"Among my colleagues, and at my age and level, it would be perceived as a sign of weakness—it would cripple me politically. And keep in mind that I've been highly critical of therapist misconduct: I've even engineered the disciplining and expulsion—a well-deserved expulsion, I might add—of my own analyst from the institute. You read about the Seth Pande catastrophe in the papers?"
"The psychiatric recall? Yes, of course!" Carol said. "Who could miss that flap? That was you?"
"I was a major player in it. Maybe the major player. And, between you and me, I saved the institute's ass—a long and confidential story, I can't go into it—but the point is this: How could I ever again speak up about therapist misconduct when there might be someone in the audience who knows that I accepted a Rolex from a patient? I'd be forced into silence—and political ineffectiveness—forever."
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Carol knew there was something seriously wrong with Marshal's argument, but she couldn't find a way to challenge it. Perhaps his distrust of therapists was too close to her own. She tried another tack.
"Marshal, go back to your statement that only an analytically trained therapist could help you. Where does that leave you and me? Look at me—a totally untrained person! How is it that you consider me helpful?"
"I don't know how —I only know you are. And right now I don't have the energy to figure out why. Maybe all you have to do is just be there in the room with me—that's all. Just let me do the work."
"Still," said Carol, shaking her head, "I'm uncomfortable with our arrangement. It's unprofessional; it may even be unethical. You're spending money to see someone who has no special expertise in the area you need. And it's a good bit of money—after all, I charge more than a psychotherapist."
"No, I've thought all that through. How can it be unethical? Your client is requesting it because he finds it helpful. I'll sign an affidavit to that effect. And it's not expensive if you take into consideration the tax consequences. Moderate medical expenses at my level of income are not deductible, but legal expenses are. Carol, you are one hundred percent deductible. You're actually cheaper than a therapist—but that's not the reason for seeing you! The real reason is that you're the one person who can help me."
And so Carol was persuaded to continue her meetings with Marshal. She had no difficulty spotting Marshal's problems—one by one he spelled them out for her. Like so many excellent attorneys Carol took pride in her beautiful penmanship, and her meticulous notes on legal-sized paper soon contained a cogent list of issues. Why was it so impossible for Marshal to turn to anyone else for help? Why so many enemies? And why so arrogant, so judgmental, about other therapists and other therapies? He was omnivorously judgmental; he spared no one, not his wife, not Bat Thomas, not Emil, not Seth Pande, not his colleagues, not his students.
Carol couldn't help insinuating a question about Ernest Lash. Under the pretext that one of her friends was considering entering therapy with him, she asked for his recommendation.
"Well—and, remember, this is confidential, Carol—he's not the first person I would recommend to you. Ernest's a bright, thoughtful young man who has an excellent background in drug research.
Lying on the Couch ^ 3 3 5
In that area he's top-notch. No question. But as a therapist . . . well . . . let's just say he's still developing, still undifferentiated. The main problem is he's had no real analytic training aside from limited supervision with me. Nor, I think, is he sufficiently mature yet to undertake proper analytic training: too undisciplined, too irreverent and iconoclastic. And even worse, he flaunts his unruliness, attempts to dignify it under the name of 'innovation' or 'experimentation.'"
Unruly! Irreverent! Iconoclastic! As a result of these accusations, Ernest's stock rose several points in her estimation.
Next on Carol's list, after distrust and arrogance, came Marshal's shame. Deep shame. Maybe arrogance and shame went together, Carol thought. Maybe, if Marshal weren't so judgmental of others, he wouldn't be so hard on himself. Or did it work the other way? If he weren't so hard on himself, might he be more forgiving of others? Funny, now that she thought of it, that was exactly the way Ernest had put it to her.
Actually, in many ways she recognized herself in Marshal. For example, his rage—its white heat, its tenacity, his obsession with revenge—reminded her of the meeting she had had with Heather and Norma that awful night after Justin left. Had she really entertained the idea of a hit man, a tire-iron beating? Had she really destroyed Justin's computer files, his clothing, his souvenirs from his youth? None of it seemed real now. It happened a thousand years ago. Justin's face was fading from memory.
