I looked forward to seeing her and being with her. Only everything was wrong: their dresses were dirty and on backward and inside out. . Forty-five years? I was afraid to go farther. Ultimately I would have to help her assume responsibility for her appearancebut saw no leverage for achieving that at this time. In fact, I stopped reading it halfway through because it was so upsetting, and Im someone who hates leaving things unfinished. (In our culture the busyness may be supplied by the funeral arrangements and the paperwork of medical insurance and estate settlement.). I was now permitted to interrupt her instantaneously (reminding her, of course, of our new agreement) whenever she giggled, adopted a silly accent, or attempted to amuse me or to make light of things in any distracting way. I knew we were entering an area where once I would never have dared to go. I turned to look at Thelma, but she averted her glance. But Dave had closed down. When I asked about how we were doing today, or asked her to describe all the feelings she had experienced toward me in the session so far that day, she rarely responded. But it was not until shortly after her father died that Betty grasped the truth about the inevitability of her own death. That would not be uncharacteristic of him. Me closed her eyes for a minute or two and, when she opened them, she had vanished and Marge was back, crying and terrified. Thelma smiled at this question. It was gratifying to him that I had seen him performing so competently and efficiently. She ultimately concurred and arranged residential care for her father in Mexico. But I was too riled up to talk. The moment had come to play my final card. As the months passed, Marge grew plump at the other Marges expense. It was a slide of a mans head. That desire must have been percolating on the back burner as I pursued my academic career, for as I began writing these ten stories, I sensed I was on the way to finding myself. 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. They moved from one tenement flat to another, often being evicted for nonpayment of rent. He has opened the door of awareness; but now he fears that too much has come out, that the door is jammed, that he will never be able to close it again.. Group therapy for Dave was, I knew, a high-gain but high-risk venture, and I wanted to facilitate his entry into it. From it, through either begging or bribing (Ive forgotten which), I obtained a precious hard copy of my work to date. What is Yalom's favorite first question to his patients? I wanted another to bear witness to what I had been going through with Marie, someone to say to me, Shes tough. She was severely handicapped. Instead, therapist and patient inevitably return again and again to adjust and to reinforce the learningindeed, for this very reaso, psychotherapy has often been dubbed cyclotherapy.. There had been another odor polluter in the house, a tenant who, according to Marie, dieted on decomposed fish. Swept along by hubris and by my curiosity, I had disregarded twenty years of evidence at the outset that Thelma was a poor candidate for psychotherapy, and had subjected her to a painful confrontation which, in retrospect, had little likelihood of success. Bjrn Borgs pulse is fifty, Ive heard. 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. Supplemental Materials. Im talking about now and about how you cannot live life because you continually replay past history over and over. It sounds important. I was musing on the tone of this final commentnot quite sardonic, not quite coquettishwhen Thelma got up, telling me on her way out that she would schedule the next hour with my secretary. I became aware of how little she had changed and how much depended on something dramatic happening the next session. As we neared our final session, I felt a mounting relief and exhilarationas though I had gotten away with something. As long as I can remember, Ive been a voracious reader and somewhere in early adolescence I began yearning to be a real writer. The entire course of therapy of another patient (Thelma in Loves Executioner) revolved around the theme of surrender to a former lover (and therapist) and my search for strategies to help her reclaim her power and freedom. For those twenty-seven days. He was still periodically impotent but brooded about it less. She was speaking more deliberately, in a bitter, forlorn tone, but there were no more tears. But nothing came. . Well be able to work this out together. She said his elevator didnt go to the top floor. He was absent: even when he was there, he was absent. And her daughter-in-law? Im not proud of it, but Im having a lot of trouble leaving the house, let alone traveling halfway around the world. Every minute of my time was committed to completing a research proposal, and the deadline for the grant application was rapidly approaching. Table of Contents. Imagine two minds pressed tight together and, like paramecia exchanging micronuclei, directly transferring thought images: that would be union nonpareil. The last thing we discussed was the timing of Marvins symptoms. Could it be that he found me? Saul was really digging in but, though I began to question my choice of a direct approach, I persisted. I informed her that it was important for her to know, before she agreed to proceed, that these were to be research, not therapeutic, interviews. But what, I wondered uneasily, about the rights of the patient? I developed a specialty in group therapy and, during my first sabbatical, embarked on writing a textbook on group therapy. 