Janet's phone buzzed and she started down to see a message from Abby:
I know you said you needed some space, but Luka and I hope everything's going OK. Don't feel obligated to call.
Janet smiled and decided to press Abby's number, and after hearing some stories about what cartoon Abby was stuck watching today and Joe's terrible threes (a continuation of the terrible twos, Abby explained), she told her friend and sponsee where she was headed.
"Therapy? Wow, I never thought I'd hear that word from you."
"That's funny, Abby," Janet quipped as she walked to her car. "I used to say the same thing about someone else, remember?"
"Oh crap. Yeah, I guess between mine and Luka's pasts I walked right into that one. Do you really think it's going to be that bad?"
"Well, maybe I am overreacting. This counselor seemed nice when Caitlyn and I had our first appointment three weeks ago, but today's my first individual session, and I guess I'm just nervous."
"How was the first appointment anyway?" Abby asked. "Actually, hold your thought for a minute...Mom, really, I don't want any more chips and dip right now; I have to save room for dinner."
"Sorry, Janet," she continued. "Mom is visiting this week and has taken over all the food prep. I mean, Luka and Joe don't seem too bothered by it, but I'm ready to burst from all this food."
"Someone's cooking for you and you're complaining? Abby, don't be so dense," Janet teased her. "If it's bothering you that much, tell Maggie to come to Chicago and cook for me. I'll gladly take a few days off from the kitchen. After all the ups and down I've had the last few months, I wouldn't mind some moments like that, and I don't think Caitlyn would either."
"I guess you're right," Abby sighed. "I have to remember it took me a long time to appreciate Mom and want her company. She's just...her usual self, but I guess I shouldn't complain since she's on her meds and she's so good with Joe. Anyway, your first session?"
"Oh yes. It was, how do I say, awkward? The counselor had us do some activities to see how well we knew each other and could talk about our emotions, and it didn't go well. I'm surprised I knew my daughter's favorite color. It's blue, by the way. I'm disappointed we're so far apart, but I think Caitlyn took the disappointment better than me. She kind of figured we wouldn't start off on the same foot, but I suppose if we had, we wouldn't need these sessions."
"I can tell you hate not being the leader on this," Abby said.
"I need to let go of that tendency to always be in control," Janet agreed. "I can lead the way at the hospital, but the rest of my life needs work."
"I can't say anything to you about that, except to say that Luka and I know how that goes."
Janet opened her car. "Well, I'm off to my destination. Thanks for texting, by the way. I really appreciate it, even if you did it to get a break from your mother."
"It really is going to be fine," Abby told her. "Look, I wouldn't have asked you to sponsor me if I didn't think you had your life in order or weren't committed to the work it takes us to stay sober. Hang in there, and it'll be over before you know it."
"I know. Thanks again for your kindness, Abby. Hopefully I'll talk to you sometime soon."
"Hi, Janet," Kathleen took her back to her office almost immediately upon her arrival. "Thank you for coming in. How are you today?"
"Honestly, I'm a bit nervous. I haven't had any counseling in some time. When I decided to give it a try a few years ago, it didn't go that great. And no disrespect, but I've never been that excited about the idea of therapy, but Caitlyn's important to me, so I'll do my best."
"None taken. You're not the first person who's been anxious to come here, and you won't be the last. Come on in and take a seat."
Janet positioned herself on a chair near the corner and pulled out a bottle of water. At least she could hold on to the bottle and take sips.
"Can you tell me what worries you about therapy?" Kathleen asked. "I know people have reservations for a variety of reasons, whether it's a mismatch with a former therapist or anxiety about the environment. I just want to know how I can put you at ease."
"The lack of anonymity is a big one," Janet answered. "It's just that, when I go to AA, it's OK if I don't feel like sharing on that particular day. Here, I'm expected to sit here for an hour and open up with just you and me, or with Caitlyn here too, and it's definitely a lot of pressure, I guess. Especially since I don't know how she'll react to what I say."
