I think he was overcome with pitypity for Phyllis, for himself, for all small, helpless people. The fact that Phyllis was unwilling to talk to me, even once, to help her husband, who was now in extremis, belied Marvins account of his idyllic, harmonious marriage. My impressions of her, my pleasure, my impatience are not precisely like any others I have known. That sense of specialness, of being charmed, of being the exception, of being eternally protectedall those self-deceptions that had served her so well suddenly lost their persuasiveness. Elva bent forward, holding her hand to her mouth as though to exclude someone in the room, showed me a remarkable number of enormous teeth, and said, I whomped the shit out of him!. You care about the poor, about ants and plants and ecological systems. Next, I was trying to get into the window of a room where her body might be. Again and again, I asked the same question: Who, what, are you grieving for?, Betty responded, I think Im grieving for love. I feel little charity for the irresponsible professionals and have urged many patients to report sexually offending therapists to professional ethics boards. Also, you didnt fall asleep. (The dream interpretative work was successful, but the patient died. In the light of that belief, the perils of overactivity seemed slender. It didnt take much experience to recognize the signs of deep distress. Theres the proof! He pointed to the scroll now resting quietly on my desk. It was the worst thing that had ever happened to me. I think it was the best hour of therapy I ever gave. But rationality and precision in psychotherapy are rarely rewarded. She continued in a derisive, gloating manner: You could have her in therapy for thirty years, but Id still win. When the emergency room nurse asked her for the name of her doctor, she moaned, Call Dr. Z. By general consensus he was the most talented and experienced oral surgeon in the area, and Marie felt that too much was at stake to gamble with an unknown surgeon. Nietszche said, The final reward of the deadto die no more. Yet here was also a wonderful opportunity to work on our relationship. Its the relationship that heals, the relationship that heals, the relationship that healsmy professional rosary. True or False? I didnt know what to say. I felt caught. In spite of her age, Thelma is physically fit and had always driven herself to my office. In working with these dreams, I did not address her concerns about death. Had I disproven the catechism? . She didnt know what would happen to her if she didnt have her weekly fix. It seemed to me she was still resisting closeness by referring to a fix rather than to me, and I gradually confronted her on that point. A cipher. Patients, like everyone else, profit most from a truth they, themselves, discover. For example, in an all-day meeting of the university laboratory where she worked, she had been pointedly ignored by the professional and academic staff. The escape from destinyfrom social class destiny and from her personal poor-crazy-old-lady destinywas a major motif in Pennys life. Betty flushed. There was no question now that I had his attention. I was going to say more when Thelma looked at her watch and said, I see that my fifty minutes are up and, if nothing else, Ive learned not to overstay my welcome in therapy.. It could come at any instant, she said, when I least expect it. For years her father had saved money and planned a family trip to Europe only to develop a brain tumor shortly before the departure date. But nothing came. Can you remember any of it? A lot of therapists, at this point, would have made an interpretation about the way she was shutting me out. I was pondering whether onions really do have a lot of sugar when I arrived at Sauls home. I tried to explore these ideas with Thelma. Fraid youll judge me, I guess. My life is being lived eight years agoan arresting phrase. I felt discouraged: all my strenuous efforts had been ineffective. And that is precisely where countertransference complicates things: I had to be clear about how much of the boredom was my problem, about how bored I would be with any fat woman. In some desperation, I stretched for ways to be helpful to Betty. And I had accepted everything and asked for even more. Gone also was my patient. love's executioner two smiles summary. I attempted to address Bettys despair, and her belief that once she left me all our work would come to naught, by reminding her that her growth resided neither in me nor in any outside object, but was a part of her, a part she would take with her. I have found that the memory loss that no one escapes has some advantages. Everyones going to die. The real issue was want of courage. Love's Executioner. Saul was spent and leaned back, exhausted. One hundred eighty. ( ) , " ". In the book "Love's executioner and other tales of psychotherapy", Irvin compiles ten of his documented cases with approval from his patients and changes names of the patients for confidentiality purposes. Will you open the letters before you mail that letter to Dr. K.? It was into this extraordinary tangle that Mikeof course, knowing none of thishad dropped his innocent, rational suggestion that Marie seek her doctors help in understanding her pain. I recalled our first meeting and how determined I had been not to get trapped into offering her therapy. You sure you want to hear all this?, Well, sometimes I thought about being on trial. I knew we were entering an area where once I would never have dared to go. 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. Ive always misrepresented myself, always felt like a fraud, always feared exposure., This was routine stuff, we had been over this material many times, and I didnt bother to challenge his self-reproaches. I saw a shrink, and it was he who advised complete silence. I envied their ability to pronounce, You are forgiven. What therapeutic power! But suppose it was never a shared experience! I had often thought about his love letters and had wondered if I would ever get a chance again to explore their meaning with Dave. Im the only person there with enough guts to tell the truth. I looked at the clock less frequently and once in a while checked the time during Bettys hour not, as before, to count the number of minutes I had yet to endure, but to see whether sufficient time remained to open up a new issue. Dave looked startled. 