Its O.K. Maybe the pain gets short-circuited and put onto other things. So I decided to take your advice, but Phyllis will not cooperate. From the beginning, of course, I had known that the pure forcefulness of my argument would not penetrate deep enough to effect any change. To see how ludicrous, how pathetic, how idolatrous he wasan old man, stumbling toward death, comforted only by a clutch of letters, a marching banner proclaiming that he had loved and been loved once, thirty years before. It is a book of its time, as you will notice from the chapter Fat Lady. Later it occurred to me that, if Saul had so badly misjudged Dr. K.s sentiments, then he probably misinterpreted my feelings as well. Guilty of what? I asked. Does anyone have any hunches about the rest of the dream? I asked. More signs of thawing: she snapped her neck and sent her long black hair flying to one side and then combed her fingers through it. Matthew, her previous therapist who was an intern. I could only sit and listen and from time to time reassure her that these were human feelings, and that she was only human for thinking them. Thats what really blows my mind. During those years I often led therapy groups of hospitalized patients, whose hospital stay was generally brief. When I retire, I think it will bring home to me more clearly than Ive ever known that life has a beginning and an end, that Ive been slowly passing from one point to another, and that I am now approaching the end., My work is about money. Thelma rambled a great deal and swerved back and forth between her reconstruction of the hour and her reaction to it. Why didnt you stop seeing me and find someone else? I phoned again and left a message irresistible to patients: to call me because I had something very important to tell him. It was hard to remember that less than a year before it had been difficult for me even to look at Betty. No one ever touches me. No response. No matter what I did, what horrid things I thought, I knew hed accept it and stillwhats the word?confirm meno, validate me. What sort of resolutions? No real need for my question, since Thelma had been on the verge of describing the resolutions, but I had to have some exchange with her. All younger people with whom you come into contact will look upon you as a guide or model for their next stages of life. That was surprising since the writer seems so youthful, energetic, and often unrestrained and sophomoric. No problem. What a story there was behind Maries relationship with him! Penny remembered her childhood in Atlanta, Georgia, as relentlessly bleak and impoverished. Instead, we must speak of us and our problems, because our life, our existence, will always be riveted to death, love to loss, freedom to fear, and growth to separation. As though hes my child and I have to answer for him. What comes to you?, I dont know. The first one came on a Monday. Ive never known anyone who wasnt. Whose death will make me truly dead? For information, address Basic Books, 387 Park Avenue South, New York, New York 10016 -8810. It was a couple days after the funeral, I was still taking off from school. I was astounded by the resistance he had put up. Or was he chiefly acting to alleviate his own isolation by taking pains to preserve the relationship he had with me? Although I had not fully thought through my proposal, I believed that Matthew would agree to meet with us. What happened was that a woman, Sonia, Here Thelma broke role for a minute and said in a loud stage whisper, Dr. She careened into them a couple of times, and they escaped only by gunning their BMW to over a hundred miles per hour. When he arrived at the Stockholm Institute, he was greeted by Dr. K., a renowned cellular biologist. I cant wait another week. When people think that we really hadnt loved one another, it belittles the love that we had. Yet I couldnt deny myself this dream; it was the via regia into the heart of the forest. At first I thought I would be encountering myself as a very young man, but a bit of arithmetic led to the realization that I was no sapling when I wrote this book: I was in my mid-fifties! Garbage. Its the only possible explanation!, Yes, thinking that, you have still protected him all these years. I didnt know what Saul was talking about. The first step in all therapeutic change is responsibility assumption. I didnt want to stop seeing Betty. In the past I hadnt tampered with his denial. But when I focused on her depression, she presented a persuasive case that depression was an appropriate response to her life situation. I wondered about the amount of intimacy in her daily life. It is wildly improbable that the receivers image will match the senders original mental image. I knew she was in pain, but still I had to restrain myself from saying, Come on, Marge! My children dont need any money. We were there, the feeling was real, I know love when I feel it. His entire well-being soon becomes hostage to sexual