“This is exactly the sort of thing Matthew used to say.”
I smiled and silently ground my teeth. I could think of nothing constructive to say. This frustrating, laborious interaction was prototypical. We were to have many similar exchanges.
It was hard and unrewarding work. Week after week I chipped away. I tried to teach her the ABCs of the language of intimacy: for example, how to use the pronouns I and you, how to identify feelings (starting with the difference between feelings and thoughts), how to “own” and to express feelings. I tutored her in the basic feelings (bad, sad, mad, and glad). I provided sentences to complete: for example; “Irv, when you say that, I feel __________ toward you.”
She had an impressive repertory of distancing operations. She would, for example, introduce what she was about to say with a lengthy, boring preamble. When I pointed this out to her, she acknowledged that I was right, but then launched into an account of how, when someone asks her for the time, she gives a lecture on watchmaking. Several minutes later when she finished that anecdote (complete with a full historical account of how she and her sister first developed the habit of telling long tangential stories), we were hopelessly removed from our starting place and I had been effectively distanced.
On one occasion she acknowledged that she had a significant problem with expressing herself. She had been herself, in a fully spontaneous way, in only two situations in her adult life—when she danced and when she and Matthew had been in love for twenty-seven days. That’s an important part of the reason Matthew’s acceptance of her loomed so large: “He knew me as very few people ever have—as I really am, completely open, nothing held back.”
When I asked about how we were doing today, or asked her to describe all the feelings she had experienced toward me in the session so far that day, she rarely responded. Usually she denied having any feelings, but sometimes she disarmed me completely by saying that she had felt very intimate that hour—an hour when I experienced her as particularly evasive and distant. Exploring the discrepancy in our views was treacherous because then she was likely to feel rebuffed.
As the evidence mounted that no meaningful relationship was developing between us, I felt baffled and rejected. Insofar as I could tell, I was making myself available to her. Yet she remained indifferent to me. I tried to raise this question with her but, no matter how I put it, I felt that I was whining, “Why don’t you like me as much as Matthew?”
“You know, Thelma, there’s something else going on alongside your letting Matthew’s opinion of you mean everything, and that is you refuse to let my opinion mean anything at all to you. After all, like Matthew, I know a great deal about you. I, too, am a therapist—in fact I am twenty years more experienced and probably wiser than Matthew. I wonder why what I think and feel about you doesn’t count?”
She responded to the content but not to the emotion. She mollified me: “It’s not you. I’m sure you know your business. I’d be this way with any therapist in the world. It’s just that I’ve been so hurt by Matthew that I’m not going to make myself vulnerable again to another therapist.”
“You’ve got good answers for everything, but what it all adds up to is ‘Don’t get close.’ You can’t get close to Harry because you don’t want to hurt him by telling him your intimate thoughts about Matthew and suicide. You can’t become intimate with friends lest you hurt them when you ultimately commit suicide. You can’t be intimate with me because another therapist, eight years ago, hurt you. The words are different in each case, but the music is the same.”
Finally, by the fourth month, there were signs of progress. Thelma stopped battling on every point and, to my surprise, began one session by telling me that she had spent many hours during the last week making a list of all her close relationships and what happened to each. She realized that whenever she got really close to someone, she managed, in one way or another, to break off the relationship.
“Maybe you’re right, maybe I do have a serious problem with getting close to people. I don’t think I’ve had a good girlfriend for thirty years. I’m not sure whether I’ve ever had one.”
This insight could have been a turning point in our therapy: for the first time, Thelma identified and took responsibility for a specific problem. I was hopeful now of plunging into real work. Instead, the opposite occurred: she withdrew even more, claiming that her problem with intimacy doomed our work in therapy.
I tried mightily to persuade her that it was a positive, not a negative, thing that had emerged in therapy. Again and again, I explained that intimacy difficulties are not extraneous static that just happen to get in the way of treatment, but are the core issue. It was a positive, not a negative, development that it had surfaced here and now where we could examine it.
Yet her despair deepened. Now every week was a bad week. She obsessed more, she wept more, she withdrew more from Harry, she spent much time planning how she would commit suicide. More and more frequently did I hear criticisms of therapy. She claimed that our sessions succeeded only in “stirring the pot,” in increasing her discomfort, and she regretted having committed herself to six full months of therapy.
Time was running out. We were now beginning the fifth month; and, though Thelma assured me she would honor her commitment, she made it clear that she would not be willing to continue longer than six months. I felt discouraged: all my strenuous efforts had been ineffective. I had not even managed to establish a solid therapeutic alliance with her: her emotional energy, every dram of it, was riveted to Matthew, and I had found no way to pry it loose. The moment had come to play my final card.
“Thelma, ever since that hour a couple of months ago when you role-played Matthew and spoke the words that would release you, I’ve been deliberating about inviting him into my office and having a three-way session—you, me, and Matthew. We’ve only got seven more sessions, unless you reconsider your decision to stop”—Thelma shook her head firmly. “I think we need some help to move along further. I’d like your permission to phone Matthew and invite him to join us. I think just a single three-way session would be sufficient, but we ought to do it soon because I think we’ll need several hours afterward to integrate what we learn.”