"So it sounds like you're afraid to share in a more one-on-one setting. That's very normal. But when you're here on your own, try to focus on yourself and what you want to work on. It's great that you're here for your daughter and want to work with her, but you should also be here for yourself so we can work on your goals and needs."
"Is there anything else bothering you?"
"I'm very much a take-charge, assertive kind of person and I like to be the boss. Not being fully in control of this situation with Caitlyn has been challenging. I also kind of like to solve my own problems sometimes and not tell others what's bothering me. I've admitted I needed help before, of course, because I'm an alcoholic. I had to do that to get better. I just tend to hold in my emotions until they either spill out and I feel worse for hiding them regardless, or I ignore them hoping they'll go away."
"I see," Kathleen nodded. "What do you think keeps you from expressing yourself? Is there something you fear?"
"The judgment. I avoid forming relationships with my coworkers a lot. Doctors and nurses understand addiction as a disease, but some of my colleagues are surprised when they find out I'm a recovering addict. They don't quite know what to say when it's someone they know, as opposed to a patient they may never see again. I'd say the majority come around and support me, but I tend to worry to this day about being gossiped about. I know Caitlyn has judged me harshly throughout the years and I've messed up some other relationships. It's like I'm never going to move past it."
"That's rational. The thing is, Janet, we can't control people's reactions to us. We can, however, work on what we can control. In your case, that might be the information you choose to tell them and how you can still be confident in yourself even if a colleague doesn't know what to say to you. You can control how you treat them and talk to them. What they do after interacting with you is up to them. Does that help?"
"Yeah." She took a sip of her water.
"A good therapist will never make you feel judged. I'm not here to give you a hard time about your mistakes or embarrass you. I do need to know what's on your mind so I can help you, but don't feel like I'm the judge and jury. We'll work at your pace and comfort level."
Janet nodded in agreement. "That sounds reasonable enough. I think I'm ready to get down to business."
"OK," Kathleen smiled. "Thank you for sharing all that with me. Now, to get started, when you and Caitlyn were here, I asked the both of you to describe your relationship in one word. Caitlyn had mentioned she called it bumpy when she first met me, but now she's changed it to apprehensive. As you remember, she's applauded your progress and willingness to listen to her, but she feels there's still work to be done. I believe your word was…untrustworthy?" She glanced down at some notes.
"Yep." Janet sighed.
"Now, has there been a particular time maybe in the past, or even in the last two months of trying to connect with Caitlyn, that you've felt she didn't trust you?"
"Well, really, I'd say it's been like that for years. She's said things like she knows I'm sober, but she needs to believe me and see evidence. I couldn't just tell her 'Well, I've been sober for 13 years' and get her to accept it. But since you want a specific example, there was something that happened in April that I could tell she wasn't going to just take my word for things."
"Can you describe that for me?"
"Sure. So I was at work, and I was just feeling exhausted from a lack of sleep the night before, and my day was going pretty badly. I went into the ER break room to try and relax after I finished a consult because I had a headache, but I started to feel worse. I was shaky and started to get dizzy because I hadn't had time to eat or drink since 5:30 or so that morning. I tried to pull it together, and the next thing I remember is waking up on the floor of the break room with a nurse next to me and other doctors running in. It turns out I had fainted."
"I'm sorry to hear that," Kathleen said. "Before we talk about how Caitlyn reacted to that, I want to ask you how you felt when you woke up and understood what was happening. Since you're a doctor yourself, was it any less scary for you because you knew what was going on? Or were you more afraid?"
"I'd say I was pretty scared. It's still pretty terrifying to wake up on the floor not really knowing how I got there. I knew everything the staff was discussing and what their exam findings meant, and that there were so many possible causes of the episode, from something benign and treatable to something more serious. When the ER doctor was ordering blood tests and an EKG, to check my heart, I was really worried about the results. I tried to resist an exam and treatment because I had a full calendar and I wanted to work-that's why there's the joke about how doctors are the worst patients-but all that happened was I almost fainted again. I ended up having to stay for a few hours to get all my tests done and I had to be on a monitor that tracked my vitals, as well as an IV to get rehydrated."
