Perhaps in some millennium, such union will come to passthe ultimate antidote for isolation, the ultimate scourge of privacy. Im not talking about major or predominant feelings, but about any other flashes you had., I know what youre after. What a time to stopin the midst of work on important issues and with Betty still camped outside the one-hundred-fifty-pound roadblock! The thief, no doubt, spotted her in a Monterey seaside restaurant and saw her pay the check in cash for three friendselderly widows all. Marie regarded his behavior as odious and gradually became harsher in her refusals. I went to the library and checked out one of your books. She hated what was happening, and she hated Dr. Z., but my every suggestion was met by but or yes, but. She was a yes, but-er (also referred to in the trade as a help-rejecting complainer) of considerable prowess. On her way home from the previous session, she stopped at the cemetery, sat next to Chrissies grave and, as she often did, wept for her daughter. What a relief to have a break from Marges droning voice and relentless whining. I have met few people with as much self-hatred as Marge. I wasnt certain whether it was to obtain his support or to reassure herself that he could tolerate what she had to say. The message:I realize now that I have not done what I might have done with my life. The smiles, appearing at points of power in his presentation, signified that Marie had understood and was affected by his message. 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. Why not? She had never before split offoh yes, there had been one time, a third personality named Ruth Annebut the woman who came today had never appeared before. And?, Well, youve got more clout than I thought. She had an excellent week, and I received no crisis phone calls. First, I was distracted by the envelopeits jagged edges were gouging my ass. I can tear down a years work in a day. . I grew up in racially segregated Washington, D.C., the only son of the only white family in the midst of a black neighborhood. Thats a question, not necessarily the question. Its eight years latermy goodness, eight years, thats hard to believebut its eight years later, Ive probably tried eight new antidepressants and they still dont work. It would seem rational to read them first., Im not sure. I wondered, If disguise were unnecessary, if the dreamer could speak to me without guile, what might he say? Though it is understood that therapists embrace other relationships, that there is another patient waiting in the wings for the hour to end, there is often a tacit agreement not to address that in therapy. Now and then, when the receptor site was well prepared, we withdrew some part of Me for transplantation. Nevertheless, without doubt, we had discussed important issues. I run to tell Phyllis about it because shes so fond of kittens. Yet I had started therapy with intense negative feelings about Bettyfeelings I had never discussed with her and that she had never recognized. The migraines, his reason for seeking therapy, had never returned. I was the person responsible for all three losses. 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 imagined, for a moment, interring them together with mine. Saul was really digging in but, though I began to question my choice of a direct approach, I persisted. It was ironic, too, that her drive to escape the destiny of poverty and failure was halted only by a deeper destinythe finitude inherent in life. She stopped eating, and soon her depression had passed beyond the reach of psychotherapy or antidepressive medication. There was another reasonthat voice, the voice of that being who had created those astonishing dreams. What difference did it make if she slept next to her daughter? All this cloak and dagger! Sarah, by now one of his greatest boosters, was invited as a guest speaker to one of his groups and attested to his responsible and competent leadership. By that criterion, Saul was psychotic. I wrote this book twenty-five years ago and, since then, had not once read it in its entirety. Once again he nodded assent. , . She added that she had a lot of friends, but no one knew her. And say other things as well, about the way to relate to a patientpositive unconditional regard, nonjudgmental acceptance, authentic engagement, empathic understanding. I have heard from many teachers and students that the numerous talessome a few pages long, some merely a paragraph or twoI had interspersed in both The Theory and Practice of Group Psychotherapy and Existential Psychotherapy vastly increased each books effectiveness. )more potently confronts us with finiteness and contingency (and none is more able to effect immediate dramatic personal change) than the imminence of our own death. The opposition stiffened. I need some time to digest all this. It seemed best to act without consulting him, and to inform his children of his condition. But Marie felt trapped with Elmer. What for? A good working formula is: the more unlived life, or unrealized potential, the greater ones death anxiety. Penny began to talk about guilt. Such a combination