When I checked with him Monday to verify our appointment time, he let me know that he couldn’t “make it downtown,” but suggested we could meet later in the week. I took him up on the offer, arranging for Tuesday.

I can’t fully describe the smile on his face as he then confessed to me that day that “I’m really sorry, but I have to tell you:  I just didn’t really feel like getting out of bed. I’d been up all night, you know.” Doing what, I’m still not quite sure, but there were movies involved. I think. In the business we call that “resistance.”

Yet I was so glad to see the smile–who cares, really?

I’ve spoken of him before, in Will the Real Me Please Stand Up? He’s doing better, much better, in fact. He’s responded well to the Suboxone treatment. Furthermore, he finally decided to consider antidepressant treatment. He’d been finding it hard to get up no matter what the reason, had been tearing up more than normally, had felt so depleted. He wasn’t excited about the prospect of medication, but he gave it a try. He even experimented with a little med furlough on his own–and started himself back on it after a few days. He was feeling more energy, getting more active, getting along well with his girlfriend and his family. Nightmares had decreased quite a bit. He finally decided that he and I were on the same page after all when it comes to this medication stuff.  Good news all around, in other words.

I want to write today about decision points: metaphorical places from which, in any encounter I have with a veteran, I have to decide whether to stay put and be happy with where we are–and hopefully where we’re going–or to push both the combat veteran and me forward, maybe toward territory the veteran and I both know needs to be traversed, maybe simply into unknown territory, or better put, the dark.

I also want to talk about foundational points, metaphorical places from which we find our steadiness to move forward, into the light, the dark, metaphorical places within us, always there.

He was happy enough.  I could have left well enough alone.  Truly, I wasn’t (at least consciously) trying to stir trouble.  Still, I thought: heck, why not pitch a little something in one direction and see if he follows it?  If he doesn’t, let it lie, wherever.

“So how are you spending your days?” I asked.

In retrospect, I can’t quite recall when he made his admission: although feeling much better, he was still stirred by the lack of focus that he’d talked about with me when we first met.

“There’s something big out there that I should be accomplishing, it’s just . . . I don’t know what.”  He hesitated a bit, appeared about ready to switch the subject, but then fell silent, his head tilted slightly downward.

That’s when I decided to make the metaphor explicit, again to see what would happen.

“So what’s getting in your way or keeping you tied down?”

The location-movement metaphor is a common one in therapy, even banal.  Most of us associate progress with forward motion, failure with backward motion, a stale discontent with being moored in one place, unable to move. Maybe obstacles get in our way. Maybe we don’t have the fuel to get going. On and on, the narrative can just flow out from us.

“I . . . I don’t know. I just . . . keep screwing myself up, you know?  I can have it good for a while, a great girlfriend, a good job. But then after a few months I begin to question it all and . . . well, like I said before, sometimes I just cause trouble to get it all to end, be over with.”

He’s an insightful guy, and I have to agree with that assessment. There’s a certain diabolical–even hellish–cycle to it all. It was curious, though: as he spoke, gone was the painful self-deprecation that had so tortured him pre=medication.  Still, there was something.  What was it?

So we seem to be ready to move, I’m now thinking.  So what will it be? Forward into “new future, new life”? Or backward into “old past, old death”?

I feel this question a lot.  I wonder whether I do more harm than good sometimes, mentioning–try as I may, gently–a  past, perhaps a feeling that still can pop up whenever that past peeks through the window to see if anybody’s home.  Maybe it’s just me, my remembering how there were ghosts in my own life that eventually were best faced, places in my life where such ghosts tended to lounge around and haunt, times when those ghosts in those places refused to remain silent, even in the face of my best breathing techniques.

“Deep down, is there a part of you that still feels him, your buddy?”

I’m vague only for purposes of this post.  I remembered the man’s name.  I remembered how he, like my patient, had been blown away that day on that road–but how, unlike my patient,  there’d not been enough of him left together to med-evac to Germany.

He noticed that I remembered.

“Not every day, thankfully,” he finally murmured.  “But a level or two down?”  He looked up, right into my eyes.  “Every day.”

This was not depression.  This was not just grief.  This was The War.

Why I went down the next road, I haven’t a clue.

“Have you ever spoken with his family?”

The look he gave me was–what?–wounded, I guess, but not one from a wound that exsanguinates life, but rather one of those that bleeds slowly, steadily, lethally

“No,” he whispered.  Then after a few seconds, “I’m afraid they’ll hate me.”

I was my usual clueless for only an instant, thankfully.  Then it was obvious.  “Because you lived.”

He could only nod, barely at that.  There were no tears.  This felt even deeper than tears.

How tempting it is to blurt out at this point something like, “Oh, no, they won’t.”  But I’m no fool, and neither is he.  Probably they wouldn’t.  Maybe they would.   But that wasn’t the point, at least this juncture, was it.

I decided to go ahead and pull out a big gun.

“You do know,” I said, “that if it had been you who had died, not him, and that if you could have found a way to speak to him today, you’d have told him that you wanted him to move forward in life, right?  That the last thing in the world you’d want would be for him to stay stuck in all this because of you?”

He’s a bright guy.  He doesn’t need the concept of analogy explained to him.  His closed eyes and subsequent downward tilt of head told me so.

For a few moments, silence.

“You’re not leaving him behind,” I finally said.  “You’ll never forget him.  You’re building upon him.  He’s become–and he’s becoming–the foundation from which you set out every day.  You’re not stepping on him, as if you were groping somewhere at his expense.  You’re building upon him.  He’ll never not be there with you.  Never.”

He was still looking down, but he winced.  Then he had this epiphany look on his face, an epiphany-from-hell look.  He directed that look right at me.

“I hate me.  That’s it, isn’t it?  I hate me.”

It’s a funny thing about therapy, life: sometimes we say words that we have said many times before–but we’re not saying the same words.  The words have finally done their job, infiltrated our souls, finally.  And then they dissolve, leaving just their scratched-on messages upon our hearts.

A few more seconds of silence.

“We have to do something about this, you know,” I finally say.  “Else the cycle will keep playing itself out.”

He lowered his head again.  “I know.”

“Once you admit it, then you’ve got to sit with it.  We’ve got to sit with it.  Maybe a long time.  But have no fear: if we take it seriously, don’t fall into it and drown in it, you will do something with it, something that will move you forward.  You’ll have no choice.  That’s the way life is.  That’s the way you are.”

He looked right up at me, not accusingly, not imploringly, just looked at me.

“I’m trusting you on this one, you know,” he finally whispers.

“I know.”

And I do.  This is serious.  I take it seriously.  He’s given me permission.  He’s given me a gift.

A few housekeeping matters, and then he stands up, pauses, and offers me his hand.  The smile’s back, nowhere near as broad, but it’s back.

“See you next week,” he says.

“See you then.  And remember that if–”

“I know, I know,” he smiles at the door, now the old broad one.  “I can call you if I need to.”

My turn to smile.  “Yup.”

“See you.”

“See you.”  Then he’s gone.

We move forward.