The event is severe (his migraines are exceptionally disabling); it is unexpected (sex never presented any unusual problems previously); and it is sudden (it erupted in full force precisely six months ago). His relationship with his mother had been exclusive, overly intimate, prolonged in its closeness and had disastrous consequences for his relationship with men; indeed, he imagined he had, in some substantial way, contributed to his fathers disappearance. Over the next few weeks, the contact with Carlos generated so much anxiety in Betty that I had to see her in several emergency sessions and had difficulty persuading her to continue in the group. Publication date 1989 Topics Existential psychotherapy -- Case studies. Far from wanting to take back her freedom from Matthew, she had a lust for . She was a stubby, unattractive woman, part gnome, part sprite, and each of those parts ill tempered. I had grasped the first half: I knew that the dirty old shoe represented Dave. I say that often to students. Hed known for a couple of years that he had deadened himself all his life. He became perversely incontinent: he refused to urinate outdoors but, waiting till he had gained entry to the house, drenched the living room carpet. I eventually decided it was unassailable, and turned my attention to helping her learn how to meet and engage men. Somehow it all seemed so natural, as if they had shared meals like this countless times before. I dont want to be just another patient. I wanted to be special. I want to be something, anything. Love's Executioner (1989), written by Irvin D. Yalom, was a documentation of the relationship and interactions between Thelma and himself. 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. No matter what you have accomplished, no matter that youve done enough for three men, you always fear imminent judgment and exposure. Members wondered about Daves hiddenness; some could understand his wish to keep the letters secret from his wife, but none could understand his excesses of secrecy. Often everything disappeared then, me and everything else, there was just the dance and the moment. First, he informed me that Phyllis was doing well: her phobia about leaving the house remained much improved. She had never done that before with me. Id like, if you two agree, to have the role of timekeeper today and to keep us focused. The past, the true story, the chronicle of real events, is unrecoverable. Ive been having conversations with you all week., Scary, good, bad, up, down Penny rattled these off. They were distracting and I didnt know how to answer them. ), and she laughed with me. Dont play dumb with me! I felt strongly that Thelmas fear of aging and death fueled her obsession. At some point while deep into a story, I observed my fickle mind flirting with another story, one that appeared to be slowly taking shape beyond my immediate perception. Matthew? His face fell, she reported, when he first caught sight of her, but, to his everlasting credit, he acknowledged that he was indeed George and then behaved like a gentleman throughout dinner. I dont know why, but Im even relating differently to the men in the group. Others, especially men, had noticed the change, and now touched and poked her during conversations. Not only did food represent her sole form of gratification, not only was it a method of assuaging her feeling of emptiness, not only did thinness evoke the pain of her fathers death, but she felt, unconsciously, that losing weight would result in her death. She knew that I only pretended to treat Marge as an equal. I was sorry I had to see him again. Then Id think about speeding up my pulse to let the blood out faster. One night she had two dreams about a lost twin brother. Im talking about now and about how you cannot live life because you continually replay past history over and over. She did not pass up the opportunity and began our next regular therapy hourfortunately the following morningby expressing that very sentiment. I must have had twenty such calls from her in the past year, and not once had I found a way to give her the help she needed. 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. Dave shared a dream with the group and Yalom's explanation referred back to his stash of old love letter's, secrecy, and fear of death. Her trademark was that she listened well and was entertaining. My wife is in front of me. I am grateful to my wife, Marilyn (always my toughest critic and staunchest support); to my Basic Books editor, Phoebe Hoss, an enabling editor in this as in my previous books at Basic; and to my project editor at Basic Books, Linda Carbone. Why did you break off? She turned and smiled, and we looked tenderly at each other. I have erred consistently on the side of too little, rather than too much, self-disclosure; but whenever I have shared a great deal of myself, patients have invariably profited from knowing that I, like them, must struggle with the problems of being human. Just as I started to come, I whispered, Kill me, into his ear. Who ever has a kind word for the fat lady? Again and again, I explained that intimacy difficulties are not extraneous static that just happen to get in the way of treatment, but are the core issue. God help you if you're a fat woman, Mr. Yalom is absolutely sickened by this filth. In college she had initially elected a premedical curriculum but gave it up for fear of being in contact with cancer patients. Early in my career, I worked in a maximum security prison where the least heinous offense committed by any of my patients was a simple, single murder. Thirty years dead. Software An illustration of two photographs. There had been another odor polluter in the house, a tenant who, according to Marie, dieted on decomposed fish. Soon he reported a series of dreams with explicit material about aging and death. He had always prowled for women