Clara (name changed for confidentiality) had been a client years ago.

She presented a remarkable story. She was a married woman with a loving husband and one boy and one girl. She lived a long distance away and came to appointments when the children were in school. She was employed part-time in a grocery store. Her devotion to her children was displayed, also in her job. Her hard work took notice, yet she couldn’t justify any longer work hours. Being home prior to the bus arrival was not a source of debate.

She had a story to tell and desperately did not want to burden Allen, her husband. They lived a life not without parenting problems. Before seeing me, she had seen a woman therapist who retired, much to Clara’s disappointment. Clara was taking prescribed medicine for depression and anxiety.

Clara used her first session as an overview to a positive therapy experience with the retired woman. That day and many more sessions to follow, Clara’s therapy history was a good fit. Issues she presented were linked to parenting and her roles including wife, mother, and daughter. The woman therapist proved to be an effective role model. The power and resourcefulness of the woman-to-woman connection built a sturdy foundation for Clara. Following the therapist’s retirement, Clara took six months off to reassess her life. Reportedly, she and Allen shared much of what she’d learned and processed. The foundation was strong. They decided together that she needed to continue therapy treatment. It became our challenge to first see if we’d be a good fit given this chapter in her life, and secondly realize a commitment to a lengthy therapeutic relationship.

When a client such as Clara presents with a remarkable history as she’d unfold over time, patience was critical. I needed to be likened to the audience as the movie moved at its pace. The tendency to rush into Clara’s therapy with multiple questions might possibly disable the gains; the progress she’d made with the former therapist.

Clara clearly expressed some hesitation, if not a degree of uncertainty working with a male therapist. Starting anew posed a unique and awesome challenge for her. The guidance she’d received did not require a misguided over-anxious therapist. Clara was certainly testing me. Her soft-spoken reference to her past therapist could not be misdirected. What she’d learned was reiterating, foundational, and a centerpiece for what would follow. Many sessions left me wondering what to write in therapy notes. Sometimes it felt like we were merely chatting. Faith in herself was shown clearly. The pace of therapy was Clara’s. Silently, when she’d look me straight in the eye, I’d wonder if I was being effective. Clara continued to come weekly for years.

Much of the information Clara had shared during this period defined her role as mother. She expressed doubts as to her effectiveness. She came alone. Years later I met her son, a troubled young man. Occasionally, Allen joined Clara. His deep abiding love for her was made clear. Allen was Clara’s second husband. Clara rarely referenced her first husband, the father of her children. Allen adopted the children and essentially was a real “dad” to them. He had a warm heart and was a hard-working man. He’d let Clara speak during the sessions he attended. He had a loving glow when Clara spoke. Over time, perhaps she’d talk about her first husband and his influence upon her life and the lives of the children. There was a lot of information, but Clara hadn’t shared that experience.

As time ventured forward, Clara began to talk about her medications and their effect on her life. She knew that they were helpful. She needed one for sleep. Getting a good night’s sleep was problematic for years. Her former therapist consulted with a psychiatrist who agreed to meet Clara. She had confidence in her therapist’s guidance in that matter. She met with the psychiatrist who suggested a trial of medicine for sleep and to get her through the days. Over the course of months, Clara and her psychiatrist agreed on two medications. She told me the psychiatrist was made aware of Clara’s life, schedule, and the need to be on alert. Her multiple roles as mother, wife, and worker would need regular assessments to determine functionality and quality of life to Clara’s liking. When I received her as my client, she’d been on meds for several years. A short respite proved unworthy of permanent discontinuation. She was agreeable to continue with the two medications.

I found that if we did a quick question and answer, (a layperson’s assessment) about her medications, it gave her several minutes to breathe. Clara’s children were both experiencing behavioral problems. Past therapy provided comfort to talk about parenting. Currently, this is a different era. Her adolescent children were becoming difficult to control. She inquired about counseling for the children. She and Allen agreed that school counseling was helpful for their daughter. She gradually developed a good rapport with the school counselor. Family counseling helped gain tools to then use at home. Their son conversely was presenting behavioral problems at school and at home. She asked that he be seen for 1:1 therapy. The question of any psychic interference was soon remedied. He saw me for a couple of sessions, complained that his mom and I would “gang up on him.” We all agreed to a change of therapist for Clara’s son. The downside she reported to me was that he’d refuse treatment if the therapist shared info with the parents, Clara and Allen. That is often a sticky decision. What’s in the best interest of the son? Because his behaviors are causing problems at home, a sound decision for the family’s well-being needs to be addressed. Tricky, yet all parties must be decisive.

Her son finally, after much torment and acting out, allowed his parents’ involvement in his treatment. Nevertheless, Clara’s anxiety struck a new chord. With so much to do for balance and equanimity, her son’s life elevated her symptoms. Enough for now. We made an appointment for next week. Let there be peace on earth and let it begin with me.

Marshall Greenstein holds a master’s degree in marriage and family counseling and is a licensed marriage and family counselor and a licensed mental health counselor in New York state. He has regular office hours at 415 E. Sixth St., Jamestown, and can be reached at 484-7756. For more information or to suggest topics, email editorial@post-journal.com.