When No One Is Watching

Psychiatric TimesPsychiatric Times Vol 35, Issue 11
Volume 35
Issue 11

A chance encounter with a patient who had been slowly and painfully emerging from under the oppressive burden of a recent life-threatening illness and impairing mood symptoms changed everything for all parties involved.




Dr Tolscik is Clinical Assistant Professor in the Department of Psychiatry at Texas Tech University Health Sciences Center at Amarillo. She specializes in women’s mental health and is in private practice in Amarillo, TX.

Pure unadulterated and uncensored joy was what came to mind as I sat quietly behind a silver-haired woman and a cherub-faced young boy, taking in their intricate interaction. I was in a darkened theater, after having casually glanced their way, noticing them both staring with wide-eyed amazement at the vibrantly costumed performers cheerfully belting out a lively song-and-dance number during a live musical production. Each time the little boy, who appeared to be about 5 years old, turned his tiny head and grinned broadly in excitement, the woman would gently lean in and whisper something with a highly expressive and animated demeanor that made the little boy giggle and clap his hands in pure pleasure and glee!

The older woman’s fully engaged and responsive body language during this loving exchange with the young child was very special and not something I had ever observed to any comparable degree at a theatrical production, except maybe on stage between the actors. These two had a deep connection that was electric. Their heightened level of personal interaction, comfort, and ease with one another was palpable and quite moving to observe.

I thought to myself, “This is how we should all act with those we love and care for when we think no one is watching.” This pair was so connected to each other and to the magic unfolding before them; they appeared to be in their own little world. Pure rapture, I thought.

After the thunderous applause signaling the end of the performance had died down and everyone turned to leave the theater, I briefly glanced back at this memorable and inspiring pair and drew in a quick breath. The joyful and exuberant woman was one whose challenging life journey I intimately knew. I watched them leave hand in hand; smiling so broadly at each other as if only the two of them existed in the entire universe.

As a psychiatrist in a relatively small town, I run into people who I work with clinically from time to time. If they acknowledge me, I smile and greet them; otherwise I afford them the privacy and anonymity they desire. This time, our paths did not directly cross, so we did not engage in a typical and expected social exchange.

Several days later, the woman from the theater came in for a session. I pondered whether it made sense to bring up the theatre experience. In case she had noticed me there and wondered why I had not acknowledged her, I chose to share my observation of her heartwarming exchange with the little boy. When happened next, I could not have anticipated. This woman, who had been slowly and very painfully emerging from under the oppressive burden of a longstanding family stressor, a recent life-threatening illness and impairing mood symptoms suddenly clasped her hands together and exclaimed, “Thank you for telling me what you saw and felt! No one knows that living like that is my true essence because I have learned to hide it from everyone. No one really listens to me anyway, so I stopped telling them things. You affirmed what I have been feeling, but after everything I have been through, was afraid to admit to myself. I am meant to live a joyful life and I am so grateful for this validation from you.”

In the work that we do as psychiatrists, we are taught to maintain boundaries in order to protect our patients, as well as to protect ourselves. It is important, however, never to forget the essential humanness that connects us all. Taking the chance to affirm this patient’s unique gift of connection with her grandson was a gamble. Not doing so for this woman, however, would have been a lost opportunity to empower and encourage her fragile sense of self on her healing journey.

This realization and admission on her part opened up the possibility of change, after many years of silent suffering. In the months that followed that affirmation, my patient was able to embark on a path of self-discovery that eventually unburdened her of the majority her depressive symptoms, as well as her psychotropic medications. Had this experience in the darkened theater gone unnoticed, she may have continued to struggle and not be able to live her life to its fullest emotional potential.

We all need to experience more moments of being our true selves, even if someone is watching. For in allowing ourselves to revel more often in our true essence, we may to lucky enough, like this patient, to find our purpose and our joy. And who doesn’t want more of that?

Related content: My Mother the Poet


This article was originally posted on 10/18/18 and has since been updated.

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