In fact, I left a message last week to let him know I was seeing you. Over the years Ive always called him whenever Ive changed therapists., But I thought you did not discuss him with all these therapists., I didnt. How to start? For example, why did Dave refuse to tell his wife that he was in therapy? She sighed, closed her eyes, and nodded. The more I looked into myself, the surer I was that my positive feelings for Saul were still intact. Swept along by hubris and by my curiosity, I had disregarded twenty years of evidence at the outset that Thelma was a poor candidate for psychotherapy, and had subjected her to a painful confrontation which, in retrospect, had little likelihood of success. Without them I might run wild., That was a curious comment. Uh-oh, I knew I was cornered now. It would be difficult to make her aware of these characteristics without hurting her. But he never lived up to that early billing. Please tell me, have you already sent that money?, Not yet. Probably there was some important oedipal competition going on between the two of us which was making communication more difficult. Moreover, for the first time, she was accompanied by her husband, Harry, a tall, white-haired man with a large bulbous nose, who sat there squeezing a grip strengthener in each hand. Going beyond words, that was what counted. Finally, I stowed it away in a drawer in my study., Yes, unopened. In that instant of confession, my entire construct of Jay exploded. And I hate their clothesthe shapeless, baggy dresses or, worse, the stiff elephantine blue jeans. It was only when I demonstrated how, in our hours together, her impersonal, shy, distancing manner re-created the same impersonal environment in therapy, that she could begin to explore her responsibility for creating her own isolation. Didnt feel comfortablethats putting it mildly. Im sure you know your business. Only a couple of weeks ago, she had grumbled that she was tired of being hadthat is, being sexually aroused and then left unsatisfied. The disguise is deep, penetrable in each case only by the patient. The benefits might be great. Then Id daydream about slicing that artery, relieving the pressure, and letting the blood out. But how should I handle the situation with him in the next hour? And yet, of course, she was in despair. Well, the last eight cant be counted as therapy because of Thelmas secretiveness. Not even for a handshake!. Whenever his cancer worsened and he was actively facing death, he rearranged his life priorities and became more thoughtful, compassionate, wiser. I flinched for Dave: that man at the advanced age of sixty-three was still six years younger than he. You kept putting the responsibility onto me, making me take charge of the session. Dont ask me any more questions about Dr. Z. I hope you dont know about whats going on between us.. Occasionally the woman into whose eyes Dan was gazing experienced the same deep spiritual linkage, and they were drawn together into lovebut a love that invariably passed quickly. Those whom he tries to restore to reality ultimately turn against him and re-enter the life of illusion. Ill be frank (like you tell me to be in therapy): that grates on me. Never have I had a supervisor like this. Thus her descent from two hundred fifty pounds set her spinning backward in time through the emotionally charged events of her life: leaving Texas for New York (210 pounds), her college graduation (190 pounds), her decision to drop the pre-med curriculum (and to give up the dream of discovering the cure for the cancer that killed her father) (180 pounds), her loneliness at her high school graduationher envy of other daughters and fathers, her inability to get a date for the senior prom (170 pounds), her junior high graduation and how much she missed her father at that graduation (155 pounds). Yet I was certain this was the correct trail to follow. I dont think Ive ever said a crueler thing, but to make myself heard, I had to speak in words so strong and so stark that they could be neither twisted nor forgotten. I, too, had my sack of letters from a long-lost love. When we finish, how will you get along without me? He became perversely incontinent: he refused to urinate outdoors but, waiting till he had gained entry to the house, drenched the living room carpet. Guinea pig litter. I suspected that Phyllis wanted to expiate her guilt for refusing to see a couples therapist. This question plagues contemporary men and women, and many seek therapy because they feel their lives to be senseless and aimless. Im strapped. This moment, this brief interval between obsessions, was the crucial time for us to workbefore Thelma re- established her equilibrium by latching onto something or someone. My wife is in front of me. Well, that was a long time ago! She also examined her feelings toward me with more honesty than before: her fears of dependency, her gratitude, her anger. The ruminations were highly repetitious: most were a fairly faithful replay of any one of their meetings during the twenty-seven days. It was in Bali that I began to write in earnest. Her voice became louder, her tone more self- accusatory. Like me, she had made the big generational jump. There was something else going on.. I was thinking of my father lying beneath the ground and how cold he must have been, and I suddenly heard a voice from above saying to me, Youre next!, Betty stopped and looked at me. It is my mother trying to overtake me. I feel old, really old. Marvin stated that he had thought about it during the last few days, and wished to begin immediately. I believed that the meaning, or at least one meaning, of her agoraphobia was now obsolete and could be influenced by paradox. The migraines, I mean. Marvin grinned, obviously pleased with himself for having stumbled upon a joke. I felt funny when Dr. C. kept talking about the dog and the poison. She didnt know what would happen to her if she didnt have her weekly fix. It seemed to me she was still resisting closeness by referring to a fix rather than to me, and I gradually confronted her on