that. I mean, I was the one by his bedside every day for six months after he was diagnosed with cancer. I think I just wanted to hear him say ..." She stopped herself.

"...that he loved you," I said.

Tears ran down her cheeks.

"Had he ever told you that?" I asked.

She swallowed hard. "No," she said. "And he never did." She looked down, as though ashamed.

I let several seconds pass. "You know the worst part?" I asked Nicole.

She looked at me.

"Part of you still thinks he was right--that you're not lovable. That's what part of any little girl would think growing up with a father incapable of caring about her. And that's the same part of you, by the way, that tells you that you have to keep tabs on your husband to keep him honest, instead of challenging him to grow if he wants to keep you around. It's the same part of you that won't express your passion for design. There's always that little voice at the back of your head saying maybe you're not worthy of love--not even your own."

"So how do I get that voice to stop?" she asked.

I smiled. "By listening to absolutely everything it has to say."

Only by hearing out the little girl inside her saying that she was never worthy of her father's devotion could Nicole, now an adult and a mother, nurture herself as she might a child--by finally focusing on the truth that she was born to a man who never made her feel worthy. And only by truly grieving that misfortune could she stop blaming herself for it. Back to top

Linda's Story

Living the Truth can help defeat psychological disorders, including major depression and panic disorder. Linda's story makes that plain.

Linda was a slight, redheaded, 42-year-old woman who came to see me with symptoms of major depression, including low mood, insomnia, difficulty concentrating, and decreased self-esteem. She had tolerated emotional abuse from her husband for several years and said she felt like she had "nothing left to give." She had three sons—4, 7, and 10—whom she was always trying to protect from her husband, literally standing between him and the boys, trying to deflect or absorb his scathing criticisms of them.

"He calls them every name in the book, even in front of people," she said. "He says horrible things like, 'You should never have been born.' And it doesn't have to be for anything major. Even little things set him off, like not taking their plates to the sink, not being friendly when we have people over the house, not wearing the 'right' clothes. But, the thing is, I know he doesn't mean it."

"Why do you say that?" I asked.

"He's just burnt out a lot of the time. He works so hard. He's under a lot of pressure. And now, I'm out of commission, crying all the time. And that just makes it even harder for him--and the kids."

Linda was actually blaming herself for her husband being abusive. "What does he do for work?" I asked her.

"He's an EMT. He has to deal with horrible things. Car accidents. Heart attacks. You name it."

Among my friends are surgeons, emergency room doctors, combat veterans, and police officers. They have to deal with plenty of ugliness, too. But I've never seen them lash out at their kids in any serious or sustained way. "He says his job makes it impossible to control himself at home and in public?" I asked.

She shook her head. "He doesn't make excuses for himself. I can just tell that's what's going on for him."

Linda's husband didn't have to make excuses for himself. Linda was doing it for him. "You can tell by the fact that he loses his temper?" I asked her.

"That and other stuff. He gets to a point where he just shuts down. I know he's thinking about everything he's seen. And he drinks a lot more than he should."

We weren't fifteen minutes into our time together, and Linda had already mentioned a second reason her husband might be losing his temper--his drinking. The fact that she was letting him off the hook by blaming his stressful job made me wonder whether she was predisposed to do so by her earlier life experience. "You're very understanding," I said.

She shrugged. "My dad was a firefighter," she said. "He retired five years ago."

"He was under a lot of stress while you were growing up?" I led.

"To say the least."

"How did he deal with it?"

"Not so well."

"Meaning?"

"Let's just say he makes my husband look tame, by comparison," she said.

Whenever people use that phrase--let's just say --they always have much more to say. It just isn't easy to find the words, or the courage. "Your father's temper was even worse?" I asked Linda.

She nodded.

"He yelled at you? Hit you?"

She smiled for the first time since arriving at the office. "He didn't mean it. He did the best he could. He loved all of us so much."

He (or she) did the best he could is another shield of denial people routinely raise. Just because our parents did the best they could, that doesn't mean they did well enough to keep us from harm. And until we're willing to admit we suffered and didn't deserve to, we can't learn from the painful dynamics we lived through. Nor can we avoid reproducing those dynamics in the future.

I wasn't surprised Linda had somehow summoned the energy to smile as she raised her shield of denial. "Did he drink, too?" I asked.

