Staying Connected

I'm not going to get too wordy here because it's Monday and the implications are scary, so much to do. But the lesson here is worth a quick post.

The "he" in the story could be a female or a Martian, there are no true identifying features in this post.

Several years ago I had a professional acquaintance who called to give me a head's up that she had referred her father to me for therapy. Her father's sister committed suicide and she worried her father was at risk.

He called that day, and I couldn't get him in immediately, told him it would have to wait a couple of weeks (!). Could he wait? Sure. I've waited this long.

He presented with two Axis I disorders, severe anxiety and dysthymia (ever-present depression, the low-grade fever thing). You would think the two can't co-exist, but they can. You're never depressed ALL of the time. You're never anxious ALL of the time.

His sister had just committed suicide. I should have done that a long time ago, he whispered

Would you want this case?

Past retirement age, our guy still worked, very responsibly, even though each day he felt inadequate.

He had been in and out of therapy for over thirty years.

His crippling anxiety, which surely did come from severe childhood emotional abuse, made parenting (and partnering) very difficult. His wife left him while the children were small (she took them with her), and he never had any meaningful contact with the kids after that, even though they begged him to talk to them, to be a part of their lives. He just didn't have the social skill to listen or to talk. There were four children. Four children, no contact. It really does happen.

Never had anyone discussed repairing his cut-offs with his children. The therapies, according to him, all addressed his relationships with his parents, his marriage, and his childhood problems, his lack of sexual/relationship attachment.

See, it's not that difficult, this case. There is a universal need to be loved by one's parents, and a universal need to be loved by one's children, and that can be repressed, of course. But it's there. And it has to be addressed if meaning in life is at all important.

Tiny steps, of course, he had to make the first moves, the calls, the visits, the toys for the grandchildren, the birthday cards and gifts. He didn't have to really talk very much at all to anyone in this therapy, but he eventually did, all on his own. It's a behavioral family therapy. Say hi, visit, go to the grandkid's baseball games. Quick guerrilla visits. Hi, Bye.

Put yourself on the map. You don't need to be a star.

No idea what those other therapies were about. Don't care. He did so well.

It's just an example, right? Anyone could see the need for that kind of intervention.

Was he still at risk? I thought so. You know how it is when people feel a little better. They have the strength to hurt themselves, whereas they hadn't before. But the thought of hurting the little ones like that, the grandkids, served as a deterrent. He said as much. And I lay on guilt big-time when it's deserved.

But I kept an eye on him over the years.

What's lovely is that I never even had to bring any of his children into my office to do that family therapy. The family system was in the room, everyone was in his head.

That's how you need to think.

Copyright 2007, therapydoc