Anna was a busy mom of four and also a pediatrician. She was a high-energy person and did almost everything well. Her family loved her, and so did her patients. Anna was known for her bedside manner and her attention to detail. Even by physician standards, Anna was highly conscientious.
Which is why it was all the more incomprehensible that something awful had happened to her child right in front of her eyes. Anna and her sister had taken their young families to the airport to greet their mom, whom the kids had not seen since Christmas. In spite of counting noses and putting a buddy system in place, Anna’s four-year-old daughter had darted into the crosswalk and been knocked to the ground by a cab that was able to stop just short of a much worse accident. Anna had seen and heard her daughter’s soft body and head hit the ground with a sickening thud. An MRI later showed a concussion, but nothing more, and the ER doctor told Anna how lucky her daughter had been that day.
In the days following the accident, Anna was wracked with guilt and shame. She felt like a fraud. How could she counsel young families all day at work about the health and safety of their children, and then let her own child get hit by a car? Sleep eluded her as her thoughts replayed the accident over and over in her mind. She wasn’t sure if she should be going to work or take a few days off. Reassurances from her husband were of no help. Anna could not stop thinking about what could have happened. Was God sending her a message? Maybe she was working too much and not spending enough time with her children? Maybe this was a warning to her that they could be taken from her if she did not appreciate them more?
When Anna contacted me, I knew she needed support and professional input. She was afraid of developing PTSD and wanted help turning her thoughts off. I was able to tell Anna that she was having an acute stress reaction that would likely not turn into PTSD, especially with supportive talking and processing of her thoughts and emotions. I shared with her that it was important to discuss the thoughts and feelings rather than try to avoid them. In fact, trying to suppress her reactions might even make them worse.
Anna found this information helpful. We met weekly for six weeks, and Anna’s symptoms largely resolved within that time. In the end, Anna still wondered if God was sending her a message, but she also came to terms with the idea that the accident was just that, an accident, and not a negation of her effectiveness as a mother or a doctor. We talked about balancing her desire for control and precision with a recognition that even the most conscientious people will sometimes experience bad outcomes. This was hard for Anna; she wasn’t sure how she was going to integrate this new way of seeing herself, and she knew it was going to take some practice.
Anna‘s life was always in high gear, and so she wrapped up her work with me once her most acute symptoms had subsided. I told her that my door would always be open to her in the future if she ever needed anything. About two years later, I heard from Anna. Her mother had died after a short illness, and she wanted to come in to sift through her grief. In this work, Anna stated that some of the skills she had developed in her previous therapy work were coming in handy now as she negotiated this new chapter. We met three times at this point, and then Anna said she would call in the future on an as-needed basis.
Many of the people I take care of are like Anna in that they use therapy on an episodic basis. It is not uncommon that I have long relationships with my clients, and that I see them off and on over a period of years. It is always a privilege to be part of a person‘s life in this manner and to get to see the continuity of their life and also what happens next in the story.
The following story is a composite inspired by my work. Details have been altered to protect privacy, while the process remains true to the therapeutic experience.