He said he had orders to paint everything, inside and out. He and Phyllis still related very well, but at times he found himself aggrieved at her newfound activities and felt ignored by her. 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. I have found that four givens are particularly relevant to psychotherapy: 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. I had always wanted to be a storyteller. How would it be for her living in the communitybeing available for legal rape, a piece of ass for whoever happens to be horny and gets off on force and seventeen-year-old girls?, Suddenly Carlos stopped grinning. What could have set her back like this? love's executioner two smiles summary Call us today! What reward did I get? Aside from two or three brief periods when she lost forty or fifty pounds on crash diets, she had hovered between two hundred and two hundred fifty since she was twenty-one. It was my hope that I would change as Betty and I progressed in her (our) therapy. It was gratifying to him that I had seen him performing so competently and efficiently. Having persuaded himself that Marie was hysterically overreacting, he refused to prescribe adequate medications for pain relief or sedation. She seemed staggered by my confrontation and retreated by sinking into her body. But in Daves group, the burning secret was age. But I got greedy. He concentrated on the meaning of neverthat he would never, never see her again. I had no weight. Psychological emptiness is a common concept in the treatment of those with eating disorders.). 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. . Our exchange had taken my breath away, and I hated to end. By that criterion, Saul was psychotic. I know that it is me who is dying. I have a lot of plans. It seemed the right thing to do. She had occasional brief periods of pride and exhilaration (especially when she went shopping for slimmer clothing), but mainly she experienced such deep despondency that it was all she could do to get herself to work each morning. Marvins change initiated an adaptive spiral: liberated from a restricting role, Phyllis underwent enormous change in the space of a few weeks and continued and solidified that improvement in individual therapy with another therapist over the next year. Youve come to see me for help, and this is just what Im trained to do. Had she considered the Sierra Club? But I want you to be sure to take care of yourself. Once, for three years, he had stored them in a safe deposit box. He majored in mathematics at a small city college and briefly considered graduate school. She is naked and standing with her legs spread apart. Marvin looked stumped. At first I thought it was to catch his breath: he had been racing through his sentences. Her mother worked twelve hours a day as a laundress and spent most nights drinking and picking up men at a local bar. Later he spoke to the oldest living member of the Socit des Amis de Flaubert who told him the true story of the parrots. Obviously, she gave him that power in an effort to deny her own freedom and her responsibility for the constitution of her own life. The doctor confirms that you do have cancer, and all your turmoil about not knowing is endedbut what are you left with?. And yet, of course, she was in despair. It was true I felt impatient with Saul. It means shes been reborn into another life., No. She felt that she was talented but had never developed her talents because, since the age of thirteen, she had had to earn a living. Thats one kind of daydream. But is there any point to dwelling on it?. I got it thirty years ago in Samoa., Old friends may feel more comfortable at home than the office.. Besides, though Nietzsche was a seer in many domains, he was no guide to interpersonal relationshipshas there ever lived a lonelier, more isolated man? But now it was his turn to be shocked. Dave began to talk about Soraya, and in a few minutes the tension had gone and his self-assured easy jauntiness returned. I had three childrenand the wrong one died., Penny gasped and put her hand to her mouth. One day when I saw her timidly scanning the objects in my office, I said, Go ahead, speak, Marge. I knew a way. Whenever his cancer worsened and he was actively facing death, he rearranged his life priorities and became more thoughtful, compassionate, wiser. The examined the content of Elva's purse which meant intimacy and trust. But she hadnt proved to be a slow learner. The good therapist fights darkness and seeks illumination, while romantic love is sustained by mystery and crumbles upon inspection. Suddenly, she stopped talking. Marvin started to read the dream in such a mechanical manner that I stopped him and employed the old Fritz Perls device of asking him to begin again and to describe the dream in the present tense, as though he were experiencing it right now. He was sarcastic, authoritarian, and, I believe, sadistic. Damn, she was stubborn! If you could plan our time together, what would be the best possible way for me to help?, Saul didnt budge. What is the smoke? I asked. Loves Executioner was meant to be a collection of teaching stories aimed (like all my subsequent stories and novels) at the young psychotherapist and all other people, including patients, interested in psychotherapy. And then a dream providing specific grievances:Im watching a heart transplant. The worst thing that can happen to someone is to die alone, and that was the way she had let her daughter die. But at the moment they felt compelling and profound. I had often done so in the past and he had a ready answer for everything. There is little awareness of the experience of being a woman in a world dominated by men and, I believe, a clear bias in the way that the male clients and the female clients sexuality is explored. Can you believe I still feel spooky when I think about this?, Your mother? What happened then? 