|a Love's executioner -- "If rape were legal ." -- "The wrong one died" -- Fat lady -- "I never thought it would happen to me" -- "Do not go gentle" -- Two smiles -- Three unopened letters -- Therapeutic monogamy -- In search of the dreamer -- Afterword [by the author]: On rereading Love's executioner at age eighty. I can tear down a years work in a day. She remained proud, somewhat judgmental, and resistive to new ideas. Published in 1989, Loves Executioner is one of Yaloms collections of case studies. A comment stating that the therapist has been thinking about the patient outside of their scheduled hour has never, in my experience, failed to galvanize the latters interest. But Thelma rushed on, not listening to my comments. She sounded like a prosecuting attorney trying to convince me of her dereliction. I remember times youve walked out of the office feeling much better than when you entered. During the last year of her life, her physicians had installed a permanent intravenous catheter that permitted easy access to her bloodstream. These discussions undermined her denial of death. So I agreed to treat her because I was certain she was suffering, not from love, but from some rare variant which she mistook for love. I saw a shrink, and it was he who advised complete silence. I wanted to shout, What? He habitually undercharged for his professional consultative services (and was habitually underpaid). Maybe if I had taken a different turn, to have done something else, to have become something elsenot a high school teacher, not a rich accountant. Maybe I need a real expert. Guinea pig litter. But, even worse, the sentence is so severeso damn tough on yourself. The teacher said I should return when I felt ready. Sometimes he put them in a file cabinet in quirky categories (under G for guilty, or D for depressionthat is, to be read when deeply depressed). Not even chalked words on the sidewalk saying, There was the blob that was once named Marge White.. No answer. Nor had he ever been, though Thelma had often asked him about that. Her cemetery visits were briefer and less frequent; she had given away most of Chrissies clothes and toys and turned her room over to Brent; she removed Chrissies last will and testament from the refrigerator, stopped phoning Chrissies friends and stopped imagining the events Chrissie would have experienced had she livedfor example, her senior prom or her application to college. Stay focused!
As long as Marge thought in those terms, she would not get better because the source of help was either outside of herself or beyond comprehension. Both Sarah and Martha were in a great deal of pain. I heard the men whispering and conspiring in a menacing way. I was transfixed by her facial plasticity: she winked, grimaced, and popped her eyes either singly or in duet. Would our confrontation break the ice jam? Otherwise, he was much as Thelma had described himslender, mustached, well tanned. You do not have to stay here for me any longer.. But now what did she have to show for the past twenty years? She uttered all these things in a gay chatty tone, as though she were talking about someone else, or as though she and I were college sophomores swapping stories in a dorm some rainy Sunday afternoon.
Love's Executioner - Irvin D. Yalom - Google Books One is the belief in personal specialness; the other, the belief in an ultimate rescuer. We stayed on such a formal level that our use of first names seemed ungainly. The message:The heart transplant is, of course, psychotherapy. It was truehe said only when I prompted himthat he was isolated and, yes, that did constitute a problem, but only because there were times when he was too weak to care for his own physical needs. Is there not a difference between a therapist scrubbing away unseemly countertransference stains and a dancer or a Zen master striving for perfection in each of those disciplines? Only one thing could have done this, I thought. Why kill herself to make mortgage payments? It was a slide of a mans head. You look uncomfortable. I had to proceed with delicacy here because of his fear (which Phyllis obviously shared) that therapists snoop out and fan marital problems, but I had to be certain that she was inexorably opposed to couples therapy. Maybe youre right, maybe I do have a serious problem with getting close to people. She assured him she would keep their secret and pleaded with him to visit her in the hospital. Or else theyll talk about it aswhat is it called when the therapist transfers something to the patient?, Yes, countertransference. I was optimistic it would. Meil- veikiau bsena, davimas, o ne potraukis; santykis su visuma, o ne su pavieniu mogumi. Her face grew rounder, her bodice fuller. ), Everyone, no one more than I, did a great deal of self-questioning. I thought psychiatrists werent supposed to give direct advice. Thats going to be my main job in the session.. 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. He suffered a small stroke and aged ten years right before my eyes. 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. Once, when he learned about the spread of his cancer to his brain, I held him in my arms while he wept. Second, Im giving almost supernatural power to Phyllis to heal me or protect me., And then everything fell apart when you overheard her plaintive, repetitive chant., That was when I realized how frail she isnot Phyllis in particular, but all women. I stressed that it would not be possible, because of other commitments and travel plans, to meet for more than six weeks. Any introduction of reality should help me release Thelma from her fixation on Matthew. He remembered them well and was convinced that they signified impact and connection. As I had expected, Thelma did not keep her next appointment three weeks later. She saw me watching, turned, and said, Dont you worry about me. I saw that in last Sundays paper. But nothing came. There is always more that can be done, but overall we had accomplished far more than I could have anticipated at our initial session. But be careful, he suspects you of playing a cat-and-mouse game.. I refuse to see a doctora real doctorgesturing mischievously at me. He freely offered the names of hospitals and his treating physicians if I should want to call. An illustration of two cells of a film strip. I havent forgiven you for preventing me from dating her. When he had first started the group six weeks ago, he talked at great length about his infatuation with Sarahor rather with her breastsand