It was at this time that I first began to suspect that for Betty there was no here there. But I was currently funded by a research institute to study the psychotherapy of the elderly and could see Thelma for a minimal fee. By that time, her anger toward Dr. Z. had rusted away, and she forgot about her resolution to raise her voice against him. Will you open the letters before you mail that letter to Dr. K.? I shouldnt have used the word enjoy a few minutes ago. Had I let my own feelings get in the way? Though I had received no messages from the dreamer for the last several weeks, I had not missed them. Suddenly they come upon a carriage, ebony black, cradling a baby girl swaddled in black gauze. She could deny responsibility for anything elsethe absence of friends in her current life, the tough singles scene, the horrors of suburbiabut I was not going to let her deny responsibility for boring me. This new information made it even more clear that Marvin and Phyllis very much needed marital therapy. How is it possible for retirement not to evoke deep feelings about the passage and passing of life, about the meaning and significance of ones entire life project? In a way he stood between me and the grave. It is a story about countertransferencethat is, irrational, often shameful, feelings a therapist experiences toward a patient that constitute a formidable obstacle in therapy. These two insights, each generated by a different form of therapy, illustrated, in quintessential form, the difference between what one can derive from group therapy, with its focus on communion between, and individual therapy, with its focus on communion within. So you deal with your guilt now by hanging on to Chrissie, by not getting on with your life?, I just cant forget her. Theres a time for thinking and analyzing but theres also a time for action. And when direct exhortation fails, the therapist is reduced, as these stories bear witness, to employing any known means by which one person can influence another. With that view of sex, anyonecertainly including mewould have problems with potency.. But I decided to say something else. Every gesture I had witnessed over the months, Marges every grimace, every action, passed in front of me in chronological order. Yalom believes that researchers will eventually correlate electrical and biochemical activity in the brain with experience. There was nothing there inside. I feel numb., Youve been living and feeling one way for eight years, and now suddenly in twenty-four hours all that is pulled away from you. He was lost in a psychosis. His mother was outside. Thelma replied that, though I was probably right, she had made a promise to herself to stop therapy. I supported her as much as possible at this point. It had been a long time since I had made a home visit. Nors susilauius koj kreipiams gydytoj ir net nesusimstom, jog tai kakokia gda. There were still a few threads of illusion to be severed. They think theyre swimming when theyre on a dry stage, or that theyre rowing a boat when sitting in a chair. For an hour, I slipped into a reverie in which the entire plot of Three Unopened Letters came to me. One dream, in particular, affected him:I saw Susan Jennings. Ive never known anyone who wasnt. Often I thought of burning them, but that thought always evoked an inexpressible ache. We were sorry the bag was empty and that the emptying was over. I was convinced the abscess had to be incised and drained and that what I needed to do was to persuade you to permit me to do it. I was too afraid of making my aversion visible. Looking back now on this interchange, I see much sophistry in my words. I ended up responding so well to the process, though, that I've continued seeing her in private practice ever since. I know, I knowyouve often told me you respected me, and told me you liked me, but it was just words. It was time to finish the job. His thoughts really cant change the kind of person you are. Such a gift might be a deft move, he thoughtan insurance policy to quell any possible censure of his behavior. Can you go on?. As her sobbing subsided, Thelmas words grew audible. How could she give it up? But could I relate to Betty? She mollified me: Its not you. Every profession has within it a realm of possibility wherein the practitioner may seek perfection. I want to know exactly what youve been going through., One of the worst things was that I had no one to talk to, nowhere to turn, no confidant, no trusted friend with whom I could dare talk about this stuff., I dont know if you remember, but it took me fifteen years to make the decision to see you the first time. ! There was yet another component in this decision. As soon as I said that, I knew it was a mistake.. So now, hearing the litany again, I pondered how to shift her from this state of mind. Arent you? In this book I tell the stories of ten patients who turned to therapy, and in the course of their work struggled with existence pain. I dont know. First, remember that Im used to it. Imagine being in therapy for eight years and not talking about the real problem! He was also highly judgmental. Perhaps others would evaluate her very differently from the way I would. If she discovers this relationships, it would be so painful, if for some mistake