We had grown deadly serious. We were similar in many ways. The more the therapist is able to tolerate the anxiety of not knowing, the less need there is for the therapist to embrace orthodoxy. Id try to feel my pulse but could never find the damned thing when I wanted it. I hoped to show her that another person could know her fully and still care for her. Though I was gradually entering her experiential world and growing accustomed to hyperbolic assessments of Matthew, I was truly staggered by her next comment. After an accident or an assault, most people tend to feel unsafe, to have a reduced startle threshold, and to be hypervigilant. If youre caught in a dilemma, or have two strong conflicting feelings, then the best thing you can do is to share the dilemma or share both feelings with the patient. Nothingnot anger, pride, or hostile brushing of her breaststook precedence over her functional and cosmetic recovery. Like a drifting boat torn loose from its mooring, I thoughtbut a sentient boat desperately searching for a berth, any berth. You cant be outside your own lawthats at the base of every ethical system., The tone of the session had changed. Hes not anywhere. , . Your patient is a dumb shit and I told him so in the group last nightin just those words. Sarah, a young psychiatric resident, paused here and glared, daring me to criticize her. I, personally, like to work with older patients. But that day the tears had no end. Miles), Im Calling the Police (with Robert Berger), and my children, Eve, Reid, Victor, and Ben. Now he took out his notepad and began to read a series of dreams:Phyllis was distraught that she hadnt been good to me. But he didnt bat an eye and, in fact, began to speak in a far more honest fashion. A bunch of knitting needles (Six needles in search of a sweater, I thought). She watched her mother kill chickens and heard the squeal of hogs being slaughtered. Whether they were compatible in other ways seemed immaterial at this point: they were vastly incompatible in their grieving, each preferring an approach that interfered with that of the other. Oh no! Maries consultation hour is a testament to the limits of knowing. I began to relinquish my ideas of striking back at Matthew. Had we tried too quickly to make a foolish old man wise? But such interpretations would only result in most of the hour being used as a conventional individual therapy sessionexactly what none of the three of us wanted. Dead and in his grave for over a year and a half. I couldnt be sure. Id like your permission to phone Matthew and invite him to join us. She was six years younger, equally shy and equally inexperienced with the opposite sex. What about all the other feelings going on inside you that you havent expressed? If you feel on the verge, call me. It was as she had said at first: No involvement, no separation., I was not dismayed by the re-emergence of these old feelings. The idea of thirty-five more years of slender high- school-teacher paychecks was unbearable. I have a packet with an envelope stuffed inside of it, and the envelope contains some thing that is immune to death or decay or deterioration. He habitually undercharged for his professional consultative services (and was habitually underpaid). Yet, can therapists or historians or biographers reconstruct a life with any degree of accuracy if the reality of even a single hour cannot be captured? And I hate their clothesthe shapeless, baggy dresses or, worse, the stiff elephantine blue jeans. I was facing a stone wall. While often such an appeal to reason is ineffective, Penny was fundamentally a well- integrated and resourceful person who was responsive to persuasive rhetoric. 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. No, not reallywe were now speaking together but in parallel, not face to face. Many years ago he had developed a strong belief in reincarnation, a belief that offered him blessed relief from fears about dying. To my great surprise, Carlos made excellent use of therapy; and after six sessions, we agreed to meet in ongoing treatment. I saw the other men in the group smiling at me. The patients are here for their therapy, not mine. My week has been a horror, sheer hell! Thus, Thelma clung to the infinitesimal chance that she might once again revive her relationship with her lover, renunciation of that possibility signifying diminishment and death. Then he turned to me. One dream, in particular, affected him:I saw Susan Jennings. Carlos said goodbye but later grew convinced that he had missed a golden opportunity by not offering to escort her to her car; in fact, he had persuaded himself that there was a fair chance, perhaps a ten- to fifteen-percent chance, he might have married her. I was in a frenzy of curiosity and questioned her closely. Give yourself a chance. Worst of all, Marvin could foresee no end to his anxiety. For example, why did Dave refuse to tell his wife that he was in therapy? Dammit! Then, at one museum, the aged guardian offers proof his parrot is the real one. Ive been hurt enough. These messages from the dreamer drummed louder and louder. One is isolated not only from other beings but, to the extent that one constitutes ones world, from world as well. Lets go back over it.. But I dont want to. She got the point quickly. Youre doing your best for me. Ive always found it difficult to treat someone with so little curiosity. The main charge she brought against herself was that she had not been really present with Chrissie. Maybe if I had taken a different turn, to have done something else, to have become something elsenot a high school teacher, not a rich accountant. Was there any moment when we began to enjoy it? To prevent any misunderstanding, I decided it would be best to clarify at once the issue of therapybefore I got in too deep with Penny, before I even asked why, four years after her daughters death, she needed to be seen immediately. Its so busy that it gives me a headache. Very few men (though there were some) were brave enough to love meeveryone was terrified of Harry. It was not hard to understand why he had started her on medication; we psychiatrists so often resort to that when we cannot get anything going in therapy. Published in 1989, Loves Executioner is one of Yaloms collections of case studies. Hed known for a couple of years that he had deadened himself all his life. We did not know, then, that it was to be a permanent farewell. I colluded with him in the fiction about his back injury. 