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. New friends only mean more farewells to say and more people to hurt.. I guess I had to have something that Marvin wanted. After making certain I was alone, I entered the confessional booth (appropriating the priests seat) and meditated upon the generations of priests who had heard confessions in this box. So I acknowledged it openly and suggested that we meet six more times and try to do as much as we could. We were there, the feeling was real, I know love when I feel it. Christ, to die! He began to twist the knobs of secret doors, to whisper to an unknown daughter, to wonder where vanished fathers go. The whole dream was soaked in fear., What feeling was there in the dream about the insertion of the cane into the babys vagina?, If anything, that part seemed almost soothing, as though it quieted the dreamor, rather, it tried to. Following that, we reviewed her phone conversation once again and planned the next hour. For years, between customers in her taxicab, she had listened to self-improvement cassette tapes on vocabulary improvement, great books, and art appreciation. Perhaps I was intrigued by her beauty, by her ebony hair in bangs framing her astonishingly white, perfectly featured face. I began to relinquish my ideas of striking back at Matthew. 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. 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? My husbands been dead for a year now, but things arent getting any better. Love's Executioner Paperback - June 5, 2012 by Irvin D. Yalom (Author) 1,521 ratings See all formats and editions Kindle $12.99 Read with Our Free App Audiobook $0.00 Free with your Audible trial Paperback $12.99 61 Used from $5.64 31 New from $12.71 3 Collectible from $11.89 MP3 CD $12.95 1 New from $12.95 A NEW YORK TIMES BEST SELLER Why would he not see her or even speak to her on the phone? 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. The markers of ones life stages are always significant, and few markers more so than retirement. The journal informed Saul that their new policy did not permit him to credit anyone without that persons written consent (to avoid spurious use of famous names). For example, why did Dave refuse to tell his wife that he was in therapy? On the positive side I guess it would give Dr. Yalom some firsthand observations.. We might as well have been in separate rooms. I wanted to leave an imprint on your life. Here is a quick description and cover image of book Love's Executioner and Other Tales of Psychotherapy written by Irvin D. Yalom which was published in 1989-. Thelma turned away and looked out the window. But which Thelma? The message:Marvin is very frightened. To my relief, she was much improved. She described, again in tedious detail, all the attractive men at work and the minute, pathetic machinations shed go through to exchange a few sentences with them. He therefore, dreaded the publication of the article and Dr. K's response. Without question she had neglected the boys for the past eight years. My next few days were filled with self-recrimination and worry about Thelma. Hypnosis works for stupid people or people with weak wills. To risk placing herself in the situation where she might be obligated to nurse you? When I imagine him dead, a great sadness descends. One hundred seventy. Garbage. She was dressed in an attractive, tight royal-blue knit dressa daring outfit for a seventy-year-old woman, but I thought she pulled it off well. Hence, her evasive response of O.K. or Fine whenever I asked about her here-and-now feelings. The first was of a young beautiful dancer wearing a sleek black leotard. After shaking hands with me, his first words, while accompanying me down the hall to my office, were to compliment me on my frames and to ask me their make. Now shes fading. The only way that can happen is through voodoo influence. I make an appointment to meet my son after the deadline. He hadnt, for example, told the group that Soraya had been dead for thirty years, that he was sixty-nine and felt near death, that he had asked me to be the keeper of the letters. But I was chilled to learn there was no play: Saul was deadly serious. Can you believe I still feel spooky when I think about this?, Your mother? I was a latchkey kid when I was ten., O.K., begin with why you wanted to see me immediately. It was, however, also true that my future patients would benefit from whatever growth I could attain. I was entirely satisfied with my words: I had covered myself and had been clear enough to prevent any