In Treatment 2 - Mia, week 5

Paul's father has died.  Mia arrives. He closes the doors to the rest of the apartment and puts on his father's watch and places his father's med school diploma on a shelf. Mia pours some of her water into a plant in the waiting area. Paul comes to the door and Mia asks if he is all right. She expresses condolences.

Mia asks again how he is. She found out because she asked his lawyer's secretary and because Paul had never cancelled an appointment.

Paul says it is ironic because they had been talking about her father last week. Mia wants to know what he thought about her card. He tells her he has not yet opened his mail. Mia presses him again about how he is. Mia acknowledges that she has been difficult and says she wonders who he has. She says she can see loneliness in his face. 

Paul wonders if she is worried that he can give her his full attention today and tells her that she needn't worry about his feelings.He asks if she is upset that he had cancelled last week. She admits she was annoyed until she found out why. She says everything has changed now because she is pregnant. Paul gets distracted looking at the snow falling. Mia says their timing is strange -- 20 years ago he was having his first child when she was losing hers. And now she gets pregnant as his father has died. She tells him Bennett is not the father. Paul wonders about the connection between finding out Bennett and his girlfriend are having a baby and her own pregnancy. Mia denies this and says she thinks it is the musician. She thought Paul would be happy and they could celebrate. She wants him to tell her she will be a good mom and that he will be there to help her with decisions. Paul asks if it is he that she wants to help with these kinds of questions. She says her sisters are married and her mother isn't available, that her mother likes her sisters.

Mia keeps trying to talk with and about Paul as if they were a couple. She is certain no man her age will be interested when she has a young child. 

She notices bronzed baby shoes on the shelf and she ass whose they are. He doesn't answer and then she accuses him of being bored, of wanting him to leave. She spins a fantasy of meeting him at a bar again.

Paul tells her that he thinks there are two issues -- one of her pregnancy and the other of not having a partner. He wonders if she is worried that there will be no one available to her when she has a child. She says picture perfect would be herself, a a baby and a man. He asks about the man and she again becomes angry and accuses him of thinking she can never have anyone. Then she leaps to wondering why she got pregnant because she claims not to like children. Paul suggests she doesn't want to have the baby. She asserts this is her last chance, no matter her feelings. Paul says this is how she was 20 years ago. She admits that is true, that then she didn't want to have a baby, she wanted an abortion. Paul reminds her that she is not in the same place now. So the question really is does she want to raise a child if she has to do it on her own. She asks if Paul will help her. He says as her therapist. But she says she needs his help because he is the father. Paul points out the fantasy, that she would like him there with her. He asks if she has told anyone. She says no one. She admits she does want to pull him in.

Mia says at the end of the hour that he should take the day off and asks that he be happy for her.


From the outset we have seen Mia's erotic transference toward Paul developing and this week it becomes more obvious as she tells him she wants him to be with her and raise her baby. Only erotic doesn't quite capture  what it is that she wants, which is for Paul to be her father, and even her baby's father. Remember last week she said she could never find another man as good as her father. And this week she tells Paul he is the father. Father or lover are the ways she knows men.

So throughout this episode we have the whole issue of father weaving in and out of the session -- Paul's now dead father, Paul as father, the absent father of Mia's baby, and Mia's father are all present in the room.

In a situation like this, with a patient who wants the therapist to say what she should do, who wants the therapist to approve of and endorse what she does, it is especially important not to take a stand except in favor of the patient do what she wants to do. remember that Mia started out telling Paul it was his fault she did not have her baby 20 years ago and it is easy to imagine she would/will do the same thing this time. Paul was quite deft handling Mia this week.

Notice how absent mother is in the session. Mia doesn't like talking about her mother, believes her mother does not like her and doesn't even really want to talk about herself as a mother. 


© Cheryl Fuller, 2016. All  rights reserved.