541-301-8460 love's executioner two smiles summary Licensed and Insured love's executioner two smiles summary Serving Medford, Jacksonville and beyond! In fact, the wish to escape from his tyranny had been a major force in her decision, eighteen years before, to emigrate to the United States. What I do remember most clearly was that lying in Matthews arms was transportingone of the greatest moments in my life., The next twenty-seven days, June 19 to July 16, were magical. Thats what you think Im worth., Marge, I apologize for that. But in the group discussion, Dave took it upon himself. Saul and I proceeded in this manner for several sessions. He was aroused by, compelled by, secrecy, and often courted it at great personal expense. My batting average for being useful on the phone isnt great. (Ive clearly not been looking in the right places). Back to the letters. Then I couldnt focus the slide. We distort others by forcing them into our own preferred ideas and gestalts, a process Proust beautifully describes:We pack the physical outline of the creature we see with all the ideas we already formed about him, and in the complete picture of him which we compose in our minds, those ideas have certainly the principal place. Her husband, whom she had met while a student at the university in Mexico, had been a surgeon and was killed in an automobile accident one evening while rushing to the hospital on an emergency call. Other patients cannot decide. He told me that about six months ago he, for the first time in his life, began suffering from headaches. 1. I never experienced pleasure from being in her presence and, as early as the third or fourth session, realized that any gratification for me in this therapy would have to issue from the intellectual realm. Not much other therapy has gone on. As she said this, Betty broke down and sobbed. They were a mystery to him. I listened for many long hours as Marie complained about her pain and about Dr. Z. Generalizing from my experience to hers, I had mistakenly assumed her life to have richness that she was missing because of her obsession. But it hurts to think about it. And then? All I do is sleep and sit and sigh. Its gone., Does any memory of it exist? Getting inundated with emotion was likely what happened to the others, to the therapists who couldnt help her. Her depression improved, and her anger lessened; yet, despite these developments, I was never able to transform Marie in the way I had wished. If I antagonized Me in any way, she would simply take her revenge on Marge. And its your own doing. The other group members would proceed to request and then demand more. I would trap him into seeing me. So I stayed faithful and, when I sensed Me approachingfor example, when Marge closed her eyes and began to enter a tranceI was quick to jar her awake by shouting, Marge, come back!, After this happened a few times, I realized that the final test still lay ahead: Me was inexorably gathering strength and desperately trying to return to me. Me was a Lorelei, beautiful and intriguing, but also lethalthe incarnation of all Marges rage and self-hatred. Who wants temporary friendships?, The problem with that attitude is you end up with an unpeopled life. Because the cable car had lurched, causing her to fall as she was leaving it, she had initiated a lawsuit against the city. I supported her as much as possible at this point. I fought to keep my equilibrium. Should I keep Daves letters? I have seen psychiatrists since I was twelve years old and cannot function without them. Neither looked at the time; they silently colluded in pretending that there was nothing unusual about talking personally or sharing coffee or dinner. It is almost miraculous how you, in such a short time, pulled me out of that funk. His parting shot to the group was to say that he would welcome a rape attempt by any woman in the group. Her life, such as it was, she said, was in New York, but to request a transfer now would doom her career, which was already in jeopardy because of her unpopularity with co- workers. At first it seemed that these flashbacks, as well as the accompanying extreme mood swings, were chaotic, random occurrences; but after several weeks, Betty realized that they were following a coherent pattern: as she lost weight she re-experienced the major traumatic or unresolved events of her life that had occurred when she was at a particular weight. We spent the rest of this hour and part of our final one exploring the ramifications of this new information. He was sitting there patientlya short, chubby, bald man with a glistening pate and owl eyes which never blinked as they peered through oversized, gleaming chrome spectacles. You'll hear the patient describe vividly a dream they had (yawn), at which point Mr. Yalom goes on to analyze this dream and self-proclaim his genius. Eventually time erodes the memory of the event, and victims gradually return to their prior, trusting state. Im not her, you know! My brother has spent much of his life in a mental hospital. I felt pleased with our work but was not deluded into thinking that she had finished therapy, nor was I surprised, as our final session approached, to see a recrudescence of her old symptoms. I once saw a newspaper cartoon of a pudgy lost little man saying, Suddenly, one day in your forties or fifties, everything becomes clear. Everything, Betty