misunderstandings. We endlessly clarify and interpret, assuming (and it is a secular leap of faith, lacking convincing empirical support) that understanding will invariably beget change. She was a heavy smoker and one of her motives in agreeing to the consultation with him was to enlist his help in stopping. Go visit the porno shops in the Tenderloinitd be good for your education. Im still on antidepressants. Did he ejaculate inside of us? Where is Chrissie? In his typical cynical mode, he said that his insurance policy would pay ninety percent of my fee, and that he wouldnt turn down a bargain like that. For more information, please contact the Special Markets Department at the Perseus Books Group, 2300 Chestnut Street, Suite 200, Philadelphia, PA 19103, or call (800) 810-4145, ext. It hit the visitor at the front door and no amount of air, shampoo, deodorizing, or perfume could cleanse Maries home. How dare they impose that body on the rest of us? So in a sense she was following your unspoken wishes by not openly expressing her uncertainties, by pretending to be stronger than she felt. I cringed when I reflected on all the other obese women whom I had related to in an intolerant fashion. Who wants temporary friendships?, The problem with that attitude is you end up with an unpeopled life. 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. The decades had eroded none of their restorative powers: she exhaled deeply, calmed herself, and sat back in her chair. If he ever were to know the truth, I honestly believe he would kill Matthew. Dave would feel hurt and trapped. She hated what was happening, and she hated Dr. Z., but my every suggestion was met by but or yes, but. She was a yes, but-er (also referred to in the trade as a help-rejecting complainer) of considerable prowess. Marvin took himself very seriously: he was practically my only patient with whom I could never joke or banter. His self- recriminations for not having acted with greater dispatch continued all week and included verbal self-assaults and physical abusepinching himself and pounding his head against the wall. Psychological emptiness is a common concept in the treatment of those with eating disorders.). By the time six months had gone by, I cared somewhat more about Marvin, yet still had no deep fondness for him. What about Marvins retirement disturbs you?. Please try again later. Dr . He was concerned about my depression. love's executioner two smiles summary. Thats what I meant when I said you were making too much out of the sexual relationship. Table of Contents. Never before had a therapist been so scrupulously honest, direct, and gentle with her. These are true stories, but I have had to make many changes to protect the identity of the patients. 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. Its the only thing he can say., Matthew did his best, but communication was difficult because of her sobbing. She viewed, she told me now, my suggestion about a possible career in nursing as a put-down, and accused me of saying, The girls not smart enough for medical schoolso let her be a nurse!, At times, she was petulant and regressed. By that criterion, Saul was psychotic. Yet Ive often thought about that crime. In spite of my curiosity, I decided to let Saul tell the story in his own way, and at his own pace. The ten years of therapy before Matthew? As though hes my child and I have to answer for him. It almost never does. Thelmas eyes were fixed on me. I knew her forty-five years ago in college. Of course, she was curious about his actions and correspondence. How comforting it would be to feel, just once, that I know exactly what Im doing in my psychotherapeutic workfor example, that I am dutifully traversing, in proper sequence, the precise stages of the therapeutic process. Their chest wall vanished, just melted away leaving a square blue-red cavity with rib-bar walls and, in the center, a liver-colored glistening heart thumping away. How did Mike interpret Marie's two smiles?-He took them to signify impact and connection; . Irvin David Yalom, M.D., is an author of fiction and nonfiction, Emeritus Professor of Psychiatry at Stanford University, an existentialist, and accomplished psychotherapist. There were wisps of smoke coming up all over the house from between the floorboards. Love's executioner and other tales of psychotherapy . ! For example, consider the decision facing her at this moment: Would she nota month, a year from nowdeeply regret her decision to stop treatment? You know, it feels right. Blush often awoke surprised to find that Brazen had emptied her bank account and bought sexy gowns, red lace underwear, and airline tickets for jaunts to Tijuana and Las Vegas. Im a little slow, but Im beginning to get it. He winced visibly and said simply, I wouldnt like that for her., But where would she fit, then, in this world youre building? Or the Thelma who was deceived by herself? I was on the right track. Nothingnot anger, pride, or hostile brushing of her breaststook precedence over her functional and cosmetic recovery. I enjoyed the joking