I like the way he avoided diagnosis or categorization. I was impressed by her use of therapy: I had never had a patient who had worked as productively. It would be a delicate procedureafter all, people change, and love never staysbut still, perhaps, it is within the realm of possibility. I also wanted support from a colleague. I reminded her that she had originally come to see me to free her mind from her preoccupation, and we had made great strides toward that. Her stutter always annoyed me. The doctor confirms that you do have cancer, and all your turmoil about not knowing is endedbut what are you left with?. My God! I had her attention. Phyllis said all this with such facility that I forgot for a moment the great strain she was under. Was he staging all this for me? In my search for power, I pushed to the limits. I knew he was entirely capable of such gross behaviorand worse. Marvin had applied to his relationship with Phyllis the insights he had obtained from a confrontation with the deep sources of his despair. Three unopened letters -- 9. Penny was frozen. That was the first important discovery I made about Betty: she was desperately isolated, and she survived this isolation only by virtue of the sustaining myth that her intimate life was being lived elsewhere. We settled into a two-month stay in Kuta on Bali in an exotic house that had a high wall around the large lush garden property but no interior walls other than hanging shades. His recovery appeared remarkably solid. Shes a mess, a real sickie, she is. Instead of talking about Chrissies tragedy, she spent the next two hours describing the tragedy of her own life. When, at the next session, I artlessly presented him with my birth certificate, drivers license, and passport, he announced that I had proved him correct: only FBI connections could have produced forgeries so quickly. During her four years of illness, many courses of chemotherapy had prolonged her life but left her, each time, bald and agonizingly ill. Chrissie had had dozens of painful bone marrow extractions and so many bloodlettings that finally there were no more veins to be found. I want to matter, to be important, to be remembered.. . Had I stepped into a trap? Her husband, whom she had met while a student at the university in Mexico, had been a surgeon and was killed in an automobile accident one evening while rushing to the hospital on an emergency call. I looked up in amazement at Marvin, who seemed unmoved and unappreciative of the power of his own creation, and the notion occurred to me that this was not, could not be, his dream. How could she give it up? Only everything was wrong: their dresses were dirty and on backward and inside out. Marie and I endlessly discussed her options. Was he acting as Marvins agent to help me to help Marvin? Thelma, this feeling that the only thing that matters is for Matthew to think well of youtell me everything you know about it., Its hard to put into words. Discussing her fathers death obviously evoked fears of her own death. Betty had heard that her father had really wanted a son and been silently disappointed when she was born. She never even heard them! Brief Summary of Book: Love's Executioner and Other Tales of Psychotherapy by Irvin D. Yalom. Besides, though Nietzsche was a seer in many domains, he was no guide to interpersonal relationshipshas there ever lived a lonelier, more isolated man? She mollified me: Its not you. The Four Gives of Life Actually, that was helpful. Also, she gets a dog, but is forced to put it down as it only holds her back. Perhaps I should have. But I aint going to be around to pick up the pieces., I heard you. Now that youre looking better, Saul, lets go back to work. Afraid of what Id say. Did he feel rejected? Now why, thought I, do her feet not reach the ground? She pronounced the purse medium-sized., Any larger, I responded, and youd need a luggage carrier to move it around., Besides, she said, ignoring my jibe, I need everything in it.. Dave would feel hurt and trapped. The ground under my house was liquefying. But youve got to remember that Im not thinking in a completely logical fashion.. Patienthood is ubiquitous; the assumption of the label is largely arbitrary and often dependent more on cultural, educational, and economic factors than on the severity of pathology. One of the things he said at our first meeting endeared him to me: Im going to be fifty-nine soon, and some day Id like to be able to stroll down Union Street and spend the afternoon window shopping.. I reminded her of the six-month commitment, of which five weeks remained. I panic. She lathered him in the shower, she shaved him, she massaged him, she took his soft penis into her mouth and held it there gently until it throbbed into life. Hes the one person who has ever known everything about me. That means youll be running late all day, doesnt it?. She had first met him twenty years before when they were college classmates in Mexico City. I stared at her. When I asked him what had happened a couple of years ago, he described an episode he had never shared before, not even with Phyllis. A series of distorting prisms block the knowing of the other. We all read books differently and have our own opinions. I was so stimulated by this idea that I could hardly wait until the hour was over so I could think more about it. The shoe is losing its soul, spelled S-O-U-L.. Saul did not know what to do. I hear your anger toward Matthew, but Im also wondering if youre not upset with me, too. Every migraine, its intensity, duration, and treatment, was coded in blue. Love's Executioner, Irvin Yalom . Hed known for a couple of years that he had deadened himself all his life. I could exercise on my stationary bicycle! For those twenty-seven days. Theres a fair chance, I thought, that hes already sent that money and, if so, hes going to get caught in a tangle of lies with me that will really