Apologizing

 It seems so easy to me, apologizing, or taking something back that I shouldn't have said. That sense of my bad is so jarring, so upsetting. There's baggage to it, triggers (if something feels bad it is because something else is at work). Someone is mad at me, someone doesn't like me. So to get rid of the baggage someone like me will be quick to own responsibility for messing up. It feels easy, like removing a finger from a hot burner on the stove. 

That's when we're aware. We're all like this to some degree. When we know, when we're aware of the feelings of others and that they will ricochet back to hurt us, we're motivated to reverse the damage. We'll say, I'm sorry.

But as the good doctor/rabbi Peter Rosenzweig likes to say, about 99% of what is happening around us isn't available to us, it's unconscious. 

Or maybe it was 95%.  You get the idea. 

The interesting thing about the subject of apologies is that we know there are people who cannot do it, cannot bring themselves to apologize, which makes doing couple therapy a bit of a challenge. Why? For some it feels like others should be apologizing to them, should be working harder to understand them, to feel their pain. Owning responsibility is exactly what some of us want others to do for us-- feel our pain. If only you would only empathize with me, you'd get it! You first. 

When I notice that going on (and it is sometimes even spoken) in therapy I might say:

(Name of pt). You have lived without that understanding this long, live without it a little longer just for today's visit. Let's get you into the position of modeling the behavior for your partner. One way to do that is to apologize first, say you are aware that you might have hurt her (him) and that you are sorry. See if it doesn't come back to you in a good way. 

We would call that secondary gain, There's just something about saying, I did that. It ends up feeling okay-- you aren't punished-- crazy, I know. You feel like there will be some kind of punishment, but there is not. 

This process is psycho-educational, and for some, it works. If therapists can help partners feel the pain of one another they are half-way there. 

We could call that an intervention, labeling the pain of the one who can't apologize. But it will not always work. There are other interventions, and we'll get to them in a second, but I'm wondering about the corollary of my first paragraph. Does what I wrote mean that people who don't take responsibility and/or don't apologize are not worried about social rejection? Does it mean that pride, a type of blinder, shields all of us from social rejection? As if  I'm right, so you must be wrong, nothing in-between. No need to apologize.

What's a therapist to do? Here are a few more thoughts, interventions:

(1) Chip away at the pride, or insecure narcissism-- that might be one option--The therapist says: Well what if you aren't correct? I think it would be helpful here, in the interest of empathizing and improving your relationship, for you to try on the idea of What if I'm not right? What happens then? 

This isa favorite intervention, although they're all good, because it forces people to face that catastrophic expectation, the consequences of being wrong, which in most situations are anything but catastrophic, and in fact, are benign.

(2) The therapist asks the partner to ask the other partner to do that-- that's good except that he or she has probably done it before without success, and that's the response I tend to get back

(3) The therapist explores the idea that they are both right and it is their challenge to find out how that could be true

(4) The therapist switches from content to feelings, simply do an emotional check-up-- how upset are you, and how upset are you, and what's weighing in on those feelings

(5) The therapist asks them who else they know who agrees with them and have they been talking about this topic with other people, and could that be affecting how strongly they are attached to being right or wrong

(6) The therapist asks, "In the past, how important was it for a parent or sibling to be right?"

(7) The therapist asks, "Has substance abuse made you feel either (a) always wrong, or (b) always right-- because according to the program. . . the program teaches. . . "

Not a complete list, for sure. But it's a start. 

Maybe I'm wrong about the whole thing. 

therapydoc

Codependent on a Bicycle

Just because we own that we contribute to dysfunctional interactions (in our own special ways), doesn't mean we can stop. Codependency is like that.

Not shown, the blood.

This one could be a scene from a Woody Allen movie.

A therapist gets a text to learn that her grandchildren, toddlers, are at the park. "Want to stop by and see us? You pass right by going to work."

Well, it is on my way.

But something hangs her up and by the time her bicycle sidles up to the swingset, the grandkids are gone. Too bad, but it is the type of day a person just continues on her way and hums,  Ain't nothin' gonna break'a my stride. Nobody's gonna' slow me down. . .

The path she didn't take

It is that rare season that Chicagoans call  Indian Summer. Not only are the leaves every shade of red, green, and yellow, but the thermometer has punched a balmy 75 degrees and it is only 11:30 a.m.

Rather than detour west to the paved bike route along the river (read that safe), she opts for her secret "city" route. She has carefully mapped this one out:  wide residential streets, stoplights at the major intersections. Safe as it gets when it comes to biking in the city.

