Patient A viscerally hated B, about whom she had murderous fantasies. Both were women in their twenties who had met on the job, but B had moved on and up. Though B was gone from Patient A’s life, Patient A’s bitterness remained steadfastly in place. How could B have so much, when she, the truly deserving one had so little? B was rich, sophisticated, a world traveler with European parents who spoke multiple languages….and, most humiliating of all, the boss preferred B.
Patient A grew up with few advantages. Her father fled the nest when she was about five years old, leaving her, her mom and two younger sisters to fend for themselves. Her chronically aggrieved mother did not warm to her girls, especially Patient A, and Patient A, in turn, warmed to no one — including me.
In session after session, I dutifully listened to a laundry list of grievances, notably her resentment of the good fortune of B. Her hostility crystallized on the other, now absent, young woman. When I tried to empathize with her feelings of deprivation and sibling rivalry, she shot me down. She wanted me to loathe B as much as she did. She wanted me wallow in her hate-fest, to talk about B’s awfulness in elaborate detail. I wasn’t being helpful, she said. Talking to me was a waste of time.
After a few weeks, I was shocked to realize that I knew B, that she was, by coincidence, another client. Neither patient was aware that I was seeing the other. To be sure, Patient B was nothing like Patient A described her. She was timid, polite, self-deprecating, a little depressive. Far from being rich, she had grown up on welfare. It was hard for me to understand how such a mild-manner individual could ignite such passionate dislike. Of course, Patient A’s hatred of Patient B was not about B at all. It was entirely impersonal.
Though they were no longer in contact with each other, I worried that they would cross paths in my neighborhood, or worse, in my waiting room. I felt guilty that I was harboring a secret – that I knew and was kindly disposed toward the object of her intense hatred. I was rigorous about scheduling wide spaces between their appointments. The whole dynamic made me anxious.
Through it all, Patient B never mentioned Patient A…not a word…not even a subtle reference. Patient A was not on her radar screen. Patient A never knew about her own triviality to Patient B. She quit therapy, and, I suspect, is still nursing her grudge.
.(Note that the patient’s identity is disguised)