Creatures of a Day: And Other Tales of Psychotherapy

  Rick looked up and finally caught my gaze.

  “How did that feel?” I asked.

  “How did what feel?”

  “What you just did. Looking at me. Looking into my eyes.”

  “I don’t understand what you’re getting at.”

  “It seems to me that this was the first time you really looked at me, the first time we really touched.”

  “Never thought of therapy consultation as a social hour. Where’s this coming from?”

  “It was that statement you made earlier, ‘I was too damned lonely.’ I was wondering how lonely you’ve been feeling in this room with me.”

  “I don’t think about that. But I admit you’ve got a point. There are people all around me, but I just don’t connect.”

  “It would help me understand more if you’d take me through a twenty-four-hour day. Pick a typical day last week.”

  “Well, I have breakfast . . . ”

  “What time do you wake up?”

  “About six.”

  “And your typical night’s sleep?”

  “Probably six to seven hours. I go to bed around eleven and read myself to sleep around eleven thirty or eleven forty-five. Get up to take a leak about two or three times.”

  “And you mentioned you don’t dream often.”

  “I rarely remember dreams. My therapist’s been on my case about that. Tells me that everyone dreams every night.”

  “And breakfast?”

  “I get to the dining room early. I like that because I can sit alone and read the paper with breakfast. The rest of the day you already know about. I torment myself about going or not going to activities. If the weather’s good, I take a walk alone for at least an hour. And I often take lunch in my room alone. But then at dinner you can’t sit alone. They seat you with others, so I put on a good act of socializing.”

  “Evenings?”

  “TV, or sometimes a film at Fairlawn. Most of the evenings alone.”

  “Tell me about the main people in your life right now.”

  “I spend a lot more time avoiding people than meeting people. A lot of single women there, but it’s awkward. If I get too friendly with one, then she’ll be looking for me at every meal and every activity. If you get involved with one, there’s no chance you can date another without hell to pay.”

  “How about people you knew before you went into the retirement community?”

  “I have a son. He’s a banker living in London, and he phones or, lately, Skypes every Sunday morning. Good kid. Two grandchildren—a boy and a girl. And that’s about it. Lost touch with everyone else from my former life. My wife and I had a lively social life, but she was the hub. She organized everything, and I just went along.”

  “It’s curious, isn’t it? You say you’re lonely, yet you have such good social skills, and you’re surrounded by people whom you try to avoid.”

  “Doesn’t make sense, I know. But not sure how this is connected to my problem about spontaneity and indecision.”

  “Perhaps there is more than one problem. Perhaps, as we proceed, some connection will emerge. What strikes me is your strong focus on task and your inattention to relationship. Your description of your dilemma about your activities at Fairlawn involves only the nature of the activity, but no mention of other people. Who’ll be there? Who’s guiding the activity? Who would you like to hang out with? And we had a small taste of that here today as you focused only on getting started quickly and being efficient but sought no real encounter with me. You never inquired about who I was or what I had to offer. Until I invited you to question me, you expressed no interest in me.”

  “I did say I read your book and already had an introduction to you there.”

  “Right. But your relationship to me was private and excluded me.”

  “Come on, this sounds silly. I’m here to get something from you. I’m paying you for your services. I’ll most likely never see you again. What’s the point in social make-believe?”

  “Earlier you mentioned your training program as a counselor. Right?”

  “Yeah, two-year training program.”

  “You remember that the interview, like our interview today, consists of both process and content? Content is obvious—it’s the information exchanged. The process—that is, the relationship between interviewer and interviewee—gives you even more relevant information, in that you get a glimpse of the client’s behavior toward others. It’s important because the interview situation is a microcosm of the client’s behavior with other people. So that’s what I’m noting. That’s why I’m commenting about the absence of connection between us until that moment you caught my glance.”

  “So you’re saying that my behavior here tells you about my behavior with others.”

  I nodded.

  “Sometimes I think shrinks place too much importance on relationships. There are other things in the world. I’m not craving to meet others. I’m getting along fine without them. Some folks prefer solitude.”