Kathleen nodded. "All that sounds stressful. I'm sure a lot of us would be frightened in that position. Is your health OK now, if you don't mind me asking?"
"Yeah. I found out it was vasovagal syncope, which is a fancy way to say a fainting episode without a more serious cause. I went back to work two days later, and I went to my doctor about two weeks after that. I had a checkup and she ordered the tests I had in the ER, plus a couple of extra ones, but no underlying conditions came up, thank goodness. I just have to try and take in more fluids and light snacks, and I got a refresher on what to do if I feel faint again."
"I'm glad to hear that. Now, getting back to that day, did Caitlyn come to the hospital to see you? Or did she find out later what happened?"
"I decided to have my colleague call her," Janet continued. "She did come; I was quite worried she wouldn't. When she was brought to the room, I could sense her nerves. She was looking at my monitor, which she can understand herself, since she's a nurse. She sat down and said she was glad I was OK, but then she was saying things like 'how did this happen' and asked me what was going on. She was also panicked that I had relapsed. I felt kind of attacked, you know? I was already tired and fearful, and I felt she was being pushy and didn't want to be supportive."
"OK, let's back up a minute," Kathleen folded her hands on her lap. "Caitlyn expressed she was worried you were drinking again. Could you understand where she was coming from?"
"Yes and no. I know with this disease a relapse or a slip is always possible, but at the same time, I don't know why she just jumped to the assumption. I've been sober for a long time; this was just a medical emergency that wasn't connected to drinking."
"Well, first, let's try to reverse the positions. If Caitlyn were in the hospital and you got a phone call not knowing the reason, wouldn't you be worried and want to get to her as soon as you could?"
"Of course. I know when we have to call patients' families, we can't explain things to them over the phone. My colleague also had to call her at work, so I'm sure getting the message from her unit secretary was scary for her. I would've freaked out, absolutely."
"Now, the second point might be hard for you to play role reversal with," Kathleen continued. "But as you might remember, it's normal for an alcoholic's family and friends to be hesitant when they enter recovery even though they're proud of them for accepting help. They're always aware that a slip or relapse could occur. You don't necessarily want to get too preoccupied with it, but as you said, it's a part of understanding addiction. It's hard for relatives to get out of the habit of assuming the worst, and for some family members, that fear never goes away. You should be prepared to address any fears and concerns Caitlyn has about those things. Hopefully, you can discuss them under less trying circumstances than someone being admitted to the hospital, of course."
"Have you tried anything to show Caitlyn that you keep a healthier lifestyle now and that you're committed to staying sober, to show her you can be trusted?"
"I showed her my AA chips—I've kept all of them—the last time she came to see me so she can see I had a track record. I told her what happened on the day I realized I needed to go to rehab and what I did when I came back, since I figured she'd want to know that I've asked for help and knew how out of control I was. I've recognized we can't go back in time and fix how I hurt her, and she's accepted that herself, but I can work harder to be a better mother and treat her the way she wants to be treated."
"Those are good first steps. But even when you think you're doing everything right, she still has the right to come to her own conclusions. It's like what we just talked about with your coworkers. You can only tell her how far you've come and do things like show her medallions, and what she does after that is her decision."
"I need a minute, if I can," Janet said. "Sorry to interrupt. Can I have some tissues?"
"Of course."
"I'm so embarrassed," Janet looked up at the ceiling, trying to control her tears.
"You don't need to be, Janet. I've seen many people cry here. These are difficult topics."
Once Janet had collected herself, she started to talk again.
"If I could take this in a different direction, having Caitlyn reach out to me has really challenged me. It brought back a lot of old pain. I guess...I had thought I'd made amends a long time ago. They were partial amends because of my kids' ages, but she didn't think it was good enough. I just got this rush when I opened the letter from her, and not the good kind. I felt awful. I thought about my downward spiral all over again and how she was affected, especially when she came to see me and shared her bad memories. To hear her tell me what she saw and heard was gut-wrenching. Imagine your own daughter remembering you throwing up at 3 a.m. or that she knew I was hiding in a room to drink while she sat in her own room, crying for Mom, and I ignored her. I feel like I've lied to everyone around me. How could I speak about my own success in AA when my relationship with my child is in tatters?"
