Blue Monday
Page 5
‘You don’t need to like him. You just need to help him.’
‘This guy,’ Jack continued, ‘is having problems with his marriage. But it turns out that the problems have arisen because there’s a woman in his office he wants to sleep with. He’s basically gone into therapy because he wants me to agree with him that his wife doesn’t understand him and that it’s OK for him to go and explore other possibilities. It’s like he’s got to go through the hoops so that he can give himself permission and feel good about it.’
‘And?’
‘When I was at medical school I thought I was being trained to cure people. In their bodies, in their minds. I’m not very happy if my job as a therapist is just to make him feel all right about cheating on his wife.’
‘Is that what you think you’re doing?’ Frieda looked at him attentively, noting his mixture of nervousness and impassioned eagerness. He had eczema on his wrists and his nails were bitten. He wanted to please her and he wanted to challenge her. He spoke quickly, in a rush of words, and the colour came and went on his cheeks.
‘I don’t know what I’m doing,’ said Jack. ‘That’s what I’m saying. This is where I can be honest, right? I don’t feel comfortable encouraging him to be unfaithful. On the other hand, I can’t just say, “Thou shalt not commit adultery.” That’s not therapy.’
‘Why shouldn’t he commit adultery?’ said Frieda. ‘You don’t know what his wife is like. She could be forcing him into it. She could be committing adultery herself.’
‘All I know about her is what he tells me. You say people need to find a narrative for their lives. He seems to have found one and it’s bloody convenient for him. I’m trying to have empathy for him, though he makes that difficult, but he’s not trying to have empathy for his wife. Or anyone. I’m troubled by this. I don’t know what to do. I don’t want to just collude with him in being a sleazebag. What would you do?’
And he sat back and picked up his coffee, spilling some of it as he lifted it to his mouth. Behind him, a stocky man came through the door, towing a child, whose large school backpack made her look like a tortoise. The man nodded at Frieda and raised his hand in greeting.
‘You can’t give therapy to the world,’ said Frieda. ‘And you can’t go out and change it to suit yourself. All you can do is deal with that little bit of the world that’s in your patient’s head. You don’t want to give him permission, that’s not your job. But you want him to be honest with himself. When I talk about a narrative, I didn’t mean that any narrative would do. You could start by trying to get him to understand why he wants your approval for this. Why doesn’t he just go and do it?’
‘If I put it like that, maybe he will just go and do it.’
‘At least he’ll be taking responsibility for it, instead of shuffling it off on you.’ Frieda paused and thought for a moment. ‘Are you getting on with Dr McGill in those group-therapy sessions?’
Jack looked wary. ‘I don’t think he has much time for me. Or any of us, actually. I’d heard so much about him before I got a placement at the Warehouse, but he seems a bit stressed and distracted. I don’t think we’re his priority. You’re the one who knows him, aren’t you?’
‘Maybe.’
Chapter Six
Lately, Reuben McGill had started to find fifty minutes a long time to go without a cigarette. He finished one in his office and put an extra-strong mint lozenge into his mouth. He knew it was useless. People could smell cigarettes on you now whatever you did. It had been different twenty years ago, when everything in the world had smelt very slightly of cigarette smoke. Still, what did it matter? Why was he even sucking a mint to cover it up? It wasn’t as if it was illegal.
He stepped into the waiting room to find Alan Dekker waiting there, ready for his first session. He led him through to one of the three session rooms they had in the clinic. Alan looked around. ‘I thought there’d be a couch,’ he said. ‘Like you see in films.’
‘You don’t want to believe everything you see in films. I think it’s better just to face each other. Like normal people.’
He gestured Alan into a grey upright armchair, stiff at the back so that it would make him sit straight and face forward. Reuben sat opposite. They were about six feet apart. Not so close that the proximity was oppressive. Not so far that anybody needed to raise their voice.
‘So what do you want me to say?’ said Alan. ‘I’m not used to this.’
‘Just talk,’ said Reuben. ‘We’ve got plenty of time.’
