I’ve often wondered how Sam would describe the same circumstances, so I tried to put on her head and write the beginning again from her point of view. Here’s a stab at that:
Matt was a 53 year old married father who was referred to me by his son’s therapist. His son was having major adjustment problems that was disrupting the family and he needed someone to speak with about this, other than his wife, with whom he was not always on the same page about what to do as parents in this situation. He came to his first session with three goals for therapy: to better understand his family dynamic and the disruption caused by his son and how to handle that; to foster a re-connection with his wife, and, because he was intrigued by my training in psychoanalysis, to “get to know myself better.”
I found him to be witty, smart, and self-aware. He asked about my credentials and my psychoanalytic orientation. He made one joke, which he described as “a haircut on a Bill Cosby joke,” wondering what happens in analysis if you peel back all the layers and realize you’re “just an asshole.” While I noted this as a joke, I also considered that it may be a fear of his since it came up in our very first session.
But that was not borne out. He was emotionally insightful, broadly knowledgeable, clearly a loving, if distressed, parent. He described a rich dream life and was a uniquely qualified narrator of the intricate action and imagery in his dreams, though he struck me as remote from his feelings in the dreams. While he searched for meaning in the plot and the implicit connection between his waking experience and his unconscious mind, I wondered more about his feelings in his dreams, which he had difficulty recalling.
His problems with his son were most on his mind. In one session, in fact, he received a call from the local police wanting to bring his son in to answer questions about an incident that had taken place at school. I observed him carefully navigate the conversation with the police officer, asking questions in the way a defense attorney might, and finally telling the police officer that unless he intended to arrest his son he would not bring him in to the station.
In another situation, first his son called him while in session to tell Matt that he hadn’t done anything wrong and then, moments, later the principal called to tell Matt to come immediately and remove his son for a suspension. What Matt was going through moved me deeply. That I was a witness to parts of it playing out while he sat on my couch was extraordinary. I asked him why he checked his phone during sessions and he replied, “I’m living my life expecting a rain of other shoes.” His easily diagnose-able and manifestly appropriate anxiety was that there was always another shoe about to drop with his son.
I felt myself very moved by Matt, so one day when he said – I think as a casual line expressing the positive thought that we were connecting so well – that if we’d met on the outside rather than in therapy he didn’t think we’d be friends, I didn’t query that as much as I should have. Instead, it felt like a trigger to my own fear of not being enough. I’ll discuss my childhood and the source of that fear later, but in my perception, he went out of his way to tell me that our connection was limited, my appeal or value was limited, and that I wouldn’t have merited a connection with him had we met in the real world. Months later, I told him that my internal reaction was “why the hell not?” I don’t know why I had to tell him that other than that I couldn’t let go of his original question, a kind of narcissistic injury, an anger I couldn’t keep in.
I believe that my internal reaction to him saying we wouldn’t be friends and my feeling “why the hell not” led me to try to somehow to cure my injury by working to make his statement untrue. That’s why, not long after, I started talking about talking about our relationship. As an analyst, the relationship between therapist and patient is important, a consciously safe microcosm in which to explore all the patient’s relationship dynamics, and it’s important for the therapist to acknowledge and explore their own feelings and reactions as part of that. Transference and counter transference.
The problem was that I had another agenda, even if I wasn’t quite conscious of it. I wanted to rush that bonding because it might salve my injury.
Boundary Violations in Psychotherapy - A Personal Case Study 