Trust, Part I, My Patient

I’ve started another therapy contract with one of the guys, Mr. W. shall we call him. I’ve carved out enough time to engage in something more than crisis checks with some of the guys interested and willing. He is one of four, currently.

I ask him his goal, and he states, “I don’t care.” Not that he doesn’t care about treatment, but his problem is existential. He has given up. A serious problem.

Let me take a moment to digress to eye contact. When I start this type of conversation, there is a phenomenon I’ve never experienced before, or at least not to this extent. Eye contact: in 20 years of therapy, I have never encountered such intensity. My office is small and meek. I sit diagonally across the desk from my patients with a pull out shelf between us, defining safety, space and giving some breathing room.

These guys look at me in a way that is difficult to describe. It feels almost sexual, but I can tell you it isn’t – I know when it is. I wonder if they are searching for my soul. If they are looking for some truth or reality that they can trust. Grrrrrrrrrr, I try to send that to them as best I may. The eye contact is intense, and he is totally present back there, more waiting than weighing.

So we talk, and I can see he is telling me truth. And I’ll ask a question and suddenly it is almost like flipping to a channel of static. He is gone. Something shuts down. I don’t know why. I can’t see a pattern to the questions that lose him.

I call him on it, and he admits it is true. We decide it is about trust. My friend, Bill, suggests, in essence, he cannot trust himself.