It appears that the therapist successfully employed a pragmatic symptom- oriented treatment plan designed to offer relief rather than deep insight or personality change. Exactly whats happened to you? She put her head between her knees, breathed deeply, and slowly regained her composure. Carlos readily agreed to meet with me. My connection with him felt tentative. After your suicide attempt, I knew I had to be very careful with what I said, and thats why I became so distant. MIUC catalog Details for: Love's executioner and other tales of So I was pleased with his being able to take a more forceful stand toward me. Believe me, I swear it, in the last meeting I was the only honest person in the group. To believe that nothing in life is more important than that he think well of you?, I dont really believe hes trying to drive me to suicide. The feeding technique was to repeat one standard question, Marge, what would she say if she were here?, Some of Marges answers were unexpected, some familiar. More than thatI thought her quest for happiness was my quest as well. I havent forgiven you for preventing me from dating her. When he had first started the group six weeks ago, he talked at great length about his infatuation with Sarahor rather with her breastsand was convinced she would be willing to go out with him. I, too, sank back in my chair and took stock of the situation. But could I relate to Betty? Im interested in the problem youre struggling with, and I think I can help you. . At times I thought of our work as cannibalistic. Its the price of admission to self-awareness.). Ten? Could Matthew release you? Nothing to do but live out my time.. Whose death will make me truly dead? But, above all, we talked about her angerabout how it had driven away her family and her friends. But I had never known the real, the secret Jay; and, after his confession, I had to reconstruct my image of him and assign new meanings to past experiences. These changes all signified that we were making progress: we were successfully addressing Bettys isolation and her hunger for closeness. Its always possible, if you want to torment yourself, to find someone to compare yourself with unfavorably. Dave had responded well to this approach and made impressive attempts to share with his wife more of his life and internal experience. Or is it that you want me to visit you at home and help open them there? I suspected I would have cause to regret this crude pressure, but I couldnt stop myself. Barnes, of course, never captured the quintessence of the man, Flaubert, and ultimately set a more modest task for himself. I told her that I had read an alumni bulletin and noted that six persons in my college class have died. I had to be sure I really knew. Where was his curiosity that his life had changed so dramatically, that his sense of direction, his happiness, even his desire to live was now entirely dictated by whether he could sustain tumescence in his penis? . Our sessions had become the most important thing in her life. I was afraid to go farther. Saul handed me the brief handwritten note from the dead Dr. K.:Dear Professor C.. Im planning a trip to the United States, my first in twelve years. The collection of ten absorbing tales by master psychotherapist Irvin D. Yalom uncovers the mysteries, frustrations, pathos, and humor at the heart of the therapeutic encounter. Was it possible that she knew all this from the start and had concealed it from me? Also, just comes off as self-satisfied; it made the reading distasteful, and I didn't finish in the end. Theyve nothing to do with reality! I lack the capacity to make friends. Existence pain. Then peoples heads kept getting in the way of the screen. In general, its best not to undermine a defense unless it is creating more problems than solutions, and unless one has something better to offer in its stead. Shortly afterward, at a party, I met a young man who had just returned from the Stockholm Institute. Touch! Marge is a creep. The first letter was from a Stockholm Institute postdoctoral fellow asking Saul to write a letter supporting his application for a junior faculty position at an American university. I didnt think so: her body contour, from chin to toes, had always been smoothly globular. She began to shed bulk. When I finally got a beat, Id start to wonder whether it was coming from my radial artery or from the tiny arterioles in my fingers squeezing my wrist. Lets try to turn this into a learning experience for him. I could have used that to keep punishing youin fact, I know Ive done that with shrinks in the past. He didnt seem to understand, we talked past each other, he had no interest in the inner meaning of events. I have a hunch thats one of the reasons she wouldnt come into therapy when we startedin other words, she picked up your wish that she not change. How is it possible for retirement not to evoke deep feelings about the passage and passing of life, about the meaning and significance of ones entire life project? love's executioner two smiles summary Penny devoted so much energy and attention to Chrissie that her marriage deteriorated, and her husband left for good about two years before. Ill have to think about it. Despite Daves jocularity, it was apparent he was dealing with very painful material. How would it go? I dont rely on role-playing or chair-switching, but this seemed the perfect place for it. Marvin was beginning to astonish me. Maries father, who lived in Mexico, had grown so frail that she contemplated inviting him to come to live with her. Despite her two hundred and