and regarded them in highly sexualized and demeaning terms. But why? You are you, you have your own existence, you continue to be the person you are from moment to moment, from day to day. And then it was that Marie smiled. Other hopeful dreams followed:I am at a wedding, and a woman comes up and says she is my long- forgotten daughter. Somehow, Marge said, our last hour turned things around. She was the most beautiful woman he had ever conquered. So, as I was saying, I flip back and forth from feeling good to feeling anxious and depressedboth togetherand it is always in the depressed states that the headaches occur. Pennys eyes widened. Then I couldnt focus the slide. In those days I would have deepened Marges hypnotic state, regressed her in age, asked her to explore early traumasfor example, her fathers sexual abuseand urged her to experience and discharge all the attendant feelings, the fear, the arousal, the rage, the betrayal. He really cared, he really accepted me. Now shes fading. Thelma remained cryptic on this matter, and I did not press her for explication. In fact, of the twenty-eight geriatric subjects involved in this study, she had the most positive outcome. At first that helped her talk, but as soon as I talked about my attack, he ignored Martha and started doing the same thing with me. I no longer remember the sequence of my words. The first letter was from a Stockholm Institute postdoctoral fellow asking Saul to write a letter supporting his application for a junior faculty position at an American university. Every minute of my time was committed to completing a research proposal, and the deadline for the grant application was rapidly approaching. He had wisely decided to bail himself out of trouble by telling the group about his cancer. Ive called him countless times since and left messages on his tape machine. Whenever I tried, they brought pain, not comfort. I run to tell Phyllis about it because shes so fond of kittens. What do you get out of it? Very few men (though there were some) were brave enough to love meeveryone was terrified of Harry. What had prevented him from forming even one intimate nonsexualized relationship with either man or woman? She had lost her belief in benevolence, in her personal invulnerability. But too much was riding on this hour. . 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. Of these facts of life, death is the most obvious, most intuitively apparent. In fact, as a result of his psychosis and what had happened with Thelma, he had, several years ago, realized that his psychological problems posed an insurmountable barrier, and he had stopped being a therapist. The message I believed the dreamer was sending me:I try to look back but my vision fails. I asked myself what, exactly, was boring about Betty, and identified two obvious characteristics. It was no big deal., I notice, too, that whenever I try to move closer to you, you let me know you dont need anything., Im here for help. I wasnt about to give a guarantee that I would never callbut fortunately she didnt ask for that. Did I ever tell you that she never adopted me? Saul suddenly was back with me again. Six months ago! I wish that there were some way in the world of our meeting every few months so I could catch up on you. I would have been pleased with it had it been my idea. The Thelma who deceived me? Only now, when she was approaching a weight when sexual invitations might materialize, only now when her dreams teemed with menacing male figures (a masked doctor plunging a large hypodermic needle into her abdomen, a leering man peeling the scab off a large abdominal wound), did she recognize that she was very frightened of sex. She was different today, her gait labored, discouraged, dispirited. Our web pages use cookiesinformation about how you interact with the site. Everyone always says things in reviews like, "I wish I could give such-and-such book negative stars!" Each session he described all of his encounters with women that week (often they consisted of nothing more than catching a womans eye in the grocery store) and obsessing about what he might have done in each instance to have consummated a relationship. That notion rains true in the book "Love's Executioner," by Irvin Yalom. As I had anticipated, Dave kept himself well concealed in the group and, in fact, received reinforcement for his behavior from another secretive member, a beautiful and proud woman who, like him, looked decades younger than her years. University of Idaho. He had never been able to confide much in anyone and certainly not in a male. I want to tear the food away. Guilt and I were old acquaintances, both personal and professional. Since she was phobic about seeing doctors (because of her shame about her body, she rarely permitted a physical exam and had never had a pelvic exam), it was hard to reassure her about her health. Most likely she would reconstruct the hour with Matthew so that her version of reality could once again support her fusion fantasy. I find them repulsive: their absurd sidewise waddle, their absence of body contourbreasts, laps, buttocks, shoulders, jawlines, cheekbones, everything, everything I like to see in a woman, obscured in an avalanche of flesh. (On that point I needed no persuasion.) Carlson. I knew that he had not injured his back (he often avoided unpleasant confrontations by malingering), and he knew I knew it; but the crisp tone of his voice signaled unmistakably that I no longer had the right to comment on it. Now that youre looking better, Saul, lets go back to work. The kindly family doctor held my hand gently as he examined itthen suddenly, with a heavy book he was holding surreptitiously in his other hand, he slammed my wrist, bursting my ganglion. She lathered him in the shower, she shaved him, she massaged him, she took his soft penis into her mouth and held it there gently until