How Therapy Helps: The Concept of Working through Our Issues

By Aisha Abbasi M.D.

Sitting down and settling into the treatment process can help us work through our issues and improve our relationships.  As an example, I will share the story of Sally, who was in her early forties when she came to see me.  She had three significant relationships in her life, all of which failed. Her boyfriends, she said, experienced her as demanding.

Sally was number three among five siblings, her brother being the oldest.  One of the most painful aspects of her childhood was that her mother often physically abused Sally and her sisters. It was heartbreaking.

In addition to this physical abuse, Sally deeply felt emotionally neglected by her mother on a day-to-day basis. She could not understand what she had done to be the recipient of such neglect and abuse at the hands of her mother. Nor could she understand why her brother Ben was spared the physical abuse. Instead, her mother singled out Ben as special and adored.  Amid tears, Sally described how her mother would hang out with Ben in his or her rooms, looking at his school projects and talking about stuff she wanted to do with him.

Given her history of abuse, the sense of neglect she endured as a child, her repeated difficulties in trying to establish an intimate relationship as an adult, and her emotional strengths (completing a PhD in biomedical engineering, loving her work, and having a good group of friends), I made a professional recommendation.  I suggested to Sally that we embark together on a therapeutic journey, meeting as often as possible.

A few months into the therapy, Sally had a session with me at 12:45 p.m. after my usual lunchbreak.  I had been teaching a class that morning and had canceled all my morning patients. I was finishing lunch at 12:25 p.m. and was about to unlock the main office door when I heard a car drive up. I looked out the window and saw Sally’s car parked in her usual spot. I quickly proceeded to unlock the main office door for her, but nobody was there. I checked the parking spot again and was surprised to see Sally’s car had vanished! I waited for some time. Puzzled and wondering what happened, I called Sally around 12:50 p.m. Sally said, “I came there, but the door was locked. So I left. I’ll see you tomorrow.”

I felt what had happened must have been connected to Sally having some very painful feelings. When she came for her session the next day, we talked about the incident. She burst into tears and said, “It felt just like when Mom would sit in her room with Ben and lock me out. I know the door was locked because you hadn’t yet started work for the day, but to me it felt as though you had locked me out.”

This was the first of many interactions that occurred repeatedly, in which Sally and I came to understand the deep and lasting impact of her past experiences, upon her perception of people and events in her present life. I shared with her that perhaps she felt the same with men she was trying to establish a close relationship with.  This would then lead to them experiencing her as demanding and unreasonable.  They were not her therapists, and they could not understand how the traumatic and neglectful experiences of her childhood had led to Sally feeling extremely distrustful of people.  She was quick to experience what was going on in a relationship as more proof she was not important and not wanted.

Through living out these feelings with me, and through my efforts to understand what she was feeling at different  moments with me, Sally could start distinguishing more clearly between past experiences and current ones, so that her reactions to current situations and to people in her life could become more realistic and less “over reactive.”

This helpful process of “working through” old conflicts, traumas, and feelings, opened up the way for Sally to have more genuinely intimate relationships in the present.

Check our blog in the coming weeks for more articles about the treatment process, including information about the termination phase of therapy.  At Tampa Bay Center for Psychological Health, our goal is to offer a safe, confidential, and trustworthy treatment setting for all patients. For more information, or to request your free 20-minute initial phone consultation, please call Dr. Abbasi at 248-851-7739.