Primarily, though, my attention was fixed on Matthew. To drive my point home, I attempted, in our final session, to use myself as an example. I want to make it through our last session next week with you still having respect for me., How do I know? At the end of this session, I was exhausted and very moved. That was good. But why? She became preoccupied with the capriciousness of death. An illustration of two cells of a film strip. It was the worst thing that had ever happened to me. Penny had wanted me to get her started; and, by sheer chance, my first question unleashed a torrent of feeling. Her string purse fell from her lap onto the floor, but she ignored it to listen wide-eyed to me. This existential dilemmaa being who searches for meaning and certainty in a universe that has neitherhas tremendous relevance for the profession of psychotherapist. I remember amusing myself by imagining introducing her to patients on long-term tranquilizer medication who had developed tardive dyskinesia (a drug-induced abnormality of facial musculature). Obviously there lay the key and I began the second session by exploring the events of six months ago. You just help get me started. However grim these givens may seem, they contain the seeds of wisdom and redemption. Believe me, I swear it, in the last meeting I was the only honest person in the group. We dont deny death. Was I to be satisfied with offering sheer presence and support? I want to travel. She was counting on a sizable financial settlement, and she feared antagonizing Dr. Z., whose strong testimony about the extent of her injury and suffering would be essential in winning the suit. Therapy has much to offer grieving parents. When she first came to see me three years ago, her husband had already been dead for four years, but she remained frozen in grief. . The men are all losersthey wouldnt be there otherwise. Thirty years! He winced visibly and said simply, I wouldnt like that for her., But where would she fit, then, in this world youre building? ), Carlos grinned at me. There were several reasons. But what I really disliked about Elva was her anger. Although I would have relished finding out what really happened, her reference to amputation intrigued me even more. Yet here the sequence seemed natural. I dont think Ive ever said a crueler thing, but to make myself heard, I had to speak in words so strong and so stark that they could be neither twisted nor forgotten. If she could play all those roles, she must be the concealed, guiding intelligence behind them all. She had, as she put it, played a lot of fantasy games. Was there nowhere in the world an odor-free place? "If Dr. C only knew what really happened." The second time she smiled was in response to Mikes equally ingenuous question, Would you feed your dog poisoned dog food?. Her mother worked twelve hours a day as a laundress and spent most nights drinking and picking up men at a local bar. Marie left the office obviously pleased with him and with the work they had done. Maybe first impressions are more accurate than second or third impressions. Sometimes the dreams, like the first ones, were frightening expressions of ontological anxiety; sometimes they foreshadowed things to come in therapy; sometimes they were like subtitles to therapy, providing a vivid translation of Marvins cautious statements to me. The ground under my house was liquefying. 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. I lost it in a second., Marvin, did you tell Phyllis exactly how you felt about her timing?, Her timing is not goodnever has been. Her love obsessionwhat else could one call it?was powerful and tenacious, having dominated eight years of her life. I need your commitment to hang in there with me., You have it. But he pressed it before me so forcefully that I had no option other than to watch his stubby finger trace out the love leavings of last July. He wants her to have a loving relationship with a man and have a loving family. Thelma had had sufficient time (twenty years of therapy!) What a relief to have a break from Marges droning voice and relentless whining. 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. Im never going to associate with losers like that. My Social Security and my university pension pay me far more than I need to live on. Ive never known anyone who wasnt. I had promised myself to Marge. Cant you see that youre doing this to yourself? Though Penny didnt remember the final hours of Chrissies life, she was certain that she did not say what she should have said: Go! Without question she had neglected the boys for the past eight years. I was not certain what would happen in this extraordinary three-way meeting, yet I felt strangely confident that all would be for the best. I didnt mention our discussion about the letters because I didnt want to compromise you. I told him I would come because I was the only one who could help, but as I started down into the darkness, the stairwell grew more and more narrow and the flimsy banister came off in my hands. I am not sure what criteria were used in picking the case studies he did for the book; I imagine he has rich history of intriguing patients and these are no exception. 