Becoming Myself: A Psychiatrist's Memoir

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Becoming Myself: A Psychiatrist's Memoir Page 21

by Irvin D. Yalom


  From Bangkok I traveled by bus to Chiang Mai, where I watched elephants at work clearing forests. I met a fellow traveler, an Austrian tourist, and we hired a guide to take us on a canoe trip up the Mae Kok River. We stopped at a native village to join the males as they sat in a circle enjoying their daily opium smoke, while the females, of course, did all the tribal work. My one experience with opium was not dramatic: simply a mildly mellow state of mind lasting for several hours. We continued on to Chiang Rei, passing along the way a host of fairyland crenelated temples that looked as though they might take flight at any moment. At Chiang Rei I walked on a bridge with other tourists connecting Thailand to Burma, where, halfway across, we met stern Burmese military guards. The guards permitted us to touch the barrier for a few moments so we could say we had been to Burma. Next I flew to the island of Phuket for a few days of beach walking and scuba diving, and then headed home to California.

  Though I loved this trip, I ultimately paid a price for it. Not long after I returned home, I developed a strange illness that plagued me for several weeks with fatigue, headaches, lightheadedness, and loss of appetite. All the paragons of the Stanford Hospital agreed that I had contracted some tropical disease, but no one ever figured out what it was. A few months later, when I had fully recovered, we celebrated with a brief trip to a Caribbean island where we had rented a cabin for two weeks. One of my first days there I took a nap on the couch, and I awoke covered with insect bites. By the following day I felt worse than I had on arriving home from India. We flew home, and the Stanford Department of Medicine spent weeks working me over for dengue fever and other tropical illnesses. Though they used every diagnostic test available to modern medicine, they never solved the puzzle of my illness.

  I remained ill for about sixteen months, barely able to get to Stanford each day and requiring a great deal of rest. One of Marilyn’s close friends told her later that many people thought I had suffered a stroke. Eventually, I resolved to rebuild my body: I joined a gym and forced myself to work out daily. No matter how bad I felt, I absolutely ignored any pleas or excuses from my body and maintained my regimen at the gym, and eventually I regained my health. Looking back on this time, I recall how often my twelve-year-old son, Ben, came into my bedroom and sat silently with me. For those two years I missed playing tennis with him, never taught him chess, never took bicycle rides with him (though he recalls our playing backgammon and reading aloud The Chronicles of Thomas Covenant by Stephen Donaldson).

  Ever since that time, I have felt tremendous empathy for patients suffering from mysterious non-diagnosable illnesses, such as chronic fatigue syndrome or fibromyalgia. It was a dark chapter in my life, and almost all memories of those days have faded—but I know it was my ultimate test of endurance.

  Though I did not meditate again for many years, I’ve come to have a higher regard for the practice, partly because I’ve known many people to whom it has given relief from suffering and offered a path to a compassionate life. In the past three years I’ve read more about meditation, spoken to colleagues with a meditation practice, and experimented with different approaches. Often, in the evening when I feel agitated, I listen to one of the countless sleep meditations available on the Internet, and often fall asleep before the end of the meditation.

  India was my first in-depth introduction to Asian culture. It was not to be my last.

  CHAPTER TWENTY-EIGHT

  JAPAN, CHINA, BALI, AND LOVE’S EXECUTIONER

  As I was checking into my Tokyo hotel in the fall of 1987, I encountered the English-speaking psychologist my Japanese hosts had flown in from New York to serve as translator. He was staying in the adjoining hotel room and would be available at all times for the entire week of my consultation.

  “Can you tell me exactly what I’ll be doing?” I asked.

  “The program director at the Hasegawa Hospital has told me nothing specific about your schedule this week.”

  “I wonder why. I’ve inquired but they’ve not replied: they seem almost to be deliberately secretive.”

  He simply looked at me, hunching his shoulders.

  The following morning when he and I arrived at the Hasegawa Hospital, I was greeted graciously with a huge bouquet of flowers by a large contingent of psychiatrists and administrators waiting inside the entrance. They said my first morning was a special occasion: the entire staff of the hospital would be in attendance to listen to my discussion of an inpatient therapy group meeting. They then guided me into an auditorium seating about four hundred people. Having commented on group meetings countless times, I felt relaxed and sat back anticipating a verbal description or a videotape of a group meeting. Instead I was stunned to see that the staff had elaborately prepared a dramatized re-creation of a group meeting. They had taped a group session held on one of the hospital wards the previous month, transcribed it, assigned roles to various staff members, and obviously spent a great many hours rehearsing the drama. It was a polished performance, but, alas, it portrayed one of the most dreadful group meetings I had ever seen. The leaders circled the group, offering advice and prescribing various exercises in turn to each member. Not once did a member of the group address another member—in my view, a clear example of how not to do group therapy. If it were only the taping of a real group session, I would have had no problem halting it and then describing alternative approaches. But how could I possibly stop a carefully choreographed production that must have required countless hours of rehearsal? It would have been a horrific insult, and so I sat and attended to the entire performance (with my translator whispering into my ear). Then, in my discussion, I gently, very gently, suggested some interpersonally based techniques.

