Sixteen-year-old girl attended three sessions then texted me: “I was wondering, am I allowed to come back to therapy if I stop going to sessions for now?” In a burnt-toast mood tempered by slight professionalism, I replied: “People quit all the time. I’d just be curious about why you don’t need counseling now but think you will need it later.” She: “I think that depression comes back eventually and I also am getting tired of talking and crying and talking and crying. I feel like it’s becoming forced that that happens every time and that I’m just crying just to do it. I think my parents think I’m supposed to be better and good and no longer need therapy. I feel like from that I’m supposed to be ‘fixed’ in a way.”
Let’s review her statements. She suggested that her depression is gone but may return “eventually.” She is tired of “talking and crying” for two entire sessions (following the diagnostic interview) in a row. She somehow felt that she was forcing herself to cry “just to do it.” Where would that notion come from? Had I handed her the meetings’ agenda – “This is where and when you cry”? No. Now, add her remark about her parents: They believe she should be better, should not need therapy.
This was, this remains, a depressed and chronically tearful teenager.
The next appointment on the books was to be a parent-only (father) session. He attended.
I punctured confidentiality for this possibly plausible reason: I was not going to see the girl anymore and felt my only potentially helpful swan song would require laying everything on the table. But not before her father informed me that all was now good and right: He and his wife had ended their conflicts. While his daughter has never shared her feelings with him, she does talk with her mother. She “blames herself” for the family unhappiness. And, her depression comes from her empathy with her depressed friend living in Michigan.
This was all meaningless stuff, which I countered. “Your daughter is grievous about the ‘years’ of fighting, alienation and conflict between you and your wife. Her mother leans on her emotionally, more than the reverse. She didn’t merely refuse to accept your apology, she is angry about it, aware that it was self-serving. She is stricken in the heart when your wife displaces her own misery by occasionally saying to her – ‘. . . if I divorce your father . . .’ It’s the rare person – and never a teenager – who improves in two sessions. Even if you and your wife were magically transformed into the most loving couple in history, your daughter would still have depression, in fact might feel worse: left behind in the wake of your sudden happiness. To help her, you would need to become the greatest listener in the world. I will explain to you what that means.”
I recommended marital therapy for him and his wife, or one of those marital encounter weekends. I offered to see all three of them in a session. None of this will happen. There is one out. The girl is invited to stay in contact with me via text-message. That way, she will not sit on my couch and cry. Her case will remain open out of pure laziness.
