From Both Sides of the Couch

A therapist reflects on her time with patients, and her time as a patient.

Cultivating Our Ideal Amount of Patience

For us to find a balance between placidity and 'wanting it now' is a process

I was an easygoing, placid child which most likely had its roots in the terror of my father’s sarcastic, cruel tongue. I had a fear of being the object of his verbal lashings when he was drunk and parading around the apartment in an unpredictable rage. That his anger was unforeseeable was more frightening and caused me to be on edge most of the time; it was safer to be a good girl on a consistent basis and that way I thought I wouldn't give him a reason to berate me.

Unless he purposefully sought me out for one of his infamous “tests.” It could be a game of chess where from the first move I was wrong. “THIMK,” he would hiss, his icy blue-eyed stare meeting my timid brown-eyed one. This mangled version of “Think” was his way of making me take back my move. I stared at the board, praying for the correct move to come down to me from the heavens.

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I learned patience, not only in playing chess, but as I read voraciously in my pink-and-white bedroom at the other end of the apartment from my parent’s room. I learned to stay in there and remain invisible and I learned the art of impeccable timing.

After my father lost his job at a high-profile Wall Street firm due to his alcoholism, our family’s financial situation was compromised and I learned not to ask for anything except perhaps for my birthday or Hanukkah . Affection was left to be doled out by my mother as my father remained a prisoner in his bed, trapped by the depression that the alcohol had been medicating.

But my mother was now supporting our family with her knitting store six days a week. My brother and I were now latchkey kids — sort of. We had to carry our own keys to let ourselves into the lobby door and the front door because we never knew if my father would answer the buzzer.

So patience became a necessity. For material things and beyond.

I've carried this virtue of patience with me into adulthood. This trait has served me well in some aspects of my life, but not in others. At times I passively wait for things I deserve to come to me when I should be assertive and actively pursue them. In a prior job I watched a promotion go to a colleague because my supervisor wasn’t aware that I was interested. I didn’t get a raise because I haven’t asked for it.

When I was younger I had crush on a guy whom I played co-ed softball with for a season. By the time the next season started he was dating another woman whom he eventually married and had a family with. My friend chastised me, “Gerri, Sam* had a crush on you for all of last summer. How could you not have noticed?”

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 Many of my patients wish for immediate gratification. When the psychiatrist at our clinic tells them that it will take between three and four week for them to feel the beneficial effects of the medication, I need to encourage them to stick with it, that hopefully they will feel better once the meds start working.

I also need to explain to them that this might not be the right medication for them and that there is the chance that this medication might not work. Trial and error is the only method we have available to us right now. Upon hearing this bit of news, patients get even more discouraged. It’s hard to convince them to stay with it. When they are suffering from depression, four weeks seems like an eternity.

Food and gambling in the form of $1 or $2 scratch-off lottery tickets are other areas in which I find patients have difficulty delaying a need for immediate satisfaction. They describe to me that eating a couple of sweet donuts or winning $5 from the scratch-off gives them a high that very little else in their life does.

I try to get them to identify how long that high lasts — until the sweetness of the donuts is gone from their tongue or until they trade back the $5 for more scratch-offs and lose their winnings. And the remorse sets in. “I shouldn’t have eaten that.” or “I shouldn’t have spent the $5 I won on lottery tickets. I knew I would lose.”

It may take some time before they can acknowledge that the high is fleeting and that’s why they go back for more. In the case of the eating, the calories — and sometimes the weight —  add up. In the case of the scratch-offs, the amount spent far outweighs the amount won.

I ask them “What is missing in other areas of your life that you are turning to food or the scratch-offs?  Often the first reply is “I don’t know.”

Some remain silent. Some change the subject. Some persist in tackling the question.

This is where I must adapt my style and pace to that of the patient. For them, connecting the dots, becoming conscious of patterns of behavior that have grown roots can be frightening. I need to be careful not to proceed too fast, or too slow.

I can never emphasize enough to my patients that therapy itself is a process. And if they continue to work in therapy, a certain amount of patience will come to them.

I think of the times when I have lost patience — in the middle of a session and walked out — or with therapy in its entirety and wanted to quit impulsively. And I realized those are the times when I need to call most strongly upon my ability to be patient for I have a lesson to learn.

Being patient all of the time has the appeal of a wrung-out dishrag.  Wanting everything when you want it is reminiscent of a charging rhino. Finding a balance between patience and immediacy calls to mind a butterfly emerging from its cocoon. Once the butterfly is out of its cocoon, this silky covering is obsolete, never able to fit the same way again.

 

* Names have been changed

Gerri Luce is a licensed clinical social worker who publishes under a pseudonym.

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