jeopardize our work. Yet he was none of these. He didnt say hello or goodbye to me. I had urged Carlos to differentiate between his core self and other, peripheral attributes or activities. How did they feel about buying a burial plot? And yet, time after time, I have seen this group exercise evoke unexpectedly powerful feelings. To risk placing herself in the situation where she might be obligated to nurse you? ), informed the group of his incurable cancer. He was in one place and you were in another. I didnt even think of asking to walk her to the car!, The things you pick to beat yourself up about! One day when he was alone, he tried it. Of these facts of life, death is the most obvious, most intuitively apparent. Elva and Yalom's mother were similar in personality; hated everything; began counter-transference by separating her from his mother. Everything, Betty replied. Often I look forward all day to a special meal; and, when the craving strikes, no obstacle can block my way to the dim sum restaurant or the gelato stand. But, above all, we talked about her angerabout how it had driven away her family and her friends. Both Sarah and Martha were in a great deal of pain. His emotional tone flattened, his face grew more frozen, he volunteered less and less informationand he lost all humor and sense of proportion. Looking back now on this interchange, I see much sophistry in my words. But if you make any attemptno matter how slightthen our contract is broken, and I will not continue to work with you. Imagine being in therapy for eight years and not talking about the real problem! I didnt mind; in fact, I liked the idea of sitting back and letting the consultant, Mike C., a friend and colleague, do the work. Professionally, he regarded it as a successful consultation. Elva, despite her swollen legs, hustled back into the restaurant to call for help, but of course it was too late. Although impotence had been his explicit reason for choosing to see me, I felt that the real task of therapy was to improve the way he related to others. I dont know what youre getting at. . Her love obsessionwhat else could one call it?was powerful and tenacious, having dominated eight years of her life. When Penny told them that he was not home, one of them ordered her to tell Jim to pay the money he owed or he could forget about coming home: there wouldnt be any house left for him to come home to. 1. Take any part of the dream and let your mind wander with it., What do you make of the white-tipped cane?, Marvin smirked. Two previous wives had obtained enormously generous and uncontested divorce settlements. Far better that he forget what we talked about than the opposite possibility (a more popular choice for patients) to remember precisely what was talked about but to remain unchanged. He keeps tossing me enticing tidbits. Irvin D. Yalom, M.D., is the author of The Schopenhauer Cure, Lying on the Couch, Every Day Gets a Little Closer, and Love's Executioner, as well as several classic textbooks on psychotherapy.. Nor would it be helpfulnow or probably ever. She undressed me and then took off all her clothes.. The three-way meeting had been my idea and I had been the one who stripped her of her illusions, I was the disillusioner. Or the responsibility? I had invaded his two innermost temples: his love for his children and his reincarnation beliefs. Usually she looked upward, as though lost in recollection. And so the hour went. A powerful lady, I thought. He was venturing into such depths that I could scarcely believe I was talking to the same person. Whenever the patient begins to develop symptoms in respect to the relationship with the therapist, therapy has really begun, and inquiry into these symptoms will open the path to the central issues. During these sessions we tried to make sense of what had happened, and mapped out a strategic response to future potential stress. . People forget that we accountants have graphic skills that are never used in tax work. Take your choice, each was told. Each session he described all of his encounters with women that week (often they consisted of nothing more than catching a womans eye in the grocery store) and obsessing about what he might have done in each instance to have consummated a relationship. Ive thought about you every day these eight years. She put me to the test, and I was always found wanting. Then my next patient entered, and I turned my attention to her. Im tempted to read this soon, so thank you! What I meant was that I thought there was a question, a personal question, you might be asking me, something involving you and me., Wouldnt psychiatrists rather treat a thirty-year-old patient than a seventy-year-old patient?, Can we focus on you and me rather than on psychiatry, psychiatrists, and patients? I leave a lot of messages on his telephone- answering tape. Subscribe. I was determined to avoid that role; instead, I placed my faith in the assumption that, if I could help remove the obstacles that lay in her path, Betty would, on her own, take the initiative to care for her body. I am now my mothers age when she died. If the situation demanded itfor example, if family members visited from out of town Phyllis was willing to entertain them in a restaurant: An inexpensive restaurant, since Phyllis hates to spend money. Money was another reason, Marvin added, that she opposed psychotherapy. I remain convinced that a therapists judicious self- disclosure facilitates the course of therapy. Its O.K. . I had long before decided not to take the baitnot to follow her into the hypnoidal statebut instead would call her out of it. Saul was spent and leaned back, exhausted. Occasionally it happens during waking life, sometimes after a personal brush with death, or when a loved one has died; but more commonly death anxiety surfaces in nightmares. The only way that can happen is through voodoo influence. I upped the