Mother: “I was a little surprised last session, that you” (the therapist) “did not say
anything to Melissa about what she was doing or the choices she was making. I need
to be able, as her mother, to express my concern for her. I wouldn’t be doing my job as
a parent otherwise.”
Therapist: “It’s really hard for a mom not to worry. I think that is the job of moms
everywhere.”

Mom: “I can’t help but feel she is making a mistake, that she doesn’t know what she
is giving up.”
Daughter: “Why can’t you just trust me and let me make my own mistake? I can’t
tell you anything! I know from the look on your face how you feel—you make it
abundantly clear!”
Mom: “But I don’t know why you don’t talk to me. You know I can handle it. I want you
to let me know what is going on with you.”
Therapist: “This is where you get caught in the cycle, because you as a mom want to do
a good job parenting and protect your daughter. Melissa, you hear all this protection
as disapproval and judgment, so you withdraw. Mom, you are left not knowing what is
happening with Melissa, which is scarier still, plus you both don’t get to have a close
relationship with each other. I would expect that’s what you both want—to feel closer
and more able to talk to each other.”

Mom: “I want to be able to talk to Melissa, but sometimes I just don’t know how. She doesn’t
want to talk to me.”
Daughter: (rising voice) “It’s not that I don’t want to talk to you, but what do you
expect? I just hear how I am screwing up. You think I want to hear that?”
Mom: “I am just trying to be your mom.”
Therapist: “It sounds like it’s really painful for you, Melissa, to go to your mom and to
see disapproval. It’s really important to you how your mom feels about you.”

Daughter: (starting to cry) “Of course it is important. She must know that.”
Mom: “I don’t know that. It seems more like you just want to get away and that you are
so angry with me for the past.”
Therapist: “That’s so hard for you to think that Melissa is mad at you, particularly
when you think of the past.”

Mom: (crying) “I don’t know how I can get over the past. I thought I was such a good
mom. I was so involved in Melissa’s life—I did everything with her and with the eating
disorder I didn’t see it—I didn’t see it at all.”
Melissa: “I was a good liar. There was no way you could know—I covered it up.”
Therapist: “This is a really painful part of your relationship. It sounds like it’s really
hard for you to get over what happened, and you feel so guilty as a mom that this
happened to your child.”

Mom: (crying) “I don’t think I can ever forgive myself. It should never have happened.”
Therapist: “And you wonder how Melissa feels about it also—could you talk to her
about that now?”

Mom: (looking at Melissa) “I am so sorry that it happened.”
Melissa: “You’ve said that before. I know that you feel that way, and I don’t blame
you—that’s not what pisses me off!”
Therapist: “What happened in the past is not so alive for you now Melissa as it might
be for your mom. When your mom feels bad about the past, you feel bad also and feel
maybe a little guilty for your mom’s feelings?”

Melissa: “I want to get over the past. I feel like a big screwup when you talk about it.
I want you to see what I have done and how I have got better. You don’t give me any
credit! You know how hard I have worked and the number of therapists I have seen—
does any of that sink in!”
Mom: “I know you have worked hard, and I am not worried about your eating. I just
don’t know what to do.”
Melissa: “You could start with not being so critical and cutting of me. I am not the little
kid who was stuck in hospital and not able to eat. I have changed a lot since then.”
Therapist: “I get the sense that it is more about what is happening today with your
mom and the disapproval that is so hard to bear.”

Melissa: (looking at her mom) “I have been working really hard to get out of this. All
my life I have been trying to please people. I would do anything for someone else and
that was something that you taught me to have compassion for others—you know, even
the sick squirrel on the street.”
Mom: “Yes, but that is what I am afraid of—that you will get stuck there, just pleasing
others and not looking after yourself.”
Melissa: “I am trying to take care of myself. I need to feel good about me” (starts to cry)
“and that is what is so hard.”
Mom: (crying) “I want you to feel good about yourself—that’s really all that I want for
you. You are so beautiful and strong, and I want so much for you to see that.”
Melissa: “And I am—some of the time. I am working on it. That’s why I am quitting—
it’s not good for me, but when I try to talk to you and I see that look on your face.”
Mom: “You know, I think that is when I am feeling bad about me—it’s hard for me to
feel the good inside.”
Therapist: “It’s hard for you to feel good inside, especially when you feel like you are
failing or not doing it right as a mom?”

Mom: (starting to cry) “I have always struggled with this. I never had a mom. I mean
she was never there. There was no way for me to feel good, I just did things for others.
I don’t really know how to be a good mom. I have just been winging it, and when I don’t
know what to do I just lose control and say and do things I never should do and then
I feel bad and the whole thing starts all over again.”
Therapist: “You have tried very hard to mother Melissa without really knowing how
and when things have gone wrong. It sounds like you feel such fear inside that you
lose control and try to make things better by overreacting which, in the end, you regret
and you end up feeling bad about yourself and your relationship with Melissa. Is that
close? Is that how you feel inside?”

Mom: “I never really thought about how I felt inside.” (pause) “But yes, it’s like terror.”
Therapist: “‘Terror.’ That sounds very powerful, very scary. Kind of like when you are
needed the most, you feel the least equipped, and that terrorizes you.”

Mom: (sobbing) “She is my baby and she almost died, and it was all my fault. I didn’t
know what to do.”
Therapist: “That is so hard, to see your child so sick and to feel so responsible. You are
so afraid of not getting it right and feeling so responsible. That is a heavy burden.”

Mom: (nods)
Therapist: “But I am also seeing Melissa sitting here, and she has done lots of hard
work and has strength and determination. Can you look at her? Do you see that?”

Mom: (raises her head) “Yes, I see her strength. She is amazing.”
Therapist: “And I see that you are not alone—either one of you. You are here trying to
work out your relationship, and you are trying to figure that out together—how to take
care of yourselves and each other.”

Melissa: “And that’s what you taught me, Mom, to take care of others. That is also a
good thing, right?”
Mom: (looking at Melissa, smiling) “Right. And you taught me that you are growing up
and that I can trust you and myself. We just need to talk to each other.”
Therapist: “What you are saying is really important, Mom. It sounds like you are say‑
ing a lot about yourself and Melissa, and how you want the two of you to be. This is
an important lesson and I want to make sure that Melissa understands what you are
saying about the two of you. Can you tell her, right now, how you want the two of you
to be in the future?”

Mom: (looking at Melissa) “You know that your grandmother and I are not close and
what I want for us is to be close. I want you to know that I will be there for you, that
you can come and talk to me anytime, and you know I will try to remember just how
grown up you are, and I will try to listen and not tell you how to be. I do trust you, and
I want you to trust me. I am there for you.”
Melissa: “I know, Mom. I do want to come to you. What do you think matters to me
most? You know, I do want to talk to you. I want you to believe that I do have my head
on straight, and I do know what I am doing.”
Therapist: “This is really important what you are saying to each other now. This is how
you want it to be and really you are doing it right now. You are talking to one another
and being open and sharing. That’s really nice to see.”