she finds his love letters. Or mine. One month from nowwill you have opened the three letters?, Yes, without question, theyll be open in one month.. I was becoming more convinced that my hunch about his behavior was correct: namely, that he had major psychosexual problems which he had acted out on Thelma (and probably other unfortunate patients). I know whats in it. I took the Buddhist credo of universal oneness and egolessness very literally. I promised myself not to be a patient any more, and Im going to keep that promise.. Thats the name of the game. Meditate on that. Another theme was escape, not just physical escape from Atlanta, from her family, from the cycle of poverty and alcoholism, but escape from her destiny of becoming a poor crazy old lady like her mother, Penny having recently learned that her mother had, over the last several years, had several psychiatric hospitalizations. I found one of his comments particularly droll. Was I walking into a trap? 1. p.38 It was deeply frustrating. Therapy and a state of love-merger are incompatible because therapeutic work requires a questioning self-awareness and an anxiety that will ultimately serve as guide to internal conflicts. whats the word? . After making certain I was alone, I entered the confessional booth (appropriating the priests seat) and meditated upon the generations of priests who had heard confessions in this box. Over the last several months, I had constructed a visionor, rather, several alternative visionsof him: an irresponsible, sociopathic Matthew who exploited his patients; a callous and sexually confused Matthew who acted out his personal conflicts (with women in general or mother in particular); an errant, grandiose young therapist who mistook the love desired for the love required. Look how often youve said, Why should I get so upset about my sexual performance? I heard her exhale. It would be an error, probably a fatal error, either to force Dave into untimely revealing or for me to reveal information he had entrusted to me in our individual work before he started the group. She was severely handicapped. Thelma, ever since that hour a couple of months ago when you role-played Matthew and spoke the words that would release you, Ive been deliberating about inviting him into my office and having a three-way sessionyou, me, and Matthew. What about Marvins retirement disturbs you?. I didnt know her name and she didnt have much freedom, but we each knew how to find the other. I had developed a variety of hypotheses about his behavior, but I was not remotely prepared for the story I had just heard. Which is good. 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. But that moment, Carlos continued, I had a vision of their naked hearts. I grew acquainted with the characters who peopled Marvins mind, and identified (and shared with him) certain important repetitive life patterns: for example, the way he had re-created part of his parents pattern in his own marriagehis wife, like his fathers wife, wielded control by cutting off sexual favors. He had always prowled for women and regarded them in highly sexualized and demeaning terms. And that, Saul told me with a great sigh, brings us up to now. 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 care a great deal. An enticing, bold glance that Marge has not yet dared to appropriate? Precisely six months after her chance meeting with Matthew in Union Square, she left a goodbye note to her husband, Harry, who was out of town for the week, waited until his goodnight phone call from the East Coast, took the phone off the hook, swallowed all the tablets, and went to bed. Her string purse fell from her lap onto the floor, but she ignored it to listen wide-eyed to me. But, committed to a life of service, he did psychological testing for a few years; then he worked in a biofeedback lab; and, more recently, he had become the administrator of a Christian health maintenance organization. I commented that, in this office, the opposite was true: the more she tried to entertain me, the more distant and less interested I felt. Besides she marshaled other responsibility- absolving arguments: the genetic component (there was considerable obesity on both sides of her family); and the new research demonstrating physiological abnormalities in the obese, ranging from lower basal metabolic rates to the present, programmed, relatively un-influencible body weight. Then she turned to me and fixed her eyes on mine. I was pondering whether onions really do have a lot of sugar when I arrived at Sauls home. Never had he done a better job. She hated the doctors who had told her that Albert was doomed. Far better that he forget what we talked about than the opposite possibility (a more popular choice for patients) to remember precisely what was talked about but to remain unchanged. The change in behavior (even though conceived out of a neurotic wish to gain and retain my love) initiated an adaptive spiral and begot many other salubrious changes. But now the important thing is to turn toward the future. Generalizing from my experience to hers, I had mistakenly assumed her life to have richness that she was missing because of her obsession. I ended the session thinking that, though she might fulfill her research