I told him that I knew it sounded crazy, but persuaded him to follow my instructions faithfully. Since Thelma had opposed everything else I suggested, I was preparing my argument to convince her when, to my surprise, she enthusiastically agreed. Was it possible that Carlos could accomplish something more ambitious in therapy? First, we explored guilt, a state of mind few survivors escape. Would those words from Matthew really release her? Penny had said she was no longer feeling a connection with Chrissie in her cemetery visits (now down to two or three a week). Ive been using it to hypnotize myself., I like your suggestions, Marge, except that youre being tough on my wall hanging. I was entirely satisfied with my words: I had covered myself and had been clear enough to prevent any misunderstandings. A well-meaning but blustering and insensitive student (later, mercifully, to become an orthopedic surgeon) was conducting an interview before his classmates and attempting to use the early Rogerian technique of coaxing the patient along by repeating the patients words, usually the last word of the statement. Although Marvin had had no nightmares or powerful dreams, he knew there were nocturnal rumblings. How would I respond when she asked about my feelings toward her? Here he is at the outset of the poignantly affecting tale, "Fat Lady": "The day Betty entered my office, the instant I saw her steering her ponderous 250-pound, five-foot, two-inch frame . She had a gift for imitating accents and mimicked her laid-back Marin County physician, her Chinese customers, and her Midwestern boss. He had so much caring, so much loving. That was Thelmas perfect cue. Perhaps it was the whimsy in his request: Teach me to hate armadillos.. Inspiration came quickly in Bali. And I can ask hard questions. We are really talking now. I hear only human feelings. Nonetheless, I felt convinced that I could resolve this whole crisis in one or two sessions. I had often done so in the past and he had a ready answer for everything. I got dressed quickly and tried to stop them. It was as though we had assigned the other Marge to a psychological organ bank. According to her mother (Betty told me she had no recollection of this), she was reassured by her parents that only old people die, but then she pestered them for weeks by chanting she didnt want to grow old and by repeatedly asking her parents how old they were. The decades had eroded none of their restorative powers: she exhaled deeply, calmed herself, and sat back in her chair. 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? Dont play dumb with me! But the patient has a right to expect fidelity during the hour. So here goes. Perhaps she was right in saying that a little more treatment would kill the patient! All in all, I deserved Thelma and Harrys criticism. We battled for months. Years ago I told him that I briefly saw Matthew once by chance. He was up front, he told me exactly what was troubling him as best he could. Although Thelma's love obsession with her therapist, and her subjective experiences on life of what is preventing her from living in the present, Yalom attempts to treat a 70-year-old woman only to learn that being love executioner more complicated as he had anticipated. Could we arrange to have payments spread out over several months? Heres what I want you to do. Could Matthew release you? I shrugged off the question. I didnt know whether a silent coronary was accompanied by a fast or a slow pulse. After her father died when she was eight, her mother had moved her and her sisters from apartment to apartment at least twenty times, often staying for only two or three months until they were evicted for not paying the rent. But my contempt surpasses all cultural norms. During a long conversation about his years fellowship, I mentioned that I once had a friend, Saul, who also had a rewarding stay there. . it is our own ideas of him which we recognizethese words provide a key to understanding many miscarried relationships. Nothing came. On several other such attempts in the past, she had been stood up by men who probably spotted her from afar and left without speaking to her. Albert was a fixer. Saul called me at approximately the same time that I was attempting to dynamite Thelmas love obsession (see Loves Executioner). As participant, one enters into the life of the patient and is affected and sometimes changed by the encounter. She and he had increasingly diverging views about religion, and she could not follow his conversion into a fundamentalist Christian sect. And he will proceed to lay out counter arguments to himself better articulated than you ever could have. I know that it is me who is dying. Thelmas voice had a lilt to it now, and she rocked her head in rhythm to a melody of eight years past. Life doesnt seem worth living. Then, at one museum, the aged guardian offers proof his parrot is the real one. We dont deny death. I told her of my own difficulties in coming to terms with death; that, though the fact of death cannot be altered, ones attitude toward it can be vastly influenced. To be truthful, I wanted to see Me again. Only then would we turn to the identification and removal of the obstacles that were preventing her from establishing intimate relationships in her social life. It almost killed him when I attempted suicide. I didnt buy his reply, but the moment called for patience, not confrontation. One hundred seventy. My good opinion of him meant a great deal. It was a clumsy effort on my part. Maybe thats something I ought to be talking about in the group. With what physical problem was Carlos dealing? Maybe I was wrong, but I think her eyes said, Are you satisfied now? I did not comment on her gaze. I felt funny when Dr. C. kept talking about the dog and the poison. I knew that by acting immediately I could help her avoid a great deal of pain. Besides, human service professionals have always practiced on the living patient. That was when he learned that he had deadened himself. It didnt take much experience to recognize the signs of deep distress. 