NOTE: This is PART I of a six part fiction serial depicting post partum depression. Due to ethical and legal considerations, confidentiality is strictly upheld in social work practice; therefore this article depicting a therapy sessions is fiction. The characters and dialogue are solely imagined and not based on any clients so any similarities to anybody you know is purely coincidental. Although the information regarding post-partum is accurate, treatment in therapy may differ as it is individualized according the specific needs of each client, a therapist's orientation, and the unique relationship created in each therapeutic experience.

First contact:

When she first calls, her voice is hesitant, soft.

“I don't know why I am calling,” she says. “My husband said I should call you. His friend gave him your number. I mean, he's not really a friend. Like an older man in his shul who he sometimes talks to and I think my husband told him some things and he recommended you.

I listen quietly to her little speech.

When she pauses for breath, I wait a second to see if she is finished, then ask, “So why is it that he thinks that you should see me?” It's not a good sign if someone comes to therapy because they are sent by someone else. Chances are they will come once, twice, inform the one that sent them that “therapy doesn't help” and because they had “tried” it and “it didn't work” it absolves them from trying therapy anymore, or even more, absolves them from personal responsibility to help themselves.

I don't even ask her name yet. She seems skittish, like a deer, and I don't want to scare her away by even asking her to divulge her name.

“I, uh, I had a baby six months ago,” she says.

I wait.

“And, I don't know, maybe it's normal, but I don't think so, but I just don't feel well. I am sad all the time. I love my baby, don't get me wrong. But it's so hard. Everything is so hard and I cry all the time and my husband says it's not normal and I don't know if it is or it isn't but I am miserable and I don't know what's wrong with me!” This she says in a rush.

“I went to my doctor and he gave me a pill. He said it will make me feel better. And maybe it does, but I still feel crazy, and then my husband said I should see a therapist and I called you.”

It bodes well for therapy that she made the call and not her husband, that she recognizes her issues that precipitated the call.

I ask her if she wants to schedule an appointment. She laughs uncomfortably. “Do you think you can help me?” she asks. Another good sign. Somehow in our short phone call, she has formed a connection and it has given her some hope that things can get better. I reply that I have helped others in her situation, and I am confident that I can help her too. I ask for her name, she tells me it is Chaya Thumin, and we make an appointment for the following week at 11am.

She forgets to ask, or deliberately refrains from, asking how much I charge. I inform her anyway. It's an interesting aspect of therapy that people who come can talk about the most difficult subjects, but money remains taboo. (More of that later.)

When I say, “Then I will see you next week,” she does not hang up, but stays on the phone. I do not hang up either. Finally she says, “I don't even know you. Is there someone I can call to find out about you?”

Although her comment is on target, it comes already after she has made the appointment so I am not sure if she is just getting her confidence now and bearing or if she is stalling for time because she does not want to get off the phone and be alone with her difficulties.

I say, “You can call RELIEF for a recommendation on me. Obviously for confidentiality purposes I cannot give you client references. You can also look me up on LinkedIn and Frumtherapist. There you can also read some articles about therapy that I have written for various publications.”

Then I say firmly, “I will see next week. Okay?”

She says goodbye and I hang up. This entire phone call probably has taken no longer than 5-10 minutes. I then text her my address and pertinent information how to find me.

The First session: Part I

The next week, the bell rings at two minutes to 11am.

I note that. She is early, but not too early. It usually means an generally put-together person. Someone who is organized and reliable. It also can mean she is anxious to start therapy and get better. Someone who comes too early would signal a red flag that she is someone who is needy and possessive, someone who may lack appropriate boundaries with others. Lateness usually connotes a resistance to therapy, an unwillingness to engage in the work; although, yes, sometimes it can just be that the car service never came!

She walks in. She is well dressed and groomed. Her hands are slightly shaking. She is average height, pleasant looking, but her nails are bitten down. She immediately hands me a check. “Here,” she says. I thank her and take it from her hand. I place it on my desk and gesture to her to take a seat. She looks around. She sees the couch, the two arm chairs, and the swivel chair. She stands uncertainly in middle of the room. I sit down on the swivel chair. “You can look around if you want, so you can get comfortable,” I say. “No rush.”

Her eyes wander over to the bookshelf, but I doubt she registers any of the titles. She then chooses the couch. She holds onto her pocketbook, keeping it on her lap. She does not take off her jacket. Her body language screams discomfort and her disconnect to this therapy room. She is a passing traveler here, evident in how she does not surrender to the room but keeps on her jacket and holds her bag close, as if she is on a train and soon to jump off at the next stop.

“Are you going to ask me questions?” she abruptly asks.

“Would you find that easier?” I ask, “or would you rather think what you want to tell me?”

“Ask me questions,” she says.

“You told me on the phone that you had a baby a few months ago,” I say, “and that you are crying a lot since then, that things are hard—“

And that is all she needs in order to talk.

She describes her pregnancy, how excited she was to have a baby, that she waited two years from when she was married until she found out she was expecting and she just knew she would be a perfect mother. The pregnancy was uneventful, she rarely threw up, and she and her husband were very excited. She lived near her parents so her mother is helping a lot, her husband is learning in Kollel, and she is the oldest in the family. All this comes out in a long run-on sentence.

Chaya describes how she had an uneventful delivery and came home with the baby. A few days later she began to feel sad and teary. She found it hard to get out of bed, to nurse the baby, or to do simple chores. Her mother was sympathetic and she went to stay at her mother's house until she felt better. But things got worse. She has little interest in the baby, and feels in the grips of a depression that just didn't let go. She has little appetite and can barely take a shower or get dressed. She just wants to stay in bed all day, but when she is in bed she feels worse, so she forces herself to get out of bed. Then she doesn't want to leave house.

The worst is that she feels like a failure as a mother, as a wife.

Nobody she knows with a baby feels like this. Nobody she knows is having such a hard time. And keeping this a secret is also killing her. She wishes she could talk to someone, like to a friend but she is embarrassed.

She feels sorry for her husband. He is really nice and supportive but she is sure he is wondering what is wrong with her and wants to her get out of it. This guy in shul who gave him my number said his wife once felt this way after a baby and therapy helped.

“But I don't understand how talking to you is going to help,” she says after she catches her breath.

TO BE CONTINUED NEXT WEEK...

[originally published by Jewish Echo Magazine]

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