When I went outside, I didnt know what to say to his mother about why we blindfolded him. Of course, there are no solutions. Just a week previously, she woke up to find herself in a drugstore checkout line with a gift for Chrissie in hand, a stuffed animal. Hence, I was uncomfortable with accepting Maries protection of my professionalism. Betty, Im going to be persistent today. He was emaciated, knobby (with swollen, highly visible lymph nodes at elbows, neck, behind his ears) and, as a result of the chemotherapy, entirely hairless. She could do it. Perhaps she loved me enough to change her behavior! I wasnt able to have children, Im afraid of people, Ive never worked outside the home, I have no talents or skills. She paused, wiped her eyes and said to Marvin, See, I can cry if I put my mind to it., She turned back to me. . Im strapped. (Sociopaths often present themselves well, I thought.) But Me knew. I want to help you, but Id be making up stuff. Though I could write a clinical article about Marge or tell colleagues about the course of therapy, I could never really convey the essence of my experience with her. 1. Saul suggested they offer a creative synthesis and identify the most promising directions for future research. I havent a clue.. But they were afraid of me. Ordinarily in therapy I would make sure to return and analyze this short sequence, but that day was not the time for such subtleties. I told you that before I referred him to you. I had been seeing Carlos in individual treatment for about six months and, a few weeks ago, referred him to Sarah for inclusion in her therapy group. For stripping away my sweet illusion and revealing its base of fleshflesh on the rampage? It sounds like your guilt and grief have already broken up your marriage. But I could not prevent myself from thinking about Carlos and wondering how I should handle the next hour with him. There are ten stories: 1) Love's Executioner 2) "If Rape Were Legal." 3) Fat Lady 4) "The Wrong One Died" For example, during one hour when I was reminding him of how much gratuitous teaching he had given to the Stockholm Institute fellows and junior faculty, he stated that, as a result of what he had done to these bright young students, he had set the field back twenty years! Well, nothing has changed in the external world. The blackout consisted of her waking up in a drugstore (the same store where she had once before awakened holding a stuffed animal) weeping and clasping a high school graduation card. Thus far I had persevered, but my patience was not unlimited, and I felt relieved to share the burden with Mike. As always, I feel isolated hereprofessional colleagueship is scarce at the Stockholm Institute. The sexual act is seen also by the protagonists of other stories as a talisman to ward off diminishment, aging, and approaching death: thus, the compulsive promiscuity of a young man in the face of his killing cancer (If Rape Were Legal . I appreciate your question about the young mother and her potential influence, but I see it differently. She walked back to her chair and sat down. I do a lot of thinking about aging and death, but my thoughts are too morbid to talk about. One is isolated not only from other beings but, to the extent that one constitutes ones world, from world as well. In fact, I feel warm inside when I see her at the end of the day. The first call she made upon regaining consciousness was to Matthews tape machine. She cried for her fatherwhoever, whatever he was. One credit a month, good for any title to download and keep. Articles Find articles in journals, magazines, newspapers, and more; Catalog Explore books, music, movies, and more; Databases Locate databases by title and description; Journals Find journal titles; UWDC Discover digital collections, images, sound recordings, and more; Website Find information on spaces, staff, services, and more . I ended up responding so well to the process, though, that I've continued seeing her in private practice ever since. I think her suicide try was a murder attempt, and I now believed that her decision to stop therapy was also a form of double homicide. Every therapist knows that the crucial first step in therapy is the patients assumption of responsibility for his or her life predicament. And so it went: the entire hour with her was an exercise of my sweeping from my mind one derogatory thought after another in order to offer her my full attention. That would have been treating her like an equal.). This seemed to me to be a poor solution for Marie since she so feared and disliked her father that she had had little communication with him for years. I clasped his shoulder as he sobbed. I'm told he's one of the greatest psychotherapists in all the land, but this book does nothing to illustrate that, as far as I can tell. You have to try, you know. Once again I began to suspect that he had already sent the fifty thousand dollars and was unwilling to tell me. So I devoted myself to being present and faithful. I promised that unless I heard from her, I would not call Matthew during the next week, and we parted. Why hadnt I thought of that? And then it goes away again! That cartoon was apt for Carlos, except that he had not one, but repeated episodes of clarityand they always went away again. There she was complaining melodramatically and mockingly