Reviving Ophelia (24 page)

At school she was in the worst category a girl could be in: She was a slow learner, shy and dressed in K Mart clothes. She had no older siblings to look out for her, no parent advocate or best friend to protect her. She was largely ignored by the other kids.

Cindy told me all this slowly over the course of several sessions. We talked about her beloved dog, Laddie. I asked about her school papers, her teacher and her time with her parents. When, during our fourth session, she left her “huggable” blue car coat in the waiting room, I took that as a sign of progress.

At my suggestion Cindy wrote down three things she was proud of each day and brought those in to share. She read me the lists: “I made my bed, did my dishes, took Laddie for a walk, remembered to turn off the lights when I went to bed, turned in my math paper.” I congratulated her on every victory.

I invited the parents in for a session. Joe, a big man who smelled of gasoline and tobacco, told me that Cindy was fine just as she was. He didn’t see the point of getting “her head worked on.” He said, “No offense, but I personally don’t believe in this shit.”

Delores was only slightly more promising. She was willing to discuss Cindy, but grew uneasy when the topic was her or Joe. She didn’t want to discuss her drinking or long hours away from home. But when I asked about Cindy’s birth and health history, Delores’ voice grew husky with emotion. She said, “I drank when I was carrying her. That was before we knew about fetal alcohol syndrome. I’m to blame for her being retarded.”

I handed her some Kleenex and watched as she wiped her red eyes. I said, “What’s important is the future. Will you help Cindy now?”

Delores looked at Joe, who shrugged his shoulders. She said, “I’ll come once a month if you think it will help.”

I wasn’t sure it would help, but I wanted to try. Cindy was in desperate need of emotional nourishment. This seemed a case where a little attention might go a long way.

Cindy loved our sessions. She brought me her school papers and pictures of Laddie. Soon she was chatting happily to me. I read her children’s books, gave her small gifts, told her jokes and listened to stories about her week. I helped her set small goals for herself and cheered her on whenever she met them.

I asked the counselor to take Cindy out to lunch once a month. I encouraged Cindy’s teacher to get involved. She encouraged the other two girls in Cindy’s class to include her in some of their activities and also arranged for a student volunteer to spend one period each day with Cindy, sometimes helping her with homework, but other times just visiting. The volunteer was a good-hearted girl who occasionally invited Cindy to her house for dinner.

We all encouraged Cindy to join an activity. She thought about it for weeks, but finally she decided on the Home Economics Club. Soon she was telling me about making chocolate cake and place mats, about taking measurements for a dress and arranging flowers.

Delores came in monthly and grudgingly admitted that Cindy was doing better. As Cindy became happier and more involved with school, Delores began to enjoy her more. She was proud of her cooking and sewing. She agreed to take Cindy to the fabric store and help her select cotton prints for her sewing projects.

Cindy’s baby teeth began to fall out and she grew two inches in the first three months of therapy. She began showing some signs of puberty. Because happiness is largely a matter of contrasts, soon Cindy was happy. Her world had changed from one in which no one would listen to her to one in which a teacher, school counselor, volunteer and therapist would listen. She no longer carried her car coat with her.

When therapy stopped, Cindy gave me a pot holder with the words “God Bless Our Happy Home” embroidered on the front. I gave her a box of stationery and stamps and told her to write. She sends me carefully printed notes. Laddie is still her best friend at home. At school, her volunteer helps with her home economics projects.

The counselor has kept up regular meetings with Cindy. Periodically she calls to say that Cindy is growing physically and doing okay at school. She is more inclined to smile and talk to other kids. She laughs in the lunchroom and volunteers for school outings and projects. She says the parents haven’t changed; in fact, their drinking seems worse. Recently the father was arrested for driving while intoxicated. She is considering reporting this family to child protective services.

Penelope was inundated with many of the blessings that Cindy had been denied. She made straight As with little effort at her private prep school. She was tall, tanned and regal in her expensive outfits and stylish shoes. She was a member of the country club clique and the school’s prize-winning debate team. Penelope had been to Europe twice and on an African photo safari. Every fall her mother took her to Chicago to buy clothes, and every summer she attended the finest camps in the Rockies. Yet she was a “poor little rich girl” who came to me after an almost successful suicide attempt.

Penelope walked into my office dressed in a white tennis outfit and carrying her racket. She fanned herself and made the exaggerated motions of someone who is hot and out of breath. I asked why she was in my office.

“I took some pills and the dumb doctor at the emergency room wouldn’t release me unless I had a therapy appointment.”

“Your mother told me that you almost died.”

Penelope dropped her mouth open in a look of mock amazement. “No way. I was sick but they released me the next day.”

“Why did you do it?”

“I was upset with my parents. I want a car for my birthday. Nothing expensive, just a Mazda or a Honda Accord. They wouldn’t buy me one.”

She slammed her fist into the chair. “They have plenty of money. They are just saying no to teach me a lesson. I hate them.”

“Tell me about your parents.”

“They expect me to do chores and clean my room. That’s utterly stupid. Mom sits on her fat butt all day and hires a housekeeper to do her work. So why should I have to work?”

Penelope had a common rich kid’s problem—she expected to be given everything she wanted. Kids from more modest homes learn early that they can’t get everything they want—their parents can’t afford it. But I sensed that there was more going on than just the money, and I asked her to talk more about her parents.

She sighed. “They don’t get along. Dad works all the time. He doesn’t come home unless he has to—for clean clothes and a shower. Mom hates him, but she wants his money.”

She ran her hands through her glossy brown hair. “Mom gets back at Dad for being gone so much. When he was away last Thanksgiving, she bought herself a diamond bracelet.”

