Week 5: FRances

Frances is sitting on the couch -- she and Paul are silent. She asks if it is normal for it to be so hard to get started. He says it is quite common. She wants to know if she said nothing would he say something. He says eventually he would say something. She asks what the longest silence has been and he says around 20 minutes. He asks her what she has been thinking about.

Paul asks if she looked at the results of her test yet. She says she is not ready yet. She says she is thinking about Izzie. She has been getting texts and phone calls from her. He suggests it is time for her to see Izzie. She says she did -- she took her things and went to her school and ambushed her. She saw her on the steps with her friends and how she looked grown up. It was surreal, like looking into the future. She looked confused when she saw Frances and she went to being her sullen teenage self. She licked her lips a lot and Frances offered her chapstick and she left. Izzie texted her after that -- telling her she should call Trish who now looks like a skeleton. Frances is upset that Izzie texts her about Trish and she sounds jealous. Paul asks if she did call Trish. Frances says she went out and got laid instead. She says it was a 25 yr old man, the first since she left her husband. He is in the cast. She had gone out with the cast and he kept buying her drinks and after the third she asked him to show her where she lived. She tells Paul that he loved her breasts. He kissed and touched them. She asks Paul if he is shocked. He asks if she is trying to shock him and she says no, but she knows how squeamish he is. Paul wonders why she thinks he is squeamish. Frances says his whole life seems squeamish to her and she understands why Trish loved him, that Trish loves repressed men.

They skirmish about why she went out and had sex when she did. Paul asks if she had opened the test results, she says no. He indicates she talked about how good it felt to her to have her breasts appreciated. And if the test were positive, she would have to decide about having them removed. She says she left during the night and when home. She says she was glad to be alone after the intimacy. She sat and stared and the envelope but couldn’t open it because she saw it as a potential death sentence and no one would be there for her. Trish has friends and Izzie. After another little skirmish, Frances tells Paul that Izzie also had sex that weekend. She thinks Izzie will feel doomed by breast cancer. Trish tells her that there is an 87% chance she will get cancer if she has the gene. Paul asks if she would rather have cancer than have her breasts removed. She says yes, because Trish did and it did her no good. She thinks Trish did it to spite her mother, to spite her vanity. 

Paul asks if she really thinks if she asked Izzie to be with her when she opens the results she would say no. She hands the envelope to Paul and asks him to open it. He says she should open it. She says he doesn’t have to tell her, just open it. So he does. She asks what it says and he tells her to read it. She does and discovers it is negative. She says she is very relieved. Frances says this means Izzie too, that cancer is no longer her inheritance. Paul says not only is she free of fearing Izzie will meet this fate but she can see her sister. Frances says she can’t see her because she would have to tell her that she is negative. Paul tells her that she would likely be relieved, that would be a normal response. Paul tells her she needs to see her sister before she dies. She has no reason not to, Frances says she will be hurt. Paul says no. He repeats she needs to see her sister before she dies. Frances asks what happened between them, why he is still in love with her because that is what Frances says. Paul says no, that was not the case. Paul says Frances is so angry with her and she is afraid she will run away from her. She says it will kill her to see her like that. Paul says Trish is the one who is dying, not Frances and if she doesn’t see her she will always regret it. Frances leaves.



Silences at the beginning of the session are interesting. In my experience the patient will usually say something within a moment or two. Learning to accept the silence is important for therapists and feels odd to new ones. I’m not sure I would be able to hold it for an entire session. More likely I would do as Paul says he has done and eventually ask what the patient is thinking. It is a fine line between allowing the silence and rigidly refusing to be the one who breaks it and each therapist has to find her own place on that line, and reflect on what she feels each time. 

This week we see more about Frances’ very conflicted feelings about her sister. Her jealousy that Izzie spends time with her and not with Frances. And her fears about seeing Trish and not being able to rise to the occasion. Frances was not able to handle being with her mother when she was dying and fears she cannot handle it with Trish either. But rather than face into that, she tries to lay it off onto Trish, to convince herself that Trish would feel resentful if she learned that Frances does not have the gene and is thus far less likely to suffer the same fate. She does not want to consider that Trish would be happy for her, because so much of her relationship with Trish is founded on jealousy and resentment. We have heard from Frances that Izzie prefers Trish, that Trish was the person who fixed Frances up with her husband because, Frances believes, she wanted to keep him in her world and she now believes he also tends to Trish. And we know from before that their mother chose Trish to take into her bed when they were small. 

Paul’s confrontation of Frances at the end of the session seems justifiable to me, though it could be seen as a technical error because he abandons a neutral stance by being so firm with her about the necessity of seeing her sister. Frances responds to this, as she does habitually, by first turning on Paul and implying that he was in love with Trish. For Frances, it likely feels that Paul too is taking Trish’s part against her by pressing her so hard to see her and so she strikes out at him. And when that does not work, she leaves.

© Cheryl Fuller, 2018. All  rights reserved.