about your shitty habits. He arrived at the conclusion that getting rich was what life was all about. Trust me, Saul, its best not to make irreversible decisions when youre highly stressed and not functioning (as you yourself have noted) entirely rationally. Her cancer and her treatment were both extremely painful. Instead, we must speak of us and our problems, because our life, our existence, will always be riveted to death, love to loss, freedom to fear, and growth to separation. After all, what can the man do to me? What does Yalom think about an intellectual appreciation of a truth about oneself and an emotional experience of it? I watched her go down the stairs. Her love obsessionwhat else could one call it?was powerful and tenacious, having dominated eight years of her life. No, he was not gay. His wife had left him four years ago. Finally you found where you belong, the home and perhaps the father you had always been seeking.. Was I really that stupid? I took the letter out of my pocket and started playing around with it. I had been absent. Also, it helped that you didnt get into your role of the wizard letting me guess about questions you know the answers to. Mind thinks in images but, to communicate with another, must transform image into thought and then thought into language. But its different with Thelmaits not that she wants it, but that she has to have it in order to escape some danger. What do you think Ill missthe new tax forms?, Sometimes retirement stirs up important feelings because it is such an important milestone in life. Marge began to treat me as an equal, she asked me questions, she flirted a bit. My connection with him felt tentative. 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. But of my hundred hours with her, what should I have shared? Above all, I wished to protect and maintain our relationship. I had never seen her so irrationaland so challenging. But such interpretations would only result in most of the hour being used as a conventional individual therapy sessionexactly what none of the three of us wanted. She gave the thumbs-down signal and one gray morning took Elmer on his final visit to the veterinarian. Soon we spent entire sessions talking about her father. His suspicions and fears of the group members would be confirmed, and he would drop out of the group, more isolated and discouraged than when he began. And outrageously activeoften charging at a patients defenses with a battering ram! 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. A cipher. For an instant I was alarmed because I thought she would walk out. Was she right? I wonder if Dr. K. and the Stockholm Institute dont represent a real haven. I like to donate books, not ever throw them away, but this one here.pfffffft. Thelma leaned over, opened her purse and pulled out a newspaper clipping about murder. I thought of tearing that chart to shreds and enjoying every moment of it. But now, after only six weeks, all the members and at least one of the co-therapists are thoroughly pissed at you. Instead, I sought for a way to connect with him. Marvin was beginning to astonish me. The hardest part for me in our work together is the frustration I have at the amount of distance you put between us. More and more these dayshere Thelma lowered her voice almost to a whisperI believe he is intentionally trying to drive me to suicide. Later he spoke to the oldest living member of the Socit des Amis de Flaubert who told him the true story of the parrots. I dont want to be just another patient. I wanted to be special. I want to be something, anything. Twelve hours of therapy is far too brief a time to identify, to express, and to do useful work with death anxiety. Penny began to talk about guilt. Why take everything so . During the year following our therapy, Penny did not consult the therapist I had suggested to her but had continued to make progress on her own. I want! He had been Charless dog, and a bit of Charles still lived through Elmer. No opening ceremonies that day. 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. (Always greatly concerned about her physical appearance, she was even more so now that she was entering the singles world.) How could Chrissie talk about dying to a mother who continued to pretend it wasnt happening? 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. One of the most interesting things I learned was that, when Marvin was seven or eight, a cataclysmic secret event shattered his family and resulted in his mother banishing his father permanently from her bedroom. 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. I have always been repelled by fat women. Our time of intimacycall it love, call it love makingwas redemptive. Albert was a fixer. Elva chuckled and continued to disembowel the purse. It was apparent that both he and I had reservations. I am now my mothers age when she died. Stay focused! Im too advanced for it., Everyone is dishonest and playing games there. Summary. 