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. Now, there is nothing, Penny told me, more important to her than her house. No matter what I did, what horrid things I thought, I knew hed accept it and stillwhats the word?confirm meno, validate me. Special Offers Email Address Field. But now, after only six weeks, all the members and at least one of the co-therapists are thoroughly pissed at you. Yalom was bored by Betty's superficial conversations and denial of responsibility. Do you know anything about Buddhist meditation practice?. Marvin feels youre cold and uninvolved and that youve taken little personal interest in his lifein how he got to be the person he is today.. I could hear each spurt splatter against the waxed walls of the cup. He cogitated for a couple of minutes. I remember that Thelma and I both asked many questions, each of which he answered fully. I ended up responding so well to the process, though, that I've continued seeing her in private practice ever since. It has been translated into twelve languages and is now in its fourth edition. Be careful. Ive never told that story to anyone. My week has been a horror, sheer hell! But the interesting thing is that all the side effects are greater today. "Do not go gentle" -- 7. Sometimes she came into my office in tears after a week without food and no compensating weight loss. Then I folded the letter and jammed it into my rear trouser pocket. Guinea pig litter. The Thelma who deceived herself? Casualties occur: the rich, fleecy texture of image, its extraordinary plasticity and flexibility, its private nostalgic emotional huesall are lost when image is crammed into language. What precisely, I asked, was helpful to you in our last hour? From there it was an easy step for Marie to transfer her numbness to all the painful areas of her face and neck. Sometimes I felt cruel as I confronted him with my view of reality. Do not get caught in a crossfire. Dave and I both had a proclivity to sexualize much in our environment. Remember how I emphasized that whatever happens in the group can be used to help us work in therapy? He nodded. However, the journal would be delighted to reconsider the article if it were updated, the basic accent altered, the conclusions and recommendations reformulated. Im working on a letter to him now which reviews, step by step, every detail of whats happened.. In recounting his patients' dilemmas, Yalom not only gives us a rare and . Shes not that short. And theres one additional bonus to aging: reading your own work can be more exciting! In fact, of the twenty-eight geriatric subjects involved in this study, she had the most positive outcome. Itll be difficult to dislodge it. I hoped that he would understand that my willingness to engage him, rather than wink behind his back, was my way of touching and caring. The more I thought about it, the more pleased I was that I had restrained my curiosity and had acted selflessly and systematically in the best interests of the patient. He immediately rejoined, Ive been wanting a session like this for years. Not Feminist. 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. Medical researchers discovered, in the early days of nineteenth-century medical research, that the best way to understand the purpose of an endocrine organ is to remove it and observe the subsequent physiological functioning of the laboratory animal. I could exercise on my stationary bicycle! The group focused upon the issue of secrecynot the issue that now most fascinated me, though nonetheless a relevant therapeutic issue. Its time for you to go. Penny didnt like my questions. You can influence itmore than you think. I believe I fell from grace when I confessed ignorance of the manufacturers name; things grew even more awkward when I removed my glasses to read the brand name on the stem and found that, without my glasses, I could not read it. I feel like a zombie, run out of gas, my lifes a void, a dead end. Encased in an elaborate illusion of unlimited power and progress, each of us subscribes, at least until ones midlife crisis, to the belief that existence consists of an eternal, upward spiral of achievement, dependent on will alone. Touch! The most common was their first encounterthe chance meeting in Union Square, the coffee at the St. Francis, the walk to Fishermans Wharf, the view of the bay from Scomas restaurant, the excitement of the drive to Matthews pad; but often she simply thought of one of his loving phone conversations. Believe me, I swear it, in the last meeting I was the only honest person in the group. In his remaining months at the Stockholm Institute, Saul worked like a demon. The first, he called (glancing at his notes), Everybody has got a heart. The second was I am not my shoes.. That was why he had always dreaded Phylliss anger, and that was why, when he was anxious, she could offer such relief by soothing him sexually. A well-intentioned victim? Some day soon, perhaps in forty years, there will be no one alive who has ever known me. Marvin, it must not be easy for you to talk about intimate aspects of your life to a stranger. Share to Twitter . A few minutes later, as I was getting some coffee, I noticed Thelma and Matthew chatting in the corridor. So, as I was saying, I flip back and forth from feeling good to feeling anxious and depressedboth togetherand it is always in the depressed states that the headaches occur. For the first four years of her bereavement, Marie made herself totally inaccessible to men. Suppose the two people had widely different experiences. What do you mean by my entertaining you?, Betty, this is important, the most important stuff weve gotten into so far. 