that point. I have found reading this book very edifying and useful in my own practice. Then Id knock him offfast!, When, in our next individual session, we discussed the consultation, I asked her about the two smiles. How many more layers would she reveal to me? How had they felt about their father abandoning them? But I aint going to be around to pick up the pieces., I heard you. It was the worst thing that had ever happened to me. If I were forced to assign an official diagnostic label to Marie, I would follow the formula prescribed in the current psychiatric diagnostic and statistical manual and arrive at a precise and official-sounding six-part diagnosis. Most important, it had killed his social life, by which he meant his sexual life: when he was on chemotherapy, he was impotent; when he finished a course of chemotherapy, and his sexual juices started to flow, he could not make it with a woman because of his baldness. I heard her exhale. His experience and your experience were very different. No, he was not gay. Finally, he grieved for himself, for the imprisoned dreamer, for the little boy crying for help in the darkness. The thief, no doubt, spotted her in a Monterey seaside restaurant and saw her pay the check in cash for three friendselderly widows all. He wants to build a new room for his exercise equipmentO. It was her depression speaking, and I was foolish enough to be persuaded by it. She could do it. She was so quick. You are much more available for love now than you were a few months ago. I hadnt been out very long when I heard about Thelmas suicide attempt. During my meeting with my next patient, it was hard to get my mind off Saul. As I walked through Sauls house on my way to his bedroom, I glanced around trying to locate that desk in which they were stored. "I Never Thought It Would Happen to Me" 6. Saul, how do you think I can help today? For more information, please contact the Special Markets Department at the Perseus Books Group, 2300 Chestnut Street, Suite 200, Philadelphia, PA 19103, or call (800) 810-4145, ext. After Harry left my office, I sat there tired and stunned and angry. But it is too late, too late to change any of my answers. Books published by Basic Books are available at special discounts for bulk purchases in the United States by corporations, institutions, and other organizations. Cant you see that youre doing this to yourself? I believed that Marvin was entirely wrong when he said that sex was at the root of his problems; far from it, sex was just an ineffective means of trying to drain off surges of anxiety springing from more fundamental sources. Now thats a facet of psychotherapy we dont learn about in training: have a romance with your patients worst enemy, and then, when you are sure the enemy loves you, use that love to neutralize her attacks upon your patient. Rather, love is a way of being, a "giving to," not a 'falling for"; a mode of relating at large, not an act limited to a single person." But Saul, failing to respond to conventionally correct therapy, sank deeper, with each hour, into despair. Dont skip anything.. The book "Love's Executioner" by Dr. Irwin Yalom is a compilation of ten cases of psychiatric treatment which include author's involvement into sorting his patients' worries out. At other times Betty expressed anger at my forcing her to think about morbid topics. But watching Marvin change over the last several weeks has been impressive. Meil- tai ne aistros blyksnis tarp dviej moni; yra didiulis skirtumas tarp simyljimo ir meils. She had often claimed, As long as a person has eyes, ears, and a mouth, I can cultivate their friendship. But no longer. The dual role of observer and participant demands much of a therapist and, for me in these ten cases, posed harrowing questions. Can you remember any of it? A lot of therapists, at this point, would have made an interpretation about the way she was shutting me out. She had been crying, her eyes downcast, but at my words she stopped sobbing and looked toward me, expectantly. Though I had difficulty imagining this shabby old woman having an affair with her therapist, I had said nothing about not believing her. The first step in all therapeutic change is responsibility assumption. I knew a way. Instead of talking about Chrissies tragedy, she spent the next two hours describing the tragedy of her own life. Where was his curiosity that his life had changed so dramatically, that his sense of direction, his happiness, even his desire to live was now entirely dictated by whether he could sustain tumescence in his penis? I appreciate that. He is not interested in your welfare. Or the responsibility? He reminded me that in our last session we had discussed his great anxiety about an upcoming presentation at work. Getting inundated with emotion was likely what happened to the others, to the therapists who couldnt help her. He knew he had not lived the life he really wanted. I was so stimulated by this idea that I could hardly wait until the hour was over so I could think more about it. Moreover, Phyllis did not permit Marvin to entertain at home either. Maybe Ill give up science. Yes, a week from Tuesday would be fineno emergency.. But couples therapy requires a couple, and if Phyllis was not yet willing to come in (as he immediately reaffirmed), I told him I would be willing to see him in a trial of individual therapy. Im here to make one final attempt in therapy to find a way to live with some iota of happiness. Dr. K. had always spoken highly of Saul, and she knew he would have wanted her to send this unfinished letter that she found on Dr. K.s desk. If you find yourself struggling and would like more information about therapy, I have written an article with some useful links. (RESPONSIBILITY) 4. He always minimized his painalways fearful of bothering me. I dont care about any of these things! It is here, in the idea of self-construction, where anxiety dwells: we are creatures who desire structure, and we are frightened by a concept of freedom which implies that beneath us there is nothing, sheer groundlessness.