fifty pounds, Betty and I had rarely discussed her eating and her weight. That idea really hit home. Ethical Considerations on Love's Executioner and Other Tales of I tried to stay away, tried to tell you to quit calling, andIll be honestit annoyed me that you wouldnt. Maybe thats part of the reason you feel empty inside. But the moment Saul arrived at the Stockholm Research Institute, the moment he was greeted by Dr. K., he felt strangely convinced that his goal was within his grasp, that there was hope for some final peace. We turned away from Pennys relationship with her sons and ex-husband and began to consider another important characteristic of parental bereavementthe loss of meaning in life. An obvious defense against sexuality, they occurred when there was a sexual threat from without or within. Of course, his isolation was his own doing, but was I going to help him to recognize or to change that? I only know that I pulled out all stops and placed the utmost pressure on her to reconsider. Although I was less engaged with him than in the past, I was doing what therapists are traditionally supposed to do: I illuminated patterns and meanings; I helped Saul understand why the letters struck him as so fateful, how they not only represented some current professional misfortune but symbolized a lifetimes search for acceptance and approval. Harry, no less than Thelma, chose to embrace illusion. Of course, I have my rationalizations. But at the moment they felt compelling and profound. Published in 1989, Love's Executioner is one of Yalom's collections of case studies. How dare they impose that body on the rest of us? She walked back to her chair and sat down. Of these facts of life, death is the most obvious, most intuitively apparent. After her father died when she was eight, her mother had moved her and her sisters from apartment to apartment at least twenty times, often staying for only two or three months until they were evicted for not paying the rent. I inquired about the precise content of her daydreams, and Thelma seemed to enjoy talking about them. 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. This dissociative process is unconscious, invisible to us, but we can be convinced of its existence in those rare episodes when the machinery of denial fails and death anxiety breaks through in full force. I felt strongly that Thelmas fear of aging and death fueled her obsession. My son earns two thousand dollars for a coronary bypass, and often does two a day. Excellent. He will never forgive me for it., But, Thelma, hes a therapist. So far, by addressing her isolation, I had already cleared away major obstacles: Bettys depression had lifted; and, having established a social life for herself, she no longer regarded food as her sole source of satisfaction. Betty spent several minutes explaining why she wouldnt go to the movies alone. Im afraid that, if I form friends here and start to like it, I might not want to leave. The ability to be hypnotized is simply a trait someone is born with. Her purse was stolen, which she believed would never happen because she perceived that the late Frank protected her. He said he had a bad back, but I knew him well for many years afterward and never heard him mention back trouble. Dont choose my wife on the one day in her life when shes being feted. ISBN-13: 9780465020119 . Perhaps, if she confronted this contradiction, she could start grieving again. Dont take away the only real thing that has ever happened to me. Who could bear to do that to anyone, much less a depressed, suicidal, seventy-year-old woman? A lover of words (he spoke several languages), he marveled at the transposition of soul and sole. Perhaps the letters might give me additional leverage. And he will proceed to lay out counter arguments to himself better articulated than you ever could have. I did not want Pennys guilt, so recently pried loose, to discover her great neglect of her boys and attach itself to this new object. As I thought about the words shed put in Matthews mouth, I could easily understand their appeal and why she had no doubt replayed them so often: they confirmed her view of reality, they absolved Matthew of any responsibility (after all, it was his shrink who advised him to be silent), and they confirmed that there was nothing wrong with her or incongruous about their relationship; it was only that Matthew had a greater obligation to another. Brief Summary of Book: Love's Executioner and Other Tales of Psychotherapy by Irvin D. Yalom. She had an impressive repertory of distancing operations. Not Feminist. Besides, I felt I had to accept the letters. He suggested that she imagine herself in the dentists chair getting an injection of novocaine. Suppose Dave did die on me? Dr. Z. desisted only when she told him that she was disgusted by him, that he was the last man in the world with whom she would have an affair, and that she would inform his wife, a formidable woman, if he continued to harass her. My secretary said she always could tell by my smile that I had seen Elva that day. Take your choice, each was told. I was fascinated with the idea of release. But Elmer loomed as a major barrier between Marie and her new life. Dave teased and joked about it but adamantly refused to state his age: he would not jeopardize his chances of scoring with one of the women in the group. Its a hell of a lot tougher facing something that threatens your life right now than something that happened a year or two ago. is a 70-year-old married Caucasian woman who, as a result of a five-month, once-weekly course of therapy, improved significantly. Some of the topics shook me up, they apply more to me than to him., For example, regret. Saul, weve got to start out on the same trusting footing we had before. She went on a liquid Optifast diet, ate no solid food, bicycled forty minutes every morning, walked three miles every afternoon, and bowled and square-danced once a week. Had Betty not known that her time in therapy was limited, she might, for example, have taken far longer to achieve the inner resolve she needed to begin her weight loss. We were both on the edge of our chairs when the clock said we had to finish. 