ante. I suggested that we meet six times and then evaluate whether treatment seemed worthwhile. She, I, anyone, can be struck down at any time. Dr Yalom's case histories are more gripping than 98 percent of the fiction published today, and he has gone to amazing lengths of honesty to depict himself as a realistic flesh-and-blood character: funny, flawed, perverse, and, above all, understanding -- Phillip Lopate I loved Love's Executioner. But suppose it was never a shared experience! Tell me more about what youre struggling with in your life, I asked. New York, N.Y., Basic Books. This possibility occurred to her a couple of years later when, while taking an out-of-town guest sightseeing, she warily entered a gay bar on Castro Street and was astounded to see fifteen Matthews sitting at the barfifteen slim, attractive, neatly mustached young men. Why was the dream a nightmare? I dont do that any more.. I had to proceed with delicacy here because of his fear (which Phyllis obviously shared) that therapists snoop out and fan marital problems, but I had to be certain that she was inexorably opposed to couples therapy. Thelma would have been a seventy-year-old ten pounder at least, and no one, absolutely no one, would have recommended psychotherapy. There were other signs as well that Betty might go no further. My eating is out of control, Betty said, chuckling, and added, You could say my eating is always out of control, but now it is really out of control. He finally got back to sleep and later that night had a dream:There was a statue of a female god on a pedestal in a large crowded room. (My secretary, whose office is immediately next to mine, habitually took prolonged coffee breaks during Pennys therapy hour.). I had often thought about his love letters and had wondered if I would ever get a chance again to explore their meaning with Dave. Would it have been better not to have spoken of the letters and to have let the dream go? He said that would be necessary for my own sanity, and he was certain that it would be best for Thelma as well.. Both Marvin and Phyllis now cared so much for the others growth and being that they could genuinely collaborate in the process of wrenching a symptom from its socket. Neither looked at the time; they silently colluded in pretending that there was nothing unusual about talking personally or sharing coffee or dinner. He seemed upset. While I was considering shifting to a hard, uncomfortable chair, it suddenly occurred to me that when I was in therapy with Rollo May, he used to sit in a straight-backed wooden chair. How excitingto be given another chance, to paint his life all over again on a blank canvas.. They moved from one tenement flat to another, often being evicted for nonpayment of rent. I remember her first words then: I think I need help. I tried the same approach with the letters, expecting that Saul, at my request, would open them immediately. Why is it so necessary for you to entertain me?. But many people never discover the folly of such a search and continue to believe that, given enough information, they can define and explain a person. Dave was talking about something important, he was moved, he had become real, and the other members responded in kind. The overactive therapist often infantilizes the patient: he does not, in Martin Bubers term, guide or help the other to unfold but instead imposes himself upon the other. I stretched to find a way to respond, but still it was less than I wanted to give. His doctors were running out of options: they had given him maximum radiation exposure and had exhausted their pharmacopeia of chemotherapy agents. It was not, as I first thought, that she was mercurial and unable to sustain focus. Now why should that be? His face fell, she reported, when he first caught sight of her, but, to his everlasting credit, he acknowledged that he was indeed George and then behaved like a gentleman throughout dinner. She giggled at my question: Do you believe, Elva, that the more of these you eat, the thinner you will become? A plastic sack of old orange peels (You never know, Elva, when these will come in handy). If youre caught in a dilemma, or have two strong conflicting feelings, then the best thing you can do is to share the dilemma or share both feelings with the patient. She looked depressed, and I went up to her to offer my sympathy. Now quickly, lets pass on to another subject. It did not keep her self-esteem stable but instead fluctuated wildly according to external events. It stands to reason that there is more to be gained in working with, say, a young mother with three children. He had consulted a neurologist, who had been unsuccessful in controlling Marvins headaches and then referred him to me. Furthermore, Thelma, to whom he said he had told this in the past, had listened with rapt attention and offered no demurral whatsoever. Our web pages use cookiesinformation about how you interact with the site. How could it be otherwise? I never had one till six months ago!, And the link between sex and depression?. She took her string purse from her lap, placed it on the floor, and put a lot of energy into her words. It seems clear that the reason youve come to see me is to get help in opening those letters. I was being a little manipulative herehe hadnt quite said that. First breathe deep and fast; then well gradually slow it down. He was smooth. At other times Betty expressed anger at my forcing her to think about morbid topics. Marie reminded me of a beautiful aunt who wore her hair the same way and played a major role in my adolescent sexual fantasies. I want to sink into the embrace of some warm daydream. with you if, from now on in our future sessions, I interrupt and point out when youre entertaining methe moment it occurs?. She was different today, her gait labored, discouraged, dispirited. Which is good. Thus one sheds anxiety but loses oneself. I saw the