Grimacing, my middle-aged patient described a somatic pain radiating out from a deep-seated void. This decades-old ache manifested itself as intractable muscle tension or tenacious migraines or debilitating heartburn and was always accompanied by emotional anguish.
At the void’s root lay existential angst, exacerbated by dark skies, loneliness, major decisions, and life’s transitions. Her genogram revealed deeply entrenched generational trauma. Her lab workup was normal. She sought out various modalities—medication, acupuncture, psychotherapy, psychic readings, herbal remedies. Her flares were fewer, but they struck randomly, disrupting her life for days.
The insecure attachment she had to her parents seeded doubt, and she wondered, “Am I enough?” She worried she was unlikeable. Or unlovable. To compensate, she offered to help everyone in her life—by cooking, advising, running errands, babysitting, and more. She then would become overwhelmed because she had no time for herself. She felt taken for granted frequently—no amount of gratitude from others could compensate for what her childhood had lacked. Perhaps, despite its self-defeating nature, busying herself to bury her fears and worries was the point.
One night, in a fever dream, a vision came to her. Her childhood self, wrapped in a giant bubble, floated into her consciousness, waving and smiling, laughing and somersaulting. She carried a message: Little You is OK! You have mothered her well, and you are released from the need to nurture her. Let Little You take care of Big You now. Let Little You’s bubble expand to fill Big You’s inner void. Little You is happy. It is Big You’s turn to lean into joy.
The next morning, she awoke feeling disoriented, in disbelief. As she processed her dream, a sense of calmness slowly washed over her. Perhaps her childhood self truly had been healed by the imperfect but unconditional love she tried to give to her inner being. Maybe her deep inner void was now sealed, and she was lovable and enough. Maybe she no longer needed to prove to the world how helpful and capable she was. Perhaps she could simply exist.
When I last saw her in the office, her pain had morphed into a gentle pressure beneath her sternum. She considered her next steps from a place of curiosity, unsure of where her path would lead. She drew comfort from the messages she received from her younger self. She drew upon her new-found wisdom to center herself while trying to do good in the world.
Pam Adelstein
Newton, Massachusetts