of a dreadful stabbing pain in her womb and breast. With wise investments in California real estate, he had become a wealthy man. This openness, this honesty! You look uncomfortable. As she left my office, I thought that even if she decided to talk about her own issues with someone else, I would still try to meet with her later when she settled down to see if we could make this a learning experience for her as well. Betty informed me that she was twenty-seven and single, that she worked in public relations for a large New Yorkbased retail chain which, three months ago, had transferred her to California for eighteen months to assist in the opening of a new franchise. That hit her very hard. She had lost her belief in benevolence, in her personal invulnerability. How frightened were they? There flashed into my mind an interaction with a patient from my first year of residency (these first clinical experiences stay with one, as through an imprinting in ones professional infancy). First, however, it was necessary to establish to Thelmas satisfaction that the obsession had to be eradicated. She then continued in chilling voice and staccato cadence to give me the real facts about herself. I had anticipated crisis after crisis. She reminded me of Marjorie Main, the tough-talking movie star of the 1930s, now long dead. Its my place to thank you for bringing it to pass. Without that drive none of us would exist on this earth. I pounced at the opportunity to understand this development. Perhaps one hundred spurts would fill a cupthats only fifty seconds. Thats an elaborate piece of work, I said. , and transcribed the notes I had made in my passport in the confessional for Three Unopened Letters. I wrote Two Smiles and Do Not Go Gentle in Hawaii and the remaining stories in Paris, most of them in a caf down the street from the Pantheon. Remember, Im in the same group with Carlos and we often chat after the group about you.. Were I my own patient (or my own therapist), I would say, Imagine the letters gone, destroyed or lost. A dirty old man whose soul is about to leave him. Ill make it anonymous. And therefore, as John Donne wrote, never send to know for whom the bell tolls; it tolls for thee.. When Chrissie was ill, Penny had spent inordinate amounts of time with her. . I was certain that my first impression had been close to the mark: that his impending retirement had stoked up much fundamental anxiety about finitude, aging, and death, and that he was attempting to cope with this anxiety through sexual mastery. Lets see if I have this right. Unless I could protect and remain faithful to that relationship, any hope of therapy was lost. Penny, youre a tough judge. Furthermore, it is difficult for me, as for most therapists, to form a relationship with a patient who has fallen in love. And there with her face in spasm, like Quasimodos, horribly distorted, barely able to talk. (RESPONSIBILITY) 4. What about my countertransference? It seemed to me that real progress had occurred: the surgery was complete, and now my task was to prevent her from preserving the amputated limb and quickly stitching it back on again. How sad it was, he said, that he had waited until now to try to come alive. Although I had not fully thought through my proposal, I believed that Matthew would agree to meet with us. She stared out the window. He ignored me, misunderstood me. Hard to quarrel with that. I shrugged off the question. She knew we were not equals. There was no one else he could ask to keep them, no friend he had dared tell of this affair. If he tried to force the issue, it would be, he said, a month of Sundays before he got laid again. Consequently, as he had done many times before, he spent the better part of a day packing up his whole collection to exhibit it in his office. As her sobbing subsided, Thelmas words grew audible. Later when we compared them, it was at times difficult to believe that we described the same hour. Stay focused! She had died while giving birth. I think of your aunt reminding you so often that you were lucky she agreed to take care of you rather than let you go into an orphanage.. Now, there is nothing, Penny told me, more important to her than her house. Fraid youll judge me, I guess. I found some old Kay Starr records. I had wanted to learn about bereavement, and Penny had, in only twelve hours, taken me, layer by layer, to the very nucleus of grief. And yet, time after time, I have seen this group exercise evoke unexpectedly powerful feelings. One of the great paradoxes of life is that self-awareness breeds anxiety. Her death, Penny said, was awfulI couldnt imagine how awful. Hence I focused on the themes of losing her house and the washing away of the foundations of her life. But before I had time to modify my response, Saul had dutifully proceeded to respond. I began to think of good reasons not to accept his letters. Although Penny voiced no regrets for her behavioron the contrary, she seemed to relish telling the storythere were, nonetheless, deeper rumblings. Nor did it matter that Saul was being deferential. What did it stir up in you?, I felt like an idiot! She had grown up, an only child, on a small, poor ranch in Texas where her mother has lived alone since her fathers death fifteen years ago. I am choking on darkness. The mother of God will protect me. I dont think