Thelma, who had been apathetically slumped in her chair, suddenly bolted upright. Her string purse fell from her lap onto the floor, but she ignored it to listen wide-eyed to me. Finally, finally, I had gotten her attention, and she sat silently for several minutes contemplating my words.
Although I had not fully thought through my proposal, I believed that Matthew would agree to meet with us. I hoped that my reputation in the field would intimidate him into cooperating. Moreover, eight years of Thelma’s taped phone messages had to be getting to him, and I was confident that he, too, longed for release.
I was not certain what would happen in this extraordinary three-way meeting, yet I felt strangely confident that all would be for the best. Any information would help. Any introduction of reality should help me release Thelma from her fixation on Matthew. Regardless of the depth of his character flaw—and I had no doubt that it was a trench of considerable magnitude—I was sure he would do nothing in my presence to encourage her fantasies of ultimate reunion.
After an unusually long silence, Thelma stated that she needed more time to think about it. “So far,” she said, “I see more cons than pros——”
I sighed and settled back into my chair. I knew that Thelma would take the rest of the hour spinning obsessional webs.
“On the positive side I guess it would give Dr. Yalom some firsthand observations.”
I sighed even more deeply. This was going to be worse than usual; she was speaking of me in the third person. I started to point out that she was speaking as though I weren’t in the same room with her, but couldn’t summon the energy—she had worn me down.
“On the negative side, I can think of several possibilities. First, your call would alienate him from me. I’ve got a one- or two-percent chance now that he’l
l come around. Your call would drop my chances to zero, or less.”
I was definitely growing irritated and thought, “Eight years have gone by, Thelma, can’t you get the message? And besides, how can your chances be less than zero, you ninny?” This really was my final card and I was beginning feel that she would trump it. But I kept silent.
“His only motivation to participate would be professional—helping a sickie who’s too incompetent to run her own life. Number three,——”
My God! She was talking in lists again. I couldn’t stand it.
“Number three, Matthew will probably tell the truth, but the wording will be patronizing and would be heavily influenced by Dr. Yalom’s presence. I don’t think I could take being patronized. Number four, this is going to put him in a very compromising and embarrassing position professionally. He will never forgive me for it.”
“But, Thelma, he’s a therapist. He knows that in order for you to get well, you’ve got to talk about him. If he’s the spiritually minded person you think him to be, then surely he’s experienced much guilt at your distress and would take pleasure in helping.”
But Thelma was too involved in developing her list to hear my words.
“Number five, what possible help could I get from a three-way meeting? There is almost no chance he’ll say what I hope he’ll say. I don’t even care if he means it, I just want him to say he cares about me. If I’m not going to get what I want and need, why should I expose myself to the pain? I’ve been hurt enough. Why should I do it?” Thelma got out of her chair and walked over to the window.
Now I was deeply concerned. Thelma was getting herself worked up into an irrational frenzy and was going to block my last chance to help her. I took my time and thought out my words carefully.
“The best answer I can give to all the questions you’ve raised is that speaking to Matthew will bring us closer to the truth. Surely you want that?” She had her back to me, but I thought I could see a slight nod of agreement. “You can’t go on living a lie or an illusion!
“You know, Thelma, you’ve many times asked me questions about my theoretical orientation. I often haven’t answered because I thought that talking about schools of therapy would get us away from the personal discourse we needed to have. But let me give you one answer to that question now. Perhaps the single most important therapeutic credo that I have is that ‘the unexamined life is not worth living.’ Getting Matthew into this office might be the key to a true examination and understanding of what’s been happening to you these past eight years.”
My answer soothed Thelma. She walked back to her chair and sat down.
“This is stirring up a lot of stuff in me. My head is spinning. Let me think about it for a week. But you must promise me one thing—that you won’t call Matthew without my permission.”
I promised that unless I heard from her, I would not call Matthew during the next week, and we parted. I wasn’t about to give a guarantee that I would never call—but fortunately she didn’t ask for that.
Thelma came in for the next session looking ten years younger and with a spring to her step. She had had her hair done and was attractively dressed in an argyle wool skirt and stockings, instead of her usual polyester slacks or jogging suit. She immediately took her seat and got down to business.
“I’ve spent all week thinking about a meeting with Matthew. I’ve gone over all the pros and cons, and I now believe you are right—I’m in such bad shape that it’s not likely anything could make me worse!”
“Thelma, those aren’t my words. I said that——”
But Thelma was not interested in my words and spoke over me. “But your plan of phoning him was not a good idea. It would have been a shock to get an out-of-the-blue call from you. So I decided to call him to prepare him for your call. Of course, I didn’t reach him, but I told his telephone-answering tape about your proposal, and I said for him to phone me or you and—and——”
Here, with a big grin on her face, she paused to let the suspense build.
I was astonished. I had never before seen her play. “And?”
“Well, you’ve got more clout than I thought. For the first time in eight years, he returned my call and we had a twenty-minute friendly chat.”
