The dream (recorded verbatim by a student observer):Death is all around me. One patient of mine, a particularly attentive wife, hardly left her husbands side for weeks during his final hospitalization, but tormented herself for years because he had died during the few minutes she had gone out to buy a newspaper. But then, in my naivet, I thought it outrageous, unnatural, something that had to be put right. But there is timing and judgment. This was the time, I thought, to open it wide, to debride it, and to allow it to heal straight and true. Ill tell you the truth, if rape were legal, Id do itonce in a while.. Maybe so, Ill admit that. ), Well, I can think of at least two reasons. Love's executioner and other tales of psychotherapy . Well go over them next week.. If I were to write my summary of that hour, I would stucture it around two particularly real moments: the two times Marie and Mike locked gazes and she smiled and nodded. She told me later it was the first spontaneous act from Herr Doctor Professor (so that was my nickname! Tears were streaming down her face and onto her denim skirt. I personally feel shocked. At first he was eager to see, but soon enthusiasm gave way to a powerful sense of regret. I have found reading this book very edifying and useful in my own practice. He ventured farther than his supply lines could reach, and now was assailed from all sides: the past was dusky and irretrievable; the future, blocked. None of this makes any sense to me. " " . To be dead! Rent or Buy Love's Executioner - 9780060958343 by Yalom, Irvin D. for as low as $1.64 at eCampus.com. How to help you see this is guilt without a crime?, My crime is misrepresentation. Those images kept drifting back into his mind especially the image of the gaunt Victorian undertaker or temperance worker. I thought it was odd that he accompanied her that day. Marie and I endlessly discussed her options. Whats the risk? Sarah, would you sit down and tell me about it? The envelope was identical to the first. Now, some of my associates are killing themselves piling up enough money so they can live on their interests interest. Marvin and the dreamer had fused, and I spoke to them now as to a single person. 2022; June; 9; love's executioner two smiles summary; love's executioner two smiles summary People in California had their own tight cliques and did not welcome strangers. When I was a child, one of my favorite booksI used to take it to Lincoln Park in Washington, D.C., to read on the benches therewas. Often, within minutes, the room rocks with emotion. Published in 1989, Love's Executioner is one of Yalom's collections of case studies. But youre right. We know about death, intellectually we know the facts, but wethat is, the unconscious portion of the mind that protects us from overwhelming anxietyhave split off, or dissociated, the terror associated with death. For the last year I have been having violent mood swings. I stretched to find a way to respond, but still it was less than I wanted to give. His fantasy about Ruth allowed him to feel that he could still be touched and cared for by another human. I reinforced their new, more open mode of communication and instructed them in some fundamentals of sexual functioning: how Phyllis could help Marvin sustain his erection; how she could help him avoid premature ejaculation; how Marvin could approach sex less mechanically; and how he could, if he lost his erection, bring Phyllis to orgasm manually or orally. Supplemental Materials. I once saw a newspaper cartoon of a pudgy lost little man saying, Suddenly, one day in your forties or fifties, everything becomes clear. Could she feel the difference? It was as though I wasnt there, or at least the part of me that hurts and pulls me down. It arrived about ten days after the second. We continued to meet, but there seemed less and less to talk about; and finally, several months later, we agreed that our work had come to an end. Share to Twitter . Without him there, I was next in line. Betty hunched up her shoulders and shuddered. Betty spent several minutes explaining why she wouldnt go to the movies alone. Id like to include California in my itinerary, provided that youll be in residence and be willing to see me. Marie was of Spanish descent and had emigrated from Mexico City eighteen years before. I was pondering whether onions really do have a lot of sugar when I arrived at Sauls home. What sort of resolutions? No real need for my question, since Thelma had been on the verge of describing the resolutions, but I had to have some exchange with her. Marie and he locked gazes for a moment. No, a therapist helps a patient not by sifting through the past but by being lovingly present with that person; by being trustworthy, interested; and by believing that their joint activity will ultimately be redemptive and healing. While vast research programs seek to decipher electrical and biochemical activity of the brain, each persons flow of experience is so complex that it will forever outdistance new eavesdropping technology. (child loss). The symptoms were those of classical migraine: a premonitory visual aura (flashing lights) and a unilateral distribution of excruciating pain which incapacited him for hours and often necessitated bedrest in a darkened room. I knew that Thelma would take the rest of the hour spinning obsessional webs. Freedom as a given seems the very antithesis of death. 