functioning. About eleven years before, she began treatment with Matthew, a young, handsome psychology intern, and met weekly with him for eight months at the clinic and continued to see him in his private practice for another year. But, to my amazement, the session proceeded well. But I want you to be sure to take care of yourself. Conquer was his word. Sooner or later were going to need to find out all about that.. Ultimately she married a sweet, elderly man. For a love obsession drains life of its reality, obliterating new experience, both good and badas I know from my own life. A week later, at our final meeting, I learned that the tears had continued most of the week. All of this followed our session with Matthew. He was sarcastic, authoritarian, and, I believe, sadistic. What should I do? I tried to raise this question with her but, no matter how I put it, I felt that I was whining, Why dont you like me as much as Matthew?, You know, Thelma, theres something else going on alongside your letting Matthews opinion of you mean everything, and that is you refuse to let my opinion mean anything at all to you. Sometimes, as Freud first showed us, sexually inspired anxiety is expressed through other devious means. Usually she looked upward, as though lost in recollection. She followed my advice to have a direct confrontation; and when the tenant refused to alter her cooking habits, Marie scarcely hesitated to ask the woman to move. Ive always lived for two things only: making love and dancing. Chrissies death and Pennys deep disappointment in her two sons must have kindled her regret at having given up her girls, must have made her feel that not only did the wrong child die, but the wrong children were adopted. I think you are determined, absolutely committed, to be jolly with me., Youve done this since our first meeting. This was all the information I could handle (and all that I thought I needed). Yep, thats it. Week after week I chipped away. Mentally and emotionally abused by his aunt who raised him, so he always sees himself negatively. I have seen psychiatrists since I was twelve years old and cannot function without them. What fueled his passion for secrecy? These are no minor adjustments: they represent basic modifications in personhood. I had three children: one was an angel, and the other two, look at emone in jail and the other a drug addict. ho! He had grown up, an only child, in Argentina. If I say the wrong thing, she can make my life hellturn off the sexual spigot altogether., Im afraid of my impulsesmy murderous and sexual impulses., Do you remember, years ago, a news story of a man who killed his wife by pouring acid on her? That was good. Now I was really worried but, again, decided not to comment on his withdrawal. He and Phyllis were just commencing sexual intercourse when he suddenly said, Maybe the doctor is right, maybe all my sexual anxiety is really anxiety about death! No sooner had he finished this sentence, thanwhoooosh!he had a sudden, pleasureless premature ejaculation. Whenever Dan discussed such experiences, I had to constrain my skepticism and rationalism: Spiritual linkage, indeed! I asked him about the two smiles. My psychiatrist finally advised me to sever all contact, to be totally silent. Summary. By now I had become accustomed to her bringing up a new concern almost every hour. I dont know what you want., How can you be so sure Im listening professionally? In fact, I stopped reading it halfway through because it was so upsetting, and Im someone who hates leaving things unfinished. After opening up to the group about this and them being very involved, Dave never came back to group therapy or individual sessions with Yalom. How old? But so much irritation? This, I thought, is precisely the reason therapists should not become emotionally involved with patients. If I hadnt kept his secret from my therapists all these years, maybe the dominoes might have fallen differently., I dont understand. Now the time was up, our work at an end. Furthermore, being an observer would provide me an unusual opportunity to reevaluate Marie. But I was too riled up to talk. . One has a choice only of certain stances: to be resolute, or engaged, or courageously defiant, or stoically accepting, or to relinquish rationality and, in awe and mystery, place ones trust in the providence of the Divine. Furthermore, he was persuaded that something significant must be happening in therapy: hed learned more about himself in the past five months than in his previous sixty-four years! And my old friend, the dreamer? . What would happen if you stopped trying to entertain me?, I dont see anything wrong with having some fun. (MEANINGLESSNESS) What does it mean that Yalom focuses on the here-and-now? Buried somewhere within Marvins walls was a dreamer tapping out an urgent existential message. I flip back and forth quickly in my feelings about Matthew. Later I was telling a small, pudgy boyobviously