In Treatment 2 - April, week 5

Paul is pacing. He straightens a picture over the couch. April comes in.

April says the stairs are hard for her. She asks if he knows what she likes best about him and she says his eyes, that she has liked them from the first visit. She winces when the port hurts for a moment and says she doesn't remember them putting it in. She asks if he saw it. Then she thanks him for taking her. April tells him she has been having many discussions in her head the last 2 weeks. She says even in her head, he doesn't say much. Except he says to her, in his head, that of course it is all worth it if she is making herself and others happy. 

April apologizes for being difficult. And she thanks him again for taking her to chemotherapy. She says she had a bad night last week and wanted to call him but didn't because she felt that he needed a break because he had cancelled. She tells him she talked to her best friend Leah. She had dreamed she had died. pal suggests that maybe it is only the part of her that resists help died. She woke up with a fever and when her friend arrived she called 911. Her friend had not known she had cancer. Her friend was surprised but came through for her. She and Leah have looked after each other for a number of years. Paul suggests to her that the people in her life -- Leah and Kyle -- have stood by her and that she only allows in people who are loyal and will stand by her. He wonders why she picks friends who will be there for her and then doesn't tell them what is happening to her until she has no choice. He asks if she believes there is a finite amount of help people will give her so she must carefully choose when she asks. 

April asks about the cancellation last week. She says it was hard for her and she wonders what happened. He tells her he had a family emergency. But she is not satisfied with that response. He tells her if he could have been there for her he would have been. She asks how old he is. She says her hair has started falling out. And she still has not told her parents. She would like for Paul to tell him. He says she could ask them to come with her to therapy. She wants Paul to take her to her next chemo appointment. Paul asks why not Leah. She does not want her parents to take her to chemo -- she wants him to. He tells her he is her therapist and she needs a therapist. But she also needs a caregiver and he cannot be both. April believes it is because he can't take seeing it. And she sobs. She thought Paul was going to take care of her. She thinks that because he won't take her to chemo, that he is dropping her. She needed him last week and he wasn't there and he lets her know his father died. She sits up and wants to know how he let her go on like that. She asks if they were close and he says not really. She says she is sorry how hard it has been for him. She tells him she wants to just feel bad for him for a bit. 

Paul turns again to the chemo session tomorrow and who will take her. She gets up to leave. Paul asks her to let hi know who will take her. She leaves. She hesitates in the waiting room then leaves the office.


Last week (2 weeks ago in In Treatment-land) Paul took April to her first chemo session. Because she fainted in his office and because she has told so few people about her illness, he took her. But in addition, she posed a serious danger to herself if she did not seek treatment so his action is actually justifiable on that count.

This week we see how much his action meant to April. Her attachment to him is now very clear, and in fact seems to reveal that she is seeing him as the super-good father or perhaps lover, the man who will be with her no matter what. Which of course would allow her to continue to avoid telling her parents, avoid having to deal with her own father, and avoid having to allow another person to care for her, thus preserving the reserves of caring held by her friends and likely by her parents as well. 

I know that some people believe that Paul should not have acted on his impulse to take her to her treatment, and though I understand that point of view, I still believe that his action was justified and the consequences worked through. Though April has apparently developed an intense transference response, this is not altogether a problem. She needs to be able to try out being dependent and then to allow herself to turn to friends and family to provide the care she needs while Paul gives her the therapeutic safe harbor that she also needs.

I was asked in email why Paul didn't call her parents and tell them or ask them to come to a session with her. But April is not a minor so it would be a violation of her confidentiality for him to contact them without her permission. His suggestion that she invite them to a session is a good one and she has not yet rejected that outright though she firmly said she did not want her mother coming to chemo with her.

Both Mia and April pushed Paul to be the person who will take care of them tonight. And both want him to be more than a therapist to them.


© Cheryl Fuller, 2016. All  rights reserved.