Thank you both for writing. To help keep this answer straight, I’m going to call the nursing student “NS” and the pastor’s wife “PW.” The problem might have something to do with early abuse but in NS’s case there is a huge mitigating factor. NS was well loved by her bio-mom who so much wanted the best for her that she encouraged the relationship with the pastor’s family. She has also been loved and supported by PW who gave her what her own mom couldn’t. One possibility is that there just may be some loyalty issues at play here for NS since PW is a nurse. Does becoming a nurse feel to NS like some final betrayal of her mother?
If NS were seeing me, I’d ask her to imagine that we had some magic and all the obstacles had been cleared away and that she has become a nurse. How would things then change? What would she expect of herself? How would her relationships with important people in her life change? What does she imagine others now expect of her? Often imagining a positive outcome will highlight the fears. Then we would address those fears directly.
I do think PW is correct: NS needs a counselor to help her identify what is blocking an otherwise smart and motivated woman. At 47, I imagine that NS is really sick of this and wants to get on with a career she has been working toward for so many years. I can’t suggest a counselor but NS’s primary care physician would be able to help her know who to call. Someone in the PC community who comes from the same area might also have suggestions. I do have a bias that a therapist who is close in age to NS would have a more intuitive understanding of what it means to be getting older and to be feeling that it may be “now or never” to go for her goals.
I wish you well,