car, praying for guidance as I drove to my office. Although I certainly had not ruled this out, it was hardly what I expected. As I unlocked the doors of my office and flicked on the lights, I raked through the memories of her last session: Natalie said the physical manifestations of her anxiety had gotten better, but her emotions felt the same. As it turned out, although we had accomplished some level of desensitization of her trauma, nothing had “settled” after the session. Seeing Donny chased by his dad had probably triggered memories of her own abuse and justifiable anger. But Natalie experienced this as the “evil” within her surfacing, and when she saw it in herself, the shame and guilt overwhelmed her. She wanted to die.
I knew we had to somehow release that rage from her system. But as long as she thought those feelings were her mortal enemy, how could we do that? I remembered that in the last session she had shrieked, “I HATE YOU!” when we touched in on this energy within her. How were we going to resolve this?
Minutes later, Natalie was at my office. She looked visibly shaken. It was hard for her to sit still in her chair, and she wrung her hands nervously. Words tumbled from her mouth like an avalanche.
“It happened again. I woke up in the middle of the night, just overwhelmed with panic. My heart was racing. All the things you taught me to help with the anxiety just flew out the window. All I knew is that I was furious, angry. I wanted to do something bad to someone. What kind of horrible monster am I?” she exclaimed, her eyes wet with tears. Her question was sincere.
“I don’t think you are a monster, Natalie,” I responded very quietly.
“But I do! It was almost like some part of me was taunting me, daring me to do something really evil.”
My mind raced. Voices taunting her? Was this schizophrenia? Somehow, it didn’t quite click.
But this was tricky. As most therapists know, when someone hates themselves enough, there is the possibility that they will take their own lives. But for my clients who are parents, I can always gently remind them that their children need them. Many a patient has decided not to commit suicide because they don’t want to see their children suffer the pain of their death. But if Natalie was really convinced that she might hurt her son, she might justify the suicide as a way to keep him safe.
While these thoughts streaked across my mind, Natalie simply looked at me with expectation. Something about her expression brought me out of my thoughts and into the room. She looked down at her hands before quietly remarking, “I really do think this is connected to another life.”
I took a moment and inhaled a deep breath. My immediate response was that she needed to express the pent up rage. And yet, in previous sessions, we had tapped into at least some of her fury, but it was still accompanied by a sense of shame. Every time she would start to experience anger, another part of her mind threw cold water on the experience. The anger that needed to be honored was tamped down by a terrible shame. It was the kind of double-bind that could stall therapy for weeks or months. Maybe Natalie’s gut feeling was right. I was still convinced there was probably some kind of abuse in her current life that “drove” the traumatic responses and her panic.
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