Penelope seemed to be following in her mother’s footsteps. She was investing her emotions in objects, not people, and settling for merchandise instead of love. She had not learned to value relationships and was using money to keep score. With the storms of adolescence, this superficial way of processing reality wasn’t adequate. Penelope needed more support and a new way of viewing her own experiences. Nice clothes and cars don’t get girls through adolescence. I wanted to help Penelope find some more sustaining values.

Mother Teresa says that Americans suffer a greater poverty than the people of India. Americans suffer the poverty of loneliness. Penelope was a good example of that kind of poverty. She’s caught between parents who dislike each other in a home without nourishing values. She lived her life without any real emotional connections to others and lacked many of the qualities that are necessary to any abiding happiness. Not getting what she wanted made her utterly miserable. She had no appreciation of others and she was self-centered. Penelope hadn’t learned that happiness comes not from using others, but from being useful.

We ended our first session by talking about her goals. True to form, she wanted to be a corporate lawyer like her dad and make a lot of money. She wanted a Swiss chalet, closets full of designer clothes and a yacht.

Surprisingly, Penelope was willing to reschedule. I asked her, “Why are you coming back?”

She said, “You listen to what I have to say. It’s sort of interesting.” I said, “Think what you would want on your epitaph and tell me next time.”

Penelope arrived with an epitaph that she’d heard her dad quote. “The girl with the most toys wins in the end.”

I laughed and told her I suspected that underneath she was deeper and more caring than she pretended. In fact, I even suspected that she was looking for love.

Her carefully arranged face fell and she was quiet.

I pressed on. “What are you feeling?”

“Why are you asking me these corny questions?”

“I want to understand what’s important to you.”

“Fame,” she said. “No, I was kidding. I really meant to say getting rich. No, not that either. I don’t know.”

I gently told Penelope that while she had many using relationships, she didn’t appear to have any caring ones. She agreed. “I’m cynical. Guys just want sex. Girls want to be seen with me. Even my parents like me because I make good grades and bring glory to the family. You’re seeing me for the money. Everyone’s a user.”

I was humbled by my inclusion in the user category and pondered what to say next. Protest seemed useless; only time might help her see that relationships might be about something other than money.

Fortunately Penelope moved on to another topic—her parents. Her father couldn’t understand why Penelope wasn’t happy. He’d been poor as a kid and thought that Penelope was lucky. He couldn’t believe that all her luxury wasn’t enough. He expected a happy child, and instead he had a daughter who’d attempted suicide.

Like most adolescent girls, she was critical of her mother, who she felt was a chump. She told me that her mom did whatever her dad wanted because she was dependent on him for money. She said, “Mom is even lazier and more screwed-up than I am. I would never stay with a man for money.”

I asked Penelope what she’d learned about relationships from watching her parents. She thought for a while. “That nobody really loves anybody. That you’d better take what you can get.”

Even though she was popular, she had no close friends. Real friends require honesty, openness and even vulnerability. They also require attention and simple acts of kindness. I encouraged Penelope to work on developing one honest relationship with a person her age.

We discussed the suicide. Penelope admitted that she couldn’t handle frustration. “When I don’t get what I want, I go crazy. It scares me.”

I agreed that Penelope needed to learn to tolerate frustration and to control her impulses. She’d had almost no practice. I borrowed an idea from psychologist John Lehnhoff and suggested that she develop the almost nonexistent “hate it but do it center” in her brain. This “hate it but do it center” is something many girls need to develop if they are to meet their own long-term goals. I use this phrase to discuss the difference between immediate versus long-term gratification of needs. Often what hurts in the short term is ultimately rewarding, while what feels good in the short term is ultimately punishing. This concept is hard for adolescents to grasp, but important for their growth into adulthood. Only when they have a “hate it but do it center” can they work in a systematic way toward goals.

For her next assignment, I suggested that she record and report her victories—denned as times she handled frustration in a mature way.

I felt good when Penelope left. I planned to do a kind of awakening therapy with her that involved building her a value system that was more nourishing than the one that had failed her. I wanted her to discover that relationships could bring joy and that the world is full of riches that have nothing to do with money. I hoped I could get her parents into some marital counseling.

But a week after our session, Penelope again tried to kill herself. Her parents had refused to buy her something she wanted and she’d swallowed pills. This time her doctor hospitalized her at an expensive private hospital. I never saw her again.

 

In my first ten years as a therapist, I never saw a client who mutilated herself. Now it’s a frequent initial complaint of teenage girls. Girls deal with their internal pain by picking at their skin, burning themselves or cutting themselves with razors or knives. This trend is particularly disturbing because most young women who have this problem think they are the only ones. As more young women came to my office with this problem, I asked myself why this is happening now. Why are young women choosing, even inventing, this at this particular time? What cultural changes have fostered the development of this widespread problem?

Just as depression can be described as anguish turned inward, self-mutilation can be described as psychic pain turned inward in the most physical way. Girls who are in pain deal with that by harming themselves. There are obvious explanations: Girls are under more stress in the 1990s; they have less varied and effective coping strategies to deal with that stress, and they have fewer internal and external resources on which to rely.

In my experience, behaviors that arise independently and spontaneously in large numbers of people often suggest enormous cultural processes at work. Eating disorders, for example, are related to the pressure that our culture puts on women to be thin. Self-mutilation may well be a reaction to the stresses of the 1990s. Its emergence as a problem is connected to our girl-piercing culture.

Self-mutilation can be seen as a concrete interpretation of our culture’s injunction to young women to carve themselves into culturally acceptable pieces. As a metaphorical statement, self-mutilation can be seen as an act of submission: “I will do what the culture tells me to do”; an act of protest: “I will go to even greater extremes than the culture asks me to”; a cry for help: “Stop me from hurting myself in the ways that the culture directs me to” or an effort to regain control: “I will hurt myself more than the culture can hurt me.”