My first case

You wear mostly neutral colors: whites, grays, browns and blacks. Your face is pale and tired. It is hard to get a sense of you at first: you speak mostly of strange dreams, and of your efforts to get pregnant. Your social worker fears you may be depressed. You tell me you're afraid your boyfriend will leave you if you can't have children. You have been to doctors, healers, herbalists. You may have been pregnant once, as a girl, but your boyfriend's parents forced you to get an abortion--though no one ever did a pregnancy test. "I'm from Mexico," is your explanation. You later married that boyfriend.

I record your affect as "down" rather than "sad"--in fact you look as if everything about you were falling downward. You voice is flat, you do not cry, and you speak little of how you feel. The first couple of months your attendance is sporadic. I decide to tell you I think our work would be more successful if you came to see me more often. I worry my pressure may push you away.

But you come to your next session, and you keep coming. I say, "We haven't talked much about your history, your childhood..." and all at once, you divulge to me your absent parents, your caretaking role for five brothers, the multiple people who sexually abused you. Your husband couldn't make love to you after you married. You list your many efforts to save your marriage. Your sadness materializes not when you discuss your husband's multiple affairs, but when you describe how grieved he was at his own predicament.

My supervisor points out that my insistence, perhaps, was what you needed. I let you know you were important.

My instinct with you is to step back, to allow you space. For a while, it is as if I'm speaking to a self who's not yet there with us. She betrays herself in little peeks. Once, you say, you punched one of your husband's mistresses. I smile in surprise, and you smile too, before telling me you later apologized.

You start to recall things you had forgotten, like the "healer" who also abused you--and I'm relieved to see you scowl in anger.

"What is wrong with people who do that? Are they sick?" You ask me.

Good question, I say. Certainly something is wrong with them.

Patriarchy stares at me straight-faced. Alive and well.

"Am I getting better?" You ask.

Good question, I say. What is 'better'?

As time passes, you seem slowly to come to life. You show up wearing exercise outfits. Your posture straightens, your face brightens. You make more eye contact. You take a new stance with your boyfriend, weighing his strengths and his faults, considering whether you want to be with him. You see him as immature. I offer that he may rely on the caretaking you provide. You say Yes, he never had a mother...and a swell of power rises in you. Quickly, you get way ahead of me in your insights. I try to reflect back the woman I see emerging.

Soon you don't really need me to say much anymore--you even interrupt me when I speak.

That's when I think you're getting better.