As a result of her discontent, our time together became ungratifying for me as well. I learned not to expect any personal rewards from my work with Thelma. I never experienced pleasure from being in her presence and, as early as the third or fourth session, realized that any gratification for me in this therapy would have to issue from the intellectual realm.
Most of our time together we devoted to Matthew. I inquired about the precise content of her daydreams, and Thelma seemed to enjoy talking about them. The ruminations were highly repetitious: most were a fairly faithful replay of any one of their meetings during the twenty-seven days. The most common was their first encounter—the chance meeting in Union Square, the coffee at the St. Francis, the walk to Fisherman’s Wharf, the view of the bay from Scoma’s restaurant, the excitement of the drive to Matthew’s “pad”; but often she simply thought of one of his loving phone conversations.
Sex played a minor role in these thoughts: rarely did she experience any sexual arousal. 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. They had attempted intercourse two other times, but Matthew was impotent. I was becoming more convinced that my hunch about his behavior was correct: namely, that he had major psychosexual problems which he had acted out on Thelma (and probably other unfortunate patients).
There were so many rich leads that it was hard to select and concentrate on one. First, however, it was necessary to establish to Thelma’s satisfaction that the obsession had to be eradicated. For a love obsession drains life of its reality, obliterating new experience, both good and bad—as I know from my own life. Indeed, most of my deeply held beliefs about therapy, and my areas of keenest psychological interest, have arisen from personal experience. Nietzsche claimed that a philosopher’s system of thought always arises from his autobiography, and I believe that to be true for all therapists—in fact, for anyone who thinks about thought.
At a conference approximately two years prior to meeting Thelma, I had encountered a woman who subsequently invaded my mind, my thoughts, my dreams. Her image took up housekeeping in my mind and defied all my efforts to dislodge it. But, for a time, that was all right: I liked the obsession and savored it afresh again and again. A few weeks later, I went on a week’s vacation with my family to a beautiful Caribbean island. It was only after several days that I realized I was missing everything on the trip—the beauty of the beach, the lush and exotic vegetation, even the thrill of snorkeling and entering the underwater world. All this rich reality had been blotted out by my obsession. I had been absent. I had been encased in my mind, watching replays over and over again of the same and, by then, pointless fantasy. Anxious and thoroughly fed up with myself, I entered therapy (yet again), and after several hard months, my mind was my own again and I was able to return to the exciting business of experiencing my life
as it was happening.
(A curious thing: my therapist eventually became a close friend and years later told me that, at the time he was treating me, he himself was obsessed with a lovely Italian woman whose attention was riveted to someone else. And so, from patient to therapist to patient goes
La Ronde
of obsessional love.)
So, in my work with Thelma, I stressed to her how her obsession was vitiating her life, and often repeated her earlier comment that she was living her life eight years before. No wonder she hated being alive! Her life was being stifled in an airless, windowless chamber ventilated only by those long-gone twenty-seven days.
But Thelma never found this thesis persuasive—with, I now think, good reason. Generalizing from my experience to hers, I had mistakenly assumed her life to have richness that she was missing because of her obsession. Thelma felt, though she did not explicitly say so at the time, that the obsession contained infinitely more vitality than her lived experience. (Later we were to explore, also with minimal impact, the reverse of that formula—that it was
because
of the impoverishment of her life that she embraced the obsession in the first place.)
By approximately the sixth session, I had worn her down and—to humor me, I believe—she agreed that the obsession was the enemy and had to be extirpated. We spent session after session simply reconnoitering the obsession. It seemed to me that the source of its hold on her was the power she had given Matthew. Nothing could be done until we diminished that power.
“Thelma, this feeling that the only thing that matters is for Matthew to think well of you—tell me everything you know about it.”
“It’s hard to put into words. The idea of him hating me is unbearable. He’s the one person who has ever known
everything
about me. So the fact that he could still love me, despite everything he knew, meant so much.”
This, I thought, is precisely the reason therapists should not become emotionally involved with patients. By virtue of their privileged role, their access to deep feelings and secret information, their reactions always assume larger-than-life meanings. It is almost impossible for patients to see therapists as they really are. My anger toward Matthew grew.
“But, Thelma, he’s just a person. You haven’t seen him for eight years. What
difference
does it make what he thinks of you?”
“I can’t tell you why. I know it doesn’t make sense but, to the bottom of my soul, I believe that I’d be all right, I’d be happy, if he thought well of me.”
This thought, this core false belief, was the enemy. I had to dislodge it. I made an impassioned plea.
“You are you, you have your own existence, you continue to be the person you are from moment to moment, from day to day. Basically your existence is impervious to the fleeting thoughts, to the electromagnetic ripples occurring in some unknown mind. Try to see that. All this power that Matthew has—you’ve given it to him—every bit of it!”
“I get sick in my stomach at the thought of his despising me.”
“What goes on in another person’s mind, someone you never even see, who probably isn’t even aware of your existence, who is caught up in his own life struggles, doesn’t change the person you are.”
“Oh, he’s aware of my existence, all right. I leave a lot of messages on his telephone-answering tape. In fact, I left a message last week to let him know I was seeing you. I think he ought to know that I’m talking about him to you. Over the years I’ve always called him whenever I’ve changed therapists.”
“But I thought you did not discuss him with all these therapists.”
“I didn’t. I promised him that, even though he never asked it, and I kept that promise—until now. Even though I didn’t talk about him all those years, I still thought he should know which therapist I was seeing. Many of them were from his school. They might have even been his friends.”