It had been only three minutes, maybe four, since Reuben had finished his cigarette. He had extinguished it on the railing out on the fire escape, though it was only a little more than half smoked, and dropped it into the concrete area below. He wanted a cigarette again. Or, at least, he couldn’t stop himself thinking about a cigarette. It wasn’t just about smoking it. It was a way of measuring out the time, and it was something to hold. Suddenly he didn’t know where to put his hands. On the arms of the chair felt too formal. On his lap felt too bunched up, as if he were trying to hide something. He moved between one and the other.
When Reuben had created the clinic in 1977, he was only thirty-one years old and one of the most famous analysts in the country. In fact, it had been more like a group or a movement than a clinic. He had developed a version of therapy that was more eclectic and less rule-bound than the traditional therapies at the time. It was going to transform the whole discipline. His picture appeared in magazines. He was interviewed in newspapers. He presented TV documentaries. He wrote books with mysterious, slightly erotic-sounding titles (Desire and Learned Helplessness, The Playfulness of Love). He had started out in the living room of his Victorian terraced house in Primrose Hill, and even when the clinic became an NHS-funded institution and moved up to Swiss Cottage, it had kept a Bohemian feel. The Warehouse had been designed by a modernist architect, who retained the steel girders and rough brick walls of the original building, then threw in lots of glass and stainless steel. Yet gradually something had been lost. What Reuben found hard to admit to himself was that there had never really been a new version of therapy. Reuben McGill had been a handsome and charismatic figure, and he had attracted colleagues and patients the way a religious leader attracted followers. Gradually the handsomeness and the charisma had faded. His therapeutic methods had proved hard to replicate, and the range of conditions for which they were deemed suitable had gradually narrowed and narrowed. The Warehouse was a success and well respected. It changed some people’s lives, but it wasn’t going to change the world.
He remained a gifted analyst, but in recent years something had happened. He had read somewhere that airline pilots, after decades of flawless service, could develop a fear of flying. He had heard of old actors who had suddenly experienced stage fright so debilitating that they could no longer perform in the theatre. He had heard of an equivalent fear of analysts, which was the dread that they weren’t real doctors, that they couldn’t offer the kinds of cure that other branches of the profession could, that it was all just talk, smoke and mirrors. Reuben had never experienced that. What was a cure, really, after all? He knew he was some kind of a healer. He knew he could do something for the people who came to him, wounded in ways they couldn’t express.
It was simpler than that, more embarrassing. Suddenly – or was it gradually? – he had started to find his patients boring. That was the real difference between analysis and other forms of medicine. In the latter, the patient presented and you examined his arm or scanned her breast or looked under the tongue. But if you were an analyst, you had to hear the symptoms over and over again, going on and on, hour after hour. In the early years, it hadn’t been like that. Sometimes Reuben had felt he was listening to a particularly pure form of literature, an oral literature, that needed interpreting, decoding. Gradually he had come to think it was a terrible kind of literature, clichéd and repetitive and predictable, and later that it was no kind of literature at all, just an outpouring of unformed, unreflect
ive verbiage, and he had started to let it flow past him, like a river, like traffic, like when you stand on a motorway bridge and watch cars and lorries rush under you, people you know nothing about and care nothing about. They would talk and sometimes cry, and he would nod and think about other things and wait for the cigarette that was coming at exactly nine minutes before the hour.
‘These thoughts were like a cancer,’ said Alan. ‘You know what I mean?’
There was a pause.
‘I’m sorry?’ said Reuben.
‘I said: “Do you know what I mean?” ’
‘In what way?’
‘Were you listening to what I was saying?’
There was another pause. Reuben sneaked a look at his watch. They were twenty-five minutes into the session. He had no memory of anything that had been said. He tried to think of something to ask. ‘Do you feel you’re not being listened to?’ he said. ‘Can we talk about that?’
‘Don’t give me that,’ said Alan. ‘You haven’t been paying attention.’
‘Why do you say that?’