How had she changed so much? she wondered. The chance meeting with Jess, probably. Or maybe just getting away from the strangulation of the marriage? And then Ernest crossed her mind . . . could it have been that, despite everything, he had managed to bootleg some therapy into their sessions?
She tried to reason with Marshal about the uselessness of his rage, and pointed out its self-defeating character. But to no avail. Sometimes she wished she could transfuse some of her newly developed temperateness into him. Other times she lost patience and wanted to shake some sense into him. "Let it go!" she wanted to yell. "Don't you see what your idiotic rage and pride are costing you? Everything! Your peace of mind, your sleep, your work, your marriage, your friendships! Just let it go." But none of these approaches would help. She remembered only too vividly the tenacity of her own vengefulness just a few weeks ago, and so could easily empathize with Marshal's anger. But she didn't know how to help him let it go.
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Some of the other items on her Hst—for example Marshal's preoccupation with money and status—were alien to her. She had no personal concourse with them. Nonetheless she appreciated their centrality to Marshal: after all, it was his greed and ambition that had gotten him into this mess.
And his wife? Carol waited patiently hour after hour for Marshal to speak of her. But scarcely a word, other than to say that Shirley was away on a three-week Vipassnia retreat at Tassajara. Nor did Marshal respond to Carol's questions about their marriage other than to say that their interests had diverged and that they had been going their separate ways.
Often while jogging, while researching other clients' cases, while lying in bed, Carol thought about Marshal. So many questions. So few answers. Marshal sensed her disquiet and reassured her that merely helping him to formulate and discuss his basic problems was sufficient to ease some of his pain. But Carol knew it wasn't enough. She needed help; she needed a consultant. But who? And then one day it occurred to her: she knew exactly where to turn.
TWENTY-SEVEN
/y/n Ernest's waiting room, Carol decided she would devote ^r her entire therapy hour to getting advice about how to ^^_^ help Marshal. She made a checklist of the areas in which she needed help with her client and planned how best to present them to Ernest. She knew she had to be careful: Marshal's remarks made it clear that he and Ernest knew one another and she would have to bury Marshal's identity very deeply. That didn't daunt Carol; au contraire, she moved easily and cheerfully in the halls of intrigue.
But Ernest had quite a different agenda. As soon as she entered the office, he opened the hour.
"You know, Carolyn, I feel that the last session was unfinished. We ended in the middle of something important."
"What do you mean?"
"It seemed to me that we were in the midst of a more searching look at our relationship and you began to get agitated. You practi-
3 3 8 ^ Lying on the Couch
cally bolted out of here at the end of the hour. Can you talk about the feelings you experienced on your way home from our session?"
Ernest, like most therapists, almost always waited for the patient to begin the hour. If he ever broke that rule and introduced the first topic, it was invariably for the purpose of exploring some issue left hanging from the last session. He had learned from M
arshal long before that the more therapy sessions flow from one to the other, the more powerful did therapy become.
"Agitated? No." Carol shook her head. "I don't think so. I don't remember much about the last session. Besides, Ernest, today is today and I want to talk to you about something else. I need some advice about a client I'm seeing."
"In a minute, Carolyn, first let me follow through with this for a few minutes. There are some things that feel important to me that I want to say."
Whose therapy is this, anyway^ Carol mumbled to herself. But she nodded amiably and waited for Ernest to continue.
"You remember, Carolyn, that in our first session, I told you that nothing was more important in therapy than for us to have an honest relationship? For my part, I gave you my word that I would be honest with you. Yet the truth is that I haven't lived up to that. It's time to clear the air, and I'll start with my feelings about the erotic . . . there's been a lot of that in our relationship and that's been disturbing to me."
"What do you mean?" Carol felt concerned; Ernest's tone made it clear this was not going to be an ordinary hour.
