The only remaining approach I could think of involved that one burst of emotion I had seen in our first sessionthe tactic seemed so contrived and so simplistic that I could not possibly have predicted the astonishing result it would produce. He wants to meet people at church socialsO.K., Noticing my quizzical look about church socials, Thelma explained, For the last three years, ever since I knew I would eventually commit suicide, I havent wanted to meet anyone new. I sighed and settled back into my chair. She had first met him twenty years before when they were college classmates in Mexico City. But we had not progressed very far in our exploration of life purpose (not that progress can be expected: absence of purpose is a problem of life rather than of a life) when Penny changed course yet again. So powerful were Thelmas words that I found no effective way to counter them, other than to acknowledge her losses and say that there was much mourning that she had to do and that I wanted to be with her to help her mourn. But I also knew they were your former students, so I checked you out some more. She had often talked about epic (and invariably unproductive) struggles she had had with her mother and with other friends who tried to help her control her eating. Such pragmatic use of dreams is commonplace in therapy. Im here today to be helpful to Thelma. In a way no patient had ever done before, she showed me everything. Love's Executioner.docx. No wonder you take great pains not to displease her. Marie reminded me of a beautiful aunt who wore her hair the same way and played a major role in my adolescent sexual fantasies. A good working formula is: the more unlived life, or unrealized potential, the greater ones death anxiety. Perhaps my discourse with the dreamer was counterproductive. Thelmas words told me clearly that she would not look kindly at any criticism of Matthew. 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. But what the hell did I know then?. Such encapsulated, exclusive lovefeeding on itself, neither giving to nor caring about othersis destined to cave in on itself. (Yet it was true that I had urged Sarah to take him on: she had been reluctant to introduce a patient with cancer into her group. Thats an elaborate piece of work, I said. For a number of reasons, I found it difficult to terminate: the sheer enormity of her suffering compelled me to stay with her. Recommended for: I gave her everything she wanted. But such interpretations would only result in most of the hour being used as a conventional individual therapy sessionexactly what none of the three of us wanted. To combat my self-recriminations, I attempted to persuade myself that I had employed a proper therapeutic strategy: Thelma was in extremis when she consulted me and something had to be done. At the end of our second hour, I discussed a treatment contract with Thelma. Could it be that her thighs and buttocks are so inflated that her feet have to go farther to reach the floor? I began to relinquish my ideas of striking back at Matthew. I dont have any more hope, Ill never have any more satisfaction. I told her that I had read an alumni bulletin and noted that six persons in my college class have died. And I can ask hard questions. Marie was brittle, irritable, and despite her avowed gratitude to me, often sarcastic or provocative. But unless something changed quickly, he would either drop out of the group or would, by next week, have ruptured beyond repair his relationships with the other members. . I told him I just wanted the trim painted. No part of this book may be reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles and reviews. . Why then? If hes the spiritually minded person you think him to be, then surely hes experienced much guilt at your distress and would take pleasure in helping.. Such people tend to be tiresome. In fact, though there had been considerable sexual caressing during her twenty-seven days with Matthew, they had had intercourse only once, the first evening. Any introduction of reality should help me release Thelma from her fixation on Matthew. In the three or four minutes Saul had been in my office, he had worked himself into a state of deep agitation. He was a marvelously generous and supportive father. Something went wrong with your request. Could it be that he found me? Sex is at the root of everything. Whats the point of it all? In my many years of work with cancer patients facing imminent death, I have noted two particularly powerful and common methods of allaying fears about death, two beliefs, or delusions, that afford a sense of safety. The dream about the giant auger could not have been more clear: the ground under Marvins feet was liquefying (an inspired visual image for groundlessness), and he was trying to combat that by drilling, with his penis, sixty-five feet (that is, sixty-five years) down! Dan, this intense closeness you feel toward Dianemaybe she did allude to the possibility of a relationship some time in the future, but look at the facts. Certainly, I no longer viewed him as an offending therapist: he was as much a patient as Thelma and, furthermore (I could not help thinking, glancing toward Thelma, who was still staring out the window), a working patient, a patient after my own heart. She had led a rich, eventful life. He learned that his eyes, like those of a newborn kitten, had been closed. It is natural, I had told him, that one should respond adversely to an attack on ones central coreafter all, in that situation ones very survival is at stake. , . My real reasons for taking on Thelma lay elsewhere: first, I was fascinated by encountering a love obsession at once deeply rooted and in a vulnerable, exposed state, and I was not to be swayed from digging it out and investigating it; second, I was afflicted by what I now recognize as hubrisI belived that I could help any patient, that no