Therapist: “But you know what? You don’t have to be in such a
lonely place anymore. You have different choices available to you today.
You can reach out for help, and you don’t have to rely only on
yourself.”
Alec was moved by that discussion. He was able to develop a new
perspective and see that not only does he have capabilities and can get
through crises, but also he does not have to rely exclusively on
himself. On the heels of that discussion, Alec started expressing
greater confidence in himself and therapy and decided to postpone
ketamine treatments. He also thought that ketamine treatments would
interfere with his ability to tell whether his success had anything to
do with his own capabilities as opposed to the ketamine therapy.
Thus, he wanted to test himself, learn about his capabilities, and
develop self-esteem based on dealing with challenges.
Indeed, as he was no longer living under his parents’ roof, life
presented him with several such challenges. First, he discovered the
complexity of departmental politics. Reporting to more than one
supervisor, he negotiated boundaries as both of his bosses placed high
expectations on him. Anxious, he worried about his ability to meet these
multiple deadlines, especially when he discovered that one of his
supervisors tended to be hypercritical. He talked about his fears, his
fluctuating awareness of his capabilities, and a helpless expectation of
failure. Gradually, he came up with a few time management strategies and
discovered that some of the junior faculty members struggled with
similar challenges. He was fearful of being open with them but gradually
decided to take that risk, and to his surprise found solace in sharing
experiences about work stress and hypercritical coworkers. Due to his
reliable productivity, his collaborations within the department
strengthened and he developed a solid reputation.
Dating was a different story. Initially, Alec was hesitant about the
possibility of being in a romantic relationship. He worried that
romantic relationships would require compromises and the acceptance of
failures as well as the imperfections of a prospective partner. These
were hard for him to imagine, as he anticipated getting annoyed with
prospective partners. He imagined that relationships are “too much work
and not enough fun”. In sessions, Alec explored these experiences. They
reflected a fear of rejection that was all too familiar to him from his
disappointing dating experiences in the previous phase of his life. To
cope, he hid behind the veil of a pessimistic outlook on his romantic
future. Such a defensive retreat into pessimistic certainty was familiar
to him as he used to rely on such a maneuver in a different area of his
life – his career. By considering dating, he also was stepping outside
of the comfort zone of the predictability of his own fantasies and
projections. Dealing with real people was far more complex and required
acceptance of the uncontrollable and unpredictable nature of their
feelings and actions. Pessimistic certainty was more predictable and
offered a promise of control, though at a price: missed opportunities. I
thought that dating could invite him to explore his fears, wishes,
expectations, and personal limits, and also help him accept the
unpredictable and uncontrollable complexity of relationships. I thought
that life experiences, coupled with exploration of them in our therapy
together, could help him start seeing himself and his prospective
partners as real people with complex and, at times, contradictory
feelings.
After talking about his hesitations, he started dating and discovered
that women found him desirable. They thought he was good looking and
witty, and his job made him an attractive catch and a viable
relationship prospect. And then he met Kate. Kate had a successful
career, and he liked her vivacious disposition as well as her caring and
patient attitude toward him. He was in love and felt happy to discover
that Kate loved him as well. His hesitation about long-term
relationships gave way to a dedicated interest in making things work
with Kate.
The relationship was
progressing and they moved in with each other. That felt like a natural
step in their connection as they had also discussed long-term commitment
and the possibility of getting married. This brought about more
opportunities to deal with disappointments. Kate was traveling for three
weeks – first, for purposes of her job and afterward with her
girlfriends. She left her three cats with Alec. Alec felt angry at Kate
as he did not want to be taking care of three cats. He seethed with
anger, feeling that he had become a “glorified cat sitter” while Kate
was away. This felt infantilizing and humiliating and brought up
memories of his domineering mother who used to make decisions on his
behalf. Close to breaking up with Kate, he mustered the courage to speak
up. Talking about it in therapy allowed him to entertain the possibility
that Kate’s intentions were different from the outcomes of her actions.
He respectfully expressed his feelings to her, negotiated with her, and
learned that Kate felt overwhelmed with her job and hadn’t thought
through her decision. She acknowledged that she was very particular
about the cats, trusted Alec with their care, and felt genuinely
remorseful that her decision hurt Alec. This was a new experience of
effective negotiation, forgiveness, and reconciliation. The breakup was
averted as Alec learned that he was not powerless and, Kate, not
heartless or controlling. He no longer felt doomed to lose the woman he
loved or destroy the relationship through his angry behaviors. He was
discovering the ability to negotiate and forgive. Accepting his own
imperfections and feeling that he could be accepted despite them allowed
him to feel more engaged in the relationship with Kate. He started to
feel a sense of agency and ability to choose his own future and make his
own choices. He discovered that history does not have to repeat itself.
Alec started contemplating proposing to Kate. He felt that they had good
chemistry and was reassured by how well they resolved their
disagreements. He shared his plans in therapy and he knew, based on
informal discussion of the matter, that Kate would like to marry him,
too. Work was stirring up disappointments that he was able to tolerate
and learn from. Planning to build his own family, he started exploring
the possibility of getting promoted and increasing his income. However,
he discovered that this was not an option and felt disappointed.
Weighing other courses of action, he started applying for different
jobs, hoping to seek more gainful employment. His pragmatic investment
in the long-term outcome was different from his past tendency to retreat
and give up. He learned from his life and trusted that the future had
something good to offer him.