"Well, look at what's happened. From the first session forward, a great deal of our time has been devoted to your talking about your sexual attraction to me. I've become the center of your sexual fantasies. Again and again, you've asked me to take Ralph's place as your lover-therapist. And then there are the hugs at the end of the hour, the attempts to kiss me, the 'couch time' where you want to sit close to me."
"Yes, yes, I know all that. But you used the word disturbing.""
"Yes, definitely disturbing—and in more ways than one. First, because it was sexually arousing."
"You're disturbed because I was aroused?"
"No, that / was. You've been very provocative, Carolyn, and since the name of the game here, and especially today, is honesty, I'll tell you honestly that it's been disturbingly arousing to me. I've told
Lying on the Couch ^ 3 39
you before that I consider you a very attractive woman; it's very difficult for me, as a man, not to be affected by your seductiveness. You've entered into my fantasies, as well. I think about seeing you hours before you come in, I even think about what to wear on the days I see you. I've got to own up to this.
"Now, obviously, therapy can't go on like this. You see, rather than help you resolve these . . . these—what shall I say?— powerful but unrealistic feelings toward me, I believe I've colluded in them, I've encouraged them. I've enjoyed hugging you, touching your hair, having you sit next to me on the sofa. And I believe you know I've enjoyed it. You shake your head 'no,' Carolyn, but I believe I've fanned the flames of your feelings to me. I've been saying 'no, no, no' all along but, in a softer but audible voice, I've also been saying, 'yes, yes, yes.' And that has not been therapeutic for you."
"I haven't heard the 'yes, yes, yes,' Ernest."
"Maybe not consciously. But if I feel these feelings, I'm certain you've sensed them at some level and been encouraged by them. Two people locked together in an intimate relationship—or a relationship that is trying to be intimate—always communicate everything to each other, if not explicitly, then on a nonverbal or unconscious level."
"I'm not sure I buy into that, Ernest."
"I'm sure I'm right on this. We'll come back to it again. But I want you to hear the gist of what I've said: your erotic feelings toward me are not good for therapy, and I, with my own vanity and my own sexual attraction to you, must take the responsibility for encouraging those feelings. I have not been a good therapist for you."
"No, no," Carol said, shaking her head vigorously. "None of this is your fault—"
"No, Carolyn, let me finish. . . . there's something more I want to say to you. . . . Before I even met you I had made a conscious decision that I was going to be totally self-revealing with my next new patient. I felt, and still feel, that the basic flaw in most traditional therapy is that the relationship between patient and therapist is not genuine. My feelings about this are so strong that I had to break with an analytic supervisor I greatly admired. It's for this very reason that I've recently made a decision not to pursue formal psychoanalytic training."
"I'm not sure what the implications of this are for our therapy."
"Well, it means my treatment of you has been experimental.
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Maybe, in my own defense, I should say that that's too strong a term since, over the past few years, I have tried to be less formal and more human with all my patients. But with you there's a bizarre paradox: I committed myself to an experiment of total honesty and yet never told you about that experiment. And now, as I take stock of where we are, I don't believe this approach has been helpful. I've failed to create the type of honest, authentic relationship that I know is necessary if you're going to grow in therapy."
"I don't believe that any of this is your fault—or the fault of your approach."
"I'm not sure what went wrong. But something has. I feel an enormous gulf between us. I feel great suspicion and distrust coming from you, which alternates suddenly with some expression of great affection and love. And I always feel baffled because most of the time I don't sense you feel warm or even positive to me. Surely, I'm not telling you something you don't know."
Carol, head bowed, stayed silent.
"So, my concern is growing: I have not done the right thing by you. In this case honesty may not have been the best policy. It would have been better if you had seen a more traditional therapist, someone who would foster a more formal therapist-patient relationship, someone who would keep clearer boundaries between a therapeutic and a personal relationship. Sooo, Carolyn, I guess that's what I wanted to say to you. Any response?"