"Only to get to sleep," she said. "He had nightmares. That's what my mom said. We all tried to make it relaxing for him when he got home, but . . ."

"But . . ."

"There's only so much you can do to settle someone down who's been running into burning buildings all day, or waiting to."

We were at the heart of the family fiction that had set the stage for Linda selecting another angry man to marry, and then forgiving his abuse of her and her children. Her mother had suggested that a man who verbally and physically abuses his family isn't to blame, that the family has the responsibility to comfort and coddle such a man, rather than confront him or flee from him, that he can have true love in his heart for his wife and children while attacking them emotionally and physically. Even the theme of alcohol abuse being a defensible way to medicate stress had been written into her life story (and that of her future family) while Linda was still a girl.

Is it any surprise that the home Linda had created was a replica of the one she had come from, where she had been valued for absorbing the rage of a man, forgiving his abuse, and trying to heal him? After all, her father supposedly really loved her, despite screaming at her and hitting her.

"Was your father an angry person before becoming a firefighter?" I asked.

She looked confused. "I have no idea."

"Did he drink before that?"

She shook her head. "I don't know. Why do you ask?"

I wanted to be forceful enough with Linda to begin to take down the shield of denial that was her birthright. "You're letting him off the hook for assaulting you and being drunk every night, because he was out all day saving lives. So I just wanted to know if he was a violent alcoholic before he started fighting fires."

"He wasn't alcoholic. He . . ."

"He drank every night."

She didn't respond.

"He screamed at you and hit you."

"But . . . "

I pushed harder. "But he was running into burning buildings. Right. I get it. Just like your husband is scraping people off the pavement, so that supposedly gives him a free pass to level you and the kids with emotional abuse. But guess what? There's no excuse for hurting your wife and kids. So why don't you go and gather some facts."

"Like what?"

"Does your father have any sisters or brothers who are still alive?" I asked.

"A sister."

"Then ask her if he had trouble with alcohol or his temper before he became a firefighter."

"What if he did?"

"If he did, you can stop giving him a free pass on hurting you just because he was helping others. Because he was just using that as an excuse. And you can start wondering whether you chose a husband a lot like him because you don't feel valuable unless you're absorbing a man's violence."

After a lot more encouragement, Linda took me up on my offer. Her aunt told her that her dad hadn't been destroyed emotionally by fighting fires. He'd been troubled as far back as his teenage years. And here's the stunning, but not surprising part (at least to me): His own father--Linda's grandfather--had been alcoholic and violent, too. And his wife had stayed by his side.

Three generations of women in Linda's family had defined their roles as wives and mothers in the same toxic way. Seeing that fact was the beginning of Linda questioning the fiction she had been taught and starting to see her reality, however painful: Neither her father nor her husband ever loved her the way she deserved to be loved--purely, without her having to volunteer for abuse as part of the bargain.

Only once Linda realized this was she able to start standing up for herself and her kids. She didn't begin to hate her husband or suddenly want to leave him, but she did get angry. She gradually made it plain to him that she wasn't going to be his doormat or let him abuse her kids any longer. She told him she would indeed have to leave if he couldn't change, starting with getting help for his alcoholism. And the most wonderful part of the story is that when he did get help, he gave her some real evidence that he actually did value her. She learned that she had the power to insist on a better life for her and her children. Back to top

Naomi's Story

When we bury emotional pain we not only jeopardize our psychological well-being, we put our physical health at risk, too. Back in 1991, toward the ending of my training in psychiatry, I treated a 71-year-old woman named Naomi whose case dramatized this fact.

Naomi was referred to me because her feet burned relentlessly. The pain was so severe that there were days she couldn't walk and spent hours lying in bed, in tears. Her internist had performed a full physical exam and run all the laboratory studies she could think of, but couldn't find any reason for Naomi's pain. MRI, CT, and ultrasound examinations all came back normal. A neurologist had performed nerve conduction studies, and a vascular surgeon had performed an angiogram. Both showed no problem, whatsoever.

Naomi had trouble concentrating when she met with me the first few times because her pain was so severe. She closed her eyes again and again and buried her frail hands in her hair. I had the sense that it was very important that I sit through some of that pain with her, supporting her and comforting her to the extent that I could, so that she would understand that I knew her pain was real--even though her other doctors had given her the sense they doubted it.