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). , . All week long Ive been seeing everyones heart beating, and Ive been saying to myself, Everybody has got a heart, everybody has got a heart. Ive been seeing the heart in everyonea misshapen hunchback who works in reception, an old lady who does the floors, even the men I work with!, Carloss comment gave me so much joy that tears came to my eyes. Cognitive Therapy; Psychotherapy; Yalom; University of Idaho PSYC 347. It struck me as wonderfully funny and I started to laugh, and laughed until my eyes filled with tears. Also, you didnt fall asleep. For one thing, I was certain it would be wise to establish a supportive community to help sustain her in the difficult diet days yet to come. If, indeed, he were bedridden, who was helping him? Occasionally she caught herself and apologized for being bitchy, but invariably, a few minutes later, was once again irritable and self-pitying. Love's Executioner.docx. Somewhere Saul had found the power to take a stand against me. Stay focused! She dripped with rage and, in our first few hours together, had something vicious to say about everyone she knewsave, of course, Albert. Drawing a thick scroll from his briefcase, Marvin asked me to hold one end, and carefully unrolled a three-foot chart upon which was meticulously recorded his every migraine headache and every sexual experience of the past four months. So deep do they run that I never considered them prejudice. In order to stay on her pedestal, she was never able to talk to you about her pain and her fearsor not until very recently.. I got down to business and asked my standard opening question: What ails?. Not only did I believe that I could help Thelma but I was intrigued by the idea that this counterfeit love could be a beacon that might illuminate some of the deep mystery of love. I do know that for the entire six months I was at the Stockholm Institute, I took off only three days. She could take care, she said, of not being poor. She had more to tell me. The disguise is deep, penetrable in each case only by the patient. I dont knowYoure always so serious. But the really major problem with keeping the letters had to do with group therapy. A mistake would be fatal: he rarely gave people a second chance. If hes the spiritually minded person you think him to be, then surely hes experienced much guilt at your distress and would take pleasure in helping.. 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. The day before, he had received a phone call from a colleague asking him to review a grant application. Two weeks later, he began our session by announcing that he had had, during that week, two major insights. He knew I would disagree. 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 know theyll say that its an infatuation or a crush or transference. My mother is a crazy, embittered lady, and I grow more like her every day. I do hate groups. Yet I was convinced part of it was bluster, and that there was a way to reach something better, something higher in him. Over the last several months, I had constructed a visionor, rather, several alternative visionsof him: an irresponsible, sociopathic Matthew who exploited his patients; a callous and sexually confused Matthew who acted out his personal conflicts (with women in general or mother in particular); an errant, grandiose young therapist who mistook the love desired for the love required. My negative feelings slowed me down. Finally, Marie agreed. She did not seem surprised by my offer and immediately agreed to return next week at the same time. First, youve got to know exactly what I mean. By approximately the sixth session, I had worn her down andto humor me, I believeshe agreed that the obsession was the enemy and had to be extirpated. She had not returned my smile when I greeted her in the waiting room, and followed a step or two behind me as I escorted her down the hall. I wondered why the authorities would permit them to camp out in the open. She mollified me: Its not you. Where was she in all this?, Like Ive told you beforeway, way in the background. My general comment may have been a guess about the whole field and not an expression of my personal feelings about you. (Like many patients, Carlos became deathly ill and despondent during chemotherapy.) Thats why I felt uncomfortable with her somehow, and so set about exploring it. Still another common scenario is for parents to overprotect the surviving children. The inevitable decision loomed. Her daughters, her friends, her veterinarian, all urged her to have Elmer put to sleep. Dr. K. had work of far higher priority, and Saul was certain that he would prefer simply to wash his hands of this whole pestilence. Thelmas life was saved only by heroic medical efforts. Id be out of his hair for good. I was thinking of my father lying beneath the ground and how cold he must have been, and I suddenly heard a voice from above saying to me, Youre next!, Betty stopped and looked at me. I had always had warm feelings toward my father and would have welcomed the opportunity to invite him to live in my home. I had to start with something more immediate. We were coming to the end of our eleventh hourno time for me to be withholding. Eventually, months later, she did develop guilt about her relationship with her sons, but by that time she was better able to tolerate it and to ameliorate it by changing her behavior. The most I can hope for is to stay out of a mental hospital. Lets try to understand this together. They call out to those who are forever lostdead or absent parents, spouses, children, friends: I want to see you again. I want your love. I want to know youre proud of me. I want you to know I love you and how sorry I am I never told you. I want you backI am so lonely. I want the childhood I never had. I want to be healthyto be young again. At an early age, far earlier than is often thought, we learn that death will come, and that from it there is no escape. Otto Rank described this life stance with a wonderful phrase: Refusing the loan of life in order to avoid the debt of death.. I retreated to fact gathering. Would that release you?, Ive tried to imagine that. For those who look