I'd been seeing Kim for over a decade when she called me late one evening. Her voice was barely audible; I'd never heard her sound so low.
"The big presentation I'm supposed to be giving on Friday -- instead of preparing for it, I've been in bed crying," she stammered. My mind went back to our last session: she'd been so elated! A new raise, an important promotion and an invitation to present her work at a national conference! When she mentioned her daughter Noreen, her mood dropped. Noreen wasn't doing well again, but Kim seemed determined not to let Noreen's eating disorder dictate her life. She'd recently been to a support group where she'd learned a new mantra from other parents struggling with children with eating disorders:
"I didn't cause it, I can't control it and I can't cure it."
The mantra felt liberating to Kim, who had often felt a prisoner of her daughter's struggle for well-being. Essentially, the mantra's message gives parents permission to step away after doing all they can do (emphasis on the "all"). As Kim spoke, I wanted to be sure to empathize with the difficult juggling act she had had: being mindful of having permission to take care of themselves, even while working to do everything they can to set the best environment for recovery.
"And even though she's 28, she's still my child," Maureen said sadly, recognizing that her daughter was still struggling and that she would, till her dying day, have to control her urge to manage everything in true "helicopter mom" style (her words).
She'd left my office in good spirits, it seemed. Not a word about feeling sad. What could have happened?
Kim, a single mom and widow, first called me when her 15-year-old daughter Noreen was diagnosed with anorexia nervosa. I'd accompanied Kim on her journey as she struggled to find the right treatment/therapist/hospital for over a decade.
Noreen's initial therapist had referred the two to many a family therapist. A short hospitalization for Kim had meager results over the long term. Next, a long series of out-patient, in-patient and day treatment settings. Noreen had tremendous resilience, and yet she took deep dives: an asymptomatic period was usually eventually followed by a relapse, followed by a slow recovery and then another relapse. Eventually Noreen graduated from college, married and divorced. A successful career took her out of state, and for a while her life was smooth, but now her old demons were back: food, weight and feeling fat.
"I feel like we are back to ground zero," Kim said sadly when we sat together in my office the morning after she'd called. "Is this the way it's always going to be -- this up and down cycle?" she wept
"Tell me about the tears," I suggested softly.
Kim cried harder. "I shouldn't be crying," she sniffled.
"Says who?" I asked.
My words sailed right over her head. "It's her life that is a mess," Kim said. "But I can't stop crying, thinking about how this happened -- to her, to me, to us. I just can't stop crying!"
I hung in, determined to reach her.
"I wonder if you can stop blaming yourself and tell me how you feel?"
Kim sat there sobbing.
"Let it out," I said, "So much pain inside. Just let it out, let it out," I said. I told her I'd never seen her so despondent and asked her if anything happened between the last time we met when she'd been so elated and now. "Just go back in time. Let's see if we can figure this out together. What happened between the day you left my office last week and now, if we can figure out when this mood came over you."
Kim began looking backwards, recalling the days between our last session and when she began feeling so agitated. Suddenly she stopped. A memory emerged.
She'd been at her parent support group, where an angry parent expressed fury and rage with her own daughter who had again relapsed -- with alcohol. Now the daughter wanted nothing to do with her mother. She wouldn't even speak to her.
Kim paused. "I can't explain why," she said thoughtfully, "I didn't even know that woman, but her story terrified me. And I began thinking about Noreen. What if I were to lose her?" she began crying again. "I know it doesn't make sense -- but I've begun to worry about losing Noreen."
As she spoke, I began thinking about the power of this complete stranger to evoke one of Kim's worse fears: that her own daughter would reject her as she had rejected her own mother. A few simple questions from me helped Kim recognize how witnessing this angry mother had evoked her unfinished business, reminding her of her own angry mother -- as well as the angry part of her.
"Losing your daughter would indeed be a nightmare," I said, wanting to acknowledge and validate that her reaction had an understandable component. "But unless I've missed something, there's nothing that's happened to make me think Noreen is about to cut you out of her life. Is this even a possibility? Am I missing something?"
Kim broke into a smile. "No, there really isn't, and now I feel kind of silly. There's really no reason for me to be so worried, but this is me, this is what I've always been like. I can get caught up in my own nightmare so easily. It's as if the whole world goes topsy turvy."
As Kim had told the story of this raging mother, I had witnessed her come back to life. "The old Kim is back," I said, wanting her to notice how telling her story had shifted her back into her competent self. "Take a deep breath and let it out. And another one, and just notice how you feel now, compared to how you felt when you came into this office a few minutes ago."
Kim smiled and said she felt calmer. "We all have different parts of us that can get activated by memories, events and people," I said. "And the trick is to figure out how to deactivate our demons before they take hold of our minds."
I explained to Kim that recent findings from neuropsychology can explain what had happened to her. "Powerful mirror neurons in our brains attune to other people's brains. When we see someone being angry, our angry neurons get fired up. If I see someone smile, I smile, if I see someone look fearful, my mirror neurons turn on my fear sensors." I used myself deliberately to normalize what I was saying and help her feel understood.
I explained that knowledge of this kind is a powerful tool and can help us pause and detach from unwanted states. She looked dubious, but when I asked if she was willing to do an experiment, she nodded, and I was delighted to have the opportunity to teach her a new coping skill.
Stay tuned to the next installment on this blog and learn a new skill to use to calm yourself when your world feels topsy turvy.