was convinced she would be willing to go out with him. Then Id wonder whether one hundred and four was good or bad? Its clear hes going to tell it his way, not mine. He was sitting there patientlya short, chubby, bald man with a glistening pate and owl eyes which never blinked as they peered through oversized, gleaming chrome spectacles. From the point of view of existential psychotherapy, and as a trainee therapist, I really appreciate Yaloms skill in explaining some difficult existential concept with ease and simplicity (unlike Heideggers trudging, heavy words). As you seeshe ran her fingers through her uncombed hairI no longer tend to my appearance.. He responded, Oh a terrible day! On the other side of the room there was an actress with a long white dress. Why not now? Would those words from Matthew really release her? She tried to poke me into joining the fun. Your experience was very different. I pass quickly from feeling good to feeling that its the end of the world. Finally, they make you kill your dog!, And she had smiled when Mike leaned over to her and asked gently, You wouldnt feed your dog poisoned dog food, would you?, So, from my perspective, Maries two smiles had not signified moments of concurrence with Mike but were instead smiles of irony, smiles that said, If you only knew . Should I remove my shoes and tiptoe aboutall shrinks have a bit of the sleuth in them till I found them, rip them open, and restore Saul to sanity with their contents? He had grown up, an only child, in Argentina. She was a misfit. (She had good recall of the scene that had just occurred.) But that would not be easy. I was still in a very fragmented state of mind. Most of us, most of the time, live comfortably by uneasily avoiding the glance of death, by chuckling and agreeing with Woody Allen when he says, Im not afraid of death. In fact, I had said nothing at all. 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. In fact, of the twenty-eight geriatric subjects involved in this study, she had the most positive outcome. He brooded for days after an episode of impotence and was entirely dependent upon her to regain his equilibrium: sometimes she brought him around simply by reassuring him that she still found him virile, but generally he required some physical comforting.
Love's executioner, and other tales of psychotherapy I suspect each of us would barely be able to recognize the hour from the others account. On the basis of data patients choose to provide about events taking place long before, therapists routinely believe they can reconstruct a life: that they can discover the crucial events of the early developmental years, the real nature of the relationship with each parent, the relationship between the parents, between the siblings, the family system, the inner experience accompanying the frights and bruises of early life, the texture of childhood and adolescent friendships. As we grow older, we learn to put death out of mind; we distract ourselves; we transform it into something positive (passing on, going home, rejoining God, peace at last); we deny it with sustaining myths; we strive for immortality through imperishable works, by projecting our seed into the future through our children, or by embracing a religious system that offers spiritual perpetuation. None of our hours passed without a good laugh. I was just getting over my worst migraine, and I was afraid Id fail and get another migraine. No one ever exhaustively analyzes a dream; instead, most therapists approach dreams expediently by examining the dream themes that will accelerate the immediate work of therapy. But before I had time to modify my response, Saul had dutifully proceeded to respond. Ill take care of the rest. In effect, that was what happened. That the other woman was Sonia, herself as a young woman, suggested I needed to spend more time looking at Thelmas feelings about her age. You knew that before, I know. Well, I can keep it very brief. Most of all, she regrets her childlessness and her refusal many years ago to see a fertility doctor., Marvin, Im amazed. Except in your memories., Elva was really crying now, and her stubby frame heaved with sobs for several minutes. Matthew? Its always damaging to a patient. Every gesture I had witnessed over the months, Marges every grimace, every action, passed in front of me in chronological order. I had placed him in a group six weeks ago to provide him with a community that would both help to penetrate his isolation and also, by identifying and urging him to alter some of his most socially objectionable behavior, help him to create connections in his social life. And evolution? Im tired. In response to my raised eyebrows, she explained she had just played eighteen holes of golf with her twenty-year-old nephew. He took over the hour: first with the silly business of the glasses, and then with his determination to stick that chart in my hands whether I wanted it or not. 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. I informed her that it was important for her to know, before she agreed to proceed, that these were to be research, not therapeutic, interviews. After they left, she stood stunned by the door for a few moments; then she cursed Jim for using his money for drugs rather than his plot payments; and after that, as she put it, she lost it completely and tore after them. Generalizing from my experience to hers, I had mistakenly assumed her life to have richness that she was missing because of her obsession. Of course, I have my rationalizations. 