‘Tell me one thing I’ve said. Just one thing. Anything.’
‘I’m sorry, Mr… erm…’
‘Do you even remember my name? It’s James.’
‘I’m sorry, James…’
‘It’s not James! It’s Alan. Alan Dekker. And I’m leaving and I’m going to complain about you. You’re not getting away with this. You’re not someone who should be seeing patients.’
‘Alan, we need to -’
Both of them stood up and for a moment they confronted each other. Reuben reached forward to catch hold of Alan’s sleeve, but then hesitated and raised his hands, letting him go.
‘I can’t believe this,’ said Alan. ‘I said it wouldn’t do any good. They said you’ve got to give it a chance. It’ll help. Just co-operate.’
‘I’m sorry,’ said Reuben, in a whisper, but Alan was no longer there to hear it.
Chapter Seven
On Friday afternoon Frieda was at the clinic again, collecting books from its little library for a talk she was going to give in a few weeks’ time. Most people had already gone home, but Paz was still there and beckoned her over.
Paz had only been at the Warehouse for six months. She had been brought up in London and spoke with an estuary accent, but her mother was from Andalucía and Paz herself was dark-haired, dark-eyed. She was intense and added a certain melodrama to the clinic, even on calm days. Now there was a sense of extra urgency about her.
‘I’ve been trying to call you,’ she said. ‘Did you talk to Reuben?’
‘You know I did. Why? What’s he done?’
‘First off, he simply didn’t turn up for his patients this afternoon. And I can’t get hold of him.’
‘That’s bad.’
‘There’s more. This patient.’ Paz looked at the paper in front of her. ‘He was in distress, having panic attacks, and he was sent to Reuben by his GP. It went badly. Really badly. He’s going to make an official complaint.’
‘What about?’
‘He says Reuben didn’t listen to a word he said.’
‘What does Reuben have to say about it?’
‘He’s said bloody nothing. He probably thinks he can get away with it. Maybe he can. But he’s messed this patient around. And he was angry. Very angry.’
‘It’ll probably sort itself out.’
‘That’s the thing, Frieda. Sorry to land this on you. But I sort of already persuaded him – Alan Dekker, I mean – not to do anything until he’d talked to you. I thought you could maybe take him on yourself.’
‘As a patient?’
‘Yes.’
‘Oh, God,’ said Frieda. ‘Can’t Reuben sort out his own disasters?’ Paz didn’t reply, just gave her a pleading look. ‘Have you talked to Reuben about this? I can’t just take his patient away.’
‘Kind of.’
‘What does that mean?’
‘It means that he isn’t really talking. But I gathered he wanted you to take him on. If you would.’
‘All right. All right. I can do an assessment, I guess.’
‘Tomorrow?’
‘Tomorrow’s Saturday. I can see him on Monday. Half past two at my place.’
‘Thanks, Frieda.’
‘In the meantime, check out Reuben’s schedule and think about transferring other patients as well.’
‘You think he’s that bad?’
‘Maybe Alan Dekker was just the first to notice.’
‘Reuben won’t like it.’
Every Friday, Frieda walked to Islington to visit her niece, Chloë. It wasn’t a social call: Chloë had just turned sixteen and would take her GCSEs in June, and Frieda was giving her extra tuition in chemistry, a subject that Chloë (who thought she might want to be a doctor herself) regarded with a mixture of loathing and rage, almost as if it were a person who was out to get her. It had been her mother Olivia’s idea, but Frieda had only agreed to it once Chloë herself had grudgingly committed herself to one hour each Friday afternoon, from four thirty to five thirty. She hadn’t always stuck to it. Once she hadn’t turned up at all (but only once, after Frieda’s reaction); quite often she slouched in late, banging her folders down on the kitchen table, among all the unwashed dishes and the piles of unopened bills, glaring at her aunt, who would ignore her moods.
