Creatures of a Day: And Other Tales of Psychotherapy (8 page)

Alvin shook his head.

“Or perhaps we can stroll around the block?”

“Not now, Irv, this is all I can do today, and I want to stop.”

“Well then, tomorrow. Can you make it at this same time, seven thirty, tomorrow evening, in my office?”

Alvin nodded. “I’ll phone you first thing in the morning.”

I sat for a few more minutes in silence and then left.

The next morning, Alvin phoned. I was not surprised by his words, “Irv, I’m sorry, but I simply can’t make it. Don’t think I don’t appreciate what you’ve done, but I can’t meet again. At least not now.”

“Alvin, I know I’ve pushed you hard—too hard perhaps—but look at what we’ve done. We’re on the brink of something crucial.”

“Nope. Not now. We’re done. Perhaps I’ll call you in the future. For now I can deal with it on my own. I’ll start to organize my home.”

I closed Alvin’s folder. Since that visit to his house I had not seen him or heard from him until the previous day at Molly’s funeral. And what was he doing there anyway? What was his connection with Molly? I recall that for some time after our last visit I thought about Alvin and wondered about what had happened to him, and while walking through the corridors or sitting in the hospital cafeteria, I scanned my surroundings looking for him. I remember, also, following my last session with him, speaking at some length with an old and close friend, also a psychiatrist, to help me deal with my own dismay at having so badly bungled a case. But now, after our meeting at Molly’s memorial yesterday, I had to reconsider. Had I bungled it? Alvin looked great and had two children and a lovely wife, who told me that I was responsible for their marriage. How had that all come about? I must have been more effective than I thought. My curiosity once again was aflame.

***

W
e met for coffee at a small café near the hospital, taking a corner table for privacy.

“Sorry,” I began, “that I was a bit slow to recognize you. As I mentioned, aging has taken its toll on my facial recognition. But don’t think I haven’t thought about you, Alvin. I’ve often wondered about how you’ve fared, especially since I thought our work together ended prematurely, leaving you with problems still to work on. I’d love a follow-up. You know, I think I didn’t recognize you at first yesterday because I hadn’t expected to see you at Molly’s funeral. How did you know Molly?”

A look of surprise appeared on Alvin’s face. “Don’t you remember? A day or two after our last session you called and gave me her name and suggested I contact her to help me get my house back in order.”

“Oh, my, I had entirely forgotten that. And you
did
contact her?”

Alvin nodded vigorously. “Oh yes. You mean, she never mentioned me to you?”

“She wouldn’t. She had her honor code: she was tight-lipped as a clam about identifying her clients. But I referred you to her over thirty years ago. You still remember her from back then?”

“No, that’s not quite it. What happened is that I called Molly immediately, and she took over. I mean took over completely. In a few days my house was neater than it had ever been, and she has taken care of my house and my bills, my taxes, and
all
my affairs ever since. I was her client right up till her death. I’ve often told Monica how grateful I am to you. You turned my life around. You gave me so much. But, most of all, you gave me Molly. All these years, the past thirty years, she’s come to my house once a week without fail and taken care of everything until just a couple of months ago, when she grew too ill. She was the best thing that ever came my way—except, of course, for Monica and my two wonderful children.”

After our conversation, my mind swirled with thoughts about the impossibility of ever learning how psychotherapy works. We therapists strive so fervently for precision in our work and aspire to be fine-tuned empiricists, trying to offer precise fixes for the broken elements in our patients’ attachment history or DNA sequences. Yet the realities of our work do not fit that model, and often we find ourselves improvising as we and our patients stumble together on the journey toward recovery. I used to be unnerved by that, but now, in my golden years, I whistle softly to myself as I marvel at the complexities and unpredictability of human thought and behavior. Now, rather than being rattled by uncertainty, I realize that it is pure hubris to posit specificity. Now, the one thing I’ve come to know with certainty is that if I can create a genuine and caring environment, my patients will find the help they need, often in marvelous ways I could never have predicted or even imagined. Thank you, Molly.