it throbbed into life. Is that true?, I didnt want to encourage the distraction. I was well enough acquainted with Marge to know exactly what she would do with my blunder: she would say that I had let my true feelings out, that I think shes so hopeless that the only persons with whom she might compare favorably would be the most hapless souls on earth. As I had expected, Thelma did not keep her next appointment three weeks later. Marie left the office obviously pleased with him and with the work they had done. To prove that point, she described a desperation date she had had the month beforeher only date in years. And theres a lot of evidence for this. While I was considering shifting to a hard, uncomfortable chair, it suddenly occurred to me that when I was in therapy with Rollo May, he used to sit in a straight-backed wooden chair. I, on the other hand, was strongly drawn toward her. It would have been a shock to get an out-of-the-blue call from you. I feel ashamed. You mentioned you had never talked to a psychiatrist before., Its not a matter of things being intimate, its more to do with psychiatryI dont believe in psychiatrists.. I felt, when I was about eight, that she had lost confidence in me and wouldnt have minded if something bad had happened to me.. That in itself was unusual, for she had seldom ever looked directly at me. Maybe first impressions are more accurate than second or third impressions. Subscribe. But when she was robbed, she felt as though she were starting all over again. He understood that she had received and registered the message. By the time six months had gone by, I cared somewhat more about Marvin, yet still had no deep fondness for him. She was convinced he was going to die soon, though the doctors claimed that his prognosis was not hopeless despite his debilitated physical condition and his advanced age (he was sixty-three). Now is the time you can make some real progress., I dont want to be in therapy any more. 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. Sitting down, Elva sighed and said, I never thought it would happen to me.. You know, it feels right. He also resisted my attempts to engage him more personally and directly: for example, when I had asked him about his wound or pointed out that he ignored any of my attempts to get closer to him. And the length of the sentence! (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. One of the things he said at our first meeting endeared him to me: Im going to be fifty-nine soon, and some day Id like to be able to stroll down Union Street and spend the afternoon window shopping.. It seemed natural for her to adjust the crumpled collar of his shirt, to brush the lint from his jacket, to take his arm as they climbed Nob Hill. At one meeting, she and Dave were asked to state their ages. I wanted to linger with the dream but had to return to the needs of the moment. She saw through her own illusions, and what illusion had shielded now lay before her, bare and terrible. What she had feared at the very onset of treatment had come to pass: she had allowed herself to feel deeply about me and was now going to lose me. . It was as though he, too, sensed that she could be released only by information, that her illusions could not endure the beam of truth. For as long as I can remember, I have taught my students that if something big in a relationship is not being talked about (by either patient or therapist), then nothing else of importance will be discussed either. Was Dan right? (A curious thing: my therapist eventually became a close friend and years later told me that, at the time he was treating me, he himself was obsessed with a lovely Italian woman whose attention was riveted to someone else. " " . He must have followed her into the parking lot and, his footsteps muffled by the roaring of the waves, sprinted up and, without breaking stride, ripped her purse away and leaped into his nearby car. Ordinarily in therapy I would make sure to return and analyze this short sequence, but that day was not the time for such subtleties. The main charge she brought against herself was that she had not been really present with Chrissie. Helping Relationships Reading Paper .pdf. Penny had wanted me to get her started; and, by sheer chance, my first question unleashed a torrent of feeling. He wanted you to be happy because he thought he was the same as you. His overwrought reaction was, I thought, totally irrational. love's executioner two smiles summary Call us today! When she had been in therapy for a few months, I decided that her progress would be accelerated if she worked in a therapy group as well as in individual therapy. Yalom believes that researchers will eventually correlate electrical and biochemical activity in the brain with experience. During the first few sessions, Betty described, in endless detail, problems she encountered at work with customers, co-workers, and bosses. Could I see her doing that? It was time to finish the job. Whenever I sat down to eat pizza or pasta al pesto or enchiladas con salsa verde or German-chocolate-cake ice cream, or any other special treat I knew Betty liked, I thought of her. I remember her first words then: I think I need help. Though I had never before worked with anyone who had lost a child, I ought to be able to help her since much of her grief was reducible to guilt. Penny nodded, sobered by my analytic tone, and her sobbing stopped. Why does an attractive, presumably accomplished young man select a sixty-two-year-old woman who has been lifeless and depressed for many years? He will never forgive me for it., But, Thelma, hes a therapist. I was now permitted to interrupt her instantaneously (reminding her, of course, of our new agreement) whenever she giggled, adopted a silly accent, or attempted to amuse me or to make light of things in any distracting way. They had attempted intercourse