Indian Summer in Chicago

And it is so quiet, so tranquil, that for a split second she forgets to check for cars at an alley.

A driver, too, apparently isn't looking. He slams on his brakes, but too late. He knocks the bicyclist down, panics, and jumps out of the automobile shouting, "OMG, OMG, are you okay?  Let me help you up!"

"Just a second," she murmurs. "I feel broken."

"And I cycle, too, is the terrible part of this!  I know what it's like, dodging cars, and here I am, the idiot driver! And here you are, the innocent bicyclist!  OMG!"  Everything but, Speak to me!

You cycle, too.

This has never happened to her before. Falls have happened, minor injuries. Once, only once, stitches, quite a few that time. But no kisses from automobiles. And how many people can say, after all, that they've been hit by an automobile? Very few. They don't all survive, is the thing.

Her mind flashes to the white bicycles on New York City street corners, the ghost bicycles, somber memorials to bicyclists killed or hit on the streets.    

"Were you texting?" she manages to ask.

"No! I wasn't even on the phone."

"For real?"

"For real. Believe me."

"Well that's good, I guess."

She is still on her back. Her foot is in the air, bent at the knee. She sees this and slowly lowers it to the ground, straightening it out. The leg seems to work.

"It's not broken," she declares, lifting herself up on her elbows, turning her head and neck each way, scrunching her shoulders. "I'm okay."

He's about to cry, literally cry. "Thank God. Seriously. Let me help you up." He shoves his hand at hers.

"Hold on, cowboy. Let's take it slow."

A pause. He is so nervous, puts his hands through his thinning hair several times. "My office is right here, I can take you inside, you can . . ."

She's on her feet now, notices the damage:  a vertical line of puncture wounds just above her ankle. They are spaced remarkably the same distance as the spikes on her front gear sprocket. A detective could figure out the exact trajectory of the fall from this evidence, but for the life of her she can't understand why the holes are where they are. But they are there, for sure, and blood is dribbling, albeit not much blood.The cuts aren't deep.

"No worries," she blithely reassures him. "I carry disinfectant wipes everywhere I go."

In her backpack, where they have been waiting all summer for this very moment, are the Wet Ones. She disinfects as he tells her how he is usually a cautious person, but the pressure of making it to an important meeting has made him irresponsible.

"We all get close to an accident at one time or another. Within a fraction of an inch of something horrible. What's this important job that you do?" she asks.

He tells her. He's an accountant.

"I'm a social worker."

He keeps apologizing. So sorry. SO sorry. She can't help but feel for the guy.

Then she comes up with an idea. "We will throw my bike into your trunk and drive me to work, seeing as I am too shaken up to get back to riding. You will drop me off, get to your meeting. I will get ready for my patients, then seize the day.

It never occurs to her that there are other solutions.

His driving is terrifying, being the type of driver who has to look at the person he is talking to, not at the road.  She begins to pray between directing him to her office and wishing he would look at the road. When they finally get to the medical building, he fumbles in the glove box, fruitlessly searches his pockets for his "information. She becomes impatient, but won't let him know.

"Don't worry about it," she insists. "Just give me a call sometime, see how I'm doing. That would feel good. That would be enough." Her business card lands in his cup holder.

At the office she takes four ibuprofen* with a water cooler chaser, and texts a picture to her doctor, a fellow she calls FD. She texts him about a tetanus shot. Has she had one recently? He thinks so. She should take four ibuprofen* immediately; the circumstances warrant this. Then he offers to pick her up later in a car. "I'm good," she replies. "Not a dent to the bike."

Awhile later, her new friend calls, propitiously between patients. "I just wanted to make sure you have my number in case you need it for any reason," he drones seriously. He is not flirting, not at all.  "I didn't want to seem like a deadbeat. You know, this really is my worst nightmare."

Understood. "Let it be a lesson to both of us. Cars are annoying and can ruin our day."

At home with FD, the two of them sit down for a bite, go over the incident. He googles the intersection, tries to get a fix on where this happened. She looks up the name of the fellow who knocked her down. He works at a distinguished family business, has a clean, simple website. He could run for judge with this name and win, hands down.

"And it never occurred to you," FD asks, "to handle it another way?"

What other way?

"Well, it seems you were more concerned with his feelings than your own health, safety. You let him do you this favor, drive you to work, got into a car with a total stranger."

"Well, first of all, I could have taken him, if necessary, in a fight. And second of all, this is a nice Jewish boy. He seemed like a boy, to me, he was so nervous."

"You know you could have called the police. People do that."

"And then what?  He'd have a ticket, and there would be court. A total waste of time. And for what?"