commitment, there was little chance she would resume therapy. The surgeon admits that was true. ), Well, I can think of at least two reasons. While we dread death, we generally consider freedom to be unequivocally positive. It was too much to absorb in a glance. I tutored her in the basic feelings (bad, sad, mad, and glad). The message I believed the dreamer was sending me:I try to look back but my vision fails. And, of course, behind the scenes, I was subtly guiding her toward that decision. So you depend on her power for protection, and she, in turn, pleads for protection by a magical chantlook where that leaves you. No, no, no! Thelma would have been a seventy-year-old ten pounder at least, and no one, absolutely no one, would have recommended psychotherapy. Soon I received more warnings:Phyllis and I are having dinner in a ramshackle restaurant. Then I couldnt focus the slide. She could only be pleased at my wanting to know her better. She had worked and worried Matthews statement that he cared for her until it now seemed an insult. 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. I could scarcely think of a single person with whom I less wished to be intimate. Author Biography. Dont skip anything.. Good try, Doc! Matthew turned back to me and, until he finished his story, did not again look at Thelma. He was right: I was not truly engaged with Marvin! Penny was still a haunted woman, but her demons now dwelled in the present rather than the past. I also wanted support from a colleague. Yet her problem fascinated me. I thought you came to see me because you wanted to stop tormenting yourself.. I had tried a more conservative approach for four months and had resorted to a radical intervention only when it was apparent I had no other choice. What would you most like me to do?, I know Ill be all right in a few days. What stops you from directly asking me the real question?, This is the kind of thing I worked on with Matthew. The collection of ten absorbing tales by master psychotherapist Irvin D. Yalom uncovers the mysteries, frustrations, pathos, and humor at the heart of the therapeutic encounter. He could neither escape nor reincarcerate them by closing the jammed door. 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. I came to some lectures here when the department was in the old building. I thought it would be difficult for her to take offense with any criticism of her behavior when framed in that context. Gone also was my patient. His search was so frantic, his need so pressing, that he defeated himself. Carlos had learned that lessonit was what he meant on his deathbed when he talked about his life having been saved. That was my ulterior motive in the consultation. )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. . I care about you a great deal., But your caringwhat does it mean? Search the for Website expand_more. Of course, his wife tried to obtain information about him. (Youve had a highly successful academic career. At a second- rate university in a third-rate department. Two hundred and sixty-three publications? Ive been publishing for forty-two years, thats only six a year. He said he didnt bother to ask Phyllis: he knew shed raise hell. No, no, its not that. No, he had never had a personal relationship with any other patient. It was also about the time that I was coercing Marvin into recognizing that his sexual preoccupation was in reality deflected death anxiety (see In Search of the Dreamer), and unwisely badgering Dave into understanding that his attachment to ancient love letters was a futile attempt to deny physical decline and aging (Do Not Go Gentle). , Mock Trial Direct Shannon Shahid (Defense), IGGY Study Guide Ch.21 Cancer Development, Laura Namy, Scott Lilienfeld, Steven Lynn. I often wrote the same article five different ways. What a story there was behind Maries relationship with him! Then I wondered about the two of themtheir unfilled wishes, their hidden reflections and opinions about the consultation. She reflected that she had to be entertaining to keep others interested in her. Nothing came. He ventured farther than his supply lines could reach, and now was assailed from all sides: the past was dusky and irretrievable; the future, blocked. Then I folded the letter and jammed it into my rear trouser pocket. We settled into a two-month stay in Kuta on Bali in an exotic house that had a high wall around the large lush garden property but no interior walls other than hanging shades. Only one thing had been changed: Penny took Chrissies bed into her own room and slept on it every night. In the ensuing discussion, Penny explored, for the first time, her desire for support and guidance from me and her resentment about my efforts to regard her as a research subject rather than as a patient. Or a razor blade? I thought about Thelmas speculation that he was gay. Consequently, I devoted the following two sessions to a detailed examination of his childhood. Finally, he grieved for himself, for the imprisoned dreamer, for the little boy crying for help in the darkness. Besides, most are less than three pages. The hypnosis helped her to tolerate the pain until, after three months, her fractured jaw had healed, her dental work had been completed, and the facial pain had subsided.