It wasn't until our third session that Naomi said the first thing that invited me to begin exploring the real source of her suffering. Just moments after sitting down in my office she said, "You know, you look a little like my grandson." She smiled weakly. " More than just a little, to tell you the truth. I don't know how I could have missed it until now."

Although she didn't know it, Naomi had just given me an important insight into her condition. When someone wonders how they could have missed something about a person or a situation, assume that's because it was too big to see.

"Tell me about your grandson," I said.

She shrugged. "There's not a lot to tell. He's a wonderful boy. Very caring. Very smart. He writes to me every week."

"He lives out of state?" I asked, wondering if Naomi missed him.

"No, right here in Boston," she said. "He loves it here. He always tells me he'll be back to stay."

"Where is he?"

"Kuwait," she said.

1991 was, of course, the year of Operation Desert Storm. Naomi's grandson was one of the troops.

"What else does he say in his letters?" I asked Naomi. "Is he scared?"

"He isn't scared," she said. "He's proud to be serving his country. The main thing that bothers him is the weather."

"What does he say about that?" I asked.

"He says it's very, very hot there," she said. "He says that the sand is like fire. No matter what boots he wears, his feet . . ."

Naomi and I both looked slowly down at her feet. The room was silent, the moment full of wonder. When I spoke, it was just above a whisper. "His feet burn," I said.

She shook her head. "You don't think . . ."

I took a few moments to collect my thoughts. "I think," I said, "that you love your grandson very, very much. And I think we should talk more about him."

We did. We talked for hours about Naomi's grandson's special talents, including his skills as an athlete. We talked about how important he was to her, since he was her only grandchild, having lost a granddaughter shortly after childbirth. And, finally, we talked about her fear that he would never return from Kuwait, that he would die so far away from home.

If I ever doubt the power of love or the miracle of empathy, if I am ever tempted to believe that neuroscience holds every answer to human emotion and behavior, if I ever question whether an alchemy of the soul can change buried fear or anxiety or sadness into physical illness, I shall remember a grandmother I once met whose feet burned relentlessly for her grandson fighting in a distant desert.

Once Naomi faced her pain and discovered its source, her symptoms slowly disappeared (and, thankfully, her grandson came home alive and well from Kuwait). Back to top

Erica's Story

Opening early chapters of our life stories holds the promise of revealing buried treasures of insight that can dramatically change our lives. Erica's story is about the richness that comes from having the courage to do so.

Erica was 39 when she first came to see me. Her marriage to an alcoholic had recently ended, but not before her husband's erratic behavior had led to the loss of their home and to Erica having to file personal bankruptcy. "It's embarrassing enough by itself," she said, "but this is something no one in my family has ever had to deal with. My mother and father have been together forty-five years, and they're still happy. Nobody can believe this is happening."

"Tell me about your parents," I said. "What does your dad do for work?"

"He owns a stationery shop," she said. "He opened it a few years after he married my mom."

"Does she work there?" I asked.

"She did for a few years," Erica said.

"And then decided to stay home to take care of you?"

"I think so. I mean, I'm an only child. It would have been to take care of me, I guess."

Confusion so often precedes clarity. "How old were you?" I asked.

"I don't think I had been born yet," she said. "I don't think she would even have been pregnant when she stopped working."

Erica was 39 and focusing for the first time on why her father had ended up running the family business alone. That meant that something in the story was emotionally threatening to her. I stayed silent to allow the truth a chance to fill the void.

"I remember my dad saying something about her moods at the time being out of control," Erica said, finally. "He laughs about it now." She chuckled to herself. "My mom was giving stuff away one day and throwing people out of the store the next. I guess you could say she wasn't exactly helping the business."

"Were her moods predictable when you were growing up?" I asked.

She stopped smiling. "Not always," she said. "She wasn't out of control or anything, but she had her highs and lows."

"Did she ever see a psychiatrist?"

"I'm not sure. I think so."

"Did she take medicine?" I asked.

She shrugged. "Probably. I think I remember my dad bringing it home for her one time from the drugstore, and them arguing about whether she needed to take it." She smiled again. "She always said I was her best medicine."

It might seem extraordinary that Erica had never really focused on the precise reason her mother had stopped working or on the fact that she needed medicine to control her unwieldy moods and behavior. She had never asked her father why her mother would be extraordinarily generous at work one day and full of rage the next.

