Mother Knows Best - Mere Psychotherapy, Part 3

It’s a joy to be hidden, and a disaster not to be found" ~ D.W. Winnicott

I hope you’re proud of yourself for the times you’ve said ‘yes’ when all it meant was extra work for you and was seemingly helpful only to somebody else." ~ Mr. Rogers

Abbi is 13 and her mother has brought her to counseling after Abbi’s mother learned that Abbi had been sexually exploited by a predator who Abbi met online. I routinely schedule their first appointment to meet with Abbi and her mother at their home. Not surprisingly they insist on having a female therapist. I am able to have a detailled and civil conversation with them lasting the entire therapy hour about (it’s not as simple or obvious as it seems) why having a female therapist is important to them and what factors into an effective (or potentially restorative!) therapeutic relationship.

At the end of the first meeting I negotiate to return to administer a trauma assessment and allow Abbi and her mother to discuss if they want to continue to work with me thereafter. I call my supervisor after leaving the first appointment, searching for affirmation that I’d made an ethically sound decision. My supervisor raises no objection to scheduling the trauma assessment, or the discussion that took place, but adamantly encourages me to refer the case to another agency that could provide a female clinician.

I don’t like the don’t like the dismissive blase’ tone in my supervisor’s voice. We hang up and I toss the phone onto my passenger seat. Referring Abbi elsewhere doesn’t feel right. This is a very rural community and it might take a month or more to get other services in place. I have a long drive tonight and plenty of time to think.

I show up the following week for the trauma assessment, score, and share the results with Abbi and her mother. They identify that they’d like to schedule another session for Abbi and I to continue. I’m curious, and speechlessly surprised, given that Abbi’s mother is as shrewd as she is teeming with feral anxiety.

About midway through our work time together I had made a report (required by law) to Child Protective Services. Enter the wrath of a mother scorned.

Abbi is moved directly from school to a group home. Immediately her mother phones me for “help”, of course I am limited in what I can disclose. Within a day or two her mother begins assailing me with a daily barrage of harassing voice messages ranging from threatening litigation to detailed and vindictive description of how my “treatment” is making her daughter worse. There is no shortage of creative profanity in either case.

The calls continue into my “vacation” and I decide to make a return call to Abbi’s mother. To my own surprise I muster the gumption to cut her off mid-sentence and pointedly remind her that at this time I’m not legally required to speak to her (the mother) and probably would be advised against doing so. “This call is a courtesy to you, because I’m trying to help your daughter.” That got her attention. More unstable than her daughter? Yes. Still a mother who doesn’t want to lose a child? Also, yes. I Proceed in the following weeks to meet with Abbi at her group home.

Around that time I bring up Abbi’s case in group supervision. My supervisor’s only response was something to the effect of; “Oh, you’re still seeing her? I thought you’d referred them out?” Somehow that comment is less than unhelpful.

By no small feat, and not without setbacks, I’m able to make some progress with Abbi. It takes more than a small miracle to get Abbi’s mother and father in the same room together, let alone participate in anything resembling “therapy.” I don’t believe in coincidences. Yet, each of those things happen.

For several meetings Abbi’s joy is able to shine through her unkempt hair. her mother’s parting phrase will forever be etched into my memory; “there’s a light at the end of our tunnel and some of that is thanks to you.” I am relieved and exhausted. It isn’t until much later that the weight of the mother’s words strike me. The same voice that venomously and vehemently cursed, threatened, and harassed me only a few short months prior now thanks me. Persistence has its benefits. It also has a cost, with an unaffordable interest rate.

Afterward:

A lot detail got missed in the telling of this story. There were layers and layers of “the ball being dropped” by DFCS, the legal system, a naive social worker (unwittingly pitting me against the until now absent father), navigating the truly insidious relationship between the mother and father, a dis-concerned supervisor, and aloof psychologist managing a group home.

I would like to point out that the supervisor here is a different than in the It’s You I Like story. This story is where I learned about anti-mentors. A couple years later this supervisor in this story would refuse to sign any and all documentation regarding my state licensure due to “my great potential, but severe ethical concerns.”

My response was to subsequently write a letter to the former CEO of the agency I was working at at the time of this story — she had since “retired” to private practice. The contrast was quite stark, the former CEO was delighted to hear from me and not only submitted the appropriate forms, but had them mailed within 3 days — including the weekend.

Reflecting on this story again makes me admire my the fortitude of my younger self to “do the right thing”, or at least try my damnedest. I have no doubt that the supervisor held a vendetta against me. What an irreverent slap in the face to be defy your supervisor and have it turn out fantastic for the patient.

Did I do the right thing for the patient? I think so. Did it cost me a tremendously unknown amount in terms of furthering my licensure and career? Unquestionably. The interest rate for persistence is compound and the world is not always kind. Unfortunately your merits and obligation to do no harm are of no interest to the personal politics of a greedy world. I once saw a motivational poster that said “you’ll never regret doing the right thing.” That’s bullshit.

Fortunately, my list of regrets in life is pretty short. Almost all of them though, come from the unforeseen consequences of “doing the right thing.” Would I make the same decisions again with Abbi? Of course. Why? Because egregious and unethical practitioners don’t get to win. My life and my practice will continue to be my protest against them. The personal is, after all, the political.