WORK: SEDUCTION OR SUCCESS?
I will now turn to the middle phase of treatmentI have artificially broken the therapy into 3 phases, to organize the material for presentation; in this treatment like most, all themes were present across the entire treatment although certain themes were more central in one phase than anotherso, the middle phase of treatment, beginning at about the 12 month mark when Caroline came to feel that a good, solid structure for recovery was firmly in place; NA and AA meetings 45 days a week, a sponsor who she spoke with every 23 weeks; a group of friends (gathered originally from meetings) who supported her sobriety, a therapy she had tested out, and a safe home existed for her. One of the largest tasks she tackled in this middle phase was that of making the use of her intelligence and talents an unambivalent source of satisfaction for her.
The persistent manner in which Caroline worked at this goal has characterized much of the therapy. She had been waiting tables for the first 6 months of treatment. Subsequently a friend helped her get hired at an advertising agency, where she began in the mailroom but quickly proved herself to be so competent and talented that she was promoted within 12 months to head of the art dept. She then reported becoming worried; "Maybe I'm being seduced into a 95 straightjacket; I've been trying to hard to keep away from that." She said she couldn't tell if she really enjoyed the work any more. "My parents would be so proud of me if they knew how successful I am; does that mean it is bad for me?" She felt very shaken, confused, and anxious for a while; she was thinking about quitting. In succeeding sessions, Caroline worried that she would lose her new "sense of herself"what she further described as having likes and dislikes all her own, not to have to worry about displeasing anyone. Caroline put it that it felt to her as though there were only two options: to go back to "the wild life," or "to accept that work is just a burden, but that's what responsible people do." The way I put it was: the two options were either to live for her parents in compliance with their rules for straightjacket living, or live selfdestructively in compliance with their expectations of her failingno matter which she chose she lost out. In these discussions, Caroline objected, saying my interpretations of compliance with her parents didn't feel accurate; her anxiety attack must be about something elseher boyfriend probably. She left the first and second and third hour in which I proposed this notion, feeling that I had not got it right, but she also reported noticing that she was feeling more enjoyment at work. While still disagreeing with me, she did come to love her work and has continued to feel so.
During the first 2 and a half years, when Caroline was so very angry and suicidal, comments of mine which cast her parents as having themselves been deprived, such as"It seems that your mother and father are doing to you what was probably done to them"made her feel so sorry for them and so guilty for criticizing them that she could not tolerate it. On several occasions she told me that she had unsafe sex or felt suicidal following comments like this in an hour and so I learned not to say them. This same issue came up again when her sponsor was helping her do step studyparticularly the step in which addicts are asked to make amends to those they have hurt. Her sponsor was urging her very strongly to forgive and let go of her anger with her parents. Caroline felt very confused and upset with herself that she was not able to do this, that she did not want to do this. I offered her an explanationthat she would eventually be able to do this step but that for now thinking about her parents' as victims themselves led her to empathize with them so fully that she couldn't make headway on her central task, that of rejecting their negative views of her which had become internalized as selfblame. Only after she had developed the ability to fend off the guilt and selfblame, could she afford to think sympathetically about her parents' life dilemmas. She has told me more than once how helpful this explanation was, in making sense of something about which she was initially confused and frightened.