Conversations with patients: You are more than you know

In these essays, I feature interactions I have had with my patients that I have found to be meaningful and thought-provoking.  Any details about the patient’s identity have been modified to protect patient privacy and confidentiality.

Wayne is a 40 year old man who has struggled all his life with his mental health.  He tells me about the significant physical and emotional abuse at the hands of his father who would strike him when he was unhappy with him, which he later realized was anytime he wanted.  Wayne resorted to trying to do everything he could to please his unpredictable and angry father.  He remembers being ordered to finish any leftover food even when he wasn't hungry, only to be ridiculed later for being overweight.  His father would beat him because his newest girlfriend accused Wayne of looking at her disrespectfully.  Wayne's mother was not in the picture because his father would not allow it, and unfortunately, his mother did not object.

When I first met Wayne, I was struck by his bright demeanor and warmth.  He quickly opened up about his struggles with a frankness that made me realize he was not as fragile as he believed.  He was unemployed but was denied social assistance.  This rejection further convinced him that he was unworthy.  He was always going to be a "have not" begging for what he believed others were entitled to.  This was a reason he had wanted to see me, could I help him get on disability support?  Without it, he did not see a way to have any quality of life.  His anxiety and depression made it impossible for him to leave the house, let alone find work.

I experienced some of the impact of his childhood trauma first hand in our time together.  He struggled in regulating his emotions with me, often because he would misinterpret my well-intentioned comments to be criticisms in disguise.  I remember an early example when I asked him for clarification.  He responded angrily, "I see that you don't believe me."

I came to appreciate how dangerous he felt the world was for someone like him.  Someone not only with his childhood but who also was overweight and physically disabled.  He could never trust anything good being said to him, he was so used to these comments being a precursor to being cut down, abused and silenced. 

I have been seeing him now for several years and he has come a long way.  In our last session, he told me about a hobby he restarted because it made him feel calm and helped him process painful emotions: colouring.  He showed me what he was working on while telling me what kinds of markers and paints he used and the technique to get the different effects he wanted.  My eyes got bigger and bigger as he unveiled piece after piece of colour, shimmer and beauty.  He even started teaching art to his neighbours.

I commented on his creativity, and he interrupts me, "I am not creative, I can't even draw well."  He then tells me how he is very particular about his art supplies and says, "I guess I am just picky and demanding, I'm sorry about that."

I interrupt him with an exercise.  During this session with him, I was very aware that it felt different from previous ones.  Usually I feel deep compassion for him and sadness for the life he has had.  I listen deeply to pick out the small barbed comments he makes about himself so I can point them out to him and process them.  In this session however,  I felt inspired, in awe and proud.  I found myself thinking, "I am not the expert today!"  I admit I was a little jealous. 

The exercise was to close his eyes and to contemplate the following words:

Community

Expertise

Excellence

Ambition

He looked at me puzzled, as if these words were foreign and random.  I proceeded to tell him that these were the words that came up for me today, to describe him.

I told him, "you believe yourself to be demanding, indulgent and ungrateful about your art supplies because this is how you were made to feel growing up.  But what I hear throughout the conversation today is how you have standards.  You actually are striving for excellence in the art you create and that is nothing to apologize for.  I also would like to point out how your art comes so naturally to you, so much so that you have enough to share with those you love and rather than drain you, it energizes you.  I could feel it just talking to you."

"I also need you to realize that I hear within you your ambition to be not just good, but great in art, and even more, you have what it takes to get there."

He had never associated himself with these traits and values.  Never heard these words mentioned in any way to describe him.  But it is there isn't?  He needs to know it.  It is about time.