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. Im working on a letter to him now which reviews, step by step, every detail of whats happened.. I had to stop bantering, I could no longer connect to him in that way. And then I slipped into a reverie about my own letters. He was certain the decision to teach school had been a serious mistake and, at the age of thirty, set about rectifying it. My attempts to generate power were shamefully inelegant and consisted mainly of fumbling, nagging, and repetitively circling her obsession and bashing away at it. Moved by my answers, Marge grew ever bolder but gentler in her talks with me. Ive spent all week thinking about a meeting with Matthew. I learned, at follow-up, that Penny was falling prey to this dynamic: she had grown fearful about her sons driving, was reluctant to lend them her pickup, and adamantly refused to allow either of them to buy a motorcycle. I developed a specialty in group therapy and, during my first sabbatical, embarked on writing a textbook on group therapy. I was hopeful now of plunging into real work. That was why you began the group, remember? Her tight shoulders relaxed, her face loosened, her head turned ever so slightly toward me. There were other signs as well that Betty might go no further. Yalom! Almost like shell find out about it., You give her a lot of power. Whats helped in the past? Every time I switch therapists, I call to let him know. She put her head between her knees, breathed deeply, and slowly regained her composure. His health restored, Saul was ready to terminate immediately but agreed to come in twice more the following week and one month hence. No one calls me on my birthday. She giggled at my question: Do you believe, Elva, that the more of these you eat, the thinner you will become? A plastic sack of old orange peels (You never know, Elva, when these will come in handy). This textbook emphatically stresses "the therapist's job is not to make someone better, but to help the patient make themselves better." She was six years younger, equally shy and equally inexperienced with the opposite sex. Usually she denied having any feelings, but sometimes she disarmed me completely by saying that she had felt very intimate that houran hour when I experienced her as particularly evasive and distant. Yaloms tone manages to be both enjoyable on a literary level and enlightening on a professional level. Dave said, Shoot! Perhaps she loved me enough to change her behavior! love's executioner two smiles summary. And that, Saul told me with a great sigh, brings us up to now. In an effort to reduce her anxiety, I urged moderation and suggested she approach sex with less drastic steps: for example, by spending time talking to men; by educating herself about such topics as sexual anatomy, sexual mechanics, and masturbation. These next few days are going to feel very disorienting. I boiled two eggs and made egg salad. , , . I held my tongue. It is when these unattainable wants come to dominate our lives that we turn for help to family, to friends, to religionsometimes to psychotherapists. There was no one else he could ask to keep them, no friend he had dared tell of this affair. Just humor me. I could have used that to keep punishing youin fact, I know Ive done that with shrinks in the past. I hate to be loves executioner. Marie and he locked gazes for a moment. Just delay the gift for the time being, until the crisis has passed, till the letters have been opened.. A cipher. He didnt give a damn about Martha and me, he was just getting his sexual kicks. A couple of weeks ago, for example, some out-of-town guests called to ask if they could view his collection of political buttons. Not only was she turned off therapy, she volunteered, but she had no further need of it: she had been feeling much better, certainly far better than three weeks ago! Do you think I feel that way about you?, To be honest, thats another reason (in addition to my promise to Matthew) that I havent talked about him to therapists or anyone else. , . Of the many risks, I feared one particular scenario. Though Elmer was really Charless dog, and though Marie had an aversion to dogs, she had gradually grown affectionate toward Elmer, who for years had slept in her bed. Even though she was now working long hours, she was barely making it. Unfortunately feminism with the best of intentions is destroying respect for motherhood, masculinity and relations between the genders. So in a sense she was following your unspoken wishes by not openly expressing her uncertainties, by pretending to be stronger than she felt. If thats so, Thelma, what better place to work on it than right here and now in therapy?, Thelma nodded her head more vigorously. I felt overwhelmed. Its so busy that it gives me a headache. His sex life now was confined entirely to masturbating while watching rented sadomasochistic videotapes. Therapy sessions always just stir the pot. She slumped into her chair and spoke slowly and softly in a resigned tone. 