Lying on the Couch (13 page)

"And all the while getting off sexually while watching them masturbate," Ernest added, sneaking a look at his watch.

"You looked at your watch, Ernest. Can you put that into words?"

"Well, time is going by. I had wanted to get into some material about Justin."

"In other words, though this discussion may be interesting, it's not what you came for. In fact, you'd rather not squander your supervision time and money on it?"

8 2. ^ Lying on the Couch

Ernest shrugged his shoulders.

"Am I close?"

Ernest nodded.

"Then why not say so? It's your time; you're paying for it!"

"Right, Marshal, it's that old business of wanting to please. Of still holding you too much in awe."

"A little less awe and a little more directness will serve this supervision better."

Like a rock, Ernest thought. A mountain. These little exchanges, generally quite separate from the formal task of discussing patients, were often the most valuable teaching that Marshal did. Ernest hoped that sooner or later he would internalize Marshal's mental toughness. He also took note of Marshal's draconian attitudes about patient-therapist sexual relations; he had intended to talk about his dilemma involving Nan Carlin at his bookstore reading. Now he wasn't so sure.

Ernest returned to Justin. "Well, the more I worked with Justin, the more I was convinced that any progress made in our hours was immediately undone at home in his relationship with his wife, Carol—an absolute gorgon."

"It's coming back to me. Wasn't she the borderline who threw herself out of the car to stop him from buying bagels and lox?"

Ernest nodded. "That's Carol, all right! The meanest, toughest lady I ever encountered, even indirectly, and I hope never to meet her face to face. As for Justin, for about two to three years I did good traditional work with him: good therapeutic aUiance, clear interpretations of his dynamics, the right professional detachment. Yet I could not budge this guy. I tried everything, raised all the right questions: Why had he chosen to marry Carol? What payoff did he get for staying in the relationship? Why had he chosen to have kids? But nothing we talked about ever got translated into behavior.

"It became apparent to me that our usual assumptions—that enough interpretation and insight will ultimately lead to external change—weren't the answer. I interpreted for years but Justin had, it seemed to me, a total paralysis of the will. You may remember that, as a result of my work with Justin, I became fascinated with the concept of will and began reading everything I could about it: William James, RoUo May, Hannah Arendt, Alan Wheelis, Leslie Farber, Silvano Arieti. I guess it was about two years ago that I gave a grand rounds presentation on paralysis of the will."

Lying on the Couch ^ 83

"Yes, I remember that lecture—you did well, Ernest.I still think you should write that up for publication."

"Thanks. I've got a little will paralysis myself on finishing that paper. Right now it's stacked up behind two other writing projects. You may remember that in grand rounds I concluded that, if insight doesn't kick-start the will, then therapists have to find some other way to mobilize it. I tried exhortation: in one way or another, I began to whisper in his ear, 'You have to try, you know.' I understood, oh did I understand, Allen Wheelis's comment that some patients have to get their backs off the couch and their shoulders to the wheel.

"I tried visual imagery," Ernest continued, "and urged Justin to project himself into the future—ten, twenty years from now—and to imagine himself still stuck in this lethal marriage, to imagine his remorse and regret for what he had done with his own life. It didn't help.

"I became like a second in a boxer's corner, offering advice, coaching him, helping him rehearse declarations of marital liberation. But I was training a featherweight, and his wife was a cruiser-class heavyweight. Nothing worked. I guess the last straw was the great backpacking caper. Did I tell you about that?"

"Go on; I'll stop you if I've heard it."

"Well, about four years ago Justin decided it would be a great thing for the family to go backpacking—he's got twins, a boy and girl aged eight or nine now. I encouraged him. I was delighted with anything that had the aroma of initiative. He always felt guilty about not spending enough time with his children. I suggested he think of a way to change that, and he decided that a backpacking trip might be an exercise in good fathering. I was deHghted and told him so. But Carol wasn't delighted! She refused to go—no particular reason, just sheet perversity—and she forbade the kids to go with Justin. She didn't want them sleeping in the woods—she's phobic about everything, you name it: insects, poison oak, snakes, scorpions. Besides, she has problems staying home alone, which is strange since she has no problem traveling alone for business—she's an attorney, a tough trial lawyer. And Justin can't stay home alone, either. A folie a deux.

