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Incarnation tamination had been required.
For her first appointment, Rachel she sat quietly Rachel continued with the treatment and be-
in a chair furthest from mine. When I asked her gan to form a warm and trusting bond with me.
reason for coming, she softly replied: “OCD is When I suggested that we increase to two ses-
what I am seeking treatment for.” Rachel’s gray sions a week, Rachel was grateful and accepted.
hair was pulled back simply into a ponytail and Her symptoms were not the focus of our sessi-
she wore no makeup. Her heavy winter coat and ons; Rachel was. Rachel shared how apprecia-
gloves worn through the session alerted me to tive she was for me. Previous therapists never
her suffering. inquired about her childhood, her pain, her fee-
I had a very tender response to Rachel. She was lings of hopelessness, her isolation.
truly a tortured person. Rachel admitted to an- Rachel shared dreams in which she was alone,
ger with God for not healing her; she must be isolated, invisible in a crowd. Her affective ex-
so unworthy of His care, for she had asked for periences of childhood returned in her dreams.
years to be healed. Her sister was mother’s favorite and Rachel was
Pomeranian dogs have been my co-therapists nudged into the role of the odd one, the one that
for many years. They are wonderful transitional nobody wanted to be with. Her symptoms com-
objects and prompt playfulness in my patients. menced with lining things up, walking around
They also assist my modeling care for vulnerab- objects, retreating into endless obsessions. She
le creatures. In Rachel’s initial appointment, she felt so defective and unworthy. Her achieve-
confirmed her preference to not have a dog pre- ment at school deteriorated and there was no
sent during appointments. At the beginning of help from her parents, only mockery.
the third session, I briefly left my office to pro- I frequently employ a technique of introducing
cess Rachel’s credit card. Fifi entered my office commentary on different internal dialogues,
and immediately soiled the carpet directly in and different modes of behavior that I hear or
front of Rachel’s chair, something my well-trai- perceive emerging in the patient. In Rachel, I
ned Fifi had never done. While I was out of my heard her mental abuse of herself for percei-
office, Rachel stood to look in a mirror. She did ved failures, for lacking in care, for not obeying
not see Fifi enter, returned to sit down in her God enough to get better. When we talked of
chair and stepped in “it.” My patient, terrified of her love for her son, Rachel’s tone softened to
germs and just starting therapy, was horrified, express deep care and cherishing with no hint
as was I. I quickly and gently cleaned everything of viciousness that she experienced toward her-
I could from the shoe of my speechless and re- self. At such times, I would simply comment,
traumatized patient. My mind was racing. How “Wow, what a different tone in your voice now
could I utilize this moment not only to keep the than when you are berating yourself. Can you
therapy from terminating, but to move it for- hear that?” Together we found this nucleus for
ward? future growth. Rachel recognized goodness in
I sensed the Spirit lead me to remember the ad- herself, an internal ally to confront her percei-
vice of a supervisor: “Use whatever the patient ved badness.
brings you as part of the therapy.” As I regained
my composure and sat down, I solemnly looked Crucifixion
at Rachel and said, “Perhaps God wanted me As we explored Rachel’s history and her current
to see just how agonized you can become, just life, Rachel began to recognize two reasons for
how horrible your life must be. I have hesitated her distorted view of herself. First, she accepted
to recommend that you reconsider medication, the role of scapegoat in her family. She was bad
but as I witness your trauma, I urge you to re- and they were good. The second reason was the
consider.” Rachel miraculously agreed to my re- impact of her family’s criticism. The OCD men-
commendation and I scheduled her psychiatric tation felt like Rachel, but the viciousness was
evaluation before she left. I learned at the next her Dad’s tone of “you’re bad”, and Mom’s tone
session that Rachel’s shoes and clothing had of “you’ll never do it right.” Her facial expressi-
been discarded and that many hours of decon- ons reflected the different states of self that con-

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