3. I was less bored now. How? It was in Bali that I began to write in earnest. I must assume that knowing is better than not knowing, venturing than not venturing; and that magic and illusion, however rich, however alluring, ultimately weaken the human spirit. Perhaps it was simply that I was flattered to be the sole confidant and protector of this regal woman. Why is it so necessary for you to entertain me?. Why do you surrender your power to Matthew? A beginners errorbut I could not suppress my astonishment. He was an extraordinary patient; and ever since I had started seeing him a few months earlier, I thought about him far more than the one or two hours a week I spent in his presence. Thats your depression talking, Marge, not you. Yet, even at the point of death, the willingness of another to be fully present may penetrate the isolation. She has her whole life ahead of her, and her improved mental condition would benefit her children and her childrens children., I persisted. No commitment - cancel anytime. Feeding him? I have often made symbolically equivalent substitutes for aspects of a patients identity and life circumstances; occasionally I have grafted part of another patients identity onto the protagonist. This textbook emphatically stresses "the therapist's job is not to make someone better, but to help the patient make themselves better." These messages from the dreamer drummed louder and louder. Good Lord, what had I gotten myself into? 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. I knew you hadnt told him about Elmerotherwise, he wouldnt have picked a dog to illustrate his talk., Well, its hard to say all this. 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. In reality, they had had a strictly professional relationship which had in no way splashed over the formal patient-therapist boundary. She dreaded the end of therapy for several reasons: naturally she would miss my professional guidance, and she would miss me personallyafter all, she had never before been willing to trust and to accept help from a man. Another one of Marges late-night phone calls! Therapist and patient conspire to pretend that theirs is a monogamous relationship. I had satisfied myself that the symbolic meaning of retirementthe existential anxiety underlying this important life markerwas sufficient explanation for the onset of his symptoms. Look at all the limp excuses he gave her for leaving the house each week to attend the group (he was retired and had no ongoing business outside the house). What a time to stopin the midst of work on important issues and with Betty still camped outside the one-hundred-fifty-pound roadblock! Pain that is always there, whirring continuously just beneath the membrane of life. We are really talking now. Nothing was going right in her life. I wished I had a brown paper bag for him to breathe into but, lacking that old folk remedy (as good as any other for counteracting hyperventilation), I tried to talk him down. Books published by Basic Books are available at special discounts for bulk purchases in the United States by corporations, institutions, and other organizations. (The dream interpretative work was successful, but the patient died. Its the only thing he can say., Matthew did his best, but communication was difficult because of her sobbing. Then the elevator crashed, killing all the passengers, and she was left sifting through his remains. Next, I was trying to get into the window of a room where her body might be. Now was the time we could address the underlying sense of emptiness and futility that had fueled the obsession. I retreated to fact gathering. A few hours later, the police found her empty purse dangling on a roadside bush. Ill talk all right! I, for my part, had reservations because I was so pessimistic about treatment: I agreed to work with him because I saw no other viable therapy option. And YES, agreed tired of the binary male/female authors category, there should be feminist reviews of all books! She really wasnt there for her. I was startled, when I looked into the face of that dancer, to meet Thelmas large eyes peering out at me across the decades. Her death, Penny said, was awfulI couldnt imagine how awful. His search was so frantic, his need so pressing, that he defeated himself. No fatenot even having me for a son-in- lawwas worse than having a spinster daughter.. I had no distractions (in those halcyon days before e-mail) and have never written better or more quickly. As I reread the book now, I am reminded once again that she was absolutely right. He seemed pasted to the surface of things. He was the only man, the only person, who told me he loved me. Marvin simply took her hand. Arent all men? We had only just begun our first session, and there was much more I wanted to know before I would feel ready to examine Marvins chart. She did lack the capacity to be close to others. Two years later, his older brother received a postcard from their father saying he was alive and well and was sure the family was better off without him. I called back immediately but reached only his answering machine. He hadnt anticipated this. If I multiplied every sign of stress by ten, I would have it: his willingness to pay fifty thousand dollars; his morbid, suicidal ruminations (he had made a serious suicide attempt five years before); his anorexia; his insomnia; his request to see me sooner. After a few minutes he tried to continue. Then I folded the letter and jammed it into my rear trouser pocket. She turned and smiled, and we looked tenderly at each other. I could only imagine the perplexity on Dr. K.s face when reading Sauls long letter defending himself against charges he, Dr. K., had never made. While Dr. K. had never won a Nobel Prize (though had been, it was well known, runner-up on two occasions), he was unquestionably made of the stuff from which laureates come. I work at it. I was particularly touched by the female characters of Thelma and Penny. Is it your plan to send that letter before opening the three letters? I hated the