But too much was riding on this hour. I could not bear for Thelma to waste this opportunity with indirect meanderings. This was her chance to ask the questions that had plagued her for eight years. This was her chance to be released.
“I’m going to interrupt you for a minute, Thelma, if I may. I’d like, if you two agree, to have the role of timekeeper today and to keep us focused. Can we spend a minute or two establishing our agenda?”
There was silence for a short time until Matthew punctured it.
“I’m here today to be helpful to Thelma. I know she has been going through bad times, and I know that I bear the responsibility for that. I’ll be as open as possible to any questions.”
That was Thelma’s perfect cue. I gave her a starting glance. She caught it and began.
“There is nothing worse than to feel bereft, to feel that you are absolutely alone in the world. When I was a child, one of my favorite books—I used to take it to Lincoln Park in Washington, D.C., to read on the benches there—was——”
Here I shot Thelma the sharpest, nastiest look I could muster. She got it.
“I’ll get to the point. I guess the bottom line is”—and she slowly and carefully turned to Matthew—“what do you feel about me?”
Atta girl! I positively beamed at her.
Matthew’s answer made me gasp. He looked straight at her and said, “I’ve thought about you every day for the last eight years! I care about you. I care a great deal. I want to know what happens to you. I wish that there were some way in the world of our meeting every few months so I could catch up on you. I don’t want to be cut off.”
“Then,” Thelma asked, “why have you been silent all these years?”
“Sometimes caring can be best expressed by silence.”
Thelma shook her head. “That’s like one of your Zen riddles that I could never understand.”
Matthew continued, “Whenever I tried to talk to you, it made things worse. You asked for more and more until it reached the point when I couldn’t find a way to give any more. You called me a dozen times a day. You showed up time and time again in my office waiting room. Then when you almost killed yourself, I knew—and my therapist agreed—that the best thing was to cut it off completely.”
Matthew’s statement, I thought, bore an uncanny resemblance to the releasing scenario Thelma had shared in our role-playing session.
“But,” Thelma commented, “it’s natural for a person to be bereft if something so important is taken away so suddenly.”
Matthew nodded understandingly to Thelma and briefly put his hand on top of hers. Then he turned to me. “I think it’s important for you to know exactly what happened eight years ago. I’m speaking to you now rather than to Thelma because I’ve already told her this story, more than once.” He turned to her. “Sorry you have to hear this whole thing yet again, Thelma.”
Then Matthew, ingenuously, turned to me and began: “This is not easy for me. The best way to do it is simply to do it. So here goes.
“Eight years ago, about a year after I finished my training, I had a serious psychotic break. During that time I was heavily into Buddhism and was sitting Vipassana—that’s a form of Buddhist meditation—” When Matthew saw me nod, he interrupted his story. “You seem familiar with it—I’d be very interested to know your opinion of it. But today I guess I’d better continue. . . . I was sitting Vipassana for three to four hours a day. I considered becoming a Buddhist monk and went to India for a thirty-day meditation retreat in Igapuri, a small village north of Bombay. The regimen was too severe for me—total silence, total isolation, sitting meditation for fourteen hours a day—and I began to lose my ego boundaries. By the third week I was hallucinating and thought that I could see through walls and had total access to both my past and future lives. The monks took me to Bombay, and an Indian doctor put me on antipsychotic medication and called my brother, who flew to India to take me home. I was hospitalized for about four weeks in Los Angeles. After I was discharged I immediately flew back to San Francisco, and it was the following day that I met Thelma, sheerly by chance, in Union Square.
“I was still in a very fragmented state of mind. I had turned the Buddhist doctrines into a real craziness and believed I was in a state of oneness with everybody. I was glad to run into Thelma—into you, Thelma,” turning to her. “I was glad to see you. It helped me feel anchored again.”
Matthew turned back to me and, until he finished his story, did not again look at Thelma.