“How did it feel to talk to him?”
“Wonderful! I can’t tell you how wonderful. It was like we had just talked the previous day. He was the old gentle, caring Matthew. He asked all about me. He was concerned about my depression. He was glad I was seeing you. We had a good talk.”
“Can you tell me what you discussed?”
“God, I don’t know. We just chattered away.”
“About the past? The present?”
“You know, it sounds crazy, but I don’t remember!”
“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. Perhaps I should have, but I couldn’t wait. I was so damn curious! It was typical of Thelma not to think that I might have some wishes, too.
“You know, I’m not trying to conceal anything. I just can’t remember. I was too excited. Oh, yes, he told me he had been married and divorced and that he had gone through a lot of turmoil about the divorce.
“But the main thing is that he is willing to come in for a three-way meeting. You know, it’s funny, he even sounded eager—as though it has been me avoiding him. I told him to come in to your office at my regular hour next week, but he told me to ask you if we could make it sooner. Now that we’ve decided to do it, he wants to do it as soon as possible. I guess I feel the same way.”
I suggested a time two days hence, and Thelma said she’d inform Matthew. Following that, we reviewed her phone conversation once again and planned the next hour. Thelma never did recall all the details of her phone conversation but she did remember what they had not talked about. “Ever since I hung up the phone, I’ve been kicking myself for chickening out and not having asked Matthew the two really important questions. First, what really happened eight years ago? Why did you break off? Why have you remained silent? Second, how do you really feel about me now?”
“Let’s be certain that you don’t also finish our three-way meeting wanting to kick yourself for something you didn’t ask. I promise to help you ask all the questions you want to ask, all the questions that might release you from the power you’ve given Matthew. That’s going to be my main job in the session.”
During the rest of the hour, Thelma repeated a lot of old material: she talked about her feelings toward Matthew, how they were not transference, how Matthew had given her the best days of her life. It seemed to me that she droned on interminably, went off into tangent after tangent, and, moreover, said everything to me as though for the first time. I became aware of how little she had changed and how much depended on something dramatic happening the next session.
Thelma arrived twenty minutes early for the session. I was doing correspondence that morning and passed her in the waiting room a couple of times as I conferred with my secretary. She was dressed in an attractive, tight royal-blue knit dress—a daring outfit for a seventy-year-old woman, but I thought she pulled it off well. Later, when I invited her into my office, I complimented her on it and she told me, with a conspiratorial hush and a finger crossing her lips, that she had spent most of the week shopping for it. It was the first new dress she had bought in eight years. As she touched up her lipstick she told me that Matthew would arrive in a minute or two, precisely on time. He had told her that he didn’t want to spend too much time in the waiting room because he wanted to minimize the possibility of running into colleagues who might be passing by. I could not blame him for that.
Suddenly, she stopped talking. I had left my door ajar, and we could hear that Matthew had arrived and was speaking to my secretary.
“I came to some lectures here when the department was in the old building. . . . When did you move? . . . I really like the light, airy feel of this building, do you??
??
Thelma put her hand to her breast as though to still her heartbeat and whispered, “You see? You see how naturally his caring comes?”
Matthew entered. It was the first time he had seen Thelma in eight years, and if he was in any way startled by the physical aging she had undergone, his boyish, good-natured smile gave no evidence of it. He was older than I expected, perhaps in his early forties, and conservatively dressed in an un-Californian three-piece suit. Otherwise, he was much as Thelma had described him—slender, mustached, well tanned.
I was prepared for his directness and sincerity and, therefore, not thrown off by it. (Sociopaths often present themselves well, I thought.) I began by briefly thanking him for coming.
He immediately rejoined, “I’ve been wanting a session like this for years. It’s my place to thank you for bringing it to pass. Besides, I’ve read your books for years. It’s an honor to meet you.”
He’s not without some charm, I thought, but I did not want to get involved in a distracting personal or professional discussion with Matthew: it was best for me to keep a low profile in this session and for Thelma and Matthew to interact as much as possible. I turned the session over to them: “We’ve got a lot to talk about today. Where to start?”
Thelma began: “It’s funny, I haven’t increased my medication.” She turned to Matthew. “I’m still on antidepressants. It’s eight years later—my goodness, eight years, that’s hard to believe—but it’s eight years later, I’ve probably tried eight new antidepressants and they still don’t work. But the interesting thing is that all the side effects are greater today. My mouth is so dry I can hardly talk. Now why should that be? Does stress increase side effects?”
Thelma continued to ramble and to consume huge chunks of our precious time with preambles to preambles. I was in a dilemma: under ordinary circumstances, I might have attempted to clarify the consequences of her indirect discourse. For example, I might point out that she was staking out a role of fragility that would immediately discourage the open discussion she said she wished. Or that she had invited Matthew here to speak freely and yet immediately mobilized his guilt by reminding him that she had been on antidepressants since he left her. But such interpretations would only result in most of the hour being used as a conventional individual therapy session—exactly what none of the three of us wanted. Besides, if I were in any way to label her behavior as problematic, she would feel humiliated and would never forgive me for that.