I could take being patronized. I want you to answer me honestly: Are you satisfied? After I was discharged I immediately flew back to San Francisco, and it was the following day that I met Thelma, sheerly by chance, in Union Square. Share to Twitter . How comforting it would be to feel, just once, that I know exactly what Im doing in my psychotherapeutic workfor example, that I am dutifully traversing, in proper sequence, the precise stages of the therapeutic process. In our discussion of her sons, I felt I had to tread carefully and to content myself with helping her to appreciate from their perspective the consequences of Chrissies death. They are informative, they are calming, and they penetrate the anxiety of isolation: the patient feels that, once you have the details, you have entered into his life. He learned that his eyes, like those of a newborn kitten, had been closed. From the beginning, of course, I had known that the pure forcefulness of my argument would not penetrate deep enough to effect any change. I asked myself what, exactly, was boring about Betty, and identified two obvious characteristics. How would she have dressed or walked? In order to stay on her pedestal, she was never able to talk to you about her pain and her fearsor not until very recently.. I was doing pretty well, but just as I was getting ready to come, Phyllis said, There are other reasons for making love than to get rid of tension. Well, that did it! I had long before decided not to take the baitnot to follow her into the hypnoidal statebut instead would call her out of it. Thelma felt, though she did not explicitly say so at the time, that the obsession contained infinitely more vitality than her lived experience. Members wondered about Daves hiddenness; some could understand his wish to keep the letters secret from his wife, but none could understand his excesses of secrecy. We agreed to concentrate on maintaining her new weight of one hundred sixty and, to that end, Betty bought a whole new wardrobe. Suddenlypresto!it was over. His amount of self-disclosure was outrageous twenty-five years ago and set most therapists teeth on edge. Too many things to deal with. . I imagined, for a moment, interring them together with mine. Dave would respond by sharing less. My implicit contract with Marge (as with all my patients) is that when I am with her, I am wholly, wholeheartedly, and exclusively with her. Mikes statement was wonderfully lucid and delivered with just the proper mixture of professionalism and paternalism. You can either move up or down.. Then Id knock him offfast!, When, in our next individual session, we discussed the consultation, I asked her about the two smiles. Id appear before the members of the institutetheyd be wigged and robed. When Marie fell from the cable car, she struck her head and was unconscious for about an hour. That notion rains true in the book "Love's Executioner," by Irvin Yalom. She was highly ambivalent about therapy: although she regarded it as her only hope, she never had a satisfying session. Im meeting with him tomorrow, and Ill work on it hard. Rapprochements occurred; as her anger receded, family and friends reappeared in her life. A powerful lady, I thought. . He had done all the work he was to do that day. Talking treatments have never helped. In this book, Yalom discusses ten clients, their therapy journey and his own development as an existential psychotherapist. Or was it my sense of obligation to my career as a teacher? . Maybe someone will think of me in some freak moment just as I think of the extinct single-edged razor blade. His face fell, she reported, when he first caught sight of her, but, to his everlasting credit, he acknowledged that he was indeed George and then behaved like a gentleman throughout dinner. The day Betty entered my office, the instant I saw her steering her ponderous two-hundred- fifty-pound, five-foot-two-inch frame toward my trim, high-tech office chair, I knew that a great trial of countertransference was in store for me. This is stirring up a lot of stuff in me. Moreover, Phyllis did not permit Marvin to entertain at home either. But it was many years before I was ever willing to shake hands with a doctor again! Although he brought up details of his sexual life, he expressed no embarrassment, self- consciousness, or, for that matter, any deeper feelings. After hearing him out, I tried to offer some support by stating that a long depression is almost as hard on the family as it is on the patient. As I turned the pages of Three Unopened Letters, Loves Executioner, The Wrong One Died, among other stories, I felt myself burning with delicious curiosity. For now, there exist formidable barriers to such mind coupling. When I asked about how we were doing today, or asked her to describe all the feelings she had experienced toward me in the session so far that day, she rarely responded. To treat someone as an equal implies an inequality which the therapist must overcome or conceal by behaving as though the other were an equal. Im pretty observant, always have been. Maybe she would have wished them to be girls? What future was there in anything? The lawsuit dragged on for three years, and she settled for a disappointingly small sum. I was moved by her, I wanted to comfort her, I imagined embracing her and feeling her body unfreeze