It only took one more session for the truth to become crystal clear. Before that session Erica had asked her father about her mother's condition and learned she had been diagnosed with bipolar disorder. She had been treated for it with lithium, but the medicine never worked well enough for her to return to work. And Erica, as an only child at home with her mom, really was a great comfort to her--her best medicine.

Never having examined what she had lived through as the daughter of a woman struggling with a psychiatric disorder, never having revisited what it had meant to love someone deeply and take care of someone who was supposed to be taking care of her, Erica never "outgrew" it. She remained locked in the dynamic that defined her childhood.

When it came time for Erica to marry, she found a situation that reproduced the one she had grown up with. She was the breadwinner; her husband was ill (with alcoholism) and needed her for stability. She felt like she was his best medicine. She felt at home in a relationship that echoed the one she had had as a little girl at home with her bipolar mother. But while Erica's marriage reproduced the past faithfully in some respects, she had chosen a man even more fragile than her mother and someone who could not be trusted with the family finances. And she paid the price--not only divorce, but personal bankruptcy.

For a time Erica grew angry at her mother. After all, she wondered aloud, wasn't it predictable that relying on a little girl to keep things together (rather than getting more professional help) would turn that girl into a caregiver for life?

Erica also grew angry at her father for letting her play such an adult role in childhood, which she correctly saw as fostering her co-dependency (with her husband) in adulthood.

"Why didn't he protect me?" she asked tearfully during one session with me. "Why didn't he see that she was using me and make her stop?"

Erica's anger was short-lived. Because once she resolved to seek the whole truth from her parents, she learned that her mother had suffered much more as a child than Erica ever knew. She had grown up with an extremely violent stepfather who beat her and humiliated her. And Erica's grandmother hadn't protected her daughter at all.

Erica also learned more about her father. She knew he had lost his own mother to cancer as a boy, but she had never spoken with him about it. And she learned he could still be brought to tears describing how helpless he felt watching the mother he adored waste away.

Rather than continuing to blame her parents for her suffering, Erica forgave them. Because she realized that they had never freed themselves from the pain of the past by doing the very thing she had finally done--facing it. Her parents were both limited in the kind of parenting they could give by running from what they had lived through long before she was born. Back to top

Mike's Story

A patient of mine named Mike, 27, shows how unexamined pain from the past can fuel conditions that might seem to have little to do with one's life story.

Mike was an assistant district attorney. He came to see me with crippling symptoms of obsessive-compulsive disorder, or OCD. For years, he had been meticulous about keeping his home clean and his clothing and car perfect, but over the past several months he had developed much more severe symptoms. Driving to work, going to the mall, or heading out on a date, he would begin worrying (obsessive thinking) that he had left the stove on or a candle burning back at his house. He couldn't get the thought out of his mind. So he would double back home (compulsive behavior) to check that all was well. But then, after leaving the house a second time, he would be gripped by another obsessive worry--maybe he had left the coffee maker on or the toaster plugged in, or he had ignored the smell of smoke as he was walking out the door.

"It's gotten to the point," he said, "where it can take me an hour or two to get from home to work. And it should be a fifteen-minute drive. I make sure I leave the house really early, but I'm still late half the time. And even once I do get in, I can't always concentrate. I can barely resist going home again to make sure the place hasn't burned down. As far as socializing, forget about it. It doesn't take women very long to figure out there's something wrong. I'm not really with them, even when I'm with them physically. My mind is back home."

Mike's symptoms were eroding his self-esteem. "I'm the one everybody else used to rely on at work to be organized and keep things moving. I can't come close to playing that role anymore. I literally move in circles half the time."

That's why, although Mike was focused on describing his obsessions and compulsions, I was intent on going deeper. I knew I needed to search for whatever had set his obsessions and compulsions in motion--for the real source of his pain.

Obsessive thoughts and compulsive behaviors were, after all, keeping Mike's mind very busy. Distracted. And I didn't think that was an accident. I believed there was something Mike's mind was running away from.

Since Mike's obsession involved the destruction of his home, my first question related to early, sudden loss. "Did your life change suddenly in any way when you were a child?" I asked.

"Like my parents divorcing or something?"

"You tell me."