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. She knew that I was weary, weary of Marges whimpering and stuttering, that I was weary of her panics, her curling up in corners and hiding under desks, and weary of her thready childlike voice. But most people work on it over and over throughout the years. The wrong one died. And how did they feel about seeing Chrissies last will and testament on the refrigerator for the past four years, attached with a magnetic metallic strawberry? She also reminded me of Madame Defarge in the movie A Tale of Two Citiesthe one who knitted at the guillotine as heads were lopped off. She had led a rich, eventful life. When I was a student at the Johns Hopkins Psychiatric Clinic, the staff had many back room indices of chronicity. Even though she gave no evidence of it, I believe she was relieved. The more I thought about it, the more I was convinced it didnt fit. Stay focused! I hate to be loves executioner. When I think about what to do, I often hear your voice asking rational questions. Ive always found it difficult to treat someone with so little curiosity. On several occasions I refused social invitations, some even from Dr. K., because I would not leave the library.. Thats rich! She could not sit for the session but three times stood and paced up and down. If only I had never gone to the Stockholm Institute! He sighed. Dave looked startled. What is Yalom's favorite first question to his patients? She was always on guard against injurywhen driving, bicycling, crossing the street. It was not difficult to lay out before her the ways she avoided life: her reluctance to engage others (because she dreaded separation); her overeating and obesity, which had resulted in her being left out of so much life; her avoidance of the present moment by slipping quickly into the past or the future. To read the exact words would only tear open the wound even more.. I know the feeling, Ive done the same thing. We were similar in many ways. But that moment, Carlos continued, I had a vision of their naked hearts. Three bags of candies (low-calorie, of course). For years, between customers in her taxicab, she had listened to self-improvement cassette tapes on vocabulary improvement, great books, and art appreciation. It is a story about countertransferencethat is, irrational, often shameful, feelings a therapist experiences toward a patient that constitute a formidable obstacle in therapy. Where is Chrissie? But that would not be easy. One hundred sixty-five. I simply hadnt realized it. The other dreams gave evidence of a savage world beneath Marvins placid exteriora world seething with death, murder, suicide, anger toward Phyllis, fears of dirty and menacing phantoms erupting from within. 4445 n 36th st, phoenix, az 85018. ct classic plates benefits; She had always lived in the privileged circle, outside the unpleasantness, the nasty inconveniences visited on ordinary peoplethose swarming masses of the tabloids and newscasts who are forever being robbed or maimed. Beware the powerful exclusive attachment to another; it is not, as people sometimes think, evidence of the purity of the love. And think of how they must have resented her attempt to keep Chrissies memory alive by continuing, for example, to celebrate Chrissies birthday every year! It was too late: his house had been built, his final examination turned in. Three Unopened Letters 9. But ultimately they realize the inadequacy of their tools for the task. What other feelings did you have about them? Remembering I hadnt wanted to take the lid off such primitive feelingsat least not this early in treatmentI switched from murder to sex. To my relief, she was much improved. Never before had he asked to meet with me. Or forcibly impose my will on a man who, incapable of acting in his best interests, allowed himself to be terrorized by three unopened letters? But they corresponded almost daily. I empathized with her and told her that I had heard many others in her situationincluding my wifecomplain of similar treatment. She was severely handicapped. She was different today, her gait labored, discouraged, dispirited. There are no rear windows. I knew that the most important thing I could do for her, especially in this time of crisis, was to maintain our relationship and not allow her to drive me away. 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. But I want to. It was a couple days after the funeral, I was still taking off from school. I do a lot of thinking about aging and death, but my thoughts are too morbid to talk about. No, at my first meeting I could find little endearing about Carloss characteror about his physical appearance. It is refreshing. I also wanted support from a colleague. Now that I had Daves permission, I proceeded to give the group members, who were by now mystified by our exchange, the relevant background: the great importance of the letters to Dave, Sorayas death thirty years ago, Daves dilemma about where to store the letters, his request that I store them, and my offer, which he had so far declined, to keep them only if he agreed to inform the group about the entire transaction. My life is being lived eight years ago.. Basic anxiety emerges from a person's endeavors, conscious and unconscious, to cope with the harsh facts of life, the "givens" of existence. I collected my thoughts, trying to decide how to help her see what she was doing to herself. Therapy has much to offer grieving parents. He was brisk and direct: I know what it is to run a tight ship, DocI did it in the army for thirty yearsand I see that youre running late. He would quiz me with some new fact gleaned from the morning paper: What vegetable has the highest sugar content? I arrived at his house early in the morning, entered through the door, mysteriously left ajar, and conducted therapy by the side of Sauls bed, where he lay flattened by an ailment we both knew was fictitious. Transference - feelings that the patient attaches to the therapist that originated out of earlier relationships. Though she acknowledged that it was an irrational thought, Betty realized that since her fathers death she had believed that weight loss would make her susceptible to cancer. I decided not to protest her accusation that I did not believe her. You say shes forgotten all traces of this life?, Its all gone. I was also aware, however, that she had expressed gratitude to me, and that felt good. If she, at the age of sixteen, had kept her two children, she would have been nailed down to the same life her mother had. And I liked his willingness to put up with uncertainty and to undertake the laborious task of inventing a different therapy for each patient. Also (as I was able to appreciate only later with a more objective view of myself), it was unfortunate for Saul that he had consulted me at a stage