is a perfect formula for guilt in the surviving child and to a perceived sense of worthlessness and badness. Ones efforts to escape isolation can sabotage ones relationships with other people. This new information made it even more clear that Marvin and Phyllis very much needed marital therapy. I floated, I glided, I danced.. I encouraged her to plunge into her grief; I wanted her to explore and express every facet of it. I remember thinking how fortunate it was that Marvins change had spurred Phyllis to change. Save, of course, my father, and he was really part of her, her mouthpiece, her animus, her creation who (according to Asimovs first law of robotics) could not turn against his makerdespite my prayers that he would oncejust once, please, Dadpop her. The story depicts my struggle to work through these unruly feelings in order to relate to the patient at a human level. Pain that is always there, whirring continuously just beneath the membrane of life. Both had dropped out of school and were heading toward serious trouble. He cried in my office that day. Of course, his wife tried to obtain information about him. I would trap him into seeing me. First, we became acquainted with Japanese culture, as I taught for two weeks in Tokyo; then, two weeks of travel in China where my wife, a feminist scholar, lectured to university students and teachers. So Saul, as he was wont to do in such situations, did nothing. St. Bonaventure University. One of the most irreverent of these was poundage: the heavier the patients clinical chart, the worse the prognosis. I started to point out that she was speaking as though I werent in the same room with her, but couldnt summon the energyshe had worn me down. . She must have been thinking, Oh, I wouldnt feed him poisoned dog foodnot unless he got a little old and bothersome. Elva chuckled and continued to disembowel the purse. In associating to this dream Betty said that, earlier the day of the dream, she had been thinking that she had shed a whole body: she had lost eighty pounds, and there was a woman in her office who weighed only eighty pounds. I also used the dreams to work upon our own relationship. These anamnestic sessions were, to my mind, reasonably productive. She was incapable, or unwilling, to reveal herself in the immediate present that we two were sharing. Reincarnation is a case in point: though I personally consider it a form of death denial, the belief served Carlos (as it does much of the worlds population) very well; in fact, rather than undermine it, I had always supported it and in this session buttressed it by urging that he be consistent in heeding all the implications of reincarnation. Now that weve decided to do it, he wants to do it as soon as possible. But too much was riding on this hour. Consequently, I devoted the following two sessions to a detailed examination of his childhood. It was into this extraordinary tangle that Mikeof course, knowing none of thishad dropped his innocent, rational suggestion that Marie seek her doctors help in understanding her pain. A couple of weeks later, I saw definite signs of a breast, two breasts. Had we stripped away too much? Marvin assured me that she was very set in her ways. Thelma was remote and stiff in our first meeting. I keep looking for him when I walk down the street. I did not think that he would be a good candidate for a deep, uncovering type of psychotherapy. Do you know anything about Buddhist meditation practice?. What are you feeling?, Disloyal. She and her dog stopped from time to time and listened for danger. Inspiration came quickly in Bali. Frozenthe metaphor often applied to chronic griefis apt. In the past Sauls eyes would have smiled and met mine, but today he was clearly in no mood for wordplay. If you want to help methen teach me how to hate armadillos!. Was it possible that she knew all this from the start and had concealed it from me? He wasnt having a love experience, because he didnt know who he was. Every session with her demanded great effort. Though she, Mike, and I shared an hour, each of us had a vastly different, and unpredictable, experience. Length: 10 hrs and 57 mins. I want to help you, but Id be making up stuff. So that was one thing in your favor. Your experience was very different. Or had she been so absorbed with her own distress and her own needs that, throughout, she had been completely unaware of Matthews mental state? Also, it helped that you didnt get into your role of the wizard letting me guess about questions you know the answers to. Could it be that her thighs and buttocks are so inflated that her feet have to go farther to reach the floor? 