one was beyond my skills. Thelma, I came to you remembering you pleasantly from the work we did together in therapy and wanting you as a friend. The strange, full contralto voice pronounced: As long as youre going to pretend to be a Jewish intellectual, you might as well furnish your office like one. While there is no solution to existential isolation, therapists must discourage false solutions. Although the consultation satisfied me professionally, I had not gotten the personal support and appreciation I had been seeking. But be careful, he suspects you of playing a cat-and-mouse game.. For the first four years of her bereavement, Marie made herself totally inaccessible to men. It seemed the right thing to do. If the candle flame stays fat, you live.. Week after week I chipped away. Phyllis, even though she knew Marvin was following my instructions, grew irritated with him for ordering her to stay at home. Love's Executioner 2. In this book, Yalom discusses ten clients, their therapy journey and his own development as an existential psychotherapist. Not only does a patients confrontation with unanswerable questions expose a therapist to these same questions, but also the therapist must recognize, as I had to in Two Smiles, that the experience of the other is, in the end, unyieldingly private and unknowable. For one thing, I was certain it would be wise to establish a supportive community to help sustain her in the difficult diet days yet to come. . Marge, Me said, should write her autobiography and entitle it (here she began to chuckle) Born to Be Pathetic.. I know theyll say that its an infatuation or a crush or transference. I sat silently for several minutes trying to identify my options. The moment he shook Dr. K.s powerful hand, Saul had a vision, redemptive and beatific, of the two of them, he and Dr. K., working side by side as full collaborators. Our discussions about sexual practice and her sexual identity generated so much anxiety and such an agonizing sense of emptiness that, on several occasions, she binged on cookies and doughnuts. Until yesterday. Her tight shoulders relaxed, her face loosened, her head turned ever so slightly toward me. True or False? I had known Carlos to close up completely like this on other occasions. Marvin simply took her hand. Our hour was long over, and I had yet to see Harry, to whom I had promised ten minutes. After Chrissies death, Penny was still unavailable to her sons: the rage she felt toward them, much of it only because they were alive instead of Chrissie, created a silence between them. I dont care about any of these things! "Do not go gentle" -- 7. She wanted to talk, yet still without seeming to be talking to me. Or was she most upset by what she had still to tell me? What precisely, I asked, was helpful to you in our last hour? She felt that she was talented but had never developed her talents because, since the age of thirteen, she had had to earn a living. As always, I feel isolated hereprofessional colleagueship is scarce at the Stockholm Institute. Again, Saul did nothing. The culmination of master psychiatrist Dr. Irvin D. Yalom's more than 35 years in clinical practice, The Gift of Therapy is a remarkable and essential guidebook that illustrates through real case studies how patients and therapists alike can get the most out of therapy. My timing had been thrown off. Having persuaded himself that Marie was hysterically overreacting, he refused to prescribe adequate medications for pain relief or sedation. Did he ever realize how much I cared for him, how much I wanted him to forget his work from time to time and enjoy the leisure of an afternoon stroll on Union Street? She had, nonetheless, accurately sensed my feelings, as she recounts at the end of the story. I was very grateful that Phyllis demonstrated so much flexibility. Two Smiles: p. 165: Three Unopened Letters: p. 187: Therapeutic Monogamy: p. 215: In Search of the Dreamer: p. 235: Afterword: On Rereading Lope's Executioner at Age Eighty: p. 279: Table of Contents . They did know that he was growing deeply depressed and seemed to have no one to whom he could turn for support. When I saw her two days later, she seemed guilty and depressed. She saw me watching, turned, and said, Dont you worry about me. She had always been a talented photographer and now, for the first time in years, had picked up her camera and was once again enjoying this form of creative expression. Her silly commentary was equally offputting. I cant tell you how wonderful. You tell me about a life that is full of despair, but you do it in a bouncy arent-we-having-a-good-time? way., When you stay jolly like that, I lose sight of how much pain youre having., But you come here for help. As I thought about the words shed put in Matthews mouth, I could easily understand their appeal and why she had no doubt replayed them so often: they confirmed her view of reality, they absolved Matthew of any responsibility (after all, it was his shrink who advised him to be silent), and they confirmed that there was nothing wrong with her or incongruous about their relationship; it was only that Matthew had a greater obligation to another. They appear in my office poised for change, and the therapy runs itself. (MEANINGLESSNESS) What does it mean that Yalom focuses on the here-and-now? Perhaps I should have. I stored it for future use. Now Im getting more and more nervous about Sorayas letters, and I wondered if youd keep them. We endlessly clarify and interpret, assuming (and it is a secular leap of faith, lacking convincing empirical support) that understanding will invariably beget change. I always take very seriously the business of entering into a treatment contract with a patient. Suddenly, when I asked for other examples of Phyllis being set in her ways, some unexpected things came pouring out.
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