Boyfriend seemed to be putting it all together. “So that’s how you know her.” He joked that dating a therapist was like dating a CIA agent.
I laughed and said that being a therapist sometimes felt more like having an affair with your entire caseload, past and present, simultaneously. We’re always pretending not to know the people we know most intimately.
But often it’s therapists who feel uncomfortable when our outside worlds collide. After all, we’ve seen our patients’ real lives. They haven’t seen ours. Outside of our offices, we’re like Z-list celebrities, meaning that hardly anyone knows who we are, but for those few who do, a sighting is significant.
Here are some things you can’t do in public as a therapist: Cry to a friend in a restaurant; argue with your spouse; hit the building’s elevator button relentlessly like it’s a morphine pump. If you’re in a rush on your way into the office, you can’t honk at the slow car blocking the entrance to the parking garage in case your patient sees (or because the person you’re honking at might be your patient).
If you’re a respected child psychologist, like a colleague of mine, you don’t want to be standing in the bakery when your four-year-old has a meltdown about not getting another cookie, culminating with the ear-piercing proclamation “YOU’RE THE WORST MOM EVER!” while your six-year-old patient and her mother look on, aghast. Nor, as happened to me, do you want to run into a former patient in the bra section of a department store as the salesperson announces loudly, “Good news, ma’am! I was able to find the Miracle Bra in the thirty-four A.”
When you’re making a restroom run between sessions, it’s best to avoid the stall adjacent to your next patient, especially if either of you is taking a malodorous dump. And if you use the pharmacy across the street from your office, you don’t want to be seen in the aisles buying condoms, tampons, constipation aids, adult diapers, creams for yeast infections and hemorrhoids, or prescriptions for STDs or mental disorders.
One day, while feeling flu-like and weak, I went to the CVS across from my office to pick up a prescription. The pharmacist handed me what was supposed to be an antibiotic, but when I looked at the label, I saw it was an antidepressant. A few weeks earlier, a rheumatologist had prescribed the antidepressant off-label for fibromyalgia, which she thought might explain some lingering fatigue, but then we decided I should hold off due to its potential side effects. I never picked up that prescription, and the rheumatologist canceled it; nevertheless, for some reason, it still sat in the computer, and every time I got a medication, the pharmacist would bring out the antidepressant and announce its name loudly while I prayed that none of my patients were in line behind me.
Often when patients see our humanity, they leave us.
Soon after John began seeing me, I ran into him at a Lakers game. It was halftime, and my son and I were waiting to buy a jersey.
“Jesus Christ,” I heard somebody mutter, and I followed the voice and spotted John ahead of us in the line next to ours. He was with another man and two girls who looked to be around John’s older daughter’s age, ten. A dad-daughter outing, I figured. John was complaining to his friend about the couple in front of them who were taking a while to make their purchase—they kept losing track of which sizes the cashier had said were sold out.
“Oh, for God’s sake,” John said to the couple, his booming voice catching the attention of everyone around us. “They’re out of the black Kobe in all sizes but the small—which is clearly not your size—and they only have the white Kobe in a kid’s size, which is also clearly not your size. But it is the size of these girls here who came to watch a Lakers game, which is starting up in”—here he made a great show of holding up his watch—“four minutes.”
“Chill, buddy,” the guy in the couple said to John.
“Chill?” John said. “Maybe you’re too chill. Maybe you should think about the fact that halftime is fifteen minutes and there’s a sizable crowd behind you. Let’s see, twenty people, fifteen minutes, less than a minute per person—Oh shit, maybe I shouldn’t be so chill!”
He flashed his gleaming smile at the guy, and that’s when John noticed me looking at him. He froze, stunned to see his mistress-hooker-therapist standing there, the one whom he didn’t want his wife or, probably, his friend or daughter to know about.
We both looked away, ignoring each other.
But after my son and I made our purchase, as we were running hand in hand back to our seats, I noticed John watching us from afar, an inscrutable expression on his face.
Sometimes when I see people out in the world, particularly the first time it happens, I ask back in session what the experience was like for them. Some therapists wait for their patients to bring it up, but often, not mentioning it makes it bigger, the elephant in the room, and acknowledging the encounter feels like a relief. So the following week in therapy, I asked John what it was like to see me at the Lakers game.
“What the fuck kind of question is that?” John said. He let out a sigh, followed by a groan. “Do you know how many people were at the game?”
“A lot,” I said, “but sometimes it’s strange seeing your therapist outside of the office. Or seeing their children.”
I’d been thinking about the look on John’s face as he watched me run off with Zach. I privately wondered what it was like for him to see a mother hand in hand with her son, given the loss of his own mother when he was a boy.
“You know what it was like seeing my therapist and her kid?” John asked. “It was upsetting.”
I was surprised that John was willing to share his reaction. “How so?”
“Your son got the last Kobe jersey in my daughter’s size.”
“Oh?”
“Yeah, so that was upsetting.”
I waited to see if he’d say more, if he’d stop with the jokes. We were both quiet for a bit. Then John began counting. “One Mississippi, two Mississippi, three Mississippi . . .” He shot me an exasperated look. “How long are we going to sit here saying nothing?”
I understood his frustration. In movies, therapist silences have become a cliché, but it’s only in silence that people can truly hear themselves. Talking can keep people in their heads and safely away from their emotions. Being silent is like emptying the trash. When you stop tossing junk into the void—words, words, and more words—something important rises to the surface. And when the silence is a shared experience, it can be a gold mine for thoughts and feelings that the patient didn’t even know existed. It’s no wonder that I spent an entire session with Wendell saying virtually nothing and simply crying. Even great joy is sometimes best expressed through silence, as when a patient comes in after landing a hard-won promotion or getting engaged and can’t find the words to express the magnitude of what she’s feeling. So we sit in silence together, beaming.
“I’m listening for whatever you have to say,” I told John.
“Fine,” he said. “In that case, I have a question for you.”
“Mmm?”
“What was it like for you to see me?”
Nobody had ever asked me that before. I thought for a minute about my reaction and how I would convey it to John. I remembered my irritation with the way he was talking to that couple at the front of the line and also my guilt at silently cheering him on. I, too, wanted to get back in the stadium before the second half started. I also remembered, when I was back at my seat, glancing down and noticing that John and his group were sitting courtside. I saw his daughter showing him something on his phone, and as they were looking at it together, he put his arm around her and they laughed and laughed, and I was so touched that I couldn’t take my eyes off them. I wanted to share that with him.