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. You saw that picture of mebe honest, tell the truth, was I not beautiful? She continued, without waiting for my response. No therapy has a chance if the patient conceals the main issues. I empathized with her and told her that I had heard many others in her situationincluding my wifecomplain of similar treatment. I never thought of it that way before!. He did that twice a day and taught me the practice as well. I hate to be loves executioner. If only I had a son, I might through him spew myself into the future past the death line.. There was something going on between the two of us. And so much pain, so close to the surface, only minutes deep. I know what I know!, But you say that every weekthe lady in the supermarket, the receptionist in the dentists office, the ticket seller at the movie. Its true, you were more open than the other men in the group. Marge, Me said, should write her autobiography and entitle it (here she began to chuckle) Born to Be Pathetic.. I could see the look of relief on her face. The most I can hope for is to stay out of a mental hospital. In your office.. There were so many rich leads that it was hard to select and concentrate on one. That dream about the candleI must have had it twenty times., That dream makes me think of what you said before about your fear of losing weight, about having to stay heavy to avoid dying of cancer like your father. While there is no solution to existential isolation, therapists must discourage false solutions. . He had no further migraines. It almost never does. Even before starting the group, he would have entered into a conspiracy with me that excluded the other members. Regardless of the depth of his character flawand I had no doubt that it was a trench of considerable magnitudeI was sure he would do nothing in my presence to encourage her fantasies of ultimate reunion. There is always more that can be done, but overall we had accomplished far more than I could have anticipated at our initial session. Indeed, the capacity to tolerate uncertainty is a prerequisite for the profession. My heart sank. I have found that the memory loss that no one escapes has some advantages. Where to start?, Thelma began: Its funny, I havent increased my medication. She turned to Matthew. Often I look forward all day to a special meal; and, when the craving strikes, no obstacle can block my way to the dim sum restaurant or the gelato stand. Every time I switch therapists, I call to let him know. She slumped into her chair and spoke slowly and softly in a resigned tone. Therapists excuses are invariably patent and self-serving rationalizationsfor example, that the therapist is accepting and affirming the patients sexuality. The last gift a parent can give to children is to teach them, through example, how to face death with equanimityand Carlos gave an extraordinary lesson in grace. I knew a way. Marges face was frozen. All this power that Matthew hasyouve given it to himevery bit of it!, I get sick in my stomach at the thought of his despising me., What goes on in another persons mind, someone you never even see, who probably isnt even aware of your existence, who is caught up in his own life struggles, doesnt change the person you are., Oh, hes aware of my existence, all right. Feed me!. I absolutely do not know.. Locked up in a convent? Does Yalom emphasize the cultural background of Carlos? Well, as I mentioned to you, I hadnt had much professional experience with . I have always admired, perhaps more than many men, the womans body. I sat there and wondered, Now what do I do? But my instincts luckily led me to what proved to be an inspired gambit. Ive been hurt enough. My impressions of her, my pleasure, my impatience are not precisely like any others I have known. When I spoke to Dr. Farber on the phone, he did not mention his naps, of course, but he did volunteer that Betty had not been able to learn how to use therapy. By examining the details of the therapy relationship (or, in a therapy group, the relationships among the group members), I can point out on the spot how a patient influences the responses of other people. I think he saw them but, to spare me embarrassment, made no comment and hurried along to the next insight: I am not my shoes.. She cooked and she fed meshe was real good at thatbut she was weakI was the one protecting her. I want to matter, to be important, to be remembered.. Thats me all right! He chuckled at his own creation. The group would be angered and accuse him of playing games with them. You havent yet talked about having cancer. (I had been urging Carlos to reveal to the group that he had cancer, but he was procrastinating: he said he was afraid hed be pitied, and didnt want to sabotage his sexual chances with the women members. Throughout this period of rapid weight loss, another extraordinary phenomenon was taking place. Asking me to keep the letters might, thus, be a way of perpetuating our special, and private, relationship. I had, once again, fallen prey to the grandiose belief that I can treat anyone. There she was complaining melodramatically and mockingly of a dreadful stabbing pain in her womb and breast. If not, I hope youll help me die and help me find a way to cause as little pain as possible to my family., I told Thelma that I thought we could work together, but I suggested we have another consultation hour to consider things further and also to let her assess whether she could work with me. Never take away anything if you have nothing better to offer. In spite of my curiosity, I decided to let