How to drive your therapist crazy in 10 easy steps

Psychotherapy, like all relationships, has its ups and down. So for those dull therapy moments when you find yourself getting bored with your own self, and wonder whether your therapist really loves you, or you just want to spice things up a bit, here's a quick and easy guide on how to do drive your therapist crazy.

I broke it down into points, though they are not steps in the common sense, and can be followed in any order. Also, you do not need to follow all of them. Chances are you will begin to see results after only 3 or 4, it all depends on you perseverance and focus.

I should add that this list has been compiled based mostly on my 9-5 clinic patients, who have a different view of psychotherapy than, say, your average private patient, and who generally think of me as their social worker rather than their psychotherapist.

HOW TO DRIVE YOUR THERAPIST CRAZY IN 10 EASY STEPS:

1. If you don't feel like keeping an appointment, remember not to call and cancel.

2. When your therapist calls YOU to find out whether you are still alive after you have missed three consecutive appointments, try not to answer the phone. Or, if you must answer, make sure to have a TV on in the background. It doesn't matter what channel it's on, as long as it's loud. If your therapist can still hear you, turn the volume up, or walk closer to the tv. Oh, and don't forget to mumble.

2a. A fun alternative to #2 is to answer the phone and pretend not to be home. "Who? Maria? Nooooooo. She's not here. What do you mean I sound like her! SHE IS NOT HERE!"

3. After you've missed several sessions, return to therapy driven by a firm refusal to discuss any psychological reasons for your absence, but be prepared to resume your conversation where you last left it, 5-6 weeks prior. Good opening sentences in this case might be: "That letter never came", or, "That letter arrived", or "Did you write me that letter?".

4. When you are presenting a complicated situation involving several people of the same sex, make sure to use pronouns only, as in 'He told him that if he ever did that again he would call him up and then he would know what he was talking about!'.

5. If you weigh over 300lbs and have multiple weight-related medical conditions so that your doctor and your therapist are on a first name basis with each other, make sure that whenever your therapist attempts to explore your relationship with food you answer: "I don't know why I'm fat. I never eat!". Ideally, you should try to have potato chip or cookie crumbs on your person when you say that.

6. Ask your therapist to make phone calls for you to settle your unpaid utility bills and make sure to say that this is because you do not feel like wasting the minutes on your pre-paid phone.

7. If your therapist insists that you make the calls yourself provided she/he lends you their own office phone, make sure to sneeze or cough into the receiver.

8. Take off your shoes to show your weird and potentially smelly foot fungus.

9. Ask for help obtaining obscure entitlements such as government-issued blocks of cheese. They do exist.

10. If your therapist has never heard of goverment cheese, or balks at your request to use his/her phone for your personal calls, or cracks open a window while you air out your smelly feet, make sure to look outraged and say "But aren't you a social worker?!"

WWFD?

Another patient decides to bring a child to her session. This is a grandmother and the child is 7 years old. She really wants me to meet this kid because, she explains with pride, he is her favorite grandson and she loves him more than she does his sister. And with that, the introductions are done.

He's a cute chubby kid in a blue Yankees shirt and purple crocs. On his grandmother's insistence he kisses me hello on the cheek, then sits down next to her, looks around the room and before I have a chance to offer him paper and crayons to draw, yells 'I love predators!'.

What am I supposed to say to that? What kind of predators, exactly? I make a non-committal sound that he appears to take as a sign of encouragement, and proceeds to list his favorite predators. To my relief, he means animals. To my dismay, the list is long. He moves from birds to fish to mammals, from extinct to fantasy to myth. That would be the Lockness Monster. Apparently, it is also a predator. And lives in Scotland. This leads him to the topics of pipe-playing and men wearing 'skirts'. The kid free-associates beautifully.

Meanwhile grandma, who is not very fluent in English, watches him adoringly and winks at me as if to say 'isn't he wonderful'. In fact, she does say it. She recognizes random animal names but reallly has no idea what he is talking about, and to be honest, neither do I.

Grandma makes an effort to provide some context: 'He likes that show with Mindy'. Only she says 'Ee likes dat chow'.

The kid stops his list long enough to say 'Who's Mindy?'

'Dat girl wid de chow wid all dee animals'

'That's Bindi, and I don't like her.'

Grandma says that Mindy is very cute. He rolls his eyes and moves on to different species of lizards and giant iguanas. We only have 35 minutes left and there are plenty of predators still unmentioned.

Grandma doesn't mind. 'I feel much less depressed now that he's staying with me', she whispers so as not to interrupt the child's list of snakes. 'He makes me so happy'.

'I like rattle-snakes!' says the kid.

Soon I will have to put a stop to this latest wave of kids joining my patients for their sessions. I know I have to. But my patient was so happy to show off her grandson....and he clearly needed someone to list his predators to.