"I don't think so," he said.

"You didn't lose anyone you loved when you were a boy?"

He shook his head.

"Did your parents go through any sudden changes in their finances? Did you move from one town to another?"

"No."

"So nothing threatened to 'burn down' your life as you knew it," I said, making the metaphor plain. "It was pretty much smooth sailing."

He shrugged. "Pretty much. My sister was sick for a while, but . . . I mean, she got better and everything, so I don't think it would have been that."

This was something I felt we had to explore. Whenever someone shares a thought, then disavows it, you can almost count on it being very important.

I simply gave Mike's words back to him. "Your sister was sick for a while . . ." I said.

"Yeah," he said. "She had cancer."

I felt myself grow calmer and more centered. I was moving closer to the real source of Mike's suffering, being held by the gravity of his truth. "How old was she?"

"Seven."

"So you were, how old?"

"Ten."

"What do you remember about it?"

"I try not to think about it," he said.

Even, he could have said, if it means driving around in circles. "I can understand why," I said. "But it could be very helpful for you to get in touch with your feelings from back then."

He nodded.

"Can you tell me how you found out she was sick?" I asked.

"You mean, what her symptoms were?" Mike asked.

"No," I said. "I meant, how did you find out? Who told you?"

"My dad."

"Where and how?"

"I don't know who sounds more like a district attorney, you or me."

"He came to watch me during my basketball practice, which was weird, you know? Because it started right after school, at three o'clock. And he worked until six every day. So I remember feeling strange, just having this really bad feeling the whole time he was in the stands watching. He was smiling and stuff, but the smile didn't look real." He sighed. "Then when I got a basket and turned around to see his reaction, he was crying."

My own heart fell just from hearing that story, which testified to the kind of impact it would have had on a ten-year-old living it. Although he had denied it when asked, Mike's life had indeed changed suddenly during his childhood. And he had never forgotten the exact moment. "Do you remember what you thought when you looked at him in the stands?" I asked.

"You might not believe this," Mike said.

"Try me."

"I didn't think anything. I didn't look at him the rest of the game. I just kept playing."

That was both believable and understandable. A ten-year-old boy who sees his father in tears can be excused for turning away, wishing that whatever has caused his father to leave work early and come find him, whatever is making his father break down into tears, would just disappear.

"When the game was over, I walked to the car with him," Mike went on. "We didn't say anything on the way. We got inside, but he just sat there, without starting it. Then he told me."

"What did he say?"

"He said, 'Katie is . . ." He stopped.

I waited.

"He said, 'Katie is sicker than we thought. She's going to have to stay in the hospital for a while."

A while turned out to be nearly two months, during which Katie had an abdominal tumor removed, suffered complications from the surgery, and began chemotherapy.

Mike watched as she grew more and more frail during her treatment. She lost her hair. Painful sores in her mouth made it difficult for her to eat.

Mike's parents had less time for him; they were consumed with getting Katie the care she needed. The pressure made them argue much more. Mike's father became melancholy and withdrawn.

There was nothing Mike could do about any of it. He didn't have the power to stop his sister's disease or assure himself of his parents' continuing devotion to him or bring harmony back into his home.

But something even more fundamental to his existence had changed for Mike, forever. The illusion that his family was secure, that life was predictable, and that death only happened to old people had been shattered. And no one talked to him about any of it.

Mike's obsessive-compulsive symptoms, it turned out, began around that time. He would check light switches half a dozen times to make sure he had turned them off. He felt compelled to knock twice for luck on the door jam of his house before leaving each day for school. And he developed a nervous tic--rocking back in forth in his seat at school.

As a ten-year-old, Mike wasn't prepared to face the possibility that his sister might die and that his family as he knew it might cease to exist. So he buried it under a mountain of silence and obsessive thoughts and compulsive behaviors.

The obsessions and compulsions never went away. They went through cycles, getting better and worse. Now, they were nearly unbearable.

It was certainly the case that Mike might be helped by medicine, and I prescribed one with a good track record of reducing the symptoms of OCD. But I also sat with Mike for several weeks, helping him talk about his gut-level fears from when he was ten, his terror when his sister's cancer recurred when she was thirteen, and his grief when, shortly thereafter, his beloved family pet--a dog--died suddenly.