of my professional career when I was impatient and managerial, and insisted that patients promptly and fully confront their feelings about everything, including death (even if it killed them). Then he rose from his chair and paced about in my office, gulping air in great draughts. In demystifying the therapist-patient encounter, Dr Yalom brings us into broader territory: he reminds us of our need for intimacy and trust and the struggle necessary to achieve them." Sunday Herald (Melbourne, Australia) My hunch was, I told Betty, that when she entered more fully into life, she would lose her terror of deathsome, not all of it. There is your Harry, and there is my Sonia.. I told you she doesnt believe in psychiatry, but it goes far beyond that. Carlos, before you started the group I tried to explain to you the basic rationale behind group therapy. In fact, of the twenty-eight geriatric subjects involved in this study, she had the most positive outcome. I was being cruel, yet the option of not being cruel, of simply humoring him, of tacitly acknowledging that he was incapable of seeing reality, was crueler yet. No more jousting or crudity. Imagine, then, how pleased she was, a year after their last meeting, to run into him late one Saturday afternoon at Union Square in San Francisco. Her daughters, her friends, her veterinarian, all urged her to have Elmer put to sleep. Well, the last eight cant be counted as therapy because of Thelmas secretiveness. After I was discharged I immediately flew back to San Francisco, and it was the following day that I met Thelma, sheerly by chance, in Union Square. No doubt they resented that arrangement while Chrissie was alive, I suggested, but what of their anger now when Penny refused to let them use their sisters room after her death? My next few days were filled with self-recrimination and worry about Thelma. Her company had originally trained her, along with eight other novices, in a three- month intensive course. Aside from a seventeen-year-old son and daughterdizygotic twins, who lived with his ex-wife in South AmericaCarlos, at the age of thirty-nine, found himself virtually alone in the world. Yet her despair deepened. It is trueor, rather, was truethat, when we first began to meet, I was put off by your body., Tell me, Betty, knowing thisseeing that I didnt look at you or was uncomfortable with you why did you stay? It was catastrophic. I can understand how fury toward a woman could lead to a crime like that.. 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. TERM PAPER: LOVE EXECUTIONER (AND OTHER TALE OF PSYCHOTHERAPY) In this Fascinating book Love's Executioner and other Tales of Psychotherapy by Irvin D. Yalom, we can appreciated different techniques used in a session of Psychotherapy, this book was easy to read and understand and especially it was very addictive, making it the perfect tool and inspiration for psychology students who are . Rather than relating to this integral self, her father, who abused her, had contributed to the development of a false, sexual self. . It is almost impossible for patients to see therapists as they really are. The fact that Marvins anguished dreams had stopped was also reassuring. Ill help you talk. How much of her grief, then, was for all her unrealized hopes? )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 words are different in each case, but the music is the same.. There was something conspiratorial about the request. Not, of course, that Thelma was paranoid, but I wondered whether she, too, would defeat any releasing statements, even ones from Matthew, by infinitely demanding more proof and reassurance. In reality, they had had a strictly professional relationship which had in no way splashed over the formal patient-therapist boundary. Then Id wonder whether one hundred and four was good or bad? Perhaps you could say that shes my Valium.. One by one they would break ranks and rush to be the first to congratulate me and ask my forgiveness. 5000, or e-mail special.markets@perseusbooks.com. Special Offers Email Address Field. 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. I rarely employ such manipulative approaches in therapy; usually the price is too highone must sacrifice the genuineness of the therapeutic encounter. Itll be difficult to dislodge it. You cannot re-create a state of shared romantic love, of the two of you being deeply in love with one another because it was never there in the first place.. I saw I had no choice but to own up. First, there is the barrier between image and language. In this instance, for example, if he hadnt been desperate for Dr. K.s approval, he would have avoided the whole problem by doing what any collaborator doessimply keep ones co-author informed about all developments in their joint work. Born to Be Pathetic. I smiled despite myself. To see how ludicrous, how pathetic, how idolatrous he wasan old man, stumbling toward death, comforted only by a clutch of letters, a marching banner proclaiming that he had loved and been loved once, thirty years before. Yet this is an existence storybut one written for the other Marge, the one who no longer exists. Alas, however, as Thelma was to teach me before this case was over, much wonderful therapy may be wasted on a patient! No one in her life now, not even her husband, knew about her past, about either her twins or her high school reputationthat, too, was something she had been trying to escape. 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 inquired whether we had covered everything. I dont do that any more.. Individual therapy may help to alter dysfunctional mourning. . He hadnt, for example, told the group that Soraya had been dead for thirty years, that he was sixty-nine and felt near death, that he had asked me to be the keeper of the letters. Often I thought of burning them, but that thought always evoked an inexpressible ache. They could communicate fully, they could try to achieve a deep authentic relationship which, since authentic love is an absolute state, should approximate what they had before. Think of that extraordinary story: for the first time in his life, a stable, if prosaic, previously healthy sixty-four-year-old man who has been having sex with the same woman for forty-one years suddenly becomes exquisitely sensitive to his sexual performance. . Marie came in to see me for some minor crisis every few months for the next four years; and, after that, our lives never crossed.