Because of my vindictive feelings toward Matthew, I was not displeased with Thelma’s words. On the contrary, I was amused when I imagined his discomfiture over the years when listening to Thelma’s ostensibly solicitous messages on his tape. I began to relinquish my ideas of striking back at Matthew. This lady knew how to punish him and needed no help from me in that task.
“But, Thelma, go back to what I was saying earlier. Can’t you see that you’re doing this to yourself? His thoughts really can’t change the kind of person you are. You
let
him influence you. He’s just a person like you or me. If
you
think poorly of a person with whom you never have any contact, will
your
thoughts—those mental images circulating in your brain and known only to you—affect
that
person? The only way that can happen is through voodoo influence. Why do you surrender your power to Matthew? He’s a person like anyone else, he struggles to live, he’ll age, he’ll fart, he’ll die.”
No response from Thelma. I upped the ante.
“You said before that one could hardly have deliberately designed behavior more likely to hurt you. You’ve thought that maybe he was trying to drive you to suicide. He is not interested in your welfare. So what sense does it make to elevate him so? To believe that nothing in life is more important than that he think well of you?”
“I don’t really believe he’s trying to drive me to suicide. It’s just a thought I have sometimes. I flip back and forth quickly in my feelings about Matthew. Most of the time what’s important is that he would wish me well.”
“But why is his wish so all-important? You’ve elevated him to a superhuman position. Yet he seems to be a particularly screwed-up person. You yourself mention his significant sexual problems. Look at the whole issue of integrity—at his code of ethics. He’s violated the basic code of any helping profession. Look at the distress he’s caused you. We both know it is simply wrong for a professional therapist, who is sworn to act in the best interests of his patient, to hurt anyone the way he has hurt you.”
But I might as well have been talking to the wind.
“It was only
when
he started acting professionally,
when
he went back into a formal role, that he hurt me. When we were simply two human beings in love he gave me the most precious gift in the world.”
It was deeply frustrating.
Obviously,
Thelma was responsible for her own life predicament.
Obviously,
it was a fiction that Matthew had any real power over her.
Obviously,
she gave him that power in an effort to deny her own freedom and her responsibility for the constitution of her own life. Far from wanting to take back her freedom from Matthew, she had a lust for submission.
From the beginning, of course, I had known that the pure forcefulness of my argument would not penetrate deep enough to effect any change. It almost never does. It’s never worked for me when I’ve been in therapy. Only when one feels an insight
in one’s bones
does one own it. Only then can one act on it and change. Pop psychologists forever talk about “responsibility assumption,” but it’s all words: it is extraordinarily hard, even terrifying, to own the insight that you and only you construct your own life design. Thus, the problem in therapy is always how to move from an ineffectual intellectual appreciation of a truth about oneself to some emotional
experience
of it. It is only when therapy enlists deep emotions that it becomes a powerful force for change.
And powerlessness was the problem in my therapy with Thelma. My attempts to generate power were shamefully inelegant and consisted mainly of fumbling, nagging, and repetitively circling her obsession and bashing away at it.
How I long at such junctures for the certainty that orthodoxy offers. Psychoanalysis, to take the most catholic of the psychotherapy ideological schools, always posits such strong convictions about the necessary technical procedures—indeed, analysts seem more certain of
everything
than I am of
anything.
How comforting it would be to feel, just once, that I know exactly what I’m doing in my psychotherapeutic work—for example, that I am dutifully traversing, in proper sequence, the precise stages of the therapeutic process.
But, of course, it is all illusion. If they are helpful to patients at all, ideological schools with their complex metaphysical edifices succeed because they assuage the
therapist’s,
not the patient’s, anxiety (and thus permit the therapist to face the anxiety of the therapeutic process). The more the therapist is able to tolerate the anxiety of not knowing, the less need there is for the therapist to embrace orthodoxy. The creative members of an orthodoxy,
any
orthodoxy, ultimately outgrow their disciplines.
Though there is something reassuring about an omniscient therapist who is always in control of every situation, there can be something powerfully engaging about a fumbling therapist, a therapist willing to flounder with the patient until they, together, stumble upon an enabling discovery. Alas, however, as Thelma was to teach me before this case was over, much wonderful therapy may be wasted on a patient!
In my search for power, I pushed to the limits. I tried to rattle and shock her.
“Suppose, for a moment, that Matthew died! Would that release you?”
“I’ve tried to imagine that. When I imagine him dead, a great sadness descends. I’d be living in an empty world. I never can think past that.”
“How can you release yourself from this? How could you be released? Could Matthew release you? Have you ever imagined a conversation in which he releases you?”
Thelma smiled at this question. She looked at me with what I imagined to be more respect—as though she were impressed with my mind-reading abilities. I had obviously tapped into an important fantasy.
“Often, very often.”
“Share it with me. How would it go?” I don’t rely on role-playing or chair-switching, but this seemed the perfect place for it. “Let’s try role-playing it. Would you move to the other chair, play the role of Matthew, and talk to Thelma here in this chair?”
Since Thelma had opposed everything else I suggested, I was preparing my argument to convince her when, to my surprise, she enthusiastically agreed. Perhaps, in her twenty years of therapy, she had worked with gestalt therapists who had employed these techniques; perhaps it was her stage experience shining through. She almost leaped out of her chair, cleared her voice, pantomimed putting on a necktie and buttoning a suit jacket, assumed a saintly smile and a delightfully exaggerated expression of benevolent magnanimity, cleared her voice, sat down in the other chair, and became Matthew.