  “You’re right. I do make the assumption that relationships are central. I believe we’re embedded in them, and we all do better in the presence of an intimate nourishing relationship. Like that long, good, loving one you had with your wife.”

  “Well, that’s gone, and, frankly, I don’t have the energy to begin again.”

  “Or maybe you don’t ever want to face that kind of loss and pain again. No relationships, no pain.”

  Rick nodded. “Yep, I’ve thought of that.”

  “You end up protecting yourself, but the cost is high. You cut yourself off from so much. And let me repeat this: even your quandary of ‘Which activity?’ might lose its power if you put ‘Which people?’ into the equation.”

  “Right. I never think of that. You may have a point, but I think you’ve glossed over my original concern, my devotion to spontaneity. You just writing that off?”

  “No, I’ve been thinking about it the whole time we’ve been talking. I personally treasure spontaneity. I rely on it when I write. I value being pulled by something unexpected and going off into unpredictable directions. In fact, I love that. But I don’t think much of your behavior is now propelled by spontaneity, that is, being pulled by something outside yourself. You’re not being pulled, but, instead, you’re being pushed by some force inside that is trying to escape fear or danger.”

  “Can you translate that into plainer language?”

  “I’ll try. Let me put it this way. I think there is a sense of great danger lurking within you that is corrupting your natural spontaneity. You said yourself that your spontaneity had morphed into a monster. You’re not being pulled by some goal. Instead your actions seem aimed at warding off some internal danger.”

  “What internal danger?”

  “Afraid I’m only going to be repeating myself, but I don’t know how else to say it. The danger is mortality, the danger confronting all of us. It lies in your dealing with the knowledge that if your wife dies, then so shall you. The retirement home, however lovely, is also foreboding, and you experience it as a trap, a final stop, as a prison confining you, and you don’t want to go along with any part of its schedule.”

  I could see him shaking his head ever so slightly. “I’ve never thought of it as a prison. It’s run damn well, and I can leave anytime I choose.”

  I knew I wasn’t getting through. I glanced at my watch. “And speaking of schedules, Rick, we’re up against one today, and I’m afraid our time together is running out. I know you’re left perplexed, but will you think about all I’ve said and get back to me by email and let me know if any of this clicks for you later? My hope is that our session will give you food for thought and help get your therapy unstuck.”

  “I’ll think on it all right. It’s a bit of a jumble now. But I’ll mull on it, and I’ll write. Are you available for another session,
say in a few months, in case I want to repeat this course?”

  “If I’m here, I’ll be glad to see you again.”

  I was tired when Rick left. The session had been a contest, a struggle, and as I thought about it, I never explicitly addressed the paradox of his having made such an effort to see me yet resisting almost everything I offered him. All I can do in one session is to be real, to leap into the patient’s life, to offer observations in the hope that he’ll be able to open doors and explore some new parts of himself in his ongoing therapy. I expected to hear from him, but there was no word for a long time.

  Then four months later, an email arrived indicating that Rick’s therapy had indeed been catalyzed but in an unexpected way.

  Hi, Dr. Y.

  I’m better. You did help me and it’s time to thank you. Since I returned, my therapist has focused full-bore on my competitiveness and why I couldn’t (or wouldn’t) admit to you that you had some good insights during our session. She’s right, and I’ve been reluctant to acknowledge it. So, here’s something I want to confess. When you said that I regarded Fairlawn Oaks as a prison, you were really right on. And I knew it even then when I was with you but I just refused to admit it. Remember my telling you how fascinated I was by that song?

  Well, what I could have shared with you, and didn’t, was that I sang you the lyrics of the second stanza of “Don’t Fence Me In.” I didn’t mention the lines of the first stanza. Here they are:

  Wildcat Kelly, lookin’ mighty pale

  Was standing by the sheriff’s side

  And when that sheriff said, “I’m sending you to jail,”

  Wildcat raised his head and cried

  Oh, give me land, lots of land under starry skies above

  Don’t fence me in . . .