"I couldn't even show he really mattered to me," Mike said. "It would have seemed weird, with everything my sister was going through."

"Did you love him?"

"What kid doesn't love his dog?"

"I asked about you."

He filled up and nodded. "He was great," he said. "Barney. Honestly, if it weren't for him, I don't know how I would have gotten through that time. I loved him a lot."

But here's the problem: Nothing could have protected Mike's sister from getting cancer. Nothing can imprison death. Only Mike being willing to feel his vulnerability (and that of everyone close to him) held the promise of him coming to terms with it. Only truly looking back at his father weeping in the stands at his basketball game, fresh from hearing that Mike's sister had cancer, could turn that event into something he had survived, instead of something he would keep running from for the rest of his life.

"It would be great if you could check the stove and the coffee maker and all the candles in your house to keep tragedy away from you," I told him. "But that won't work. You can drive back and forth from your house all day, every day, making sure it hasn't burned down, but that won't stop cancer. All it'll do is keep you from living your own life."

The combination of medicine and counseling helped Mike abandon his shield of obsessions and compulsions. "I figure," he told me, "that even if it costs me my house, I'm not driving back to check anything. Let it burn down, if that's what's going to happen. Because I can't let it destroy everything else I have." He looked directly at me. "Not after realizing how much I went through to get here. And you know I'm not talking about law school."

By looking directly at his pain, Mike was able to put it in the past, where it belonged. He was able to step out of the role of trying to control the future. That didn't mean he would be immune to sadness about his sister's struggle with cancer or the loss of his beloved pet or the period of discord in his parents' marriage. Much to the contrary, it meant that he would be in touch with those feelings. And that meant he would no longer remain hostage to them. Back to top

Frank's Story

So often, the shields we hold up to protect us in life end up hurting us. Using Living the Truth principles to lower those shields reveals our real strengths. Frank's story makes the point.

Frank was forty years old when his attorney sent him to see me for an evaluation before going on trial for assault and battery. It was the third time he had been arrested for a violent offense. He'd had words with another man at work, had sensed things were about to get physical and had, as he put it, "hit first and hit hard." He hadn't stopped with one punch, though. He had left the other man barely conscious. The prosecutor was asking for five-to-seven years in state prison.

"I've done jail time before," Frank told me. "It's nothing I can't handle. But if there's something wrong with me you think a jury ought to know, I'm good with that, too."

Everything about Frank was hyperbolically aggressive. He seemed like an actor playing a gangster. His tone of voice and mannerisms were, in fact, nearly identical to those of Tony Soprano, the fictional mafia kingpin featured on the HBO television series. His face was scarred from a knife fight years before. He had worked out and taken steroids to create a hulking physique. Of every patient I have ever sat with, he would be the last one I would want to meet in a dark alley.

"Tell me something," I said. "Why the tough guy routine?"

He looked at me askance. "Excuse me?"

"You look like you're wearing armor and you talk like you just stepped off the set of The Sopranos. I'm guessing that means someone hurt you pretty badly when you couldn't defend yourself--like when you were growing up."

"Way off, Doc," he said. He smiled. "I'm a quick study. I ain't been beaten down since I was sucker-punched back in the second grade."

I was drawn magnetically to that comment. Whenever someone offers up a memory of childhood pain, especially in the context of telling you how strong he is, assume there's much more pain where that came from.

"So tell me about second grade," I said.

"Are you kidding me?"

"No."

After much prodding, he did. He told me he'd been bullied for not being able to read. And he told me what his father had done to toughen him up. He had made him fight one bully after another in the family's front yard; until he was satisfied his son had enough courage never to run away from anyone. "It was no big deal," Frank said.

But it was a big deal. It's called growing up with a sadistic father, and it's a good reason to start looking really tough really fast.

"What did you do with all your fear?" I asked.

"Buried it, real fast," Frank said, pointing at his heart.

"That's what I'm getting at," I said. "It's still there. The Soprano routine--like telling me you're fine with going to jail for five years--is your way of hiding it."

"Hey, I maybe had to put on a little act out there in the yard with my dad," he said. "But I promise I'm not acting now. I'm not afraid of anything."

The truth is Frank was no longer conscious he was acting. The fear of being made fun of and being victimized had driven him so deep into the role of tough guy that he was now completely lost in it.

