In Treatment -- Sophie, week 8

I always look forward to Sophie, to see Paul at his best as a therapist.

Sophie and her mother drive up to Paul's. Sophie argues with her mother about the fact that they are a bit early. Sophie tells her she doesn't have to wait. Her mother says she doesn't mind. She compliments Sophie on her hair and touches it, smiling. Sophie starts to say something at the same time as her mother does. She suggests to Sophie that after her session they might do something together. Sophie leaves the car.

Sophie is crying and sitting on the floor. Paul sits across from her also on the floor. She says everything is going to shit. She says she has tried all week to talk with her mother but she can't, she just can't. She says she just wants to talk to her. She says her father has been calling every day this week, like he is trying to be most attentive father of the week. She hasn't returned any of the calls. And she says yesterday her leg began to shake and she thinks she will be pulled from the meet. She says even if she makes the meet how can she ace the national trials if she is shaking. Something is wrong , she says. She recites the series of events from the accident to the rash she has now. Paul reminds her the dermatologist says there is nothing wrong, that it is anxiety.

Paul tells her she is trying to do 2 very big things at once -- talk with her mother and avoiding her father. And that could lead to some very difficult places, like telling her mother her secrets about her father and telling her father she is angry with him. Paul tells her about an episode he had himself years earlier. He says they found he had had an anxiety attack. 

Sophie pulls up her shirt and shows him her rash and asks if that is just anxiety. She is angry with Paul for thinking she is normal. Sophie says she shocked him, he shakes his head. She thinks he is shocked by how small her breasts are. Paul asks if she is concerned. She says of course not, that when girls stop training everything explodes. Sophie say she knows she has the body of a child but that children don't want to kill themselves.

Paul asks if she is thinking about suicide again. She says yes because everything is falling apart. Paul says he remembers her telling him about being in the ambulance. And he thinks that when things go wrong, she blames herself, that she sees herself as always the problem. It never occurred to her that Sy was the problem. Paul asks her why she thinks she was the problem. She tells him to stop. 

Paul asks if she has ever read the Bible. He tells her that in the New Testament God is always good and man is bad. She sees the point that people prefer to see themselves as wicked. Paul helps her to see that her father left his second wife for other reasons than that she wanted to live there. She asks if there isn't a law that parents have to love their kids forever. And Paul says she feels it must be her fault for her father to leave and that her mother became so depressed. Sophie had to make what happened be her fault because nothing else made sense.

She gets up off the floor. Paul says she saw her father cheating on her mother and does she really think that is a reason for her to be abandoned. Sophie says she found her diary from 4th grade. She says she took it out to see if he was right, about how hard it was to lie to her mother. She reads to Paul. Paul asks where she kept it and she says on her night table. Paul says it is a wonderful gift, because it shows her  world. Sophie asks if he thinks she wanted her mother to find the diary. Paul says yes and to ask what was the secret she was keeping. The entry she was reading was from Sept. 11. He asks her to go on. She closes the book after reading that her father told her she was going to inherit an evil world. She asks what kind of parent would say that and then run off to photograph bimbos.  

Sophie asks if he really thinks the rash and spasms are coming from her head. He says yes and he thinks she has to start to forgive herself. That her parents were going to separate anyway, that she didn't make it happen. Sophie asks how she can forgive herself. Paul says it will be slow but she has to start trying now. He tells her she deserves to be happy. Sophie smiles and looks relaxed. She asks Paul if she should go to the competition Friday. He says he thinks so. She says she has to go because her mother is waiting. He tells her if she starts to compete and starts to feel anxious to call him. He suggests something she can tell herself if she starts to feel her leg shake. 

Sophie leaves. Paul sits back.

Outside her mother is waiting. Sh asks where to. Sophie says she wants to go home then says they could stop for coffee somewhere. And her mother is so happy she almost cries.


It is a pleasure to watch Paul with Sophie. He has carefully built trust with her over these weeks and now she can talk with him, she wants to talk with him and get his help. We aren't always so successful with patients; it is with people like Sophie that we often feel so rewarded by this work.

What Paul does this week is help Sophie to see something Harry Guntrip wrote about -- that most of us would rather be bad than weak, rather be responsible for the bad things that happen, the failed relationships, than to accept that we cannot control the world and others. Because if I believe I am bad and make people treat me as they do, that means if I work hard enough, I can change and in changing, change them too. But to know that I am weak, that I have no control over other people and their behavior places me at the mercy of forces beyond me and means I am unable to make the world be as I wish it were. This is a tough pill for any of us to swallow and is a part of the work with most of the people I have worked with.

Sophie could not have heard this before today. But she now trusts Paul enough to be willing to consider that he is right. And she so wants to be close to her mother, to stop being at odds with her. So we see her start the work she needs to do to be a much happier person.

So far, Sophie is the only of Paul's patients we have seen him be successful with. The work with Laura is in tatters and his feelings threaten to destroy his marriage, his career and do harm to Laura as well. Alex is dead, perhaps a suicide. Jake & Amy are in deep difficulty. If these four were all of Paul's practice, I am certain he would be quite depressed himself. But we must remember that the work in therapy is mostly the patient's to do. The therapist must listen, reflect, interpret and monitor how things are going, but the hard work of facing into themselves belongs to the patients and we have seen a variety of ways in which some patients cannot engage that work while others do. 

So it is very good to see Paul at his best with Sophie, the patient it is easiest to root for.

© Cheryl Fuller, 2018. All  rights reserved.