“I had nothing but good feelings for her. I felt one with Thelma. I wanted her to have everything she wanted in life. More than that—I thought her quest for happiness was my quest as well. It was the same quest, she and I were the same. I took the Buddhist credo of universal oneness and egolessness very literally. I didn’t know where I ended and another started. I gave her everything she wanted. She wanted me to be close to her, she wanted to come home with me, she wanted sex—I was willing to give her everything in a state of perfect oneness and love.
“But she wanted more and I couldn’t give more. I grew more disturbed. After three or four weeks my hallucinations returned, and I had to re-enter the hospital—this time for six weeks. I hadn’t been out very long when I heard about Thelma’s suicide attempt. I didn’t know what to do. It was catastrophic. It was the worst thing that had ever happened to me. I’ve been haunted by it for eight years. I answered her calls at first, but they kept coming. My psychiatrist finally advised me to sever all contact, to be totally silent. He said that would be necessary for my own sanity, and he was certain that it would be best for Thelma as well.”
As I listened to Matthew, my head began to spin. I had developed a variety of hypotheses about his behavior, but I was not remotely prepared for the story I had just heard.
First, was it true? Matthew was a charmer. He was smooth. Was he staging all this for me? No, I had no doubt that things were as he described them: his words had the unmistakable ring of truth. He freely offered the names of hospitals and his treating physicians if I should want to call. Furthermore, Thelma, to whom he said he had told this in the past, had listened with rapt attention and offered no demurral whatsoever.
I turned to look at Thelma, but she averted her glance. After Matthew finished talking, she began to stare out the window. Was it possible that she knew all this from the start and had concealed it from me? Or had she been so absorbed with her own distress and her own needs that, throughout, she had been completely unaware of Matthew’s mental state? Or had she known for some brief period and then repressed the knowledge because it clashed with her own vital lie?
Only Thelma could tell me. But which Thelma? The Thelma who deceived me? The Thelma who deceived herself? Or the Thelma who was deceived by herself? I doubted that I would find the answers to these questions.
Primarily, though, my attention was fixed on Matthew. Over the last several months, I had constructed a vision—or, rather, several alternative visions—of 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.
Yet he was none of these. He was something else, something I had never anticipated. But what? I wasn’t certain. A well-intentioned victim? A wounded healer, a Christ figure who had sacrificed his own integrity for Thelma? Certainly, I no longer viewed him as an offending therapist: he was as much a patient as Thelma and, furthermore (I could not help thinking, glancing toward Thelma, who was still staring out the window), a working patient, a patient after my own heart.
I remember feeling dislocated—so many constructs exploded in so few minutes. Gone forever was the construct of Matthew as sociopath or exploiter-therapist. Instead there arose a haunting question: In this relationship, who had exploited whom?
This was all the information I could handle (and all that I thought I needed). I ha
ve only a dim recollection of the rest of the hour. I remember that Matthew encouraged Thelma to ask more questions. It was as though he, too, sensed that she could be released only by information, that her illusions could not endure the beam of truth. And I think, too, that he realized that only through Thelma’s release could he obtain his own. I remember that Thelma and I both asked many questions, each of which he answered fully. His wife had left him four years ago. She and he had increasingly diverging views about religion, and she could not follow his conversion into a fundamentalist Christian sect.
No, he was not gay. Nor had he ever been, though Thelma had often asked him about that. It was only at this moment that his smile narrowed and a trace of irritation entered his voice (“I kept telling you, Thelma, that straight people live in the Haight, too”).
No, he had never had a personal relationship with any other patient. In fact, as a result of his psychosis and what had happened with Thelma, he had, several years ago, realized that his psychological problems posed an insurmountable barrier, and he had stopped being a therapist. But, committed to a life of service, he did psychological testing for a few years; then he worked in a biofeedback lab; and, more recently, he had become the administrator of a Christian health maintenance organization.
I was musing about Matthew’s professional decision, even wondering whether he had evolved to the point where he should go back to doing therapy—perhaps he now might make an exceptional therapist—when I noticed that our time was almost up.