thought of Saul ruining his career with some foolish action. And yet every time I talk about whats happened, I have a miserable week. love's executioner two smiles summary. I thought about Thelmas speculation that he was gay. Thelma leaned over, opened her purse and pulled out a newspaper clipping about murder. Her life, such as it was, she said, was in New York, but to request a transfer now would doom her career, which was already in jeopardy because of her unpopularity with co- workers. Describe Carlos's sex life when he came to Yalom. I know this, Dr. K. knows it now, and if you knew something about neurobiology, youd know it, too. Penny was a survivor. Obviously, the foundation was in place for major oedipal problems in Marvins relations with women. They did know that he was growing deeply depressed and seemed to have no one to whom he could turn for support. All your life youve worked. So far it was apparent that Thelmas love for Matthew was, in reality, something else perhaps an escape, a shield against aging and isolation. Touch! Twenty-four hours later she was sitting opposite me. I colluded with him in the fiction about his back injury. The two of you cant help one another with this because it was not a shared state. Matthew turned back to me and, until he finished his story, did not again look at Thelma. I felt pleased with our work but was not deluded into thinking that she had finished therapy, nor was I surprised, as our final session approached, to see a recrudescence of her old symptoms. What about Elva, Yalom's mother, and counter-transference? Since then the leitmotif in his life had been a ceaseless search for home, affection, and approval. If, after all, the problem lies out there, then why should one change oneself? I was certain that I, even in my impatience, would act in Sauls best interests. It was only when he started acting professionally, when he went back into a formal role, that he hurt me. Somehow, Marge said, our last hour turned things around. In fact, just asking the question, What helped in the past? was helpful because it assured me that there was a way I could get better. I had turned, now, in treatment to a consideration of unconscious motivation. I got scared and kept saying over and over, I only wanted the trim painted.. I am surprised that the food is so good. After three or four weeks my hallucinations returned, and I had to re-enter the hospitalthis time for six weeks. He freely offered the names of hospitals and his treating physicians if I should want to call. Was it good to forget? Some people are wish-blocked, knowing neither what they feel nor what they want. No answer. I even added that, though there was a chance that talking might help, it was also possible that talking might be temporarily unsettling. Hypnosis works for stupid people or people with weak wills. Should I remove my shoes and tiptoe aboutall shrinks have a bit of the sleuth in them till I found them, rip them open, and restore Saul to sanity with their contents? I have found that the memory loss that no one escapes has some advantages. Can you see how impossible it would be for each of you to re-create the particular mental state you were in? As a result of her discontent, our time together became ungratifying for me as well. I was entirely satisfied with my words: I had covered myself and had been clear enough to prevent any misunderstandings. That sense of specialness, of being charmed, of being the exception, of being eternally protectedall those self-deceptions that had served her so well suddenly lost their persuasiveness. Now he realized where this discussion was leading, and began to perspire. What about Yalom, Marvin, and vorbeireden? Nonetheless, it was with regret that I passed up the opportunity of working in depth with him: the dynamics of his situation fascinated me. I said, Marge, and was about to utter the rest of the sentence, Will you please come back? when I heard a strange and powerful voice come out of her mouth: You dont know me.. No one could have guessed that she felt her life was over; that she was desperately lonely; that she wept every night; that in the seven years since her husband died, she had not once had a relationship, even a personal conversation, with a man. Her fatty casing began to disintegrate. A year ago when I first accepted Marge as a patient, I knew thered be calls; as soon as I saw her, I sensed what was in store for me. My psychiatrist finally advised me to sever all contact, to be totally silent. ), Everyone, no one more than I, did a great deal of self-questioning. Ive had some difficulties with sexnot as bad as nowwhich caused me to flip back and forth in my moods for twenty years. I knew I was taking a risk. Susan Jennings? (We are all stuck with some anxiousness about death. What are they teaching you in medical school nowadays?. Love's Executioner 2. I had turned the Buddhist doctrines into a real craziness and believed I was in a state of oneness with everybody. Suddenly she began again, like a key-wound mechanical toy that still had one remaining spasm of energy: You tell me to be patient. I wasnt so sure. 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. 