The Client who Hated Therapists
She was broken when I first met her. These were her words, not mine, and she hated therapists. Barely made eye contact, hair hanging long in front of her face, a hollow shell of trauma laden with all the resulting symptoms that come from that- scars up and down her arms from years of cutting, a hoarse voice from the years of purging, and a current love affair with Xanax, cocaine, and vodka. She had been abused in every way a person can be abused.
In therapy for much of her life, she had been diagnosed with everything under the sun. From Ambien to Zyprexa, it also seemed she had tried all the psychiatric medications. For years, she had been a psychology lab rat for test trials and research projects. She made friends in psych wards and found love in rehabs. She was institutionalized, also her words, and was more comfortable with living in forced, sterile structure than living independently.
She had run, crawled, and skated through the mental health gauntlet, and she was left with the bitter taste for therapists and everything they represented. Nobody had been able to help her. Of course, she was mandated to therapy. And, of course, the therapist assigned to see her was me.
Here’s where I’m supposed to write about the genius interventions I did to save her life. Here’s where I’m supposed to shine with my own humble bragging.
Instead, this is what happened. She walked into the room (this was before I had my own office), slouched on a stiff chair (before I had real therapy furniture) across from me, her gaze fiercely fixated to the ground, arms crossed, all nonverbal language screaming that she wanted utterly nothing to do with me and nothing to do with life.
I began with the simple questions, the ones therapists are supposed to start with, the what brings you here? What would you like to work on in therapy? How can I be of help to you?
She had none of it.
You can’t help me.
There is a standing cliche that we cannot help those who do not want to be helped. That mantra flashed through my mind, but my ego and determination pushed it aside. Of course you can help her, Nicole, I thought to myself. She’s just scared…she’s just putting up her walls…she’s just testing you…and of course, the favorite therapist one, she’s just resistant! Assumptions ran like wildfire through my novice therapist mind.
I tried again. What would it be like if someone could help you?
Her response. You can fucking try. Good luck.
This was my green light. Challenge accepted.
I tried conventionally at first. More therapist questions. More of the usual probing explorations. Whatever tiny piece of bait she bit, she promptly regurgitated and threw back at me. When I pointed this out to her, she would shrug, seemingly unfazed.
We danced a complicated tango.
Then, I stopped asking questions. Because this approach was getting us nowhere.
I started talking to her like just a person instead of a problem. I told her stories and said stupid things to make her laugh. I made fun of my own self a lot. Together, we even made fun of therapy. She began showing me some her writing, and I would read it. Sometimes, we drew pictures. Sometimes, we sat on the floor. And sometimes, we went for walks outside because it was cool, and she (unlike me) loved cold weather.
I always told her I cared about her. She never said it in return.
And, then one day, as it does, her insurance ran out, her finances ran dry, she returned back home to her mother’s home (out-of-state), and I never saw again.
There was no cure in this therapy. I never even came close. All I know is that when I saw her, she wasn’t throwing up, she wasn’t shredding apart her skin with razor blades, and she wasn’t popping pills washing them down with alcohol. I don’t know if she returned to any of those vices. I hope not, but I know, logistically, the odds are slim.
We never had closure, but in all interpersonal relationships, closure is a luxury.
I think about this client every now and then, and I think about her sunken eyes and the lines in her poetry. I think about the small smiles she gave me, when she didn’t really want to, because she couldn’t help herself. I think about her when I get frustrated with my own professional competence- when I feel lost with a client because I don’t have the answers and I don’t have the “perfect” interventions, and I don’t exactly know what they need.
I didn’t do anything I was supposed to do, but I did everything I could.
I never gave up on her, and she never gave up on me. It was not stated like that, but it was felt. And that was when I learned that, even when it’s ugly, psychotherapy is always beautiful.
- Some identifying details have been changed or added to protect the privacy and confidentiality of individuals.