Amelia comes shame-faced to one of her twice-weekly sessions. We are in our fourth year. This is her second treatment of some length. She is a professional woman in her 40s, married, with two kids. She is back in therapy to leach out a gray layer of depression that doesn’t seem to want to budge. She has read this and given permission to publish.
She blew a gasket at a meeting at work. Shaking with rage, she screamed at an older female colleague. For several sessions, she just needs to vent. After some time has passed and she can think again, she wants to work.
Workaholism
Here are the threads we find. Once again, she has taken on too much. The meeting is after work hours requiring an arduous commute home. She misses bedtime with the children. The work is essential, but dull. We chalk her volunteering for this thankless job up to her masochism. Who is she trying to please? What does she expect in return?
What are the problems that working all the time solve? If she isn’t dog tired and booked solid, what might she do? Aiming toward pleasure is not yet her default. She is supposed to wear herself out and deny herself the pleasure of her children at bedtime. All of this is for her mother. Who is fifteen years dead. I point out that her identification with her martyred mother isn’t helping her right now. And then I wonder if she misses her mother, and we grieve a little. That frees her up some.
She realizes that there is something about her colleague that reminds her of her mother. Aside from her coloring and her small frame, Amelia notices an anxiety around taking action mixed with a kind of steely resolve. Amelia experiences this woman as trying to thwart the committee’s mission because of her fears.
We find a rich vein of associations.
Masochism: Hurting Yourself in Order to Get Something
Once, she and four of her friends wanted to go hear an opera at an outdoor music festival. Amelia was 18, an honor student, driving for two years, never had an accident. Driving to this festival would involve the highway and her mother’s response was a quick, absolute, and anxious “no.” Amelia doesn’t fight for herself. Instead she cries all night and then shows her puffy face at the breakfast table. She is then given grudging permission. She dare not make her case for herself, instead she suffers in her mother’s general direction. Weaponized pain.
[You may notice that you just got annoyed at Amelia. This is a common reaction to masochism. One that befuddles the suffering person. Masochism induces sadism. You want to smack her. Bracket that and move it a little to the left.]
I see this over and over again. The patient is not taught to find her voice and stick up for herself. Instead she suffers and hopes that someone will notice her suffering, read her mind, and give her what she wants. And it’s not just girls, people. If you don’t know who you are, how do you fight for yourself? If you are so concerned about someone else’s well-being that you deprive yourself, you set yourself up for a rage or rage’s flip side, depression.
Amelia realizes that her colleague’s anxious insistence on sameness is touching a deep rage at her mother. “You can’t, because I will worry too much” too often stopped Amelia from exploring or living fully or taking pleasure in things she did do. Once we elucidate this, Amelia can experience her colleague as an annoying stick in the mud, and her rage subsides. She can even access some empathy for this timid woman.
Humor as Defense and Protection
Amelia is very, very funny. It’s a protective layer over her rage. It protects me and it protects her. We have a good working alliance and that tamps down the fear of attack I feel when I’m with her and she’s raging. The current technical problem is that I want very much to laugh with her when she makes fun of people. Taking her pain and spinning it into comedy is something she did in her family of origin and continues to do with me. When I buy in and enjoy, it buttresses this dynamic, and her hurt goes unnoticed.
Ameilia has gotten angry at me, but it is a kind of anger that is a therapy victory. She is blazing, articulate and true. THAT kind of anger, I pray for. Not that it doesn’t sting a little. I’m cheer and cower.
What’s alive in this short sketch is a hot transference outside the room and masochism. Or as I like to call it: the dilemma of a good girl who doesn’t want to scare her mother so she lives small.
This is rage in a high-functioning woman and this is how I heal it.