inward, retirement is a time of life review, of summing up, a time of proliferating awareness of finitude and approaching death. He grieved for his past and his impending losses. Love's executioner, and other tales of psychotherapy There she was in an autotrance, eyes closed, flickering eyelids covering frenetic REM-like activity. Ive got to sell some stocks first to raise that much cash., Well, heres what I think. All names, identifying characteristics, and other details of the case material in this book have been changed. I could have gone back earlier, but it didnt seem right to go back so soon. Or, was it possible that he was far ahead of me and mocked himselfand me, toowith subtle irony? I heard the men whispering and conspiring in a menacing way. The worlds finest tennis players train five hours a day to eliminate weaknesses in their game. I wouldnt have made it without you. The first step in all therapeutic change is responsibility assumption. Your name appeared on four of their liststhey said you were a good last ditch therapist. So that was one thing in your favor. When Betty, an obese patient, announced that she had binged just before coming to see me and was planning to binge again as soon as she left my office, she was attempting to give up her freedom by persuading me to assume control of her. Thats why I dropped out of school. This was all the information I could handle (and all that I thought I needed). Penny burst out crying. I sighed even more deeply. The real actress, the responsible consciousness, remained concealed backstage. And then it was that Marie smiled. Listen to what shes telling you.. I often wrote the same article five different ways. I know youre listening professionally. We stood, walked to the door, shook hands, and parted. 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. You could tell she had been through a lot. No matter how good your food, you are no match for a woman.. My obsession has gone or almost gone, I guess. From the point of view of existential psychotherapy, and as a trainee therapist, I really appreciate Yaloms skill in explaining some difficult existential concept with ease and simplicity (unlike Heideggers trudging, heavy words). I had to change my clothes. I want to hear every detail.. I suggested that we meet six times and then evaluate whether treatment seemed worthwhile. All of my arguments met a similar fate. (The dream interpretative work was successful, but the patient died. . love's executioner two smiles summary I am thirty-five years old. Betty represented the ultimate countertransference challengeand, for that very reason, I offered then and there to be her therapist. He remained remarkably clinical. The book "Love's Executioner" by Dr. Irwin Yalom is a compilation of ten cases of psychiatric treatment which include author's involvement into sorting his patients' worries out. I knew that the most important thing I could do for her, especially in this time of crisis, was to maintain our relationship and not allow her to drive me away. Two smiles -- 8. 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. After a few days she went to the library alone, then shopping, and in the next few weeks ventured farther than she had for years. I cant wait another week. But nothing came. Share it with me. He was a marvelously generous and supportive father. I would be making a pact with his shadowan alliance with pathology. . Meditate on that. Knowing he had a married daughter living nearby, I had intimated, in passing, that I assumed she was looking after his needs. They are informative, they are calming, and they penetrate the anxiety of isolation: the patient feels that, once you have the details, you have entered into his life. He opened them suddenly and checked with me: You asked for this. About five years before, when Chrissie was still alive but weakening, Penny signed a contract for an expensive cemetery plota plot large enough, she pointed out (as though this should make things self-evident) to keep the whole family together. Each family memberPenny, her husband, Jeff, and her two sonsagreed, after intense pressure from her, to contribute a share of the cost in payments spread over seven years. Often dialogue is fictional, and my personal reflections post hoc. Thats going to be my main job in the session.. He brooded for days after an episode of impotence and was entirely dependent upon her to regain his equilibrium: sometimes she brought him around simply by reassuring him that she still found him virile, but generally he required some physical comforting. I asked, in return, that he agree not to make any irreversible decisions. But Phyllis supplied additional explanations for Why now?, Im sure you know what youre talking about and that Marvin must be more upset than he knows at the idea of retiring. The time had come to unearth everything. The whole dreadful catastrophe. After they left, she stood stunned by the door for a few moments; then she cursed Jim for using his money for drugs rather than his plot payments; and after that, as she put it, she lost it completely and tore after them. Yalom is especially famous for his work with existential theory. Then life seems to be attacking on all fronts: parents feel guilty and frightened at their own inability to act; they are angry at the impotence and apparent insensitivity of medical caregivers; they may rail at the injustice of God or of the universe (many ultimately come to understand that what has seemed injustice is in reality cosmic indifference). I put it, also unopened, on top of the first one in the same desk drawer. , . Marvin stated that he had thought about it during the last few days, and wished to begin immediately. I was convinced the abscess had to be incised and drained and that what I needed to do was to persuade you to permit me to do it. Six months ago! I tried to help Thelma talk. It would seem rational to read them first., Im not sure.