A very brief therapy

 

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.