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. Since we had now run almost fifteen minutes over, and I had another patient, also in crisis, waiting, I reluctantly ended the session. Ill bet they all compare themselves unfavorably with you.. Only once did he step out of role: when Thelma asked him how the relationship with the new person in his life was going, Matthew snapped, You have no need to know that!. Is there not a difference between a therapist scrubbing away unseemly countertransference stains and a dancer or a Zen master striving for perfection in each of those disciplines? I simply hadnt realized it. To treat someone as an equal implies an inequality which the therapist must overcome or conceal by behaving as though the other were an equal. But, Thelma, go back to what I was saying earlier. I taught myself to type on the flight overseas by means of a video game in which, when letters attacked my spaceship, my only defense was to punch an attacking letter before it detonated my ship. When I make a resolution, I never go back on it., Also, Thelma, I cant work well with a suicide threat hanging overhead. I think I just collapsed in a kitchen chair and sat there. Only Thelma could tell me. I grew up in racially segregated Washington, D.C., the only son of the only white family in the midst of a black neighborhood. However good his health, he was sixty-nine. Marvin looked stumped. That was the top priority in my life then; that was why I had advertised for volunteers. I want to accomplish something. Alarmed at the prospect of my work disappearing without a trace into the computers innards, I sought help. I had tried a more conservative approach for four months and had resorted to a radical intervention only when it was apparent I had no other choice. For years he endured his friends jibes about dating his mother. Do you know anything about Buddhist meditation practice?. I think Ive been staying just ahead of them for sixty-three years. He tiptoed in and saw Phyllis kneeling by her bed, praying, chanting the same phrase over and over: The mother of God will protect me. I wonder whats left of her now? She concealed her depression well. What a story there was behind Maries relationship with him! . She didnt know what would happen to her if she didnt have her weekly fix. It seemed to me she was still resisting closeness by referring to a fix rather than to me, and I gradually confronted her on that point. Besides, where in the hell would I store them? To my surprise, she began sobbing so forcefully that she could not catch her breath. We were to have many similar exchanges. "I never thought it would happen to me" -- 6. Thelma, who had been apathetically slumped in her chair, suddenly bolted upright. Getting inundated with emotion was likely what happened to the others, to the therapists who couldnt help her. Angles or gimmicks were not going to help Dave relate to others directly and authentically: I had to model straightforward, honest behavior. It was the flesh-and-blood Marvin who was irritating and uninteresting. And then? That one, Thelma informed me when she saw me turning to the second photo, of a sixty-year-old handsome but stolid woman, was taken about eight years ago. What was important was that he connect or even fuse with you., Thats right. I also make it a practice to play for the patient a tape recording of part of our initial session. You yourself mention his significant sexual problems. I shuddered when I thought of her dining, can opener in hand, on Optifast liquid. The second time she smiled was in response to Mikes equally ingenuous question, Would you feed your dog poisoned dog food?. One month from nowwill you have opened the three letters?, Yes, without question, theyll be open in one month.. While I struggled internally with these feelings, I had not expected my patient to perceive them. But regardless of his motivation, his advice was sagacious. It was ineffable. Rarely have I ever heard of a dream that so transparently laid out the answer to an unconscious mystery. Heady stuff! I want! is heard throughout these tales. He always minimized his painalways fearful of bothering me. Excellent. In fact, most of my life goes on in these daydreamsI scarcely take note of whats happening in the present. But the main thing is that he is willing to come in for a three-way meeting. Matthew turned back to me and, until he finished his story, did not again look at Thelma. Betty, being loved is not sheer chance or fate. Thats the name of the game. Or was she most upset by what she had still to tell me? I went to the library and checked out one of your books. They both giggled the first few times Marvin told Phyllis not to leave the house: it seemed ridiculous and artificial; she had not left the house in months. It did not keep her self-esteem stable but instead fluctuated wildly according to external events. After Chrissies death, Penny was still unavailable to her sons: the rage she felt toward them, much of it only because they were alive instead of Chrissie, created a silence between them. 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.
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