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. It was time to face the truth: I had botched this case beyond belief, and I could not transfer blame to the patient, or her husband, or the human condition. I inquired about the precise content of her daydreams, and Thelma seemed to enjoy talking about them. Over the first ten weeks I learned that, if we analyzed her feelings toward Matthew, her obsession tormented her for the next week. Once, for example, when I inquired about why she had become inactive in her therapy group, she simply glared and refused to answer. I envied their ability to pronounce, You are forgiven. What therapeutic power! I had not anticipated such tenacity. Over the next several months of therapy, I continued faithful to Marge. . Why dont you believe him?, Hes saying that because he has to. Itll be difficult to dislodge it. I had never seen him look worse. As I walked through Sauls house on my way to his bedroom, I glanced around trying to locate that desk in which they were stored. Besides, though Nietzsche was a seer in many domains, he was no guide to interpersonal relationshipshas there ever lived a lonelier, more isolated man? Our web pages use cookiesinformation about how you interact with the site. You are highly threatening to both of them. And theres one additional bonus to aging: reading your own work can be more exciting! In recounting his patients' dilemmas, Yalom not only gives us a rare and enthralling glimpse into their personal desires and motivations but also tells us his own story as he struggles to reconcile his all-too human responses with his sensibility as a psychiatrist. When we started I personally didnt feel comfortable with obese people, In unusually feisty terms, Betty interrupted me. It was time now to make a recommendation to Marvin about treatment. Its past. Im not sure youll be there for me. In the group, he had participated in many dramas but always against the horizon of what he might get from me. so . You look better, you relate better, you are so much more approachable and available now.. Perhaps she was right in saying that a little more treatment would kill the patient! All in all, I deserved Thelma and Harrys criticism. These words were said quickly, but the cadence slowed for the last sentence. Table of Contents. How could Penny overcome her grief when Jeff refused even to talk about Chrissie; when (and this had initiated a dreadful row) he refused, six months after her death, to attend the graduation of Chrissies junior high school class? After a minute or a minute and a half (a long silence in therapy), Thelma stood up, offered me her hand, and said, You have my promise.. We sat in silence together. "Four givens are particularly relevant for psycho-therapy: the inevitability of death for each of us and for those we love; the freedom to make our lives as we will; our ultimate aloneness; and, finally, the absence of any obvious meaning or sense to life." Irvin D. Yalom, quote from Love's Executioner: & Other Tales of Psychotherapy It didnt take much experience to recognize the signs of deep distress. I remember that Matthew encouraged Thelma to ask more questions. 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. What about Marge's self-hatred and her stuttering? And so it went: the entire hour with her was an exercise of my sweeping from my mind one derogatory thought after another in order to offer her my full attention. I first obtained Marvins agreement to help Phyllis overcome her phobia by promising to follow any suggestions I gave him. Indeed, Marvin reinforced that whimsical notion. I fumbled for words of comfort. Not only was our initial, tentative cocktail chatter indefinitely prolonged, but I had a strong sense that, even when we got past this stage, we would remain fused to the surface of thingsthat as long as Betty and I met, we were doomed to talk about pounds, diets, petty work grievances, and the reasons she did not join an aerobics class. Although he brought up details of his sexual life, he expressed no embarrassment, self- consciousness, or, for that matter, any deeper feelings. She usually knew what was going on in my life, but shed want to know about her friends and her brothers. I think Ive been staying just ahead of them for sixty-three years. But, to my amazement, the session proceeded well. Of course, I never explicitly expressed these sentiments. She put me to the test, and I was always found wanting. But what I really disliked about Elva was her anger. Or the Thelma who was deceived by herself? Listen to what shes telling you.. Second, he remembered my warning to him, the first time we met, that there were going to be times in therapy when he would feel worse; he trusted my word that his current anxiety was a stage in therapy and would ultimately pass. . I sighed even more deeply. No, we were not off to a good start. So Marvin disrupted the pace of the hour. That means youll be running late all day, doesnt it?. Spare me any more psychiatrists home photos!. A creep! Was I so rigid, in such a rut that if the first hour didnt proceed just the way I wished it to, I grew cranky and stomped my feet? I heard a small child crying below in the darkness, calling for help. He had no genuine care for Thelma, for the flesh-and-blood Thelma! But what? Now, unexpectedly, he had broken out and casually rejoined me. He then proceeded to summarize the events of his life since we had last met. I never saw Blush (or Brazen) again. Heady stuff! She didnt make friends easily, she pointed out: no obese woman does. I know that it cant be done, and I try to tell them but they cant hear me. Two weeks ago we had not been able to get far with the dream. I was able to see myself in their worries, questions, thoughts and fears. So the fact that he could still love me, despite everything he knew, meant so much.. That was an improvement on Dr. Farber., The second reason is that I could understand how you felt. When I visited him in the hospital he was so weak he could barely move, but he raised his head, squeezed my hand, and whispered, Thank you. As we ended this meeting, I was exceedingly hopeful. So much inconsistency, so much anger, almost mockery, standing cheek by jowl with such reverence. I went to the library and checked out one of your books.