In Treatment 2 -- April, Week 6

April is on the far end of the couch. She is angry. Paul says he is afraid that what happened last week changed their relationship. April says they have no relationship. She says she has dumped people for less. Paul suggests she wanted to tell him in person. She is furious with him. Paul says he had to tell her mother because she was delirious. She was taken to the ER with a very high fever. He tells her if it happened again he would do the same thing. She tells him she was leaving therapy. 

Paul tells her he did not think it was right to leave her there alone on the brink of death. April says he does not understand what he was to her. Then she asks what her mother said to him when he called. He tells her that her mother was surprised because she didn't know April was seeing anyone. She would meet him but she did come to the hospital. He says he recognized her because they look alike. Paul tells her what he told her mother. April asks if she cried or was angry. Paul says not at all. That she had a hard time believing April would keep something like that from her. They spoke for just a few minutes because she wanted to see April.

April says she woke up to find her sitting next to her. That it felt like when she was a child. She feel asleep and when she woke up she was still there and glaring at her as if she had gotten sick deliberately.

April tells Paul he broke her heart, worse than Kyle. She went for coffee with him and thought he looked like a boy and that she wanted a man like Paul. Paul says last week he was heroic and good and today he is her betrayer. Paul says that as a parent he knew he had to call her mother. When he made one decision that did not agree with her, he becomes worthless. No one can live up to her standard because she cannot live up to it either.

April says that her friend Leah lets her down and that's okay because she knows she loves her. Paul says Leah got in when they were children, before she closed the gate to others. Paul suggests to her that she is someone with heightened emotional responses that she has been working overtime to bury. He asks why she thinks her mother used to tell her to keep her feelings to herself and suggests that she didn't want her to be like Daniel. He tells her she has been living for a long time in reaction to her mother and doesn't really know herself. Her mother was agitated and she couldn't deal with her but when her father came he was perfect and got her what she needed. He sat by her and told her she is a strong girl and will beat it. Paul suggests he is comfortable in hospitals while her other was out of her element.

She tells Paul he over her. He is puzzled and asks what she means. She says because he called her mother. He pulled rank on her and called her mother. Paul asks if she thinks of herself as an adult and she says not really. Paul says maybe that's because she didn't have time to be a child. She says their work is done and Paul says it is just beginning.

Paul tells her that he wonders if maybe she came to see him so that he would tell her mother after she had gotten chemo, so that she could be the hero child, the perfect child who caused no problems. She says she thought the cancer would clear of all of this, but it is worse inside, that she no longer believes in anything any more. Paul reminds her of her dream last time, where she is dying. He says he thinks maybe it is about a rebirth, the dying of the old self. He asks her to call him when she gets the results of her blood tests. She asks him to help her get up.


This season is starting to feel rushed -- too much accomplished in a short time. I am finding I have to imagine that the time span between sessions is longer than the story line suggests. I understand they are meeting the demands of the schedule but this really is very condensed.

April is in the grip of a fierce complex about perfection, fierce enough to kill her in her efforts to be the perfect undemanding child. It is a possession really when we are gripped like this, rather like being under a spell or enchantment and such a spell must be broken if she is to survive. We might guess that April has always been furious at the demands her brother makes on her mother and the way that has deprived her of much needed attention. Her solution has been to strive to be perfect, in absolute contrast to her brother with his inability to control his emotions and the threat of violence hanging over the family from him. If she can be perfect, so perfect that she even takes care of herself -- as when she made herself not cry when she fell from the window and then didn't even tell them what had happened, or in her current effort to deal with her cancer alone and not tell them until she has managed to deal with it -- if she can manage this, then she can allow her mother to know and her mother will appreciate her and love her. But this is a deadly pursuit. Which Paul understands. Acting out of his own experience as a parent and knowing her mother would not want to be left uninformed, he broke it open. And yes, April is angry because he thwarted her perfection project. But I believe he is correct that she wanted Paul to be the vehicle for informing her mother because she needed her to know. 

Caught between her mother, who by April's description flutters around trying to get information and cannot hide her own distress, and her father who meets her physical needs and tells her how strong she is, April is not being met where she is -- which is frightened, sick, depressed. Only Paul really sees this and she is furious with him. But she cannot get what she needs from her parents unless she is willing to let them in, let them care for her. And allow Paul to help her find her way through this so that she might have a better life going forward. His reference back to the dream in the previous session seemed spot on -- that what was dying was the perfect child she could never be, a death which must occur in order for her to have a full life. 

Next week is the final episode of the season. We would expect work with a patient like this to go on for many more weeks. So I do not expect the conclusion to be terribly satisfactory. If April decides to remain in therapy, she can do very well.

There is a lovely book by Jane Wheelwright, who was a Jungian analyst. The book, The Death of a Woman, recounts Wheelwright's work with a woman in her 30's who was dying of cancer. They worked through her dreams and it is testimony to a kind of work that can be done.


© Cheryl Fuller, 2016. All  rights reserved.