Carol started to speak twice but fumbled for words. Finally she said, "I'm confused. I can't speak—don't know what to say."
"Well, I can guess what you're thinking. In the light of all I've said, I'd expect that you'd be thinking you'd be better off with another therapist—that it's time to bring this experiment to an end. And I think you may well be right. I'll support you in this, and I'll be glad to make suggestions for another therapist. You might even be thinking that I've improperly charged you for an experimental procedure. If so, let's talk about that; maybe returning your fees is the proper thing to do."
The end of the experiment — a certain lilt to that, Carol thought. And the perfect way out of this whole sticky farce. Yes, it's time to go, time to stop the lie. Leave Ernest to Jess and Justin. Perhaps you're right, Ernest. Perhaps it is time for us to stop therapy.
That's what she should have said; instead, she found herself saying something quite different.
Lying on the Couch ^ 3 41
"No. Wrong on all counts. No, Ernest, it is not your therapy approach that's at fault. I don't like the idea of your changing it because of me . . . that troubles me ... it troubles me a great deal. Surely one patient is not enough for you to reach such a conclusion. Who knows? Maybe it's too early to tell. Maybe it's the perfect approach for me. Give me time. I like your honesty. Your honesty has done me no harm. Maybe a lot of good. As for returning your fees, that's out of the question—and, incidentally, as an attorney, I want to advise you against such statements in the future. Leaves you vulnerable to litigation.
"The truth?" Carol continued. "You want the truth? The truth is you've helped. More than you know. And, no, the more I think about it, I don't want to stop seeing you. And I won't see anyone else. Maybe we're over the tough period. Maybe, unconsciously, I was testing you. I think I was. And testing you severely."
"How did I do on the test?"
"I think you passed. No, better than that . . . top of your class."
"What was the test all about?"
"Well . . . I'm not sure I know ... let me think about it. Well, I know a few things about it, but could we save that for another time, Ernest? There's something I must talk to you about today."
"Okay, but are we clean—you and I?"
/>
"Getting cleaner."
"Let's go on with your agenda. You said it involved a client."
Carol described her situation with Marshal, revealing he was a therapist but, in all other ways, carefully disguising his identity and reminding Ernest of her professional commitment to confidentiality so that he wouldn't ask leading questions.
Ernest was not cooperative. He didn't like turning Carolyn's therapy hour into a consultation and posed a string of objections. She was resisting her own work; she was not making good use of her time or her money; and her client should be seeing a therapist, not an attorney.
Carol countered each of these deftly. Money was no issue—she was not wasting her money. She charged the client more than Ernest charged her. As for her cHent seeing a therapist—^well, he just wouldn't and she couldn't explain further because of confidentiality. And she wasn't avoiding her own problems—she'd be willing to see Ernest more frequently to make up the hour. And since the client's problems mirrored her own, she was working indirectly on her issues by
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working on his. Her most powerful point was that by acting in a purely altruistic manner for her client, she was enacting Ernest's exhortation to break the cycle of selfishness and paranoia passed on to her by her mother and grandmother.
"You've persuaded me, Carolyn. You're a formidable woman. If ever I have to have a case argued, I want you as my counsel. Tell me about you and your client."
Ernest was an experienced consultant and listened carefully as Carol described what she was confronting in Marshal: rage, arrogance, loneliness, preoccupation with money and status, and withdrawal of interest in anything else in his life, including his marriage.
"What strikes me," Ernest said, "is that he's lost all perspective. He's so caught up by these events and these feelings that he's become identified with them. We need to find a way to help him take a few steps back from himself. We need to help him see himself from a more distant perch, even from a cosmic perspective. That's exactly what I was trying to do with you, Carolyn, whenever I asked you to consider something from the long skein of your life events. Your client's become these things—he has lost the sense of a persisting self who is experiencing these events for some small fraction of his existence. And what makes things worse is that your client is assuming that his present misery is going to be his permanent state—fixed for all time. Of course, that's the hallmark of depression—a combination of sadness plus pessimism."