  —Thanks, Rick

  ~ 6 ~

  Show Some Class for Your Kids

  Because I could not stop for Death,

  He kindly stopped for me.

  These opening lines of an Emily Dickinson poem came to mind when a phone call informed me that Astrid had died from a ruptured aneurism. Astrid, dead? Impossible. An unstoppable life force, Astrid had shaken off one crisis and tragedy after another and kept on walking. Such boundless, crackling energy. And now forever quiescent? No, I couldn’t steady that thought in my mind.

  Astrid was a therapist for whom I had served as both a supervisor and a therapist for more than ten years, and we had grown close. When an email from her family announced a ‘life celebration’ for Astrid to be held two weeks later at a local community center, I immediately accepted. On the designated day I dressed in a suit and tie—very rare for me as a committed Californian—and showed up promptly at noon. Along with two hundred other guests, I was greeted with champagne and hors d’oeuvres. No flowers. Nothing black. No tears or long faces. No suits and not a necktie in sight, aside from mine. Soon a small child, probably one of Astrid’s grandchildren, walked through the crowd with a megaphone in hand and announced, “Please take your seats. Ceremony to begin.”

  We then viewed a polished, forty-minute video celebrating Astrid’s life. It took us seamlessly through images of her life. First, as an infant in her father’s arms, she yanked off his spectacles and waved them gleefully. Then, in rapid succession, we saw Astrid’s first steps toward her mother’s outstretched arms, Astrid playing pin the tail on the donkey, Astrid as an adolescent surfing at sunset beach in Hawaii, Astrid at her graduation from Vassar, Astrid as a bride at her most recent marriage celebration (she had married three times), several shots of Astrid pregnant and radiantly smiling, Astrid playing Frisbee with her children, and then the heartbreaking finale that brought tears to my eyes: Astrid gaily waltzing with her six-year-old grandson the evening before her sudden death. When the film ended, we sat silently in darkness. I was sorry when the lights came on because no one knew what to do. One brave, self-confident soul clapped, and soon most of the audience joined in. I found myself longing for a traditional religious ritual, a very rare state of mind for me. I missed the cozy familiar cadence and orderly sequence of events led by clergy and rabbis. What is one supposed to do at a funeral manqué that commences with champagne and hors d’oeuvres and has no place for weeping?

  After some hurried discussion among themselves, her three children and five of her grandchildren strode in a cluster to the microphone, and each in turn, showing remarkable poise, shared remembrances of Astrid. Each was well prepared and well spoken, but I was most fascinated by an eight-year-old granddaughter who described how Grandma Astrid used to invite them to play by creeping silently up behind them and shaking a box of jigsaw puzzle or Scrabble pieces.

  Since this was a life celebration and not a funeral, I was not surprised that there was no mention of her fourth child, Julian, who had been killed by a lightning bolt on a golf course when he was sixteen. But Astrid and I had devoted more than a full year of therapy to dealing with his death.

  Next, many of Astrid’s friends spontaneously rose to take the microphone and share their memories. After two hours, quiet reigned for a few moments, and I expected someone to signal the end of the event. Instead, to my surprise, Astrid’s third and last husband, Wally, rose to address the celebrant-mourners. I was astonished at his composure; I tried to imagine speaking at such an occasion only weeks after my wife’s death and knew I would not be up to it. I would not be able to raise my head to the world. I examined Wally closely. For years I had heard Astrid’s version of him and was now faced with the odd task of superimposing the flesh-and-blood Wally on the image of him Astrid had given me. Every single time I have encountered a patient’s spouse, I have been surprised. Almost without fail I exclaim to myself, Can this possibly be the same person I’ve heard about for so many hours?

  To my surprise, Wally was a stately man and much taller, more handsome, and more graceful than I had expected. And far more present. Astrid had often portrayed him as absent, as a man who, even into his seventies, was wedded to his hedge fund and to his office that he always entered at six am to prepare for the opening bell of the stock market. Absent on weekends also, either sailing or fixing his twenty-seven-foot sloop. Astrid told me she had never set foot on it. I remembered our chuckling together when she told me she got seasick whenever she saw a boat, and I responded that I get seasick even looking at a picture of a boat.

