Ruminating worry. Although it would be years before Kathy would seek help for debilitating symptoms, she began being troubled by ruminating worry after the birth of her first child, and this continued apparently until sometime before CM therapy ended. Daily, Kathy would imagine the loss of one of her children in great detail and fantasize how she would comfort what she called the surviving children. Then she would change which child died and which survived and repeat the process. When asked to explain the symptom, Kathy said, "For some reason, as soon as my eldest son, James, was born I realized what my mother had experienced when she lost Dan, and that if that happened to me I could understand how that loss would be so devastating that she could never recover and properly mother me."
I have indicated that inner experiences such as this are granted consciousness for a motivational reason. What could that reason be in this case? I believe, to remind Kathy of her vulnerability. Because of her identification with mother and her strong commitment to motherhood, she possibly would react just as mother had if one of her children died, with the result that her career ambitions would die too. These daily daydream-like episodes acted as a spur, reminding Kathy that she had to find some way to distance herself from more from mother and weaken her overzealous commitment to motherhood.
Motherhood was fulfilling for Kathy, but it also was a way of marking time while she carried out unconscious plans aimed at increasing her readiness to the point that she could consciously begin to pursue a career. To use Erik H. Erikson's word, motherhood was Kathy's "moratorium." She wasn't yet ready to openly pursue a career path, but time was passing. Years were slipping away, yet she remained stuck at "start." When she tried to comfort her children in these daydreams, she was actually trying to find a way of comforting herself, and her failure to do so provided compelling evidence of her vulnerability.
"Crazy" time. As the years went on, her husband became threatened by Kathy's successes, but Kathy would not hide her abilities or her competitiveness, as she had with her father. As a result, her husband divorced her. Fairly soon after the divorce, Kathy became involved with a man whose company she enjoyed. Although she had tolerated birth control pills well during her marriage, she discontinued using them, claiming that she became concerned that they "might be bad" for her health. She became pregnant in this new relationship due to a failed diaphragm, and a "battle" began inside her. She had always had strong feelings about abortions: She believed in the fetus as a living being, but she also believed in every woman's right to choose for herself. Kathy aborted the pregnancy and ended the relationship with the man, stating that his "lenient attitudes" toward abortion made her conclude that he was not right for her.
Soon she began a four-month long, passionate romance with a man-about-town businessman who was fabulously exciting and put her "in the limelight." He treated her as an intellectual equal and described her as the smartest partner he had ever had. She felt recognized, prized, and special. They had fabulous times together. Then one wonderfully romantic weekend she got pregnant again: the second failed diaphragm pregnancy. Kathy felt that it was "unforgivable" to get pregnant twice and to have two abortions: "The first time was bad enough; the second time was the breaking point." She ended the relationship, never telling the man about the pregnancy because she "feared he would be permissive of abortion rather than seeing it as the killing of an individual." Every Mother’s Day since that time has been a "trauma" for Kathy: "Abortion is the antithesis of mothering." Soon afterwards a very curious sort of "depression" began.
One of the most dramatic changes the depression brought was in Kathy’s feelings about mothering. Although previously she had always been intensely "fulfilled" by her children and her mothering, she suddenly felt intensely "empty" with her children. She felt resentful of what she referred to as the "surviving children." It became very hard to mother them.
She also experienced an intense "vulnerability" and a feeling that her emotions were "totally out of control." Although Kathy disliked the feelings of loss and the physical symptoms of depression, she valued highly this state of vulnerability, which allowed her to feel alive and connected to people in ways previously unavailable to her. Previously, she was closed off from feelings, hidden, cautious, and guarded with others. During the depression, however, she somehow gained access to her feelings and allowed herself to express them.
"I didn’t feel depressed. I felt crazy. My hands would shake; I lost weight; my emotions felt out of control; I cried all the time. But I also played, had fun, and flirted with all these people. I felt very special. Then I would return home and feel lonely and miserable with the children. And I felt so guilty: Here I had these three beautiful children I had always felt so fulfilled by, and I wished I could be somewhere else." Although she disliked feeling emotionally out of control, she cherished feeling uncharacteristically alive. She became exceptionally animated and outgoing in her social and work worlds.
What was going on during this time? The first thing is to note the phoniness of Kathy's rationalization for changing to a diaphragm as a means of birth control. This, to me, is a tip-off that the relationships with the two men were part of an unconscious plan to reduce the importance of motherhood in her life. This happened with mother when she lost a child, so Kathy planned to become a bad mother too by losing a child through abortion. The first abortion didn't leave her feeling bad enough, so she repeated her tactic.
The symptoms that arose tell the whole story. They enticed her by allowing her to live the life she always wanted to lead while showing her that living that life was apparently possible only at the expense of her children. Her symptoms, therefore, dramatize one of her fundamental conflicts, namely, the fear that her ambitions were incompatible with her role as a mother, that if she allowed herself to pursue her ambitions vigorously, she would necessarily neglect her children. The symptoms also showed Kathy that she was getting in over her head, that she needed to seek help. So she started seeing a psychiatrist who diagnosed her as severely depressed and gave her pills to take. The anti-depressants cleared up the physical symptoms, but verbal therapy did not help much.