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? But soon I heard my voice offering her another appointment. It was time to finish the job. Her stutter always annoyed me. Why hadnt I thought of that? His having forgotten the content of our last session troubled me little. When Marvins periodic impotence began, Phyllis had at first shown great understanding and patience but, during the last couple of months, had become irritable. Weighing all these considerations, I finally chose my response. Furthermore, he was persuaded that something significant must be happening in therapy: hed learned more about himself in the past five months than in his previous sixty-four years! Therapists excuses are invariably patent and self-serving rationalizationsfor example, that the therapist is accepting and affirming the patients sexuality. The flush of pride I first experienced quickly gave way to a sense of deflation: This guy writes a lot better than I can.. Now he took out his notepad and began to read a series of dreams:Phyllis was distraught that she hadnt been good to me. Ill answer all your questions.. She wanted to talk, yet still without seeming to be talking to me. She got it. Frightening dreams with similar messages followed rapidly:It was night, I was perched high on the balcony of a building. I had asked for dreams, and he had given them to me. Itll be difficult to dislodge it. Also, you didnt fall asleep. Of course, his wife tried to obtain information about him. During these sessions we tried to make sense of what had happened, and mapped out a strategic response to future potential stress. I did not want Pennys guilt, so recently pried loose, to discover her great neglect of her boys and attach itself to this new object. When she woke up from the blackout in the drugstore, she had the strongest sense that the graduation card in her hand was not for Chrissie (who would have graduated from high school at this time) but for herself. But that was a false alarm. Even more important, meaning gives birth to values and, hence, to a code of behavior: thus the answer to why questions (Why do I live?) Ive been thinking a lot about telling you. Maries father, who lived in Mexico, had grown so frail that she contemplated inviting him to come to live with her. Anything Ive said to you is an open book. His penchant for concealment, his sexualization of all transactions with women, his fear and distrust of all menall of these traits, it seemed to me, were excellent issues to work on in group therapy. Saul, on Tuesday I felt about the letters the way I believe a surgeon feels about a large, dangerous abscess. Saul had in the past been amenable to surgical analogies, being familiar with them from medical school (which he had attended before settling on a research career); moreover, his son was a surgeon. And I hate their clothesthe shapeless, baggy dresses or, worse, the stiff elephantine blue jeans. It was with much sadness that Thelma said goodbye to him. I hear your anger toward Matthew, but Im also wondering if youre not upset with me, too. But its your dream, Marvin. . Id like you to check in on your internal state every four hours, when you are awake, and jot down your observations. He didnt answer my questions. Betty spent several minutes explaining why she wouldnt go to the movies alone. I dont want to be one of your ants!. Instead, I used the dream material to explore themes that had already emerged in our work. Here is a quick description and cover image of book Love's Executioner and Other Tales of Psychotherapy written by Irvin D. Yalom which was published in 1989-. I began to relinquish my ideas of striking back at Matthew. It would have been a shock to get an out-of-the-blue call from you. Then I wondered about the two of themtheir unfilled wishes, their hidden reflections and opinions about the consultation. He still hasnt told me why he cut me off!. I dont know what you want., How can you be so sure Im listening professionally? He helped me in the way therapists usually do, but he did a lot more., He introduced me to the spiritual, religious dimension of life. Arent you asking this question: How do you, IrvThelma smiled here. I wondered about the amount of intimacy in her daily life. She pointed to her watch to remind me our time was up and rushed from the office with her face buried in Kleenex. She has her whole life ahead of her, and her improved mental condition would benefit her children and her childrens children., I persisted. Ultimately she married a sweet, elderly man. Twenty-six times four is one hundred and four a minute. Yet it is one thing to know about death in general, to grit ones teeth and stoke up a shudder or two; it is quite another to apprehend ones own death and to experience it in the bones and sockets of ones being. Carlos, before you started the group I tried to explain to you the basic rationale behind group therapy. Its not sexyouve been saying that all along, and now I know youre rightmy penis can be completely soft. When I asked about how we were doing today, or asked her to describe all the feelings she had experienced toward me in the session so far that day, she rarely responded. Drawing a thick scroll from his briefcase, Marvin asked me to hold one end, and carefully unrolled a three-foot chart upon which was meticulously recorded his every migraine headache and every sexual experience of the past four months. Although she was in bad shape now, she was no worse than when she started. Sharing something about my wife was doing something for Marge, giving her a gift. Reveal herself? How much do you think about it?, I guess Id have a different slant on therapy if I were forty rather than seventy. Here, with a big grin on her face, she paused to let the suspense build. Nothing came. Every one of my notes of these early sessions contains phrases such as: Another boring session; Looked at the clock about every three minutes today; The most boring patient I have ever seen; Almost fell asleep todayhad to sit up in my chair to stay awake; Almost fell off my chair today.. ), It was a virtuoso performance. As the dream continued Dave saw that the envelope had been slit open and was empty. Many people take issue with this description of death denial. Another reason we can never fully know another is that we are selective about what we choose to disclose. Irvin D. Yalom, quote from Love's Executioner and Other Tales of Psychotherapy "Love is not just a passion spark between two people; there is infinite difference between falling in love and standing in love. Horrible thing! This was a woman steeped in self-deception. The time had come to unearth everything. I was also aware, however, that she had expressed gratitude to me, and that felt good. There were wisps of smoke coming up all over the house from between the floorboards. Since patients tend to resist assuming responsibility, therapists must develop techniques to make patients aware of how they themselves create their own problems. Especially a patient with advanced cancer. In thousands of group meetings, whose members supposedly bare all, I have yet to hear group members disclose their incomes. Let me try to get my thoughts out clearly. In fact Id forgotten it, forgotten it for years until this week., I feel good youre willing to trust me with it. His overwrought reaction was, I thought, totally irrational. Youve got to be kidding. I smiled and silently ground my teeth.
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