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. I was definitely growing irritated and thought, Eight years have gone by, Thelma, cant you get the message? And Im going to be open with you: Im almost certain I will eventually commit suicide. Marvin had moved fast, too fast perhaps. Something has gone from me. You tell me: Whats the perfect scenario to drive an ex-lover to suicide? I retreated to fact gathering. Its four years now. A week later, I arrived at work one morning to find my door broken open, my office rifled, and the clothes gone. She gave no evidence of wanting a response from me. And powerlessness was the problem in my therapy with Thelma. It is here, in the idea of self-construction, where anxiety dwells: we are creatures who desire structure, and we are frightened by a concept of freedom which implies that beneath us there is nothing, sheer groundlessness. In his remaining months at the Stockholm Institute, Saul worked like a demon. Lets be very realisticas you say, this is the place to be honest. How did you decide to get into this field? How can you stand to be with her? In addition, the replacement child suffers, too, especially if the parents grief remains unresolved. My next few days were filled with self-recrimination and worry about Thelma. I doubted whether it would be possible to separate her from her obsession without first helping her to enrich other realms of her life. When I asked for his reaction, he became strangely formal and said, Ill take your suggestions under consideration and let you know my decision., Was he disappointed? I only know that I pulled out all stops and placed the utmost pressure on her to reconsider. ), Well, I can think of at least two reasons. You talk about having done nothing, having accomplished nothing, not being fit to exist, but we both know that these ideas are a state of mind. I dont want to make Dr. Yalom look bad.. It was deeply frustrating. I told you Phyllis doesnt like to spend moneyshe loves sales. You look uncomfortable. Would our confrontation break the ice jam? Marvin estimated that the mood swings were now approximately the same as they had been for the previous twenty years. Why then? At first they startled, then irritated, her. I want you to focus on one thing, nothing else. The creative members of an orthodoxy, any orthodoxy, ultimately outgrow their disciplines. Weary of traveling alone on these little subterranean excursions, I decided to stay closer to Marvins concerns. I reminded her of the six-month commitment, of which five weeks remained. The day started out like any other day. She was the most beautiful woman he had ever conquered. The current upheaval began the day after our last session when Penny learned that Jim had, for the last three months, not kept up his payment for their cemetery plot. Her face grew rounder, her bodice fuller. Remember, Sarah, often extreme situations like this can end up being important turning points if theyre worked through carefully. I moved all over the auditorium to get an unobstructed view, but I could never see the whole slide. I never beat around the bush. . Yet she chose her terms so deliberately that I assumed they had been Matthews words, maybe an example of his fine technique! From a feminist point of view, I realise that this book is one of many written by old white men and it shows. I know she has been going through bad times, and I know that I bear the responsibility for that. She cried even for her poor old mother and the sisters she had blotted from her life twenty years ago. Ive been dreading the publication of this article. Some believe in the merits of the enterprise and devote their careers to ever greater nosological precision. One becomes ones own parent or remains the eternal child. Yet Ive often thought about that crime. She did not pass up the opportunity and began our next regular therapy hourfortunately the following morningby expressing that very sentiment. I needed something stronger. Phyllis, Marvin and Yalom never met together, Love's Executioner General Chapter Overviews, CH 7 Yalom - Transference & Transparency/ CH, . But the problem is that sex is turned into something medicinalno, thats not strong enoughsex becomes a life or death proposition, and your survival depends on merging with this woman. Students have told me they were more willing to plod through dry theory knowing there would likely be an interesting tale just around the bend. I walked over to my desk, opened her file, and read aloud parts of a letter she had written only three weeks earlier when she was feeling exhilarated about life: . I often havent answered because I thought that talking about schools of therapy would get us away from the personal discourse we needed to have. 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! Over the past two years, as her depression lessened, she had arrived at the conclusion that her only possible salvation was to develop a new romantic relationship, but she was so proud and intimidating that men regarded her as unapproachable. One experiences interpersonal isolation, or loneliness, if one lacks the social skills or personality style that permit intimate social interactions. Matthew, her previous therapist who was an intern. No one is in a position to make a more accurate judgment of my work than me.. But I decided to say something else. The preparation was finally complete, and the real therapy could now begin. When I first began to work as a therapist, I naively believed that the past was fixed and knowable; that if I were perspicacious enough, I could discover that first false turn, that fateful trail that has led to a life gone wrong; and that I could act on this discovery to set things right again.