"For the crime of hitting a biker. A person. Hitting people with your car is against the law, which is why he was so nervous."

She disagrees. "Number one: This was my bad. My job, as the invisible bicyclist, is to make eye contact at every intersection with drivers of automobiles. It is called good communication. Okay if I go first?  And I didn't make eye contact. Didn't even see the car!

Number two:  He was nervous because crashing into someone with your car conjures up catastrophic fears. The worst possible things can happen, and we're simply lucky that they didn't this time. Who wouldn't shake?"

Then FD hit her with the jugular, the more likely truth. "You didn't call the police because you were worried about his anxiety. You went into therapist mode. You could have cancelled out the afternoon. The police would have taken you to a hospital."

"Huge waste of time. Wouldn't let 'em."

"Think about it," he said, "The codependency thing."

And he passed her the salad.

therapydoc

*Friends, do NOT take 4 ibuprofen unless your doctor tells you that you should.  You only have one liver.

Anger and Abandonment

It has been blustery in Chicago, the reputation as the Windy City well deserved. So blustery that at the end of March, when the weather is supposed to be mild (March comes in like a lion, out like a lamb, every second grader knows this) that we tell frail little people like mother, "Don't go out for lunch. You'll be grabbing onto your walker as the wind carries the both of you away." She goes to lunch anyway.

FD tells the story. He's in a parking lot at Home Depot, returning the cart. A bundled-up middle-aged man with a white beard is holding on tightly to a cart. If we don't hold them tightly, carts will take charge, fly off and hit parked cars. Chicagoans know this.

The man begins to curse as his hat flies off his head and hits the ground. FD, retrieving it, is rightly impressed by the long string of expletives, ef__, es___, d__, ef'in___b, b___, ef___, ef'n___, es-ef___, spewing from the man's mouth. Listening to this, he doesn't say it, but is thinking, Save your expletives for when you break a leg, or lose a house, maybe. Why waste them here?

A few years ago, two men with romantic accents came to see me in one week for anger management. It sometimes happens that two or even three new patients with similar problems come to therapy in the same week. It is as if there is something in the air or the stars are aligned in some special way. This affords the therapist the opportunity to experiment, to do her own little research study, assign homework and see what works and why, and see what doesn't and why not, because there is something of a control, having that second patient with comparable symptoms, comparable objectives.

It gets better. Both tell their narratives fluently, and both are from that continent hailing the new pope, South America. Both are reflecting upon a childhood living with extended family, not their moms or dads. Their parents left southern climes to establish themselves in this country, the United States, a land of opportunity, and called the sons to join them years later.

Years. Later. A long time to miss a parent. Without means, long distance phone service was prohibitive back then, and letter writing, well, there wasn't money for computers and email, and who had time for it anyway?

The child left behind, defenseless, odd-man out among the cousins, abused by drunk uncles and bullied at school, learned to be a very tough human being, so tough that peers eventually realized that to mess with him meant a fist fight that he relished. To beat another human being with his fists felt fantastic. This is where the phrases  sees red, has a hair-pin trigger, and Intermittent Explosive Disorder can meet as one.

Left behind.

Therapists hear about domestic violence, but usually not from the perpetrator, but the victim. The spouse or child tells the story. Here the patient is both victim and perpetrator. As an angry man, however, he doesn't hit his children or his partner, and has learned, as an adult, not to beat other adults, either, unless the circumstances clearly warrant physical violence. To him, they occasionally do, certainly if he hasn't stopped drinking yet.

We don't need advanced degrees to see where it comes from, the anger, and why the expletives become something that will need work, and surely the physical pounding, the rage, the immediate need to redistribute justice and turn things around, has to be channeled productively. One of the interventions I love, one that started with those two-in-a-week, works as follows.

The patient is told that he has to deliberately lose every argument. Every disagreement, every difference of opinion, my bad. He is to tell his partner, dispassionately, "Fine, I'm driving poorly?  I'll work on it." That kind of thing.

"Two weeks, you're an idiot for two weeks. She's the smart one. It's okay. You're really not an idiot. In your heart, in your head, you know that. You do know that, right?!" The therapist asks this in all sincerity. "Keep that in mind at all times. Nobody left because of you. Nothing to prove. Nobody thinks less of you if you are wrong. Your partner will value you more for being human."

It helps to have a partner or spouse in the therapy to reinforce the intervention, someone to look into his eyes, to tell him, "You're the smartest guy I've ever known. I love you. Love me."

And if he can't, there is that possibility, she might leave. Been there, done that.

therapydoc