other men in the group smiling at me. She was down to two hundred forty pounds, then two hundred thirty, and two hundred twenty. Me closed her eyes for a minute or two and, when she opened them, she had vanished and Marge was back, crying and terrified. I asked whether she felt guilty over having given up her children. It would be difficult to make her aware of these characteristics without hurting her. Ultimately she married a sweet, elderly man. In other words, even though his body was imperiled, he himself, his vital essence, was intact. I felt caught. Dave scarcely wondered about the ultimate meaning of his clutch of letters and now, tight and brittle, he would not be receptive to such an inquiry. This book is all the more intriguing for being written by a qualified and experienced psychiatrist. (child loss). What do you think, will you have opened the letters before you send back the fifty thousand dollars?. . I could not blame him for that. Many a friendship or marriage has failed because, instead of relating to, and caring for, one another, one person uses another as a shield against isolation. Then he had to disidentify with the non-core parts: they might represent what he liked, or did, or valuedbut they were not him, not his central being. What made Thelma spend her whole life raking over a long-past love affair? Marvin felt better after our session and was highly optimistic until, a few days later, a curious event occurred. What youre saying doesnt make any sense at all. In one dream she and he wore identification badges and kept switching them with each other. Eight years ago, about a year after I finished my training, I had a serious psychotic break. None of this makes any sense to me. In my many years of work with cancer patients facing imminent death, I have noted two particularly powerful and common methods of allaying fears about death, two beliefs, or delusions, that afford a sense of safety. He hesitated and then said that he had decided to return the fifty-thousand- dollar stipend to the Stockholm Institute! After being hospitalized for a week, she began treatment with an oral surgeon to repair her teeth. You know, Im not trying to conceal anything. Though I was gradually entering her experiential world and growing accustomed to hyperbolic assessments of Matthew, I was truly staggered by her next comment. I keep looking for him when I walk down the street. Well, nothing has changed in the external world. A couple of weeks later, I saw definite signs of a breast, two breasts. My secretary said you sounded desperate. ); and an old mans clinging to yellowing thirty-year-old letters from his dead lover (Do Not Go Gentle). Take this all away. Besides, my questions had a hollow ring. I find them repulsive: their absurd sidewise waddle, their absence of body contourbreasts, laps, buttocks, shoulders, jawlines, cheekbones, everything, everything I like to see in a woman, obscured in an avalanche of flesh. But I was too riled up to talk. I was walking in the fields behind the house. 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. Love's Executioner offers us the humane and extraordinary insight of renowned psychiatrist Irvin D. Yalom into the lives of ten of his patients - and through them into the minds of us all Why was Saul tormented by three unopened letters from Stockholm? Ten? Chicago / Turabian - Author Date Citation (style guide) . The facts are obvious. Mike, obviously pleased with Maries response, turned to his final task. Sometimes Id imagine the blood filling a paper cup. I could bring them in and open them here with you and have you take care of me if I collapse. About thirty minutes before the hour, he called my secretary to inform me that he had thrown out his back and was unable to leave his bed. If she, at the age of sixteen, had kept her two children, she would have been nailed down to the same life her mother had. All this rich reality had been blotted out by my obsession. Love's Executioner is a fiction book based on psychotherapy and the human psyche, written by Irvin D. Yalom, who is a psychotherapist and also the main protagonist (the therapist) among each of the stories. Pain that is always there, whirring continuously just beneath the membrane of life. Ive won, you know.. This should be done on the work of every male therapist IMO. There was no point. Even her last, unfinished homework assignment lay on the desk. It was cold outI could see my breath, and it was hard to walk because the earth was clumped and the plow ridges were frozen. A ghostly, Cheshire cat smile? Despite Matthews high-sounding ethics, I believe I am more honest than he. Generalizing from my experience to hers, I had mistakenly assumed her life to have richness that she was missing because of her obsession. We met thrice weekly during this time, and I attempted to help her understand the source of her tears. But now what did she have to show for the past twenty years? I dont want to get closer to them.. It reminds me of the strong feeling youve often expressed of never belonging anywhere. I had always before imagined women sitting on Mount Olympus with a line of men before them and sorting them outthis one to my bedroom, this one not! Where do you think we should start today?. Then, without waiting for any comment from me and without unbuttoning the heavy jacket she wore over her jogging suit, she took a sharp deep breath and began: Eight years ago I had a love affair with my therapist. I had often wondered about the strength of my attraction. Saul, nothings going to happen to you. Though she continued to take it, it had not helped her: she was deeply depressed, cried every evening, wished she were dead, slept fitfully, and always awoke by four or five a.m. She moped around the house and on Sundays, her day off, never dressed and spent the day eating sweets in front of the television set. Thats what good accountants get paid for.