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. I would be brilliant. Since guilt seemed to be the primary problem, I set about, for the rest of the two-hour interview, learning as much as possible about Pennys guilt. In a couple of minutes, I could get my pulse up to one hundred twenty. She retreated to bed for entire weekends; she had long crying jags; suicide suddenly seemed appealing again. For ten years the tumor had responded well to treatment but now had invaded his lungs and was encroaching upon his heart. For an instant I was alarmed because I thought she would walk out. Love's executioner (2000 edition) | Open Library What does running wild mean? They chose that part of the dreamthe theme of secrecythat was most relevant to the way Dave related to them, and they whacked away at it beautifully. Show me the parent who could have done otherwise. No matter that the cataclysm she meant for me would engulf her as well: in fact, her sadomasochistic trends were so pronounced that she was attracted by the idea of dual immolation. Take this all away. It was not difficult to lay out before her the ways she avoided life: her reluctance to engage others (because she dreaded separation); her overeating and obesity, which had resulted in her being left out of so much life; her avoidance of the present moment by slipping quickly into the past or the future. There was no way that she could deal with my revelation of negative feelings. Also, that figure includes abstracts, book reviews, and chaptersalmost no original stuff.), Instead, I said (and could do so with the ring of authority since I was talking about myself as well as him), Thats what you meant when you said that these letters have been pursuing you all your life! This business of comparing yourself unfavorably to others is always self-destructive. Still, I wanted him to know about the damage he had done. Would someone like Dr. K. write a letter to the journal belittling me? I replay in my mind each of our meetings together during those twenty-seven days. Only one thing had been changed: Penny took Chrissies bed into her own room and slept on it every night. Marge couldnt answer this question at first, but she showed interest in it. For one thing Carlos had, months before, only half jokingly told Betty he was going to take her to Hawaii for a weekend when she had lost a hundred pounds. According to her mother (Betty told me she had no recollection of this), she was reassured by her parents that only old people die, but then she pestered them for weeks by chanting she didnt want to grow old and by repeatedly asking her parents how old they were. For several minutes she sobbed and then finally talked about what had happened. He had been Charless dog, and a bit of Charles still lived through Elmer. Love's Executioner Irvin D. Yalom, MD He didnt let me get away with anything. During this time, Carlos was particularly helpful. You havent yet talked about having cancer. (I had been urging Carlos to reveal to the group that he had cancer, but he was procrastinating: he said he was afraid hed be pitied, and didnt want to sabotage his sexual chances with the women members. This book is all the more intriguing for being written by a qualified and experienced psychiatrist. Betty and I had talked about her father before but never with such intensity and depth. She had heard nothing from him since. But that moment, Carlos continued, I had a vision of their naked hearts. Obviously, Thelma was responsible for her own life predicament. Both Sarah and Martha were in a great deal of pain. You created it, what do you make of it? Precisely what part of it was frightening?, As I think about it now, the last thingputting the cane in the babys vaginais the horrible part. You were going to say something else, Phyllis?, Well, this is the hardest thing to say. Precisely six months after her chance meeting with Matthew in Union Square, she left a goodbye note to her husband, Harry, who was out of town for the week, waited until his goodnight phone call from the East Coast, took the phone off the hook, swallowed all the tablets, and went to bed. She added that she had a lot of friends, but no one knew her. Though we may falter, grow ill, though we may arrive at the very edge of life, there is, we are convinced, a looming, omnipotent servant who will always bring us back. She had told me she was thirty-five, a lab technician; that she had been in therapy for ten years with a psychiatrist who had just relocated to another city; that she was desperately alone; and that sooner or later, it was just a matter of time, she would kill herself. I have a lot of respect for Stanford University. You talk about having done nothing, having accomplished nothing, not being fit to exist, but we both know that these ideas are a state of mind. Number four, this is going to put him in a very compromising and embarrassing position professionally. I couldnt go any farther, but it was too narrow to turn