"Justin, with my vehement urging, of course, insisted that he would go camping and he would go with or without her permission. He was putting his foot down this time! 'Atta boy, 'atta boy, I whis-

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pered. Now we're moving. She raised hell, she wheedled, she bargained, she promised that if they all went to Yosemite and stayed in the Ahwahnee Hotel this year, then next year she'd go camping with them. ''No deal," I coached him, "hold firm."

"So, what happened?"

"Justin stared her down. She caved in and invited her sister to come stay with her while Justin and the kids went camping. But then . . . twilight zone set in . . . odd things began to happen. Justin, dazzled by his triumph, became concerned that he was not in good enough physical shape for such a venture. It would be necessary, first, to lose weight—he set twenty pounds for his goal—and then to strengthen his back. So he began working out, mainly by climbing forty stories to get to and from his office. During one workout he developed acute shortness of breath and got an extensive medical workup."

"Which was negative, of course," said Marshal. "I don't remember your telling me this story, but I think I can fill in the rest. Your patient became morbidly concerned about the camping trip, couldn't lose weight, grew convinced his back wouldn't hold up and that he wouldn't be able to take care of his children. Finally he developed full-blown panic attacks and forgot about backpacking. The family went off to the Ahwahnee Hotel, and everyone wondered how his idiot shrink ever came up with such a harebrained scheme."

"The Disneyland Hotel."

"Ernest, this is an old, old story. And an old, old error! You can count on this scenario whenever the therapist mistakes the symptoms of the family system for the symptoms of the individual. So that was when you gave up?"

Ernest nodded. "That's when I switched to a holding action. I assumed he was stuck forever in his therapy, his marriage, his life. That's when I stopped talking about him in our supervision."

"But now comes a major new development?"

"Yes. Yesterday he came in and, almost nonchalantly, told me he had left Carol and moved in with a much younger woman—someone he had hardly mentioned to me. Three times a week he sees me and he forgets to talk about her."

"Oh-ho, that's interesting! And?"

"Well, it was a bad hour. We were out of sync. I felt diffusely annoyed most of the session."

"Run through the hour quickly with me, Ernest."

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Ernest recounted the events of the session, and Marshal went straight for the countertransference—the therapist's emotional response to the patient.

"Ernest, let's focus first on your annoyance with Justin. Try to rehve the hour. When your patient tells you he has left his wife, what do you begin to experience? Just free-associate for a minute. Don't try to be rational—stay loose!"

Ernest took the plunge. "Well, it was as if he were making light of, even mocking, our years of good work together. I worked like hell for years with this guy—I broke my ass. For years he was a dead weight around my neck . . . this is raw stuff. Marshal."

"Go on. It's supposed to be raw stuff."

Ernest searched his feelings. Plenty there, but which ones dare he share with Marshal? He wasn't in therapy with Marshal. And he wanted Marshal's collegial respect—and his referrals, and his sponsorship for the analytic institute. But he also wanted the supervision to be supervision.

"Well, I was pissed—pissed about his throwing the eighty thousand dollars in my face, pissed that he would just mosey out of that marriage without discussing it with me. He knew how much I had invested in his leaving her. Not even a phone call to me! And, let me tell you, this guy has phoned me about incredibly trivial stuff. Also, he had hidden the other woman from me, and that pissed me off, too. And also I was pissed about her ability, the ability of any woman, to simply crook her finger or twitch her little cunt and enable him to do what I had failed to do for four years."

"And what about your feelings about the fact that he actually left his wife?"

"Well, he did it! And that's good. No matter how he did it, it's good. But he didn't do it the right way. Why in hell couldn't he have done it the right way? Marshal, this is nuts—primitive stuff, practically primary process. I'm really uncomfortable verbalizing this."

Marshal leaned over and put his hand on Ernest's arm, a very uncharacteristic act for him. "Trust me, Ernest. This is not easy. You're doing great, Try to keep going."

