The car pulled into the driveway and he sat in his car for several minutes because he was late for his appointment. I decided to open the door and give him the whistle to which he did not respond. So I returned to the study and waited for him. After another 45 minutes or so there was a knock at the door. When I opened the door I was confronted with a man in his mid-fifties, well-dressed but not clean shaven. He avoided all eye contact and his chin was lowered as he softly spoke. “Are you Brian the counselor guy?” I replied that I was and asked him to come on in. He soon began to move slowly and methodically as if he was in a great amount of pain. I went into the study and waited for him there. He remained standing in the hall for quite some time so I went out and asked if he was coming into his session. He seemed very disconnected and spaced, out a sign that he was on some type of psychotropic medication. He moved to the large couch and sat down as if he was sitting on something that was extremely painful. He maintained the same facial expression of anguish so I welcomed him and introduced myself.
So now that we got introductions out of the way, how can I help you?
While I don’t know really but I think my life is not going so well.
So what’s not going so well in your life?
I don’t know! I think I have some idea but I’m not sure?
Well let’s start from what you think you know. Can you tell me about that?
I’ve been seeing a psychiatrist but I don’t think it’s helping very much. My wife is living at her sister’s, and her sister saw you for some marriage counseling so she recommended you. Between the medication I’m on, the psychiatrist, and the fact that my wife is no longer interested in our marriage, I don’t think talking to another person is going to help.
Okay I understand but what happens if by talking to me it is helpful?
I’ll continue to come I guess.
Well that’s great. If I’m going to help you I need a little time but I do appreciate you saying you don’t want to waste any time because you’re already seeing a psychiatrist. When you see the psychiatrist, how much time do you spend actually getting some counseling from him?
Well it’s a her and I’d say about 15 to 20 minutes, sometimes a little more if she wants to change the dose or talk about other possible medications. The problem she sees is I’m depressed because I can’t deal with the fact that my wife left me.
I can see that you are depressing, but you also seem to be in a significant amount of physical pain as well. Is this true?
Yes.
Have you ever had this kind of pain before physically?
Yes.
When was that?
When I lost my job back in the late 80s.
So you’re in a significant amount of pain right now, the last time you felt this was when you lost your job late 80s and do you think you were depressing then as well, when you lost your job?
While I think I was depressed after I lost my job!
What happened between you and your wife that she left you?
She found out I was having an affair with a woman from work!
So how would you describe your relationship with your wife before the affair?
We have a very good relationship. We got along great, until she found out.
That is pretty interesting because if your relationship was very good and you are getting along great what is the need for the affair?
That’s what I can’t figure out because my wife and I are very compatible – we get along well, we have our differences, but we’re able to work things out.
What were the differences you are able to work out?
At this point the client gave out a huge ahhhh sound and he began to shuffle his feet and tap the sides of his thighs with his hands in a angry fashion.
I don’t think this is going to help me very much!
Do you think anything’s going to help you unless you talk about what’s really bothering you? You seem very angry when I wanted you to point out the differences you have solved with your wife.
My wife is a good person she didn’t deserve me having an affair on her so it’s my fault I know. I deserve it but it still hurts.
I know it hurts and I can see you in great pain but if you don’t talk about what’s behind that hurt how do you see getting through your life in the next week or so.
Well I don’t!
Have you thought of killing yourself?
Yes! And I’ll tell you more: I know exactly how to do it where do it. I’m just afraid of what would happen to the kids, knowing their father is such a fuck up!
I’m glad to hear you say that!
And why is that?
How long you been living with this situation?
A couple of months now.
And it sounds like you thought this thing out but something is preventing you from doing it! Whatever it is I’m glad for that reason because it gives me a chance to help you and like you, protect your kids from an awful situation.
Yeah I guess you’re right.
So I need you to gimme some time here! And I also want to know this: has you wanting to kill yourself increased since you’ve been on medication?
Well I don’t know. I have to think about that.
Well I need you to think about that right now! Because I’m questioning whether this medication is helping you or not. Can you tell me what it’s doing for you?
Well I just don’t feel the pain as much. I can just feel … kind of numb I guess.
Before the medication, what were you doing?
I was crying a lot, like blubbering idiot, I can’t be like that all the time, I never cried so much in my life.
Hey you have good reason to cry. You messed up with your wife, you hurt her badly, and you may have had good reason to have an affair!
What would be a good reason for having an affair? I blew it!
I agree with you but people don’t have affairs who are in loving, caring, and supportive relationships where their needs are met. I asked you a question earlier and it was a difficult question for you. I asked you what difficulties have you and your wife worked out in and you got a little antsy.
Well, about a year ago now … it’s longer than that almost two years ago, I lost interest in her sexually. I guess it just wasn’t very good. And there was this woman I work with that is very attractive, few years younger than me and I was fantasizing about her.
