In Treatment -- Laura, week 5

Paul is cleaning his teeth; the sofa bed is still open and the bed unmade. It is raining. Is Kate back? Is that the reason Paul is sleeping again in the office?

Laura is sitting on the couch and making a call. Paul tells her that they have to talk about ending therapy, not abruptly but to create a timeline. Laura says no, they are ending today and that it feels good. She says she feel better, relieved now that she has told him. And asks how Paul feels.

Paul tells her this comes as a bit of a shock and that he also feels sad. Laura doubts that he feels sadness, she thinks he is relieved.

He asks Laura how her week has been and she says terrible. Tells him about a patient, a 15 yr old, whose procedure goes wrong and she does not come out of the anesthesia and she stops breathing. The attending jumped in and managed to bring the patient back. She says she was terrified, that she only looks confident. 

Paul asks if she expects that nothing will go wrong. He asks more about the girl.

Laura talks of the girl as being pretty and with beautiful hands whereas at her age her own nails were chewed down. Ad he asks her who was watching over her when she was young. Laura asks what good it does today to know how much she suffered then.

She says she hates eggs, because omelets and all sorts of eggs were what she and her father ate the year after her mother died. She talks of how absent her father was and how much she wanted to get away, and then she went to California. And when she returned she thought she could make her father feel better but she couldn't. She says that when David came to visit from California, she seduced him and compares it to Lolita. She again tells him in great detail what happened.

Paul asks if she ever felt that David was taking advantage of her. Laura disagrees. Paul says the comparison to Lolita made him ask, as Lolita was only 12. And she tells him that David was her first lover. Laura is adamant that she was not a victim. Paul tells her that he was 40 years old and he had a responsibility to send her away. Paul asks if she ever feels anger toward David. He asks where her father was when all this was going on. Laura says he was depressed and needed her to take care of him. Paul asks again if she might not be resentful that her father did not protect her.

Laura asks for something other than water to drink. She sees the coffee machine. She keeps herself very close to Paul. She tells him she ended it with Alex. She pushes Paul again to respond. Then confesses that she made an error with the girl because she was thinking about Paul and that it has to stop. She goes to the door to leave. She hugs him and he returns the hug. Laura leaves.

If Paul really believed they were terminating, then I question the wisdom of his pursuing the issue of her father and David with Laura. If he actually believes that they are ending, then this is not the time to go deeper. And in that case, Laura's question about what good it does today to talk about her suffering when her mother died makes sense -- termination is not the time to explore the wound. But if he believes they are not ending or is hoping to turn things around, I can understand what he did. 

Paul's statement to her that her father failed her by not protecting her is also a statement to himself, because he must stand firm against her wish to have him in order to keep this from being another enactment of her earlier life. 

The hug at the end -- I understand the desire to respond to a patient who is in pain, and Laura is in pain. But this was not the time to relax and be willing to hug her. No, Paul, no. For my commenter who sees Paul as the major problem in this case -- his return of the hug was an error because of his feelings for Laura and because his estrangement from his wife no doubt leaves him starved for touch and care -- a very bad combination. Paul needed to be the man who holds the boundary against the efforts of the girl to seduce him.

Now, touch in therapy is a real can of worms. It is way too easy to fail to pay attention to what a hug means. And if it is not made part of the talk of the session, if the reason for wanting the hug is not explored, then it becomes acting out -- on both sides. Someone might ask what then could Paul have done? He could have said to her that he is sorry to see her go, hopes she will return next week so that they might talk about what happened and how she feels. No doubt that would make Laura angry but on a deeper level it would support the boundaries Paul has attempted to hold, with mixed success. A handshake is far less subject to misunderstanding and far less fraught with potential sexual overtones.

© Cheryl Fuller, 2018. All  rights reserved.