~ 5 ~

Don’t Fence Me In

Dear Dr. Yalom

I’m a seventy-seven year old (former) CEO and a year ago I moved into a retirement home in Georgia. Nice place but it’s not working out: I’m having severe and persistent adjustment problems. I’ve been seeing a therapist for the past year but our work has recently bogged down. Can you see me in consultation? I’m willing to fly to California at any time.

Rick Evans

T
hree weeks later Rick Evans strode confidently into my office appearing as though he had been there often. He looked the way I think a retired CEO should look: lean, attractive, relaxed. With his bronze golfer’s tan, his regal posture, his masterfully chiseled nose and chin, I could picture him on the brochure cover for any upscale retirement community. And his thick shock of straight, neatly parted, gleaming white hair was a wonder to behold. I ran my hand dolefully over my own
balding
scalp. Though I couldn’t catch his glance full on, I liked his intense yet slightly plaintive eyes.

Rick wasted no time, speaking even as he was taking his seat. “That book of yours,
Staring at the Sun: Overcoming the Terror of Death
is strong, very strong. Especially for someone my age. That book is why I’m here.”

He glanced at his watch as though checking that we were starting on time. “Let me get right to the point. As I mentioned in my email, I moved into Fairlawn Oaks a year ago. After my wife died, I first tried to make a go of it at my home. Tried like hell for eighteen months, but couldn’t do it, not even with a lot of household help. Just too damn much hassle with all the shopping, the cooking, the cleaning. And it was too damn lonely. So I made the move. But it’s not working out. Not that I’m knocking Fairlawn Oaks. The home is great. But I’m just not adapting.”

I was struck by all Rick had
not
done. He had not looked around at my office—not even for an instant—nor had he made any social gesture of greeting. He had come all the way across the country to see me and yet had not once cast his eyes in my direction. Perhaps he was more anxious than he appeared. Perhaps he was entirely task-oriented and intent only on making the most efficient use of his time. I’d get back to all that later. For now, I encouraged him to continue his story.

“Not adapting how?”

He flicked off my inquiry with a twitch of his wrist. “I’ll tell you about that. But first I want to say something about the therapist I’ve been seeing for a year and a half. She’s a good lady. She helped with my grief, no question about it. She got me up from the floor, sponged me off, and back into the ring, back into the world. But now we’ve stalled. Not blaming her, but in our therapy hours we’re wasting time and money, though she doesn’t charge your high-end rates. We’re just going around in a circle, covering the same stuff over and over again. Then, after reading your book, I read some of your others, too, and suddenly had the thought that a consultation with you could give my therapy a jump-start.” Even here he didn’t look at me. This felt odd, as he certainly was not a shy man. He just plowed right ahead. “Now, I know therapists are possessive and touchy about that sort of thing, so I decided to run it by her in a diplomatic fashion. Don’t get me wrong: I wasn’t asking her permission. I was going to contact you whatever she said. Turned out she was very positive. She grabbed at the thought: ‘Sure, sure, good idea. Contact him for a consultation. I’d welcome that. California’s a long way off, but what better use for your time and money?’ She offered to write you a note describing our therapy work, but I felt a bit miffed and told her I was a big boy and I could take care of filling you in.”

“Miffed? Why?” It was time to push myself into this monologue.

“I’m old but not helpless. I can figure out how to contact you by myself.”

“That’s all? That worth a miff? Go deeper.” I felt impelled to be more confrontational than is my wont.

Rick’s cadence slowed. Maybe now, finally, he had taken note of me, though he still hadn’t really looked at me. “Well, I don’t know. Maybe miffed at her being just a tad too happy at the thought of possibly getting rid of me. Maybe I
wanted
her to be a little possessive. But I get your point. I know my getting miffed isn’t rational. After all, she and I are using this consultation with you to help us continue our work together. She’s not trying to get rid of me, and she said as much. But I’m leveling with you. That’s the way I felt. Miffed. I’m not going to hold anything back today. I want my money’s worth out of this investment. You know, with your fee and the airfare, this adds up.”

“Tell me about your adjustment to the retirement home.”

