Case Study - Page 2

He said he came to therapy because he was feeling "desperate." He'd moved to town with his girlfriend Cynthia, but after nearly two years of an on-again, off-again relationship, she'd abruptly cut off all contact. He was shocked by his own reaction: he'd been crying uncontrollably for days. When he wasn't crying, he ran what he called the "Cynthia movie" in his mind, obsessing about what went wrong, what he said, what she said, and what he could do to get her back.

What Luc hated and feared most of all was being alone, and he dreaded going back to his solitary apartment. At the same time, he knew that if he quickly got involved with another woman, he'd only be repeating the same old pattern—which, obviously, wasn't working for him.

From the beginning of treatment, I sometimes felt connected to Luc and sometimes completely invisible to him. While he could easily draw me in with entertaining banter, when he talked about his own life and personal issues, it was as if he were talking to himself. He used vague pronouns, and I had to ask questions repeatedly just to understand what he was saying. For instance, at one point in our first session, he said, "It's been hard." When I asked what the "it" was, he lit up. "Oh good," he said. "You're not going to let me get away with that." It wasn't that Luc was trying to mislead me; he'd simply become accustomed to being distanced from his own experience, which was reflected in his language. In that one moment, he looked directly into my eyes, and I felt a sense of genuine connection before he was gone again into his somewhat detached monologue.

In our first few sessions, I asked about his early history and what he knew about being alone. The sixth of nine children, he'd grown up surrounded by others, but didn't remember much nurturance at home. His mother was, by turns, neglectful and abusive; his father, largely absent. Luc told me that he recalled being dropped off alone on the first day of kindergarten. Early on, he'd learned to be a self-sufficient child, who grew into a self-sufficient man who could handle anything by himself, thank you very much.

I asked him when he'd last seen a kindergarten-aged child. Together we wondered if he'd benefit from taking a look at one. During the next week, he closely observed a group of youngsters on a playground and then reported: "Those kids were really little, really young. I was let loose way too early." This set the pattern for "homework" assignments: we'd agree on them together after either one of us had made the initial suggestion.

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