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In matters like this, it was hard to build consistency, but she was trying and the good thing was, Lisa was also putting in the hard work to get better; to build her self-esteem and rid herself of all the negativity she had experienced at the hands of her ex-boyfriends, “Keep your head up,” Dr. Ansah told Lisa when they ended their sixth session in the third week, “Everything will be fine and you will be proud of yourself” she hugged her patient warmly and Lisa hugged her back, filled with gratitude. Now she didn’t talk down on herself constantly; she tried to be more patient with herself and held on to positive thoughts as much as she could.

She was dieting as well and even though it seemed smooth sailing on the surface; it really was a struggle, if she was being honest. But as Dr Ama Ansah said, it wasn’t just a matter of dieting. It was mainly a matter of loving and taking care of one’s whole body, soul and mind. If you love yourself, you will pay attention to what you eat and not open yourself up to anything at all. She loved the philosophy and so she was using it as an empowering quote to help her through the process. She hadn’t shared off a lot of weight for yet but she was striving forward daily.

*****

“Let’s talk about your upbringing,” Dr Ama Ansah said to Lisa at their seventh session in the fourth week, “how will you describe your parents?”

Lisa was sitting in the long grey couch, with Dr Ansah some meters away in a firm black one. Lisa sat thoughtfully for a while and then answered, “They are strict, verbally abusive. You do one thing wrong and you’ll be called all kinds of names. The last time I visited, my mother called me an elephant because of my weight. She said I’m ugly”

“She did…? And how did it make you feel?”

Lisa inhaled and exhaled softly, “I’m thirty-two years and my mother thinks the best way to advise me is to insult me constantly. She has always been that way”

“But how does it make you feel?” Dr Ansah insisted on her question, “It seems your mother doesn’t care about your feelings and calls you ugly”

For a while she sat quietly with the question, “I feel worthless” Lisa finally voiced, tears filling her eyes, “She is my mother and yet she says such things to me. They have both always been very dismissive people. My dad…” she started and then stopped herself.

“Say it. It’s okay. Say it” Dr Ansah urged.

“My dad believes in shaming as a way of correcting. He always says a dose of shame on your face is all you need to keep you grounded” Lisa started to sob. She pulled up some tissues and began to wipe her nose, “and he taught my mother to do. He said it’s either that or I’ll disgrace them eventually”

“Does your father abuse your mother; like verbally abuse her?”

“All the time” It surprised her how Dr Ansah was able to make the connection, “sometimes, he beats her”

“And afterwards she would turn her anger on you, right?” Dr Ansah asked.

“Yes,” Lisa answered softly, draped in shame, her head slightly bowed.

“It’s not your fault” Dr Ansah interrupted her thoughts, “It’s your mothers’ way of coping with the abuse and unhappiness,” she said and Lisa lifted her head, “She wants to defend herself and because she can’t fight your father, you become her target. She abuses you instead because it’s her coping mechanism” Dr Ansah explained.

“But does that make it right?” Lisa almost flared up.

“No, it doesn’t. It’s not right and I’m not defending it in any way. I only want you to understand why your relationship with your mother is the way it is. If you understand the roots of it, we can work to make changes. You want the relationship to improve, right?”

“I don’t know,” she shrugged, “it’s what it is…”

“What do you mean by that?”

“I don’t have any immediate intention to visit them again,” Lisa revealed, “I’ve decided I want to keep my distance. So whatever becomes of our relationship is not my priority right now”

“And you think this is the best way to deal with the situation?”

“I don’t know” Lisa raised her voice, “at least I won’t have them in my ear berating me. So yes, if staying away is what I need to do, then that is what I intend to do”

“I understand,” Dr Ansah said calmly. It was her place to stay calm and allow her patients to vent. She had been through this process many times with different patients and it never got old. She understood the confusion Lisa was dealing with and her role was to offer guidance and support, “I’m not saying how you choose to process this situation is wrong. I’m asking the questions to help us explore all the options”

“Well, right now this is the best way for me,” Lisa said firmly, which Dr Ansah felt was actually a good sign of growth. That fact that Lisa was beginning to find reasons to distant herself from things that berated and abused her was a positive sign. Three weeks ago, she was crying about the state of her life. This week she was cutting ties with all things that brought her pain and discomfort, and instead focusing on how to improve her sense of self-worth. It was a good sign and Dr Ansah was proud of that.

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