"Unfortunately, there will be times on your journey where the past comes back to haunt you," Kathleen replied. "You don't have to be perfect to be of service, though. It's not unusual for people with addictions to have burned bridges, but they can still find a way forward to help others and build new relationships. Has there been anything else besides reliving the past that's been hard about having Caitlyn come back?"
"Well, yeah. It just doesn't feel quite right yet, to me or to her. Now all of a sudden not only do I have this letter from my hurting child, I'm letting her into my home. My safe place where I'm in control and can unwind. She comes into that space and I feel like she's an intruder even though I told her to come, you know? And she's rather perceptive. She walks around and explores everything she can and I can tell she's taking mental notes to see if she can see that I've changed."
"Sure. It can feel intimidating when you're sitting face-to-face and just starting to be honest with each other. There's a lot of feelings from over the past years that you need to get out and discuss. You don't always have to meet at your home if it makes you feel nervous. You can take her to lunch or dinner, go for coffee, or take a walk in the park. Maybe a different setting will help you both feel more comfortable, although keep in mind it doesn't absolve either of you of communicating with each other."
"Last time she visited me, we went for a walk and stopped for some ice cream," Janet said. "She told me later she wants little moments like that too. That we don't always have to have intense, serious discussions. She wants to have fun with me and make good memories too."
"I'm glad that worked well. Now, of course, if you two want to meet where the other lives, I won't force you to do it differently. But it's not a bad thing to do something else, either, especially if this is something she wants. Part of how you're going to build trust is honoring each other's wishes where you can and within reason. So, before you come see me with Caitlyn in a couple of weeks, why don't you think of some ways you can continue to build trust in your relationship? Feel free to write them down if you can't remember them in two weeks' time, but I want you to be prepared to share them with Caitlyn and get her feedback."
"Homework, huh?" Janet chuckled. "I haven't done that in years."
"You'll both get some during this process. Sometimes I'll ask you to do separate activities; other times it will be a worksheet that you both do, but not together, of course. So yes, this is your first assignment. If you have any questions or concerns in the meantime, you can feel free to call me or we can set up another individual appointment."
"You did a good job today, Janet. I know the first session can be a bit intimidating."
"I'm just glad I got through it."
Janet called Caitlyn once she returned to her office at County.
"Well, you're calling me, so I'm guessing you didn't die in there," Caitlyn joked.
"Stop with yourself. It was hard, but overall, not as bad as I feared."
"See? Mom, I told you; I don't hate you. I wouldn't ask you to go to a counselor I didn't trust or didn't click with or ask you to do something I wouldn't do myself. I just want you to be comfortable sharing things and opening up, and I want us to be better to each other. I'm glad you took the first step. So do you think you're hooked?"
"Now, let's not count our chickens before they hatch. I'll return, but I need more time until I'm fully comfortable. Still, it felt good to talk with someone who wasn't looking to shame me."
"That's what therapists are there for." Janet could hear a smile in Caitlyn's voice. "Make sure to work on your homework before our next appointment."
"I know. I got some today to get your feedback on next time we're together, so I'm sure you'll get an individual assignment at some point too."
"It's all part of the process. I've had homework with other counselors, and it can feel helpful if it's the right activity."
A knock at Janet's door interrupted her.
"Dr. Coburn?" Megan walked in. "I need you in L&D 2."
She nodded. "Caitlyn, I'm sorry to cut you short but I have to get to a patient. Is it OK if we talk later?"
"No problem. I just took a quick break from work because I agreed to work until 7."
"Sounds good. I'll catch up with you tonight."
Janet grabbed her lab coat and went back to work, relieved she could set aside her worries for now.