“In a minute.” Once again, he flicked me away. “First let me get on record and make it clear that Fairlawn Oaks is great. It’s a damn good organization, and if I were running it, I don’t think there’s much I’d change. My problems are all my own stuff—I acknowledge it. Fairlawn Oaks has it all. The meals are fine, and they offer a ton of terrific activities. The golf course is a bit tame, yet at my age it’s just right. But here’s the thing: all day long I am crippled with ambivalence. Every time I start to do something, my mind starts wanting to do something else. Now I don’t do schedules—at least not other people’s schedules—that’s not who I am. Schedules are for others. Why
must
I go to the swimming pool exercise class at four pm every day? Or to the current events class at ten am? Why
must
I put the door key in that pouch on the door
every
time? And why
must
I have meals at the same time every day? That’s not me. The real me, the real Rick Evans, reveres spontaneity.”

He turned his head in my direction. “You went right from college to medical school, right?”

“Right.”

“And then into psychiatry, right?”

“Yep.”

“Well, I’ve had nine professions.” He held up nine fingers. “Nine! And did damn well in all nine. Started with nothing as a printer’s apprentice. . . . Then I became a printer . . . then started a magazine . . . then a publisher of several magazines . . . then head of a small textbook publishing company . . . then bought and built up a string of board and care places for the mentally disturbed . . . then ran a hospital, and then, believe it or not, took training as a counselor and went into organizational development work . . . and then CEO of two different companies.” He sat back in his chair looking satisfied. It was my turn to say something. I had no particular plan in mind but began responding anyway, hoping my muse would guide me.

“A lot of different paths. Hard to register them all. Tell me, Rick—OK if we use first names? Call me Irv?”

Rick nodded. “I prefer it.”

“Rick, how do you feel now when you look back on your
careers
?”

“Look, be assured that none of these moves was forced. I never failed with any of these careers. I just got fidgety after a while. I refuse to be locked into any way of life. I require change. Spontaneity. I repeat:
spontaneity
—that’s who I am!”

“And now?”

“Now? Well, that’s the whole point. Spontaneity, once a good thing, once my strength, my polestar, has now morphed into a monster. Look, here’s the picture: when I start to head off to some activity, be it fitness training, pool aerobics, current events, yoga classes, whatever, my mind starts rattling off other alternatives. I hear my inner voice asking, ‘Why
this
activity? Why not some
other
activity?’ I’m stuck in a logjam of indecision. And what happens? What happens is I end up doing none of these activities.”

I checked into my own flow of thoughts. As Rick spoke, I thought of Buridan’s ass, an ancient philosophical paradox involving an ass placed between two equally sweet-smelling bales of hay, who starves to death because he can’t decide which one to choose. But I saw no benefit to Rick in speaking of this. I’d be just responding to his challenging manner and showing off my erudition. Then another thought occurred that might be more acceptable and more useful to him. “Rick, let me share something that’s just drifted into my mind.”

I knew I was being a bit loose, but that often paid off—patients generally appreciate my sharing something of myself, and it usually works to accelerate more sharing. “Maybe it will be of interest. It’s an episode that occurred long ago. I wrote about it somewhere but haven’t thought about it in ages. One day, I noted that my eyeglasses weren’t functioning properly, and I paid a visit to my ophthalmologist, a much older man. After he tested my vision, he asked my age. ‘Forty,’ I responded. ‘Forty, eh?’ he said, and he took off his own glasses, wiped them carefully, and said, ‘Well, young man, you’re right on schedule. Presbyopia.’ I remember feeling very annoyed and wanting to say to him, ‘What schedule? Who’s on schedule? You or your other patients may be on schedule but not me! Not me! I’m different.’”

“Nice story,” Rick replied. “I read it somewhere in one of your books. I get your point, but actually it’s not really
my
point. I already know the math. I’m seventy-seven, and we don’t need to waste time working on that. I’m not in denial anymore. Not only do I tell myself every day that I’m seventy-seven, but my one-note therapist keeps hammering it home. My unwillingness to confront my age was what made it so difficult to leave my home and move into Fairlawn. But I’ve moved on. I’m talking about something new.”

Hmm, it was clear that sharing my eyeglasses story had not been a great idea. Rick was not someone with whom I could be loose and share associations that float into my mind. He was more invested in competing with me than being helped by me. I decided to keep a sharper focus.