Just think what Frank might have become if he had been in touch with his pain instead of being an expert at burying it: a teacher, reaching out to kids with learning challenges; a guidance counselor, sticking up for bullied kids; a pediatrician, helping children "fight off" powerful diseases (the ultimate bullies).

Frank's pain could have been his power. But like so many of us, he had become convinced that the best way to deal with the train wreck behind him (being bullied, living with a father devoid of empathy, feeling frightened and inadequate) was to keep running.

All that running ignored a critical fact: The wreck was behind him. What he needed to do was to turn and look at it.

"You're sure you're not afraid of anything?" I asked him toward the end of the session.

"Doc," he said, "I been beaten, knifed, clubbed. I got people right now saying they want me dead. Doesn't even faze me. Nothing does."

"How about reading?" I asked him.

He laughed.

"Did you ever learn?"

"Of course." He shrugged. "A little." His tone of voice was softer, with a hint of sadness in it and less "street." "I do good enough to get by," he said, even more quietly.

I looked into his eyes and saw real pain. I nodded, understanding. Frank may have been tough on the outside, but on the inside he was full of fear and insecurity. A forty-year-old gangster had come into my office, but so had a little boy unable to read who had never stopped running away from that fact, or the feelings of weakness and vulnerability that had come with it.

I met with Frank several more times and helped him see that his shame at not being able to read, along with his father's cruelty, were the fuel for his explosive rage. That rage had taken over during the assault and battery he was arrested for. Another jail term was inevitable. But this time, Frank resolved to use his years in prison to learn to read and to finish his college education.

"I figure the only way I'm ever gonna stop using my fists," he told me, "is to start using my head." Back to top

Rachel's Story

I recently treated a 21-year-old woman named Rachel who brings the point to life. Rachel was suffering from depression and cocaine addiction and had tried to overdose on sleeping pills. She came to my office with her mother, Wendy, who had taken the entire day off from work to make it possible for Rachel to spend a few hours with me (even though she was having trouble making ends meet for herself, Rachel, and her two sons).

I met with Rachel alone. She spent the first five or ten minutes we were together reciting her symptoms in great detail. They were classic ones for major depression, including low self-esteem, low energy, disturbed sleep, lack of interest in the acting classes she once loved, sudden tearfulness, and lack of appetite. It was clear she had been trying to treat those symptoms with cocaine. But her diagnoses--major depression and cocaine dependence--were really just labels for her suffering. They didn't tell me anything about why she was suffering.

In fact, as she detailed the number of hours she had slept each of the nights the previous week and exactly how little she had eaten the prior few days, I felt as though she was using her laundry list of symptoms like a shield to stop me from getting to know her—as if she was trying to transport me into her world of not feeling.

I wasn't about to go there. "Tell me the most painful part of your life," I interrupted.

"You mean the worst part of being depressed--not sleeping or not eating or . . . ?" she asked.

"No," I said. "What about your life has caused you the most sadness or anxiety or made you the angriest? What hurt you?"

"Nothing," she said immediately.

I waited.

She shrugged. "I don't know . . . If I had to say something, I guess I'd say I didn't exactly love leaving Ohio as a kid. Does that count?"

"How old were you?"

"Eight."

When a person remembers emotional pain from over a decade ago, it definitely counts. I told her so, and asked her to tell me why she remembered that year as a difficult one.

"I had to leave my school and my friends," she said. "And I wasn't used to moving around yet."

"Why did you have to leave?" I asked.

"My dad divorced my mom," she said. She sighed and looked away.

"How many times have you moved since?" I asked.

She laughed, but without joy. "I stopped counting at fifteen."

By the end of our session together I had learned that Rachel's mother took her and her brothers to Los Angeles following the divorce. Her father didn't make any attempt to keep his children nearer to him. And when Los Angeles didn't seem to offer her mother a good enough job or a good enough relationship, she moved the family to San Diego. Then, every year or two, she moved them again, usually after breaking up with a man, as if one more change of scenery would finally change their lives.

There's a very wise saying: Wherever you go, there you are. Geographic cures don't work. Running from her demons--from her pain--couldn't have healed Rachel's mother's underlying psychological injuries. And it had real potential to injure Rachel.

"She wasn't worried you would have trouble adjusting to so many moves?" I asked Rachel.