replied. We considered the men in her life: a father (faded from personal memory but forever reviled by her mother) who deserted her, through death, when she was eight; her mothers loversa lineup of unsavory night characters who vanished at daybreak; a first husband who deserted her one month after their wedding, when she was seventeen; and a cloddish, alcoholic second husband who ultimately deserted her in her grief. Yet this womans appeal was strong, almost irresistible. She then continued in chilling voice and staccato cadence to give me the real facts about herself. I am persuaded that, in these infatuating first meetings, Dan and the woman mistook what they each saw in the other. She became preoccupied with the capriciousness of death. I always listen carefully to first statements. Irvin Yalom is expressing his natural masculinity when he describes a client as sexy or wanting to protect. I felt discouraged: all my strenuous efforts had been ineffective. By that time, her anger toward Dr. Z. had rusted away, and she forgot about her resolution to raise her voice against him. I knew that Dr. K. would read it. Im not sure when it started. Ironically, while Love's Executioner strongly demonstrates psychology's ineptitude at understanding the mind, the book also shows that when applied in therapy, psychology remains mysteriously effective. Elva and Yalom's mother were similar in personality; hated everything; began counter-transference by separating her from his mother. Shes middle-aged and dressed in rich brown colors. Its all I can do to get her into the dentist when shes got a toothache.. He came to every hour with a list of issues he wanted to discuss dreams, work problems (a successful financial analyst, he had continued to work throughout his illness). Over the next several months of therapy, I continued faithful to Marge. Youre going to feel lost. I dont want to get closer to them.. And I liked his willingness to put up with uncertainty and to undertake the laborious task of inventing a different therapy for each patient. Fidelity! Im interested in the problem youre struggling with, and I think I can help you. Nietzsche claimed that a philosophers system of thought always arises from his autobiography, and I believe that to be true for all therapistsin fact, for anyone who thinks about thought. For several months I had attempted to challenge her belief that life, real life, can only be lived if one is loved by a man. Yes (review grant application, announcement of Dr. K's funeral, and an unfinished letter from Dr. K). After Matthew finished talking, she began to stare out the window. I didnt know whether a silent coronary was accompanied by a fast or a slow pulse. The search for meaning, much like the search for pleasure, must be conducted obliquely. He does so in a non-morbid way. I did not want Pennys guilt, so recently pried loose, to discover her great neglect of her boys and attach itself to this new object. That notion rains true in the book "Love's Executioner," by Irvin Yalom. What do you make of the fact that the only kind of car you could get was a green Honda Civic?, I hate green and I hate Honda Civics. Anyway, Im going to stop that group. After that we got along famously. Carlos readily agreed to meet with me. Many people take issue with this description of death denial. Three hundred dollars meant a lot to her, and for a few days Elva was preoccupied by the money she had lost. Another thing: if she was revealing more of herself to me than to anyone before, then what was the nature of her close relationships? Obviously, she gave him that power in an effort to deny her own freedom and her responsibility for the constitution of her own life. In fact, I stopped reading it halfway through because it was so upsetting, and Im someone who hates leaving things unfinished. You fell in love with Matthew because of what he represented to you: someone who would love you totally and unconditionally; who would be entirely devoted to your welfare, to your comfort and growth; who would undo your aging and love you as the young, beautiful Sonia; who provided you the opportunity to escape the pain of being separate and offered you the bliss of selfless merger. What changes in his life had occurred then? He wasnt loving you, Thelma, he was using you. He told her explicitly that the most important thing in the world to him was their relationship, and that he had never felt closer to her. She sat motionless, a cigarette smoldering in the ashtray in her lap; her gray eyes were fixed on me. Now its too late, its too late to live., I sat unblinking through this litany and, for a moment, felt ashamed for being unmoved. But they were afraid of me. But in Daves group, the burning secret was age. I was delighted for her and commended her strongly each week on her efforts. Any other therapist could have written a brutally honest account of their work, and not come off as such a whiny, self-aggrandizing putz. 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. Thanks also to many, many colleagues and friends who did not bolt when they saw me approaching, a new story in hand, and offered criticism, encouragement, or consolation. She compared our three-way session to a visit with the doctor when you suspect you have cancer. Perhaps the most reasonable hypothesis was that Matthew was working on (or acting out) some personal psychosexual issuesand using his patient (s) to do it. Besides, he was a person who wanted to try everything once, and he had never before spoken to a psychiatrist. I absolutely do not know.. Saul was strongly motivated to send the fifty-thousand-dollar gift, and I continued firm in my opposition to that plan and explored the history of his penchant for buying his way out of problems. He really cared, he really accepted me. But if you make any attemptno matter how slightthen our contract is broken, and I will not continue to work with you.