What Would Freud Do?

He'd probably turn on the TV and watch Bindi.

The mummy's accomplice

My blind patient brings her 5 year old daughter to the session. She has no one to watch the child today.

The little girl complains that she is cold, and I lend her my extra-large pink pashmina. Her eyes light up.

While I listen to her mother, the kid proceeds to wrap herself in the shawl. It covers her head to toe. She wriggles around in it, adjusts it, and pretends to sleep. She then takes it off and wraps it around her head like a turban. She models it for me, moving her head this way and that and smiling like Carmen Miranda.

The mother talks on.

The girl takes the pashmina and bundles it up then holds it like a baby. She silently kisses it, then voila! unwraps it and tries to wave it like a flag. It's too long. She gives up and re-wraps herself in it, this time leaving an inch of room for her eyes to peek out. She looks around the room, then sticks her tongue out within the material. She pulls the pashmina off her face and pulls fuzz from her tongue with her fingers, then re-wraps herself, mummy style.

The mother stops talking: "What are you doing?"

"Nuttin..."

From a slit in the wrapping, the cashmere mummy looks in my direction, then winks.

Juxtaposition

My 11 o'clock patient sits down with his usual rustle of plastic bags. He tells me that he has been feeling much more anxious since the weekend.

'I have been feeling a tightness in my head. I think maybe it's high blood pressure. Do you think it could be high blood pressure? I know you can't answer that, but I was just wondering. I'm just anxious. I'm afraid of being sick again.'

My cellphone rings. I forgot to turn it off. It's my mother. I send the call to voicemail.

'I went to the doctor's on Friday but he forgot to take my blood pressure. I wonder if I should go again.'

(My heart is pounding. My mother doesn't usually call me during the week. We just talked yesterday. She said that my uncle is in the hospital with pneumonia and he's not doing well. He's in the last stages of Alzheimer's.)

'I could go back to my doctor. Do you think I should go back? Though I have been taking my blood pressure medication. But my head feels tight. No it's not anxiety! I'm anxious because of it!'

(Could he have died? Why else would my mother call me on a Monday morning?)

'I heard that drinking water is good for high blood pressure. Have you heard that too? No? Well, I have. Though it's hard to drink too much water. I get bored of swallowing.'

(He no longer knows how to chew his food. They have started to feed him by IV because he cannot swallow.)

I take a sip of my coffee.

'I used to drink lots of coffee, you know. Always black though, never liked milk. But now I cut down, I only have a small cup in the morning, with my dry wheat toast. Food is just fuel for the body, not the other way round, right?'

(Oh, how he loved to eat! He used to call himself the human sink. You don't like that? I'll have it. Those leftovers? I'll finish them!)

My stomach lurches. I hold on to my coffee cup.

'So I spoke to my sister. She said that she's coming to see me on Saturday. I said 'ok' but only for a couple of hours, no more. I don't want to have her in my apartment all day long. She talks too much. I like my quiet. I like walking on the boardwalk, looking at the water, thinking. Exercise is good for the mind. Calms me down.'

(The last time we spoke he had just been diagnosed. He told me he wanted to come to NY to run the marathon. He was training, he said. He sounded so normal, so much like himself that I thought perhaps the doctors were wrong, perhaps it was just a misdiagnosis, a mistake that would clear itself out while my uncle, my funny, smart, loud-talking uncle would turn out to be fine.)

Something inside my head spins. It disorients me. I put down the coffee cup and grab the arms of my chair.

'I wish I could walk more, but I get tired easily now. Plus I don't want to overdo it. 30 minutes, tops. That's a good amount of exercise. Sometimes I just sit on the benches and read. I've been reading this book about the history of Japan. Incredible culture. Reading relaxes me, but only history books, or philosophy. Novels are tricky, they can give me nightmares.'

(He was planning a Japanese garden for the backyard. He had a complicated plan for a pond and a bridge and possibly some fish for the pond, maybe water lilies if the could live through the cold winters. Without wanting to, I see him hunched over his architect desk, drawing, drawing.)

It's only 11:20. I want to listen to my mother's voicemail. My patient's face goes out of focus, briefly. I blink twice.

'I think I have nightmares when I eat certain foods. I don't believe that dreams mean anything. Except perhaps for those dreams I had that were clearly warning me of things to come. I'm gifted that way. Always have been.'

(Didn't I dream that someone I loved was dying? Wasn't I hugging my mother in the dream? Could he really have died? So quickly? And if he had, would I feel it, somehow, before anyone told me?)

'When I was a kid, they used to tell me to think about this person or the other before I went to bed, and I usually had a dream about that person. Then the next morning they would ask me what I dreamed, and the person would pay my father. Can you believe that? My father made money out of me, and never even gave me a present for it. Not even a trinket! What a family.'