Ernest felt encouraged. It was interesting for him to experience that strange paradox of therapy and supervision: the more unlawful, shameful, dark, ugly stuff you revealed, the more you were rewarded! But his associations had slowed: "Let's see, I'H have to dig. I hated it that Justin allowed himself to be led around by his pecker. I had

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hoped for better things from him, hoped he could leave that dragon the right way. That wife of his, Carol . . . she gets to me,"

"Free-associate to her, just for one or two minutes," Marshal requested. His reassuring 'just for one or two minutes' was one of Marshal's few concessions to a supervisory rather than a therapy contract. A clear and short time limit put boundaries around the self-disclosure and made the process feel safer to Ernest.

"Carol? . . . bad stuff . . . gorgon's head . . . selfish, borderline, vicious woman . . . sharp teeth . . . eye slits . . . evil incarnate . . . the nastiest woman I ever met. ..."

"So you did meet her?"

"I mean the nastiest woman I never met. I only know her through Justin. But after several hundred hours, I know her pretty well."

"What did you mean when you said he didn't do it the right way. What's the right way?"

Ernest squirmed. He looked out the window, avoiding Marshal's eyes.

"Well, I can tell you the wrong way: the wrong way is to go from one woman's bed to another woman's bed. Let's see ... if I had my wish for Justin, what would it be? That, for once, just once, he'd be a mensch! And that he'd leave Carol like a mensch! That he would decide that this was the wrong choice, the wrong way to spend his one and only life, that he would simply move out—face his own isolation, come to terms with who he is, as a person, as an adult, as a separate human being. What's he's done is pathetic: shucking his responsibility, falling into a trance, swooning in love with some young pretty face—'an angel made in heaven,' he put it. Even if it does work for a while, he's not going to grow, not going to learn a goddamned thing from it!

"Well, there it is. Marshal! Not pretty! And I'm not proud of it! But if you want primitive stuff, there it is. Plenty of it—and it's patent. I can see through most of it myself!" Ernest sighed and leaned back, exhausted, awaiting Marshal's response.

"You know, it's been said that the goal of therapy is to become one's own mother and father. I think we could say something analogous about supervision. The goal is to become your own supervisor. Sooo . . . let's take a look at what you see about yourself."

Before looking inside, Ernest took a look at Marshal and thought, ''be my own mother and father, be my own supervisor —Goddamn he's good."

Lying on the Couch ^ 87

"Well, the most obvious thing is the depth of my feehngs. I'm overinvested, for sure. And this crazy sense of outrage, of proprietorship—of how dare he make this decision without consuhing me first."

"Right!" Marshal nodded vigorously. "Now juxtapose outrage with your goal of diminishing his dependency on you and cutting down his hours."

"I know, I know. The contradiction is glaring. I want him to break his attachment to me, yet I get angry when he acts independently. It's a healthy sign when he insists on his private world, even concealing this woman from me."

"Not only a healthy sign," Marshal said, "but a sign that you've been doing good therapy. Damn good therapy! When you work with a dependent patient, your reward is rebellion, not ingratiation. Take pleasure in it."

Ernest was moved. He sat in silence, holding back tears, gratefully digesting what Marshal had given him. A caregiver for so many years, he was not used to being nourished by others.

"What do you see," Marshal continued, "in your comments about the right way for Justin to leave his wife?"

"My arrogance! Only one way: my way! But it's very strong—I feel it even now. I'm disappointed in Justin. I wanted better things for him. I sound like a demanding parent, I know!"

"You're taking a strong position, so extreme you yourself don't believe it. Why so strong, Ernest? Where's the push coming from? What about your demands on yourself?"

"But I do believe it! He's gone from one dependent position to another, from wife-devil-mother to angel-mother. And the swooning, falling in love, 'angel from heaven' business—he's in bliss-merger, like an incompletely divided amoeba, he said . . . anything to avoid facing his own isolation. And it's the fear of isolation that's kept him in this lethal marriage all these years. I've got to help him see that."