in my arms. Not every day does a student charge into my office and, with no trace of chagrinindeed, she seemed proud and defianttell me she has verbally assaulted one of my patients. Nevertheless, without doubt, we had discussed important issues. Weighing all these considerations, I finally chose my response. I dont like being away from her, even for one night. Sixty-nine-year-old men have been known to die suddenly. But no one was spared. The message:Marvin understands, he really understands, that his eyes have been closed, and that he is finally preparing to open them. Pleased with his progress, he had realized, as he put it, a good yield on his investment. Ive always had ways to delay the judgment. I edged an inch or two closer. It seems the real questions are whenwhen will you open them?and howhow can I best help?, I should just do it. Youve got to be kidding. As soon as I said that, I knew it was a mistake.. Though nightmares differ in manifest content, the underlying process of every nightmare is the same: raw death anxiety has escaped its keepers and exploded into consciousness. Believe me, I swear it, in the last meeting I was the only honest person in the group. I know about your caring. Table of Contents. I continued. Though she resisted almost any new experience and was particularly fearful of hypnosis, she finally consented with the condition that I remain present during the entire session. Even the word disillusion, with its negative, nihilistic connotation, should have warned me. I hoped that my reputation in the field would intimidate him into cooperating. Although I was less engaged with him than in the past, I was doing what therapists are traditionally supposed to do: I illuminated patterns and meanings; I helped Saul understand why the letters struck him as so fateful, how they not only represented some current professional misfortune but symbolized a lifetimes search for acceptance and approval. Meaning ensues from meaningful activity: the more we deliberately pursue it, the less likely are we to find it; the rational questions one can pose about meaning will always outlast the answers. (MEANINGLESSNESS) What does it mean that Yalom focuses on the here-and-now? . None of this makes any sense to me. There was no point. Penny continued to stare. And that, Saul told me with a great sigh, brings us up to now. I was well enough acquainted with Marge to know exactly what she would do with my blunder: she would say that I had let my true feelings out, that I think shes so hopeless that the only persons with whom she might compare favorably would be the most hapless souls on earth. The message I believed the dreamer was sending me:I try to look back but my vision fails. How would it be for her living in the communitybeing available for legal rape, a piece of ass for whoever happens to be horny and gets off on force and seventeen-year-old girls?, Suddenly Carlos stopped grinning. Weve only got seven more sessions, unless you reconsider your decision to stopThelma shook her head firmly. At one level the dream related to Chrissie. She careened into them a couple of times, and they escaped only by gunning their BMW to over a hundred miles per hour. I felt more like a philosophy or religious teacher than a therapist, but I knew that this was the proper trail. There was a man at every window with a spray gun. Just time enough for his letter to reach me in California., Saul stopped here. Phyllis and I do have some communication problems, more than I really told you about last week. That means youll be running late all day, doesnt it?. In part she cried because of her loss, but in large part because she considered her fathers life to have been such a tragedy: he never obtained the education he wanted (or that she wanted for him), and he died just before he retired and never enjoyed the years of leisure for which he had longed. Maybe its too painful to feel. He liked to talk to me, but I believe that the primary attraction was the opportunity to reminisce, to keep alive the halcyon days of sexual triumph. Like me, she had made the big generational jump. Ive had some difficulties with sexnot as bad as nowwhich caused me to flip back and forth in my moods for twenty years. In the middle of her dirge, she suddenly closed her eyesnot in itself unusual since she often went into an autohypnotic state during the session. Ive never met anyone who wouldnt cut you dead for a dollar, a job, or a cunt. He had been married only briefly and had had no other significant relationships with women. Moreover, where was the aura of love bliss? I stretched for supportive and constructive words, but they came out more pedantic than Id intended. Somewhere Saul had found the power to take a stand against me. Staring at the Sun was revolutionary, and The Gift of Therapy unequivocally changed who I am as a mental health professional. Youre going to feel lost. I could see Marge flicker her eyelids and then close them. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); This site uses Akismet to reduce spam. Love's Executioner. My whole lifes gone by feeling it was too late. Especially a patient with advanced cancer. Try again. Nothingnot anger, pride, or hostile brushing of her breaststook precedence over her functional and cosmetic recovery.
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