  I tried my best to be a helpful teacher during my week in Tokyo, but I never felt I was being effective. I realized during that week that something deeply embedded in Japanese culture opposes Western psychotherapy, especially group psychotherapy: mainly, shame at revealing oneself or sharing one’s family secrets. I volunteered to lead a process group for therapists, but the idea was rejected, and, to be honest, I was relieved. I think there would have been such powerful silent resistance that we would have made little progress. In all my presentations that week, the audience was respectfully attentive, but no one made a comment or asked a single question.

  Marilyn had a similar experience on the same trip. She gave a lecture on twentieth-century American women’s literature at a Japanese women’s institute before a large crowd in a beautifully appointed auditorium. The event was well orchestrated, with a lovely dance recital preceding the lecture and an attentive, respectful audience. But when she asked for questions or comments, there was silence. Two weeks later, she gave the identical talk at the Beijing Foreign Studies University and at the end was bombarded with questions from the Chinese students.

  Every imaginable courtesy was given me in Tokyo. I loved our formal bento box luncheons with seven layers of delicate and splendidly arrayed courses. Lavish parties were given in my honor, and my host generously invited me to use his 360-degree-view condominium in Hawaii whenever I wished.

  After my consultation, wherever we traveled in Japan we were always treated generously by hosts and strangers. In Tokyo one evening when we were heading toward the Kabuki Theater but had lost our way, we showed our tickets to a woman washing the steps of a building and asked for directions. She instantly dropped what she was doing and escorted us four blocks to the door of our theater. Another time, in Kyoto, we had disembarked from a bus and were strolling through the city when we heard hurried footsteps behind us. An elderly woman struggling to catch her breath approached with the umbrella we had left on the bus. A short time later at a Buddhist temple we fell into a conversation with a stranger, a college professor, who immediately invited us to his home for dinner. But their culture did not welcome my approach to therapy, and very few of my books have been translated into Japanese.

  Japan was the first stop of a year’s sabbatica
l. I had just completed a difficult period revising, once again, my group therapy textbook. Beginners, like me, who write a textbook are generally unaware that, if the textbook is successful, they are signing on for life. Textbooks must be revised every few years, particularly if there is new research and change in the field—and that, indeed, was the case for group therapy. If they are not revised, teachers will search for a more current text to assign to their classes.

  In the fall of 1987, we had an empty nest: my youngest child, Ben, had left home for college at Stanford. After sending my textbook revision to the publisher, Marilyn and I celebrated our freedom with a full year of travel abroad, stopping for long writing retreats in Bali and Paris.

  For a very long time I had been considering a very different kind of book. All my life I have been a lover of narrative, and I have often smuggled therapy stories, some only a few lines long, some lasting a few pages, into my professional writing. Over the years many readers of my group therapy text had informed me that they were willing to put up with many pages of dry theory because they knew there would be another teaching story coming around the bend. So, at age fifty-six, I resolved to make a major life change. I would continue to teach young psychotherapists through my writing, but I would elevate the story to a privileged position: I would put the story first and allow it to be the primary vehicle for my teaching. I felt the time had come to liberate the storyteller within me.

  Before leaving for Japan it was imperative to get the hang of my newfangled gadget: a laptop computer. So we rented a cabin for three weeks in Ashland, Oregon, a town we had visited many times for its extraordinary theater festival. We saw plays in the evenings but during the daytime I assiduously practiced writing on the laptop. When I felt confident about its use, we took off for our first stop: the consultation in Tokyo.

  I was a one-finger typist at that point. All my prior books and articles had been written in longhand (or, in one case, dictated). But to use this new computer I had to learn to type, and I succeeded via an unusual method: I spent my long flight to Japan playing one of the early video games in which my spaceship was attacked by alien vessels firing missiles in the shape of letters of the alphabet, which could only be repelled by pressing the corresponding key on the keyboard. It was an extraordinarily effective pedagogical device and by the time the plane landed in Japan I knew how to type.

  After our visit to Tokyo we flew to Beijing, where we met four American friends and, with a guide, which was mandatory during those years, set off on a two-week tour of China. We went to the Great Wall, the Forbidden City, and, on a river trip, to Guilin, where we were enthralled by the pencil-like mountains in the distance. On all these journeys I continued to contemplate how I would write a collection of therapy stories.

  One day in Shanghai I was feeling a bit under the weather and did not accompany the others on their full-day tour, but spent the morning resting. From my briefcase crammed with dictated session notes, I randomly selected one folder (out of twenty-five) and read over the summaries of the seventy-five therapy sessions I had had with Saul, a sixty-year-old biochemistry researcher.