two other times, but Matthew was impotent. Without opinions, without impulses, without inclinations, they become parasites on the desires of others. Thelma wasnt sure whether the new person was a man or a woman. Look, give yourself a break. I wouldnt have made it without you. Thelma arrived twenty minutes early for the session. I turned my attention to Thelma and dismissed, for the time being, the question of Matthews motivation. The three-way meeting had been my idea and I had been the one who stripped her of her illusions, I was the disillusioner. But the next week Thelma, for the first time, missed her appointment. Julian Barnes has, in Flauberts Parrot, illustrated in a beautiful and whimsical manner a persons inexhaustible complexity. Thats what I call crazythey should see a psychiatrist.. I like hard women, and I liked her style. ), Well, I can think of at least two reasons. Betty made it clear immediately that she hoped therapy would help her get to the point where she could seriously consider weight reduction, but she was a long way from that at this time. I decided to start with her lack of self-revelation and, toward the end of a particularly soporific session, took the plunge. We had to blindfold him so we could continue. Ultimately I would have to help her assume responsibility for her appearancebut saw no leverage for achieving that at this time. 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. Marie was a forbidding presence and most people felt daunted and distanced by her beauty and hauteur. I had asked for dreams, and he had given them to me. There turned out to be only one printer in Denpasar, the major city of Bali, and it was located in a computer school. , , . 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. What a relief to have a break from Marges droning voice and relentless whining. When Im depressed I get impotent, and then because Im impotent I get more depressed. I havent had any more fantasies about Matthew, she went on. In summary, T.H. Take a look at this. Anything Ive said to you is an open book. In similar fashion, Bettys (Fat Lady) therapy was ineffective as long as she could attribute her loneliness to the flaky, rootless California culture. The course and the exam is over. She tried to poke me into joining the fun. Within seconds after seeing him, before he said a word, I was aware that he had profoundly changed: the old Saul was suddenly back with me. They call out to those who are forever lostdead or absent parents, spouses, children, friends: I want to see you again. I want your love. I want to know youre proud of me. I want you to know I love you and how sorry I am I never told you. I want you backI am so lonely. I want the childhood I never had. I want to be healthyto be young again. The author sets out to discover the real Flaubert, the flesh-and-blood man behind the public image. Christ! Saul did not show up for his next appointment. Or only part honest, or easy honest? I remember looking forward to each session with more than a little curiosity about the choices that he would make. I remember the games of imagination I played as a child trying to invent the existence of someone she did not hate: A kindly aunt? The secretaries all loved him. One of the most irreverent of these was poundage: the heavier the patients clinical chart, the worse the prognosis. After being hospitalized for a week, she began treatment with an oral surgeon to repair her teeth. Such people tend to be tiresome. He shouted aloud, I will never see you again! Still, nothing. She then cleared her apartment of foodevery can, every package, every bottle. Im tired. In response to my raised eyebrows, she explained she had just played eighteen holes of golf with her twenty-year-old nephew. The patient, who was very paranoid, insisted that I was not Dr. Yalom but an FBI agent, and demanded proof of my identification. Probably not one in a million, Carlos said in a sad and weary voice. Though Betty never again heard from George, she often thought about him. In the other, she was lying in a hospital bed with a candle, which represented her soul, burning at the head of the bed. But why a year? 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. It almost never does. He was now crossing that critical boundary that separates the troubled, suffering, anxious person from the psychotic. She knew I wanted a real woman. Im just not thinking clearly. That Martha. Other doctors have told me that I am in a vicious circle. Penny went to work at thirteen, dropped out of school at fifteen, was an alcoholic at sixteen, married and divorced before she was eighteen, remarried and escaped to the West Coast at nineteen, where she proceeded to bear three children, buy a home, bury her daughter, divorce her husband, and put a down payment on a large cemetery plot. I felt otherwise. The no-suicide contract (a written or oral contract in which the patient promises to call the therapist when feeling dangerously self-destructive, and the therapist vows to terminate therapy if the patient violates the contract by a suicidal attempt) has always struck me as ludicrous (If you kill yourself, I wont treat you ever again). After all, eating was her life. After three or four weeks my hallucinations returned, and I had to re-enter the hospitalthis time for six weeks. Hes very attractive, hes the kind of man Id like to have in my life., Well, obviously I was embarrassed. And suppose one of them mistakenly thought her experience was the same as his?. Pointing this out to Marie, I also questioned the advisability of yanking an eighty-year-old, non-English-speaking man out of his culture. I shuddered when I thought of her dining, can opener in hand, on Optifast liquid. The body is stiff; the face taut; cold, repetitive thoughts clog the brain. Most likely that was the point of his preoccupationthat he might forget his infestation.