At 63 years of age, Lily felt a little odd making her first-ever appointment to see a therapist. In terms of her generation, her faith beliefs, and the region she had grown up in, this was not something people typically did, or at least if it was, they didn’t say much about it to their friends or family. Lily wasn’t sure what to say in our initial messaging about what was bringing her in for therapy, so she went with her most immediate problem: she couldn’t sleep.
When Lily and I met for the first time, she was visibly nervous, and her story came tumbling out. She had a good life, a typical marriage that after multiple decades was neither great nor terrible, and four adult children. Three of the children were doing well, and one had more problems than Lily could shake a stick at.
Lily’s son wore her out. He went from being a fussy baby, to a demanding toddler, to a defiant teen; and despite the fact that he was now 36-years old, he still seemed to be functioning as a self-involved adolescent. He had a history of relationships that never worked out, children he did not support, and jobs he could not keep. He always seemed to be at the edge of legal trouble and financial disaster. Lily and her husband had loaned him thousands of dollars that they had little hope of ever having returned. When her son needed something from them, he would be attentive, ingratiating, and kind, but as soon as he got what he wanted, they did not hear from him again until the next crisis. Attempts to put limits on his behavior were met with angry outbursts, threats of estrangement, and mean comments about their capabilities as parents. His siblings had given up on him long ago and tried to have as little contact with him as possible. All of this broke Lily‘s heart.
Lily wanted so much to be able to fix the situation and help her son. She had been trying everything she could think of, literally for 36 years. It never worked. She dreaded his phone calls, but worried if she didn’t hear from him. It was a vicious cycle.
Lily reported that she had a lot of trouble sleeping at night because her mind wouldn’t turn off thinking about her son and his problems. She had recently developed high blood pressure, and her doctor wanted to put her on medication and also asked her if she was under increased stress. She had to admit to herself that she was. As she was getting older, the chronicity of worry about her son was starting to wear her down.
As therapy progressed, it became clear that the things that were keeping Lily awake at night could be thought of as existing on two different levels. The top level had to do with the crisis of the moment and how her son was behaving that week or month. The next level down was deeper psychologically and even more painful. It had to do with Lily’s conviction that she was the root cause of her son’s problems.
Lily was sure that she had either done something or failed to do something that had caused her son’s difficulties. Conversations with Lily often included her saying things like, “I don’t know what I did wrong… Why is he like this?” The pain for Lily was deep, and she cried frequently when talking about how she felt. She was sure she had failed as a mother. She had never admitted to anyone, even her husband, how responsible she felt for her son‘s problems.
Lily’s son was the youngest of her children and the product of a difficult pregnancy. She had not wanted a fourth child. She had a long recovery from an emergency C-section. She worried that she had not held him enough in the days after his birth, smiled at him enough, or bonded with him. In retrospect, she worried that because of her guilt, she spoiled him with things more than the older ones, but that he had not gotten enough undivided attention. Her husband had been gone a lot for work in those years, and the older children had kept her busy. She felt she had had too many babies too close together. She ashamedly admitted that she was often distracted and tired in those years, and they didn’t have the regular church attendance that she would have liked. In short, Lily was sure she had ruined her youngest child.
As Lily shared more about herself in therapy, we began to develop a picture of her broader life, her upbringing, her marriage, and aspects of her life when she was a younger adult. I had a hunch that Lily’s son had not been the only difficult person in her family. One day I asked Lily, “Does your son’s behavior remind you of anyone else in the family tree?” At this point, Lily paused and blinked, and then with a look of surprise and recognition she said, “He’s just like my father.”
This was a pivotal point in Lily’s therapy. It turned out that Lily‘s father was “one mean son of a gun.” Because he had trouble keeping a job, the family moved with some frequency. Everyone knew he had a terrible temper, and Lily’s mom had spent her life trying to keep him from getting upset. Her efforts had been futile. When Lily was a young teen, her father had been briefly jailed for tying up an unruly dog and dragging it behind his truck for a couple of blocks, injuring, but not killing, the animal. Lily’s dad was a brutal, self-absorbed man who said what he wanted, did what he wanted, and did not care who got hurt in the process.
On one hand, Lily was able to see the connection between her father‘s personality and her son’s, (she stated that they even looked like one another in family pictures from when her father was younger), but on the other hand, she continued to feel that she should have been able to do something to help her son turn out differently. It took a lot of effort in therapy for her to begin to shift her view that there must have been something she could have done to help her son turn out better. I talked with her about the role of genetics and how much we don’t yet know in psychology about all the factors that form personality. I told her that personality research shows that many traits are at least 50% inherited, if not more. I told her, “It’s not uncommon that we see this in families. There’s one kid who comes out different than the others and who seems to struggle no matter what. These things happen in families, good families. You did the best you could. It is not your fault.” These words caused Lily to weep profusely. She had carried so much guilt for so long, and also a great deal of trauma from her own childhood that she had never discussed before.
In time, Lily began to develop a more balanced view of her son’s difficulties and her lack of control over them. She could not fix them, and she began to entertain the idea that she had not caused them. She and her husband started to set more limits on giving their son money, and if she had a day where she didn’t feel up to taking one of his phone calls, she let it go to voicemail or let her husband handle it. She still had bad days, like Mother’s Day when she would not hear from him or get a card, or when she would hear from his kids that he had lost yet another job, but she had more good days where she could mentally separate her life from his.
Lily started to talk more about her own upbringing and the bad things that she had experienced at home due to her father’s temper. In time, and with some initial medication from her doctor, her sleeping and her blood pressure both corrected. As she progressed, we met less frequently, but still sometimes got in touch for a check-in when there was a new crisis. The last time I saw Lily, she told her that one of the biggest things she had gotten out of therapy was developing compassion for herself as a young mother and understanding that she had done the best she could, and that her son’s difficulties likely had very little to do with her parenting—maybe even nothing at all. Her other children had certainly told her this often enough.
Lily described an experience that a lot of mothers have, feeling that when your children are young, you control everything about their lives (because for the most part you do), but then realizing that as they grow to adulthood they are more and more their own people, and whatever the cause of their difficulties, only they can figure them out. It was hard for Lily to let go of the idea that she could help or fix her son, but the more she practiced this new way of thinking, the better she felt in her body and in her spirits.
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.