No. I did not read the book, but for eight weeks, my husband and I ritualistically tuned in to the Fleishman is in Trouble television series. The storyline essentially untangles what every couple in a long term relationship comes to learn — that there is no objective reality in relationships. In psychodynamic jargon, it’s what we call “the swirl,” meaning that my subjective reality and your subjective reality get entangled and while both real, neither are actually true. Philip Bromberg referred to it as the “tsunami,” in therapeutic relationships, and in her famously quoted text, Anaïs Nin wrote, “we don’t see things as they are, we see things as we are.” The swirl of intersubjectivity is mysterious to us all and yet so desirable to understand.

In the show, it eventually comes to light that Rachel Fleishman may not actually be the horrible person we’ve been led to believe. Maybe she didn’t leave her children on her ex’s doorstep like it looks — maybe it’s a whole lot more complex than we could ever know. In light of this revelation, on our usual morning walk, my husband said to me, “I know you’re really good at what you do, but I don’t know if you could help Rachel Fleishman.”

I don’t think my husband meant to challenge me, and I definitely don’t think he imagined I would come up with a treatment plan for a fictional character. But Rachel Fleishman is actually a common clinical presentation, with common problems and treatable issues. Doing a light dive into how my mind might think about her, can give you some insight into how I work and think about people without compromising anyone’s confidentiality.

There’s the diagnostic question, which I don’t even think is the most important, but does Rachel Fleishman have bipolar disorder? The answer is that I do not know, but it certainly appears that she might. There’s the not sleeping, there’s the periods of high energy and productivity followed by depressive crashes where she cannot function, and there’s certainly an argument for impulsivity. I would hold all of this in mind when working with her, examine the cyclical nature of her struggles, and refer her to a psychiatrist so that we could get her mood stable enough to safely address her pain.

What I see as the root issue that informs every relationship Fleishman has, is the abandonment from her own mother, who died when she was a child. As adults we know that death is not literally an “abandonment,” but as children we experience it that way. It is the ultimate failure to a child, that leaves them wondering “why wasn’t I enough,” experienced almost as if the parent had a choice in the matter. They left, and they left at a crucial time in the child’s development. Lifetimes are spent trying to overcome that— but often are just re-enacting the trauma with the unconscious intent of mastery and finally obtaining the love that was never received, but so profoundly deserved. We need that hole to be filled, and we expect our partners to fill it — setting them up for the impossible and setting ourselves up to experience yet another failure.

I see the pain of her mother’s abandonment impact her in three main areas — the most obvious being her romantic relationships. No one can fill the shoes she needs in a partner, and most likely no one will. She needs to begin the long and painful process of that grief so that she can become the parent she has needed all along and develop more realistic expectations of a partner. That would be the bigger and longer term treatment goal that could take years of work (sorry).

The second is the relationship with her kids. She has unconsciously repeated her trauma on her own children by abandoning them at a crucial time in their development. We see that played out so explicitly as her daughter prepares to become a woman in the Jewish tradition and her son grapples with “manning up” by going to summer camp even though he doesn’t want to. They are forced, in a way, to grow up, just like she was when her mother died. I would very carefully and gently assess her tolerance and readiness to accept this truth — for only when she accepts what she’s done, can she begin to remedy the relationship.

Lastly, we would look at the relationship Rachel has with herself. We would acknowledge that the coping skills she developed as a young woman are no longer working. I see Rachel’s focus on achieving at all costs to be a distraction from a painful reality that worked until it didn’t. That distraction was a) a way to finally feel important enough, admired, and loved — although mostly superficially and in limiting ways, and b) the ultimate “justifiable” reason to avoid facing the parenting failures she has already committed and fears most. To come to grips with the fact that she left her children even before she “left” them. Rachel Fleishman has a lot of grieving to do.

Carl Jung famously wrote “until you make the unconscious conscious, it will direct your life and you will call it fate.” As Fleishman’s therapist I would be acutely aware that despite my best efforts, she may experience an abandonment from me as well until she truly grasps this is how she experiences the world. I would skillfully test her tolerance for facing these truths. We would slow down and begin the gut wrenching work of accepting what was, who she has become, and we would hold faith for the future. We would hopefully have enough time together for Fleishman to experience a meaningful relationship in a new way, to get through the hard parts in a new way, and go out into the world with a new framework and understanding of how she moves through the world — the hope being that this would ultimately enable her to make more intentional choices instead of unconscious ones, and achieve what she truly wants to achieve.