  “Thank you all for coming to say goodbye to our Astrid,” Wally began. “I know there are a lot of her shrink colleagues here, and as you all know, she never tired of teaching. So I’m sure she’d have appreciated my passing on to you a bit of her legacy, her top secret weapon against anxiety: egg salad sandwiches!”

  I cringed. Oh no. Don’t do this, Wally. Dear Astrid dead only ten days and you inflict a Jay Leno imitation on us.

  “When Astrid was a child,” Wally continued unabashed, “and upset about anything—school, argument with friends, boyfriend trouble, you name it—her mother always soothed her with an egg salad sandwich. Just chopped eggs, mayo, celery, and a bit of pimento on toasted white bread. No lettuce. Astrid called it her Valium and claimed it had four and a half times the potency of chicken soup. Whenever I came home late in the evening and walked from the garage through the kitchen, I always took a look at the sink, and if I spotted eggshells there, I braced myself for the worst.”

  I looked around. Smiling faces! Everyone except me was engaged by Wally’s attempts at humor. For a moment I felt very alone, as though I were the only one who seemed to be taking this seriously. Then I reminded myself that I was not the outsider—I was the insider, the one who really knew Astrid.

  Throughout the event, I had vacillated in my feelings. At first, as the speakers described their special contact and their stories about Astrid, I had felt smug about my privileged place in her life. After all, wasn’t I the one who had the inside truth, the one who knew the real Astrid, the authentic Astrid? But as time passed and I listened to speaker af
ter speaker, I wavered. Perhaps my belief in a privileged place in her life was illusory. Yes, she and I had shared that special hour each week for so many years. And I had access to the real stuff—special knowledge of her fears and passions and inner conversations and fantasies and dreams. But was that more real, more true, more privileged than knowing what made her smile? Which folks she liked most? What she liked to eat, her favorite movies, books, shops, yoga poses, music, clouds, magazines, games, snacks, and TV series? The in-jokes with husband and friends, the sexual secrets known only to lovers? I especially wondered if I knew her better than that grandchild who had heard her footsteps as she crept up behind the sofa shaking pieces of a Scrabble game or jigsaw puzzle? Yes, I think it was that grandchild who put me in my place, who made it clear that, though I knew some parts, there was so much of Astrid I never knew.

  I had first met Astrid over ten years earlier, when she asked me to supervise her work with several patients. She was fifty, and though she had been in practice for many years, she always sought to sharpen her skills. She was a delightful student: savvy, empathic, intelligent. For the next two years we met for an hour every other week. The supervision was a pleasure. Rarely had I known a student with such wonderful clinical instincts. But toward the end of our second year, things changed between us when she began to discuss her work with one of her patients, a young man named Roy who was a disorganized alcoholic with whom she became uncharacteristically over-involved. She gave him her home phone and took calls from him at all hours of the day or night; obsessed about him frequently during the day, even while seeing other patients; and allowed him to run up a large bill of several thousand dollars that he would obviously never pay. Once Astrid started discussing Roy, she moved from being student to patient. When it is evident that the student has strong and irrational feelings toward a patient (“countertransference” in the professional jargon), the supervision often must change form.

  There was no mystery about the source of her powerful feelings toward Roy: Astrid had a brother, Martin, six years older than she. He had been her savior during and after their mother’s death from breast cancer, when Astrid was an adolescent. Martin had protected Astrid from their abusive father, and she remembered the car ride home from their mother’s funeral when he put his arm around her, leaned over, and whispered in her ear, “For the rest of your life, Astrid, count on me. I’ll be there for you.” Martin kept his word until he enlisted in the Marines and served in the 1991 Persian Gulf War, from which he returned with Gulf War Syndrome and multi-drug addiction. Though she did her best to be there for him, she was no match for heroin and could not protect him from a fatal overdose in 2005. Astrid never forgave herself for not saving Martin. Her over-involvement with young Roy was only the latest embodiment of her reliving her attempt to save her brother.