myselfabout it, and he got so excited he began to cry. It felt conspiratorialas though I acknowledged that I had something to hide. This led naturally into the other primary reason I found Betty so boring: she was acting in bad faith with mein our face-to-face talks she was never real, she was all pretense and false gaiety. The concept of sexual identification has been around at least since De Beauvoirs seminal work The Second Sex, but Yalom fails to mention or even notice that he might be objectifying his clients. A psychiatrist in New York, Dr. Farber, whom she saw for approximately four months, had treated her with antidepressant medication. My parents arrived in the United States in their twenties, penniless immigrants from Russia. For an hour, I slipped into a reverie in which the entire plot of Three Unopened Letters came to me. He said he had a bad back, but I knew him well for many years afterward and never heard him mention back trouble. Marie came in to see me for some minor crisis every few months for the next four years; and, after that, our lives never crossed. I remember that Thelma and I both asked many questions, each of which he answered fully. The veterinarians extensive and expensive incontinence diagnostic work-up was of little value. You cant blame me for being on guard, can you?. In other words, our awareness of death can throw a different perspective on life and incite us to rearrange our priorities. She added that she had a lot of friends, but no one knew her. Youve gotten your meaning out of working. Right here, this office, is the one place I can tell the truth, and the truth is that, more than anything else, what I want to do with those two cunts in the group is to fuck them! She was back in her green jogging suit and had obviously not combed her hair or made any other attempts to groom herself. Perhaps I read too much into it, but I imagined that Dr. K. was looking for something from Saul, something just as crucial for him as the affirmation Saul sought from him. And then I slipped into a reverie about my own letters. ho! You cant go on living a lie or an illusion! I continued, Ive been thinking about you the last couple of days. Now I was reaching deep into my repertory of engaging devices! When Betty, an obese patient, announced that she had binged just before coming to see me and was planning to binge again as soon as she left my office, she was attempting to give up her freedom by persuading me to assume control of her. Here, with a big grin on her face, she paused to let the suspense build. I felt like a surgeon preparing the operative field but avoiding any deep dissection. 1989 is not that long ago. From both my personal and my professional experience, I had come to believe that the fear of death is always greatest in those who feel that they have not lived their life fully. And suppose one of them mistakenly thought her experience was the same as his?. This book is all the more intriguing for being written by a qualified and experienced psychiatrist. Or else theyll talk about it aswhat is it called when the therapist transfers something to the patient?, Yes, countertransference. Furthermore, he could not have guessed how difficult a patient Marie had been and what a herculean job I had done with herwith him, she had played, perhaps from sheer perversity, the model patient. Born to Be Pathetic. I smiled despite myself. Ive gone over all the pros and cons, and I now believe you are rightIm in such bad shape that its not likely anything could make me worse!, Thelma, those arent my words. Surely you want that? She had her back to me, but I thought I could see a slight nod of agreement. I thought I had known him well a week, a month, six months before. Careful, I thought. Dr. K. responded, I cant prevent you, of course, but I consider it ill advised. I couldnt be sure. And these were things I should have said before. He wants her to have a loving relationship with a man and have a loving family. Marvin, you said youre frightened also by your sexual impulses. Do you mean extramarital affairs?, My question shocked Marvin. To my mind, good therapy (which I equate with deep, or penetrating, therapy, not with efficient or even, I am pained to say, helpful therapy) conducted with a good patient is at bottom a truth-seeking venture. Nonetheless, we find ourselves under ever-increasing pressure (from hospitals, insurance companies, governmental agencies) to sum up a person with a diagnostic phrase and a numerical category. That seemed to help. Never had he done a better job. He was still periodically impotent but brooded about it less. Who wouldnt feel depressed holed up in a small furnished apartment in an impersonal California suburb for eighteen months, torn away from ones real lifeones home, social activities, friends? Could we take another walk across the Golden Gate Bridge? Why slit open and empty? Gone forever was the construct of Matthew as sociopath or exploiter-therapist.