“Rick, earlier you said, ‘Spontaneity—that’s who I am.’”

“That’s right. It’s my mantra. That is who I am.”

“
That is who I am
,” I repeated. “If we transpose that statement, it becomes ‘If I am not spontaneous, I am not me.’”

“Yes, I guess so. Sounds cute, I guess, but . . . your point?”

“Well, that thought has dark implications. It’s a close cousin to saying to yourself, ‘If I am not spontaneous, I won’t exist.’”

“I won’t exist as
me
, as the core person I am.”

“I’m guessing it runs even deeper. It’s as though you believe your spontaneity wards off your death.”

“I know these pronouncements are meant to be helpful, but I’m not getting it. You’re saying that? . . .” he held out his hands, palms facing me, fingers splayed.

“I’m wondering if, at some deeper level, you might feel that giving up your spontaneity is risky, that it brings death closer. I mean, if we look at your situation rationally, we’d ask, ‘What’s the real threat in doing some things on schedule?’ At seventy-seven putting your keys in some designated place makes sense. I sure need to do that. And obviously it makes sense to go to exercise classes or current events discussion at a certain time because a group’s existence requires a designated time to get
together
.”

“I’m not claiming that my thought is rational. I grant that it doesn’t make sense.”

“But it
does
make sense if we assume it is powered by some deep, not entirely conscious fear. I think that being ‘on schedule’ symbolizes, to you, marching in lockstep with everyone else toward death. Fairlawn Oaks can’t help but be connected in your mind with the end of life, and your inability—or, rather,
unwillingness
—to engage in the program must be a form of unconscious protest.”

“Pretty far-fetched. Sounds like you’re really stretching. Just because I don’t want to line up, towel in hand, to do water exercises with all the other old ninnies doesn’t mean that I refuse to accept my mortality. I don’t do lines. I’m not about to get into any kind of line.”

“I’m not getting into any kind of line because? . . .” I asked.

“I designate lines; I don’t stand in them.”

“In other words, I don’t get into lines because I’m special.”

“Damn right. That’s why I told you about my nine careers.”

“Stretching, expanding, actualizing yourself: all these endeavors seem right. They seem appropriate for a certain time of life. But perhaps they may not fit
this
time of life.”

“
You’re
still working.”

“So what questions do you have for me?”

“Well, why do
you
work? Are you really in step with
your
age?”

“Fair enough. Let me try to answer. We all face aging in our own manner. I know I’m very old. There is no denying that eighty is old. I’m working less—I see far fewer patients now, only about three a day, but I’m still writing much of the rest of the day. I’ll tell you the truth: I love what I’m doing. I feel blessed to be of help to others, especially others who are facing the issues I’m dealing with—aging, retirement, dealing with the death of a spouse or friends, contemplating my own death.”

For the first time Rick did not respond but silently looked at the floor.

“Your feelings about my answer,” I asked in a softer voice.

“I got to hand it to you. You go right into the tough stuff. Death of friends, your own death.”

“And your thoughts of death. Is it much on your mind?”

Rick shook his head. “I don’t think about it. Why would I? Wouldn’t do any good.”

“Sometimes thoughts enter the mind involuntarily in daydreams, for example, or night dreams.”

“Dreams? I don’t dream much . . . none for weeks . . . but strangely I had two doozies last night.”

“Tell me all you remember.” I picked up my notepad. Two dreams just before our session. I had a hunch these were going to be illuminating.

“In the first one I was at a school playground with a big chain-link fence around the field—”

“Rick, let me interrupt. Would you mind describing the dream in the present tense—as though you’re just now seeing it.”

“Okay. Here goes. I’m in a school playground—maybe my junior high school field—and there’s a baseball game getting organized. I look around and see that everyone there is much younger. They’re all kids—adolescents—in uniform. I want to play—I really do—but I feel strange because I’m too big. Then I see the teacher. . . . He looks familiar, but I can’t place him. I start to approach him to ask what to do, and just then I notice another area of the playground where several older people—my age—are organizing another game—maybe golf, maybe croquet—not sure which. I start to join them, but I can’t get past the fence surrounding the ball field.”