What I Learned From a Patient I Treated in Therapy
By Sarah Gundle
I was chopping carrots to make soup when I returned the hospital social worker’s call about my patient Sharon. I had made calls like this many times before. At 78, Sharon had multiple medical conditions and was often hospitalized for brief periods. But this time was different. The social worker said brusquely, “Your patient, she died today of Covid.” The knife in my hand dropped to the cutting board. I began to cry deep, gasping sobs. In the five days since we’d last spoken, Sharon had died of Covid? How could that be?
Sharon was the first patient assigned to me on internship, a year before I completed my psychology doctorate. She had wiry, grey hair and piercing, blue eyes. In our first session, I asked her if there was anyone who really understood her. She didn’t answer right away.
“No,” she eventually replied. “I don’t think anyone has ever really gotten me.” Then she wept.
We circled around that question for the next 19 years as I treated her in both individual and group trauma therapy. I sat opposite her for so long that I memorized the veins on her hands; I would have recognized those hands anywhere.
“He’s like a piece of furniture,” she told the group about her second husband. “He’s just there. I should dust him when I dust the armoire.” She cackled.
Sharon called me from the emergency room after her husband hit her—not for the first time.
“I’m done. I’m moving on from him now. I’m telling you so you can hold me accountable.” Her voice was ragged and hoarse. I promised her that I would.
As a young girl, her mother was constantly telling her to cover her mouth when she smiled because her teeth were crooked. The one person who appreciated her vivacious spirit was her father. He bought her overalls, instilled in her a love of plants and the outdoors, and woke her up one night to see the full moon. He also sexually abused her for years; nobody ever knew. It took years of therapy for her to admit that it was wrong. “I don’t know how to be angry at him,” she said. “ How do you hold anger for someone who was also the only person who ever showed you tenderness?”
At times the therapy relationship is straightforward, the boundaries clear. With Sharon, from that first moment of intuition, it was different.
Before she married (and divorced) a third time, I told her it was time to revisit the sexual trauma.
“But why would I want to do that? I’m doing just fine without remembering all of that.” She couldn’t meet my eyes as she said this. I didn’t need to tell her that it wasn’t true, that marrying men who abused her meant that she wasn’t doing fine at all. She sighed heavily. In a small, tight voice she began to unwind the abuse, a process that unfolded over many years.
“I wonder if he died regretting what he did to me? Did it ever occur to him, or was I just not that important?”
A couple of years later, she asked, “Did you know in that first session what had happened to me?”
I paused for a long moment. “I think I did.” Perched on the edge of my seat, I was ready to explain but she quickly nodded.
“I knew you did.”
I might have recognized certain patterns from work with previous incest survivors, but the truth is that I just knew.
At times the therapy relationship is straightforward, the boundaries clear. With Sharon, from that first moment of intuition, it was different. She needed me, intensely at times, and I grew to love her. Some days after sitting with her I would go home and make dinner for my husband and pretend I still loved him.
But I couldn’t ignore the contrast. The person I was at home was a pale shadow of the person who, at work, dug so doggedly to find the truth about abuse. At first, the difference in the two versions of myself made me feel like a fraud. Ultimately, though, my relationship with Sharon helped me discover the version of myself I liked better.
“Sarah, you don’t look happy. Are you sure marriage agrees with you?” She asked me one day. She didn’t expect me to answer, but she was extraordinarily perceptive and rarely wrong. She predicted my divorce long before that relationship’s weary collapse and asked if I was pregnant before I had even allowed myself to take a test.
After my divorce, it took me time to acclimate to the idea of being a single mom. I felt ashamed that I wasn’t ready to take off my wedding ring, but I knew I wasn’t. I bought myself a chunky silver ring, so different from my thin, gold wedding band. Sharon was my only patient to comment on the new ring, or to notice, with raised eyebrows, its removal after a full year. “Good for you, honey.” She pointed to my hand. Our eyes met, and I swallowed the lump in my throat.
She also knew instinctively that I would not want to be questioned when I had a miscarriage at five months. Instead, she wrote a poem about loss and mailed it to me, so I could read it privately.
One line tore at me: “I remember to breathe, I continue to rise, up where the sun, or the stars grace the sky.”
“Sometimes I just marvel at the world,” she told me in her thick Texas twang the day I returned to work. “There’s just so much beauty in it. Every day I find something remarkable. So much heartbreak, but so much beauty.”
I learned to calibrate my honesty with myself through the intensity of our relationship. I learned to look in my own relationships for the satisfaction of feeling “gotten,” a word I will forever associate with Sharon.
Leaving my office was always hard for Sharon; she hated goodbyes. Eventually, we developed a ritual: I opened the door and said, “I’ll see you next time.” Every time she looked panicked. Then she would collect all her belongings (she always had at least three bags with her) and shuffle out.
In the long run, she was never able to truly escape her unresolved traumas. She longed for lasting connection but rarely found it. The same indomitable, obstinate spirit that inspired her to leave Texas often curdled into rage. The social isolation of Covid had made her angry outbursts much worse. She pushed away nearly everyone in her life but me.
My enduring imprint of her, though, is one of hope and vivid, irrepressible light. Her deep, throaty laugh was like the bud on a tree limb scorched by fire. I learned to calibrate my honesty with myself through the intensity of our relationship. I learned to look in my own relationships for the satisfaction of feeling “gotten,” a word I will forever associate with Sharon. Our work together helped me to both acknowledge my own broken parts and to notice and hold onto beauty. She saw life as a surprising gift. But, for me, she was the gift.
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Sarah Gundle is a psychologist living in Brooklyn with her two daughters. She has a doctorate in Clinical Psychology and a master’s degree in International Affairs from Columbia University. In addition to her private practice in Chelsea, she teaches courses on trauma and international mental health at Mount Sinai Hospital system. Her writing has been published in HuffPost, Wired, Salon, NBC’s Think, and Insider.