So did you work this problem out with your wife?
No, I guess we couldn’t work out this problem, I tried though, believe me I tried.
It sounds like you’ve been trying for quite a while, maybe longer than a year and a half?
Well isn’t it the main issue in most marital relationships sex, money, power, control?
So exactly how long has this been going on in your relationship?
Alright, for a long time! I tried talking to her but she wouldn’t listen. So I just stayed away for her, golfing, hanging out with the boys. Every time we were together she would always be telling me what to do and how to do it and I got goddam fed up with that.
So you see how involved this is. It sounds like you both been unhappy for quite some time.
Yes, yes I think you’re right.
Well it’s all water under the bridge now. What’s happened happened and you can’t go back and fix it.
At this point the client put both hands against his knees and began raising his voice and gesturing abruptly.
I’m not stupid you know! I know I can’t go back and fix it! And knowing that doesn’t help me now and it sure doesn’t make things any less painful!
You know years ago you lost your job and I imagine you were depressing then too. How long did you stay depressing?
Well that’s a peculiar way of putting it!
Yes I know. Can you answer my question?
I don’t know a couple weeks maybe!
Then what happened?
Well I have bills to pay, my kids were younger, I had to go out and find another job, I had to drag my ass out of bed each morning and it was horrible.
And your body was aching!
Every joint in my body. I even started to take Advil for the pain.
So when did the pain stop?
I don’t know! It was years ago!
Well think back for a minute. What time of year was it?
Just after Christmas.
Wow, that sucks. Must’ve been pretty hard?
Yes. Christmas debt!
Do you play any sports?
I do remember something. My body was so sore I stopped playing broomball!
Okay so when did you start playing again?
About a week after I got my new job!
So this is what I hear you saying: you lost your job, you were depressing, plus your were in such pain that you couldn’t even play the sport you love which is broomball. You ended up quitting the sport but a couple weeks after you get a new job the pain disappears and life goes back to somewhat normal!
Yeah, so?
So what does that tell you?
I guess the fact that I was depressed because I lost my job, my body was aching, I got a new job and I stopped be so so depressed because I didn’t have time to depress because I need money for my family?! Wait I see what you’re getting at but I don’t see how this relates to me now.
Well you’re going through a very significant loss, you and your wife are separated. That’s painful, your depressing, your body’s aching … I think it’s pretty similar.
I agree but how does that help me with anything?
Well is your body aching right now?
No it’s not. It feels pretty good actually!
So what are you doing now that you weren’t doing before you came in the room?
I guess talking about things.
And when you’re talking about it do you think you’re depressing as much?
No I don’t think I am.
Well that’s my point.
So you think I’m depressing on purpose and I’m causing my body to ache?
Look: you have good reason to be depressed, you have good reason for your body to ache. And I also think you have some pretty solid reasons not to kill yourself. You think it’s over between you and your wife?
I don’t know!
Do you remember earlier on in the session when I asked you to tell me what were the difficulties you and your wife were working through and you got angry at me?
Yes I’m sorry about that.
You don’t have to be sorry. I don’t think you can control me with your anger but have you been controlling your wife with your anger?
I think that’s a good question.
Well if it’s a good question would you mind answering it for me.
Bastard! So you’re making it my fault?!
I’m simply asking you a question. Do you think you attempt to control your wife with your anger?
I heard you. I’m not deaf! Well, my wife tells me and has said to me for sometime that I have an anger problem.
Do you think you do?
Well isn’t it obvious asshole! Do you have to ask so many goddam questions?
Hey, I know you’re upset right now but do you think your depressing is another way to try to get control back from your wife?
So you’re telling me that I’m not really depressed, that I’m just doing this to get my wife back?!
No, I’m saying I think your depressing and part of your depression is to cover up how angry you are and since you’ve been on this medication you don’t feel as effective in your life because you can’t see it getting any better. It’s not getting any worse. She’s still living at her sister’s and obviously she wants you to get some help and she still cares about. And if you give me a little bit of time with you, go see your doctor, get off the meds and come to counseling, we might be able to put your marriage back together. I can’t make any guarantees but you seem to want her back.
I do want back!
Well I can’t guarantee it but if you continue to come and see me maybe we can map out a plan together that would spark the interest of your wife and give you another chance. Now I haven’t spoken to your wife, I don’t know what she’s thinking, but do you think what you’re doing right now, with this situation in your life, is bringing you closer to her or farther away ?
Farther away.
So the ball’s in your court! You can’t control your wife, you can only control you and if you give me a chance I can teach you some internal psychology that may improve the quality of your relationship with your wife.
Okay I’m game. Nothing else seems to be working
Okay then our session is over for the day. When is the next time you can come and see me?
How about two days?
Okay that means Sunday. Wonderful. See you Sunday.
coachbri