This article is part of an ongoing series exploring the role of psychotherapy in addressing deep emotional wounds, particularly those rooted in early abandonment. Each installment follows one segment of a single, real-life case study, offering an intimate look at the challenges and breakthroughs that emerge in the course of therapeutic work. Through the unfolding story of Patricia, we witness how past pain can resurface—and begin to heal—when held within a safe and reflective space.

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The Orphancy Lens, Part 6.
In this session we see the internalized orphan’s fear of “The Deep Work” and the resulting enactment of preemptive abandonment. Patricia’s compulsive busyness and slap-dash emotional remodeling serve as a psychic defense against the intimacy of the therapeutic bond. By missing her appointment and going “MIA” at the onset of labor, Patricia effectively orphans the therapy before she can be ‘dropped’ by the process of change. She remains an orphan at heart, trapped in a cycle where she recreates abandonment—both by distancing herself from Liz and by potentially distancing herself from her newborn—thereby ensuring that her unhealed, rejected parts remain isolated rather than integrated into a cohesive Self.

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orphancy at work

Liz thoughtfully sipped her tea and thought about the progress her client, Patricia, had made over the past few months. Before getting to know Patricia, she would probably never have believed that she would find in her such a willing and able client. Patricia’s gutsiness and her agile mind combined to make her very determined, indeed. Still, several of her characteristics as a client were troubling, and tempered Liz’s admiration for Patricia with a more sober underlying assessment.

Patricia was as avoidant as she was determined, which combined to retard her progress and make it doubtful that she would complete therapy. Their closeness as partners in therapy seemed at times to make Patricia giddy, but when too much progress occurred, Liz could be sure that Patricia would later cancel appointments, bounce a check, or have some crisis that would delay one or more sessions.

Just in case a crisis or missed appointment wasn’t in order, Patricia made sure she was busy all the time. Though now nearing the end of her pregnancy, her life was full of endless errands, projects, work-related tasks, parenting, and other activity that left her no time to reflect or work on issues that had been raised in therapy. As a result of her compulsively busy lifestyle, Liz knew that it was unlikely that Patricia would make much progress at really reversing the destructive habits established during her crippled childhood.

“She’s still an orphan at heart,” Liz mused to herself, “a lost girl who never got what she needed—and is still paying for it—and perpetuating it.” If only Patricia would make healing her priority! Liz grinned wryly and said out loud, “Liz, now you sound like a therapist!”

client mia

Liz looked at her watch again and realized that Patricia was 10 minutes late. She walked out of her office and asked the receptionist, Ashley, if there had been any calls. “No calls, Dr. Campbell,” Ashley replied. “And no cancellations.”

Liz frowned. Not again. Patricia made time for what she wanted to do, whether it was PTA meetings or watching American Idol with friends. It was becoming increasingly clear that their therapeutic relationship wasn’t a priority, maybe because Patricia had received just enough help to begin to feel better about herself and her ability to give her children a better life than the one she’d had. After all, Patricia wasn’t an alcoholic and didn’t keep addicts and alcoholics in her life; that made her a better parent than the ones she’d had.

This was the problem that many clients had: they accepted just enough help, and relieved just enough emotional pain that they thought they didn’t need anything more. After a little therapy, they considered themselves finished. Rather than plumbing the depths and fixing what was truly broken, they did a slap-dash remodel job, and made things look better on the surface, like a home staging you see on a house flipping show, Liz thought to herself. Once their lives look acceptable, they quit doing the deep work they so needed.

Many such clients were even able to raise children with the appearance of ‘normal,’ but because real health was lacking and so much was repressed and projected, usually the selfsame problems that had occurred in the family of origin resurfaced later. Even if Patricia managed to keep drunks and enablers out of her own life, she was almost certain to have a child who developed an addiction or who needed to enable one, because Patricia’s unhealed, rejected parts would demand reparation and finally become manifest in the very children she sought to save.

Carl Jung admonished more than once that those destined to fall into a pit ought to prepare themselves for it rather than falling into it backwards. “Everyone goes into the pit of self-discovery,” Liz mused, “but most don’t go there voluntarily.” Yet how much better it would be if they did!

This was a problem many clients had: They accepted just enough help, and relieved just enough emotional pain that they thought they didn’t need anything more. After a little therapy, they considered themselves finished.

delivery

Liz picked up her desk phone and dialed Patricia’s work number. This was a young woman who could do this–she could make it! She could do something different than her parents and grandparents had done, if only she would stick with the grueling psychological work. But Patricia wasn’t at work, the receptionist said.

Liz called Patricia’s home phone and was surprised when a young child answered. “Is Patricia there?” Liz asked, and was answered with heavy breathing and the sound of little feet pattering along the floor. “IT’S FOR MOMMY!” the child’s voice cried, and after a moment a woman’s voice asked “Who’s this?”

“This is Dr. Liz Campbell calling for Patricia,” Liz repeated. “Is she home? We had an appointment today.”

“Oh, this is her neighbor, Karen. But she’s not here. She went to the hospital this morning, she’s having the baby. Want me to take a message?”

Liz’s heart sank. The baby? Already? Patricia’s due date was still two weeks away. Now what would happen?

“Yes, please tell her that Liz Campbell called and that I’m hoping the best for her and the baby, and to give me a call when she feels up to it.”

Dismay washed over Liz as she replaced the phone. Patricia was on her way to realizing that she could be a good person, and that she needed to heal and could heal. If Patricia stuck with her decision to give her baby up for adoption, she couldn’t possibly feel good afterward. On some level she might believe she was doing the best thing, but a fractured part of herself would also be a mother longing for her baby. Patricia would have to bury yet another part of herself, making it even less likely that she would be able to integrate all the disparate parts and find a cohesive whole in them, a Self.

Liz sighed, knowing she might never hear from Patricia again and knowing that whatever choice Patricia made about her baby boy would set into motion a lifelong chain of events. Liz had worked with enough families separated by foster care and adoption to know that, if Patricia chose adoption, it would not be as simple a solution as Patricia seemed to think it would be. On the other hand, if she kept her son, life would be even more difficult than it already was.

Patricia was just as likely to have her healing thwarted by keeping the baby as she was by giving him up.

“Time will tell,” Liz said. “Time will tell.”

in session: tales of transformation

• Intro: An Introduction to Tales of Transformation
• In Session, Part 1: Considering Adoption
• In Session, Part 2: Client and Therapist Meet
• In Session, Part 3: Message in Blood
• In Session, Part 4: Dream Work
• In Session, Part 5: The Analyst is Analyzed
• In Session, Part 6: Deliverance
• In Session, Part 7: Disconnected
• In Session, Part 8: Termination

CONFIDENTIALITY NOTICE
This case study is based on real-life therapy work and reflects the emotional and psychological truths of the process. To protect the privacy of those involved, all names and identifying details have been changed.