(He gave me my very first necklace. It was long, with a round medallion, all beaded. It was beautiful. I felt like an Indian princess. I decided that I wanted to marry him when I grew up. I was five. )

The top of my head spins again. I close my eyes, open them, swallow hard.

'And to think that my sister was treated so much better. She was so white though, like you. Looked so European. Maybe that's why.'

(His skin is all freckled, white, his eyes dark blue. A mole on the corner of his left eyebrow. No, the right. No, no. The left. I try not to picture him sunken against a hospital pillow.)

'You may have a point. Sometimes I think I look for things to make me anxious. My whole life I've had to worry about something, now I have nothing. Maybe I'm afraid that I would feel lonely if I didn't have my anxiety. I would miss it.'

(I miss him I miss him I miss him. His back burnt from working in the yard, his smell of sweat, the red mini-morris he had before he got married, his horrible singing voice, his passion for dogs. I want to see him in his bee-keeper outift, shaking bees out from under the sleeves. Let me see him one more time.)

My patient rustles his plastic bags. 'This session went by so quickly. I'll go see my doctor's today. Have my blood pressure taken. See you next week.'

He leaves.

I dial my voicemail. My mother sounds like she has food in her mouth. She wants to know if I can send her my new address again. She seems to have lost it, and wants to send me a package.

Why

Why do you constantly call me without ever leaving a message? I can see your number on my caller ID, it showed 21 times today. I know who you are. You've done it before. What I don't know is why? I am left guessing:

You don't want to leave a message because you feel that I should be answering your call.

You cannot comprehend that I have other patients besides you, but if I must see other people, the least I could do is interrupt their sessions to answer your call. Aren't you, after all, my most important patient?

There is something extremely urgent you need to let me know. Your shoelaces are untied. Your wife/husband/father/mother/child is not paying you enough attention. You heard on TV that Armageddon is coming.

You have all these free minutes on your cell phone and figured it might be fun to have a chat. With me. During someone else's session.

You have an emergency, much like the time you called, breathless with urgency, to tell me that you received a Jury Duty summons for the following month. And you don't like the idea of serving as a Juror.

Or perhaps you just want to make sure that I am still here, waiting for you, ready to welcome you back into this space where you feel safely loved and important, exactly where you left me yesterday and where you will find me again next week.

Unless Armageddon comes.

Bless you!

Life is funny. Just when I was losing faith in my patients' ability to identify and acknowledge me as a real person, as opposed to a nebulous maternal object placed in front of them in a listening capacity, something happened to restore my faith.

I was in session with my first patient of the morning. This is a patient that, sadly, I have had to learn to endure, mostly because he smells. He also happens to be very narcissistic, which means that a previous therapist's attempt to bring up the body odor caused a major disruption in the treatment, ending with said patient dropping out, and wanting a new therapist.

Enter: me.

I have never said anything to him directly, but I did come up with a pretty smart technique to fight the smell: I spray industrial quantities of Lysol before he enters. As a side-note, I hate the smell of Lysol, but it is pervasive enough to numb my sense of smell for about half a session. The other half I endure. I have tried holding my breath for the duration but 45 minutes really is too long, hence the Lysol.

After four years as his therapist, I have learned that this patient really wants very little from me. Mostly, he needs to come and talk, uninterruptedly, for the entire duration of his session. Often he starts talking when we're still in the waiting room, and continues talking on his way out the door. This is the kind of patient that understands a session is over only when I get up from my chair, walk to the door, open the door, and start walking out. On him.

Anyway.

What he does is he talks about everything that has or has not happened to him in a given week. Any interruptions on my part, I have learned, bring on extreme anxiety and at times confusion. The general idea is that he needs to come and dump his thoughts onto me, as his maternal object, and this will make him feel less adrift. However when I say something, I stop being an object and become a person. He does not like that. It annoys and confuses him. Imagine you are talking to the picture of a loved one. Maybe someone who has passed away. And suddenly, the picture talks back! You can understand how it might be disorienting. So I have learned to be quiet, and listen, and try not to space out too much (that's true, therapists do space out! but that's for another post).

There is an old joke in the field about the 'cardboard cutout' therapist. That is the kind of therapist that this patient requires, someone who is there, but does not have dymension, or a mouth from which to speak. A listener made of heavy duty paper. This is one of the most difficult things for me to endure as a therapist. Forget the smells. Forget the heart-breaking topics. Forget the rage, the depression, the traumas. The cardboard thing depersonalizes me and fills me with un-therapeutic resentment. It forces me to juggle my countertransference so I can be what the patient needs me to be. Nothing new, only hard.

This is until this morning, when fumes of recently-sprayed Lysol tickled my nose and, while the patient talked, I sneezed. The sneeze was followed by a short silence, at the end of which there was a curt and annoyed "Bless you!".

I felt momentaily confused and disoriented. It was great.