Today they would be working through covalent bonding. Chloë hated covalent bonding. She hated ionic bonding. She hated the Periodic Table. She hated balancing equations. She abhorred converting mass into moles and vice versa. She sat opposite Frieda, her dark blonde hair hanging down over her face and the sleeves of her over-sized hoodie pulled over her hands so that only her fingers, with their black-painted nails, showed. Frieda wondered if she was hiding something. Nearly a year ago now, Olivia had rung Frieda up, hysterical, to say that Chloë was cutting herself. She did it with the blade from her pencil sharpener or the needle on her compasses. Olivia had only discovered because she’d opened the door of the bathroom and seen score marks over her daughter’s arms and thighs. Chloë had told her that it was nothing, she was making a stupid fuss, everyone did it, it didn’t do any harm. Anyway, it was all Olivia’s fault, because she didn’t understand what it was like to be her, the only child with a mother who treated her like a baby and a father who had run off with a woman not much older than his daughter. Disgusting. If that’s what it meant to be an adult, she never wanted to grow up. Then she’d locked herself into the bathroom and refused to come out – at which point Olivia called Frieda. Frieda had arrived and sat on the stairs outside the bathroom. She told Chloë that she was there if she wanted to talk, and would wait for an hour. Ten minutes before her time was up, Chloë emerged from the bathroom, her face swollen with weeping, new marks on her arms, which she’d shown to Frieda with an angry defiance: There, look what she made me go and do… They had talked – or, rather, Chloë had blurted out half-articulated sentences about the relief of running a blade over her skin and watching the bubbles of red form, her rage about her pathetic father and, oh, God, her drama queen of a mother, the revulsion she felt at her own adolescent, changing body. ‘Why do I have to go through this?’ she had wailed.
Frieda didn’t think Chloë cut herself any more, but she never asked. Now, she turned her gaze away from the pulled-down sleeves, the sullen set of her face, and concentrated on the chemistry.
‘When metals react with non-metals, what happens, Chloë?’
Chloë yawned loudly, her mouth opening wide.
‘Chloë?’
‘Dunno. Why do we have to do this on a Friday? I wanted to go into town with my friends.’
‘We’ve had this discussion before. They share electrons. We’ll start with single covalent bonding. Take hydrogen. Chloë?’
Chloë muttered something.
‘Have you heard a word I said?’
‘You said hydrogen.’
‘Right. Do you want to get out a notebook?’
‘Why?�
�
‘It helps to write things down.’
‘D’you know what Mum’s gone and done?’
‘No, I don’t. Paper, Chloë.’
‘Only joined a dating agency.’
Frieda closed the textbook and pushed it away from her. ‘You object?’
‘What do you think? Of course I object.’
‘Why?’
‘It’s pathetic, like she’s desperate for sex.’
‘Or she’s lonely.’
‘Huh. It’s not as if she lives all by herself.’
‘You mean, she’s got you?’
Chloë shrugged. ‘I don’t want to talk about it. You’re not my therapist, you know.’
‘OK,’ said Frieda, mildly. ‘Back to hydrogen. How many electrons does hydrogen have?’
‘You don’t care, do you? You don’t care one bit. My dad was right about you!’ Her voice wavered at the expression on Frieda’s face. She had learned by now that any mention of Frieda’s relationship to her family was forbidden, and for all her defiance she was in awe of her aunt and dreaded her disapproval. ‘One,’ she said sulkily. ‘It has one bloody electron.’
Chapter Eight
When she had been in the neurology rotation of her medical training, Frieda had treated a man who had been in a car crash that had destroyed the part of his brain that dealt with facial recognition. Suddenly he was unable to tell people apart: they had become collections of features, patterns without emotional meaning. He no longer recognized his wife or his children. It had made her think about how unique each human face is and how extraordinary our capacity to read it. At home, she had dozens of books of portraits, some of them by famous photographers, but others that she had picked up in second-hand bookshops by anonymous recorders of unknown and long-dead subjects. Sometimes, when she was unable to sleep and even walking couldn’t tire her into oblivion, she would take down a book and thumb through it, peering into the faces of men and women and children, trying to see their interior lives in the expression in their eyes.