"I don't know," Rachel said. "I've never asked her what she was thinking."

There were other things Rachel and her mother had never spoken of, including the circumstances that had led to her parents' divorce, circumstances that could have shed light on why her father made little or no effort to stay in touch with her or her brothers.

I met with Rachel a few more times and helped her confront the things she had been trying to avoid. We talked about how many friends she had left behind over the course of so many moves. We talked about how much it really did hurt that her father hadn't done more to keep her close. And we talked about how angry she really was that her mother had forced her to pull up the meager roots she put down in city after city as a little girl.

Then I had her mother join us.

It was obvious to me that Wendy loved her daughter. I knew she was driving nearly three hours to bring her to see me. I knew she was sacrificing income she desperately needed. Her voice cracked as she described how Rachel had changed after she started using cocaine. She cried as she spoke about her fear that Rachel would kill herself.

There wasn't any chance that in meeting with Rachel and Wendy that I was simply with a victim and a perpetrator. I knew from listening to thousands of other stories that Wendy had to have been injured psychologically herself to be blind to the ways in which she had injured Rachel. "What was your dad like?" I asked her.

"Why does that matter right now?" Wendy asked.

"You and Rachel have never spoken about why her father doesn't stay in touch with her, or how she feels about that fact, so I'm guessing you have a reason not to go near the subject. Maybe it has something to do with your father."

Wendy shrugged, in exactly the way Rachel had during our first meeting. "I didn't know my father very well, either. My parents split up while my mom was pregnant with me."

"Did you spend any real time with your dad?" I asked.

"No," she said, immediately.

"Is that something that's caused you a lot of pain?"

"Not at all."

"Why wouldn't it?" I asked Wendy.

"My mother always told me she loved me enough for two parents," she said. "I never felt like I needed anyone else."

When a mother tells a daughter that her love should be enough to make up for the absence of that girl's father, she makes it very hard for her to disagree. To do so would risk offending the only reliable support the girl has in the world. Yet Wendy never truly felt she had had all the love she needed. That's why, as an adult, she would find herself constantly moving from one state to another, running from broken relationships. Abandoned by her father, she craved male attention and took it extraordinarily hard when a man withdrew that affection. "Did your mom remarry?" I asked her.

"No," Wendy said.

"Was there anyone special that came into her life--and yours?"

"Where are you going with this?" Wendy asked.

People usually ask that question when I'm moving closer to their pain. "I just wondered whether your mother fell in love again and let that man get to know you."

"There was one person," she said, seemingly reluctantly. "Sam."

"Nice person?"

She was silent a few moments. She cleared her throat. "Very."

"Was he kind to you?"

"To all of us," she said. "He was a wonderful man. Very generous. Very patient. A gentleman."

"And what happened to him?" I asked.

"I don't know. I mean, my mom stopped seeing him, and . . ." She shrugged. Her eyes filled up with tears. She fought them back, then took a deep breath. "And that was the end of that," she said.

But it wasn't "the end of that." It was only the beginning. Wendy lost contact with her father, then lost another father-figure, and it had kept her running from rejection her whole life. And that had set the stage for her daughter to inherit the same toxic psychological dynamic.

I have no doubt that Wendy's mother--Rachel's grandmother--had her own issues with abandonment, hence her flawed decree that her love for Wendy should be equivalent to the love of both a father and a mother.

Three generations of women had been fighting the same emotional demons. And I do not believe for a moment that those demons were encoded in their DNA. I believe they were passed, mother to daughter, because each woman feared her demons and fled them rather than face them. And that only made their demons stronger, until, in Rachel's life, they finally created conditions--major depression and cocaine dependence--that could not be ignored.

Rachel went in search of her father. When she found him, he did the right thing: He apologized to her. He admitted that his fear of fathering and of commitment led him to allow time and distance to come between them. And he swore that he would stay in her life from that day forward.

Once Rachel faced the sadness of having been separated from her father, once she confronted the resulting unconscious questions she harbored about whether she was loveable, she started to love herself. She got sober, she agreed to use an antidepressant temporarily, and her symptoms of depression remitted.

Three generations of women. Three generations spent, in part, running from the truth. And yet, the singular resolve of one of those women to look squarely at her pain was ultimately more powerful than decades of denial.

It can be every bit as powerful in your life. Back to top