Should I suggest that she get numb?

"Sixteen-year-old girl remains in a steady-state of disconsolateness, silent, glazed-eyed and bereft looking for much of the hour. This sometimes ruins to silent heavy tears. 'Carly' spoke more quietly than a whisper, said that she's been 'telling myself things that aren't true.' Initially not interested in disclosing what these things are, she later said: 'I tell myself that no one cares about me.' She knows her star-crossed girlfriend Runa cares about her, and can't deny that I care about her. But she believes (not merely 'feels') that neither her mother nor her father cares about her. Carly said that she skipped dinner and no one inquired after her. I talked with her about the challenges of making friends under the shadow of depression and fatalistic assumption. She acknowledged that at school she may wear an 'I want to be left alone' look. After all, she doesn't want to be there and might project an off-putting air to potential friends.

Challenge of the day, this young person. I have twice invited her mother to have a parent-only session. Her response to the first request was "busy," not even "maybe." Her response to the second request was silence. I've seen her father once in my office, once in the waiting area. This is one flaccid walking coma. He does nothing to challenge his wife's solipsistic childishness and meanness. "Perfunctory attention" should be his middle name. I believe my client: Her parents really don't care about her.

Her kind of negativity redoubles itself, though she comes back week after week and must sense my effort to mitigate her doom feeling. I wonder if a young female counselor would be a better interactor with her. Girl talk, collages, maybe a more delicate and discreet way of approaching her parents. I am delicate and discreet, benign and gracious, practically courtly, when it's a matter of keeping the child in therapy, not directly angering the parents. In the 1990s when I worked in rural Logan, Ohio, I might walk downtown (five buildings, maybe) with my teen clients to the book-snack store. The ambience of walking, caring, getting air had power and strength. In Pickerington, Ohio, the teens and I could walk in a miniature meadow -- a couple trees and a gentle grassy hill. These ways get us out of the box of therapy. Where I am now, we could only do the parking lot circuit of a medical park. So we are stuck on a chair and a sofa feeling and questioning the worst feelings.

Nine years ago when I started the blog, I would have ended this piece with a pessimistic or optimistic statement. Now, there's no reason to.