Saul tell the story in his own way, and at his own pace. Everything I saw in my first glanceher wrinkled seventy-year-old face with that senile chin tremor, her thinning, bleached, unkempt yellow hair, her emaciated blue-veined handstold me she had to be mistaken, that she could not be in love. Yet Thelma, in the opening minutes of our first interview, told me that she was hopelessly, tragically in love, and I never hesitated, not for one moment, to accept her for treatment. Dont choose to compare yourself with Professor G., who may be the most brilliant speaker in the whole university. And that is precisely where countertransference complicates things: I had to be clear about how much of the boredom was my problem, about how bored I would be with any fat woman. Nor was it necessary to sweep from my mind derogatory thoughts about her appearance. Listen to Flauberts lament, in Madame Bovary: Whereas the truth is that fullness of soul can sometimes over flow in utter vapidity of language, for none of us can ever express the exact measure of his needs or his thoughts or his sorrows; and human speech is like a cracked kettle on which we tap crude rhythms for bears to dance to, while we long to make music that will melt the stars. We had run twenty minutes over and had to stop even though Thelma had still not regained her composure. The better I knew her, the less interesting she seemed. ho! I shrugged off the question. Yalom! So we changed our focus. Youve come to see me for help, and this is just what Im trained to do. Nonetheless, though I have put myself on trial several times and found myself guilty, let me take advantage of this opportunity to state my defense. The obsession must draw part of its strength from the impoverishment of the rest of her existence. I asked him, Suppose I call you next year or in five years? Ignoring my gambit, he responded that Thelma had always been a good wife and that perhaps he had aggravated her problem by being on the go and traveling too much. 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. It was not, as I first thought, that she was mercurial and unable to sustain focus. I know she has been going through bad times, and I know that I bear the responsibility for that. His lover, Soraya? Marvin grew up in New York, the child of impoverished first-generation Jewish parents. What had happened in their lives that might have pushed them into the choices they made? His eyes open now to the existential facts of life, he was grappling with the inevitability of death and with his powerlessness to save himself. If not, bingo! Such massive denial always plays havoc with the survivors, and Betty had neither been prepared for his death nor had the opportunity to say goodbye. Love's Executioner: And Other Tales of Psychotherapy > ISBN13: 9780465020119 Summary. Another asked about what it felt like to reveal the existence of the letters to the group. I was too afraid of making my aversion visible. 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. University of Idaho. Ill get back to you. He left my office, his briefcase and homeless letters in tow. As a result of her discontent, our time together became ungratifying for me as well. I dont know how much he has told you about me and traveling. If I consorted with Me, it would be catastrophic for Marge: shed become a bit player, a replaceable character. (Nor, it turned out, was he willing to resume individual therapy with me or anyone else. Saul did not show up for his next appointment. In the book "Love's executioner and other tales of psychotherapy", Irvin compiles ten of his documented cases with approval from his patients and changes names of the patients for confidentiality purposes. That march, from image to thought to language, is treacherous. But, even though I dont show it very muchIm not good at saying thank youI really appreciate what youve done for me these last months. I very, very badly wanted to love this book. You remember them?, Id offer profuse apologies, prostrate myself, spread innuendoes that I had advanced cancer (that has never failed). While Dr. K. had never won a Nobel Prize (though had been, it was well known, runner-up on two occasions), he was unquestionably made of the stuff from which laureates come. Do you know that for the first six months you hardly ever looked at me? In Search of the Dreamer Afterword: On Rereading Lope's Executioner at Age Eighty His silence is killing me. She had joined a womens therapy group and was working on her fear of attending social functions. Remember that I said that each of us establishes in the group the same kind of social world we have in our real life?, Now, look whats happening to you in the group! This was necessary, functional pain in contrast to the unnecessary pain stemming from irritated, bruised nerves which served no useful purpose. I just stopped thinking and worrying about me. They might, if discovered, provide me some cover. To my surprise, she joined a square-dancing group (this ladys got guts, I thought) and a weekly bowling leagueher father had often taken her bowling when she was a child, she explained.