around and go back. Controversy has always existed among psychiatrists and psychologists about the validity of personality diagnosis. Ive been thinking a lot about telling you. I saw the other men in the group smiling at me. Remember that every time youve sunk into a depression, youve climbed out again. I had promised myself to Marge. Her love obsessionwhat else could one call it?was powerful and tenacious, having dominated eight years of her life. Then when you almost killed yourself, I knewand my therapist agreedthat the best thing was to cut it off completely.. Its not too much to askwhen we walked in Golden Gate Park, he almost sprained his ankle trying to avoid disturbing an anthill. At sixteen? Almost like shell find out about it., You give her a lot of power. Besides, though Nietzsche was a seer in many domains, he was no guide to interpersonal relationshipshas there ever lived a lonelier, more isolated man? I thought of one old regular patient on my rounds, a diabetic who had both legs amputated. I want to make it through our last session next week with you still having respect for me., How do I know? Her voice became louder, her tone more self- accusatory. Counter-transference - irrational feelings the therapist has toward the patient? Perhaps this was a ploy to manipulate me into seeing him in individual therapy. Her tight shoulders relaxed, her face loosened, her head turned ever so slightly toward me. At this point she started to sob. Thank you for sharing your thoughts James. She had made it clear that she would not commit herself to long-term treatment; and, besides, I thought that I should know within six months whether I could help her. The hypnosis helped her to tolerate the pain until, after three months, her fractured jaw had healed, her dental work had been completed, and the facial pain had subsided. It means shes been reborn into another life., No. The course and the exam is over. Sharing something about my wife was doing something for Marge, giving her a gift. I make an appointment to meet my son after the deadline. I sat there and wondered, Now what do I do? But my instincts luckily led me to what proved to be an inspired gambit. There were several reasons. You havent seen him for eight years. You shake your head no almost instantaneously. I didnt know what Marvin would do, nor did I know how else to help. No sense of spending good money and sitting here and lying to you. And so, for better or worse, I decided to focus sharply upon the letters and to get them opened in one or, at the most, two sessions. His questions jarred me. I answered her calls at first, but they kept coming. A slide with a head in it obstructs the view. The singles world is impossible for obese people. I want to hear every detail.. We had a good talk., God, I dont know. You want me to go on? What a story there was behind Maries relationship with him! In one meeting when one of the women members pressed him to tell his age, Dave offered an exchange: his secret, his age, for her home telephone number. What is Yalom's primary clinical assumption? ), Perhaps we might have forestalled his departure, but I doubt it. She came to see me to escape becoming crazy. That would have been treating her like an equal.). Medication had been of no value and it was to relieve the pain that I had suggested a hypnotic consultation. The head in the slidemy head, my vision, my memorygets in the way. I thought psychiatrists werent supposed to give direct advice. I was certain that I, even in my impatience, would act in Sauls best interests. Set a reasonable goalyou can do this as well as I. My answer soothed Thelma. "If Rape Were Legal." 3. She called and arranged to go out to dinner with a man named George, who asked her to wear a rose in her hair and to meet him in the bar of a local restaurant. He was now crossing that critical boundary that separates the troubled, suffering, anxious person from the psychotic. He must have followed her into the parking lot and, his footsteps muffled by the roaring of the waves, sprinted up and, without breaking stride, ripped her purse away and leaped into his nearby car. And if I eradicated the illusion, then I had to be prepared to encounter the despair it had concealed. By now I had become accustomed to her bringing up a new concern almost every hour. But its your dream, Marvin. Perhaps she was right in saying that a little more treatment would kill the patient! All in all, I deserved Thelma and Harrys criticism. 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. When Marvins periodic impotence began, Phyllis had at first shown great understanding and patience but, during the last couple of months, had become irritable. Thelmas life was saved only by heroic medical efforts. In part she cried because of her loss, but in large part because she considered her fathers life to have been such a tragedy: he never obtained the education he wanted (or that she wanted for him), and he died just before he retired and never enjoyed the years of leisure for which he had longed. This moment, this brief interval between obsessions, was the crucial time for us to workbefore Thelma re- established her equilibrium by latching onto something or someone. Required fields are marked *. Would it help Dave to see that image? But the interesting thing is that all the side effects are greater today. Phyllis wants you out of their lives. Well, why not? You look uncomfortable. Its O.K. You may not realize it, but the mere fact that Im here today, in a psychiatrists office, talking about myself is in itself a big, big, step..