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. Well, nothing has changed in the external world. Thelma and Harry, with limited financial means, had never been able to afford to see anyone other than student therapists. Im not her, you know! One is isolated not only from other beings but, to the extent that one constitutes ones world, from world as well. I didnt know the person who talked. As the reader you are not quite sure why Thelma, at this stage, has decided to do this. She had lost her hope for the future (by that she meant she had lost her one-percent chance of reconciliation); she had also lost the best twenty-seven days of her life (if, as I had shown her, they werent real, then she had lost this sustaining memory of her lifes highest point); and she had also lost eight years of sacrifice (if she had been protecting an illusion, then her sacrifice had been meaningless). He remembered banging his fist on his desk, forcing himself to remember the chill of his mothers forehead when he kissed her as she lay in her casket. It was what I did, not what I said. What about Elva, Yalom's mother, and counter-transference? He told her explicitly that the most important thing in the world to him was their relationship, and that he had never felt closer to her. My pleasure with her progress? It was a clumsy effort on my part. Saul, if youre as bad as you say, if, as you insist, you lack all virtues and all discriminating mental faculties, why is it that you think your judgment, especially your judgment of yourself, is impeccable and beyond reproach?. No, behavioral therapy was the best choice. That is precisely the situation with Betty: she completely externalized the problem. Those whom he tries to restore to reality ultimately turn against him and re-enter the life of illusion. What did I do? Dave said, Shoot! is a 70-year-old married Caucasian woman who, as a result of a five-month, once-weekly course of therapy . If she were to reveal herself, what would she show? Four weeks ago you couldnt eat or get out of bed or stop vomiting. Looming ahead was an important symbolic markerthe loss of the one-hundredth pound. The author of two definitive psychotherapy textbooks, Dr Yalom has written several books for the general reader, including Momma and the Meaning of Life and Love's Executioner, collections of true and fictionalised tales of therapy; Staring at the Sun; and the novels When Nietzsche Wept; The Schopenhauer Cure, and The Spinoza Problem. Love's executioner and other tales of psychotherapy . The waiter is never there when you want him. The fear of death is naturally feminine because you are the givers of life. Getting into the spirit of it, Elva hoisted her purse onto my table, opened its jaws wide, and began to empty it. She had died while giving birth. Mentally and emotionally abused by his aunt who raised him, so he always sees himself negatively. . I know youre listening professionally. Freedom, another given of existence, presents a dilemma for several of these ten patients. Chapter 5 I Never Thought It Would Happen to Me, The Theory and Practice of Group Psychotherapy, (with Morton A. Lieberman and Matthew B. Another compelling boundary experience is the death of a significant othera beloved husband or wife or friendwhich shatters the illusion of our own invulnerability. She had strong feelings about hair loss as well. Would Dr. C. think I was a slut? I thought you came to see me because you wanted to stop tormenting yourself.. The fact that Penny was in crisis, or said she was, presented me with a dilemma. To illustrate, Mike suggested, Think of your dog or, if you dont have one now, imagine a much-loved dog. Though Betty was very frightened and initially resisted my suggestion, she gamely agreed and entered a therapy group led by two psychiatric residents. But I aint going to be around to pick up the pieces., I heard you. But at the moment they felt compelling and profound. 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. Maries view of psychiatry? What are you going to tell her about your health?, When I get to know her better, Ill tell her the truththat Ive got cancer, that its under control now, that the doctors can treat it., That the doctors arent sure whats going to happen, that there are new treatments discovered every day, that I may have recurrences in the future., What did the doctors say to you? You saw his callousness. All your life youve worked. Take a look at this. Maybe someone will think of me in some freak moment just as I think of the extinct single-edged razor blade. Whenever we went out during the twenty-seven days, he never failed to say something that would make the waiter or the store clerk feel good. It must have taken you days., I liked doing it. Bad technique! Though Mike knew that his patient had grasped the concept, he nonetheless pressed the point home: Then why not treat your body as well as you would treat your dog?. I pass quickly from feeling good to feeling that its the end of the world. He never calls back. Why was the dream a nightmare? . About three weeks later, three weeks after my discovery of the importance of the therapeutic act, an extraordinary event occurred. But that conjecture aside, this much was certain: all of Sauls apocalyptic forebodings were disconfirmed; the tone of the letter was unmistakably accepting, even affectionate and respectful. It must be scary or liberating to say these things for the first time!, I feel O.K. You havent yet talked about having cancer. (I had been urging Carlos to reveal to the group that he had cancer, but he was procrastinating: he said he was afraid hed be pitied, and didnt want to sabotage his sexual chances with the women members. Furthermore, Thelma, to whom he said he had told this in the past, had listened with rapt attention and offered no demurral whatsoever. Some surviving children are filled with resentment toward their dead sibling for such claims upon the parents time and energy; often the resentment exists side by side with their own grief and their own understanding of the parents dilemma. 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. downtown stuart riverwalk, which document provided a rationale for american independence,