Tuesday, September 29, 2015

Would I Accept My Patient's Gift? - The New York Times

In our first session after I returned from vacation, my patient Tim handed me a box of homemade candy. "I wouldn't eat this myself if I were in your place," he said. "After all, how do you know this candy hasn't been doctored? I might have put in some bad stuff."

Over the years, I have received many small presents from patients, especially around holidays and at the end of therapy. This was different.

I tried to mask my surprise. "So, you give me something sweet," I said, "yet you are warning me it might be bitter, even dangerous?" 

He smiled sadly.

Early in his therapy, Tim revealed that, when he was a child, his parents would give him food laced with sedatives. Then, when he could barely move or think, they would beat and molest him. He had become too afraid to eat most of the time and had been terribly skinny. (He still was.) He had trouble sleeping and had nightmares in which he was attacked by leopards and lions.

That day's session covered much of the same territory. At the end of the hour, Tim begged me: "Please believe I made the candy especially to thank you for our work and for your trying to understand me. I wouldn't really want to hurt you." 

I tried my best to be analytical. "I think you want me to worry the way you had to every time you were being fed, so I'll know how you felt," I ventured.

He nodded vaguely at my comment.

I wondered if it would be helpful for Tim to know that he had succeeded, that I was indeed afraid. Being sensitive, as people who have suffered trauma usually are, he probably knew anyway. 

Just before he walked out the door, Tim turned and asked me: "Did you have a good vacation? I had to work like a dog." The guilt-inducing nature of this question was not lost on me.

After Tim left, I took a moment to gather my thoughts. Was he getting back at me for being gone? Tim often expressed doubt that I would be able to help him recover from his past trauma and learn to trust people. To him, I, too, was potentially unreliable.

Yet there was also a tender aspect to Tim, a wish to connect to another person without fear. His gift seemed to symbolize so much — on one side, hostility and terror; on the other, yearning for love and care. 

What was I going to do? Could I trust that Tim, with this gift, wasn't repeating his family's cruelty?

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