  That afternoon, while meandering alone through the back streets of Shanghai, I came upon a large, handsome, and long-abandoned Catholic church. Entering through the unlocked door, I wandered down the aisles until my eye caught the confessional booth. After making certain I was alone, I did something I had always wanted to do: I slipped in and sat down in the priest’s seat! I thought of the generations of priests who had listened to confessions in this box and imagined all that they had heard—so much remorse, so much shame, so much guilt. I envied those men of God; I envied their ability to pronounce to sufferers, “You are forgiven.” What therapeutic power! My own abilities felt dwarfed.

  After sitting and meditating for about an hour in that ancient seat of authority, an amazing thing happened: I slipped into a reverie during which the entire plot of a story, “Three Unopened Letters,” revealed itself. I suddenly knew everything about that story—its characters, its development, and its moments of suspense. I was desperate to record it before it evaporated, but I had no paper or pencil (this was the pre-iPhone era)—no way to record my thoughts. Scouring the church, I found a one-inch stub of pencil in an empty bookshelf, but not a scrap of paper, so I turned to the only paper available to me—the blank pages of my passport—on which I scribbled the essentials of the story. This was the first of a collection I would ultimately title Love’s Executioner.

  A few days later we said goodbye to our friends and to China and flew to Bali for a two-month stay in an exotic house we had rented. There I began to write in earnest. Marilyn also had a writing project (which eventuated in her book Blood Sisters: The French Revolution in Women’s Memory). Though we dearly loved our four children, we exalted in our freedom: this was our first prolonged sojourn together without children since our honeymoon in France, thirty-three years earlier.

  Our Balinese house was unlike anything we had ever encountered. From the outside we could see only the high wall encircling the large property, which was filled with lush tropical flora. The house had no walls, only hanging shades dividing and enclosing the rooms. The sleeping area was upstairs, and the bathroom was in a separate structure. Our first night there was unforgettable: about midnight, a swarm of flying insects descended upon us, millions of them, so overwhelming that we pulled the sheets over our heads. I eyed my suitcases, planning to get as far away from this place as I could as fast as possible when morning arrived. But by the time the sun rose, all was quiet again, not an insect in sight, and the servants swore to us that this termite mating swarm happened only one night a year. Birds in iridescent colors boldly perched in the intricately twisted trees of the garden and caroled strange melodies. The perfume of unfamiliar blossoms drugged us, and we found the kitchen stocked with several types of strange-looking fruit. A staff of six living in huts on the property spent their days cleaning, cooking, gardening, playing music, and making flower and fruit arrangements for the frequent religious festivals. A three-minute walk out the back gate down a sandy trail took us to the magnificent Kuta Beach—still pristine and deserted in those days. And all of this for far less than the rent we charged for our Palo Alto house.

  BALI, 1988.

  After writing “Three Unopened Letters,” the story about Saul, from the notes I had sketched in my passport, I spent mornings on the garden bench trolling my case notes for the next story. In the afternoons Marilyn and I wandered for hours along the beach, and, almost imperceptibly, a story would take root and develop such momentum as to compel me to put aside all other notes and devote myself to that particular tale. As I started writing, I had no idea where a story would lead me or what shape it would take. I felt myself almost a bystander as I watched it take root and send up shoots that soon interlaced.

  I have often heard writers say a story writes itself, but I hadn’t understood it until then. After two months, I had an entirely new and deeper appreciation of an old anecdote Marilyn had told me years before about the nineteenth-century English novelist William Thackeray. One evening, as Thackeray came out of his study, his wife asked how the day’s writing had gone. He responded, “Oh, a terrible day! Pendennis [one of his characters] made a fool of himself and I simply couldn’t stop him.”

  Soon I became used to listening to my characters speaking to one another. I eavesdropped all the time—even after finishing the day’s writing, when I was strolling arm in arm with Marilyn on one of the endless buttery beaches. Before long I had another writerly experience, one of the peak experiences of my life. At some point while deep into a story, I observed my fickle mind flirting with another story, one taking shape beyond my immediate perception. I took this to be a signal—an uncanny one, to myself from myself—that the story I was writing was coming to an end and a new one readying for birth.

  Now that all my words existed only on this unfamiliar computer, I grew more and more uneasy at having no
paper copies of my work—such things as flash drives, Time Machine, and Dropbox were yet unborn. Unfortunately, my portable Kodak printer did not enjoy travel and, after only one month in Bali, gave up the ghost. Alarmed at the prospect of my work vanishing permanently deep in the computer’s innards, I sought help. There turned out to be only one printer in all of Bali, in a computer school in the capital city of Denpasar. One day I brought my computer to the school, waited until the end of class, and begged or bribed—I forget which, perhaps both—the teacher to print a precious hard copy of the work to date.

  Inspiration came quickly in Bali. Without mail, a telephone, or other distractions, I wrote better and more rapidly than ever before. In my two months there I wrote four of the ten stories. In each story I spent a great deal of time disguising the identity of the patients. I altered the patients’ appearances, occupations, ages, nationalities, marital status, and often even gender. I wanted to be entirely certain that no one could possibly recognize them, and, of course, I would send the patient the finished story and ask for written permission.

 

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