I inquired whether we had covered everything. I asked Thelma to project herself into the future and to imagine how she might feel several hours from now. Would she be left with unasked questions?
To my surprise, she began sobbing so forcefully that she could not catch her breath. Tears poured down upon her new blue dress until Matthew, outracing me, handed her the box of tissues. As her sobbing subsided, Thelma’s words grew audible.
“I don’t believe, I simply can’t believe that Matthew really cares about what happens to me.” Her words were directed neither to Matthew nor to me but to some point between us in the room. I noted with some satisfaction that I wasn’t the only one she addressed in the third person.
I tried to help Thelma talk. “Why? Why don’t you believe him?”
“He’s saying that because he has to. It’s the right thing to say. It’s the only thing he can say.”
Matthew did his best, but communication was difficult because of her sobbing. “I mean exactly what I said. I’ve thought about you every day these eight years. I care about what happens to you. I care about you a great deal.”
“But your caring—what does it mean? I know about your caring. You care about the poor, about ants and plants and ecological systems. I don’t want to be one of your ants!”
We had run twenty minutes over and had to stop even though Thelma had still not regained her composure. I gave her an appointment for the following day not only to be supportive but also because it would be best to see her again quickly, while the details of this hour were still fresh in her mind.
The three of us ended the hour with round-robin handshakes and parted. A few minutes later, as I was getting some coffee, I noticed Thelma and Matthew chatting in the corridor. He was trying to make a point to her, but she was looking away from him. Shortly afterward, I saw them walk away in different directions.
Thelma had not recovered by the next day and was exceptionally labile throughout our session. She wept often and, at times, flashed into anger. First, she lamented that Matthew had such a low opinion of her. She had worked and worried Matthew’s statement that he “cared” for her until it now seemed an insult. He had, she noted, mentioned none of her positive features, and Thelma convinced herself that his basic posture to her had been “unfriendly.”
Furthermore, she was convinced that, probably because of my presence, he had adopted a pseudo-therapeutic voice and manner which she had found patronizing. Thelma rambled a great deal and swerved back and forth between her reconstruction of the hour and her reaction to it.
“I feel like an amputation has taken place. Something has gone from me. Despite Matthew’s high-sounding ethics, I believe I am more honest than he. Especially in his account of who seduced who.”
Thelma remained cryptic on this matter, and I did not press her for explication. Although I would have relished finding out what “really” happened, her reference to “amputation” intrigued me even more.
“I haven’t had any more fantasies about Matthew,” she went on. “I’m not daydreaming any more. But I want to. I want to sink into the embrace of some warm daydream. It’s cold out and I feel empty. Now, there is just nothing.”
Like a drifting boat torn loose from its mooring, I thought—but a sentient boat desperately searching for a berth, any berth. Now, between obsessions, Thelma was in a rare free-floating state. This was the time I had been waiting for. Such states don’t last long: the unbonded obsessional, like nascent oxygen, quickly melds with some mental image or idea. This moment, this brief interval between obsessions, was the crucial time for us to work—before Thelma re-established her equilibrium by latching onto something or someone. Most likely she would reconstruct the hour with Matthew so that her version of reality could once again support her fusion fantasy.
It seemed to me that real progress had occurred: the surgery was complete, and now my task was to prevent her from preserving the amputated limb and quickly stitching it back on again. My opportunity arrived soon, as Thelma proceeded to lament her loss.
“My predictions of what might happen have come true. I don’t have any more hope, I’ll never have any more satisfaction. I could live with that one-percent chance. I’ve lived with it a long time.”
“What was the satisfaction, Thelma? A one-percent chance for what?”
“For what? For those twenty-seven days. Until yesterday there was always a chance that Matthew and I could go back to that time. We were there, the feeling was real, I know love when I feel it. As long as Matthew and I were alive, we always had the chance to return to it. Until yesterday. In your office.”
There were still a few threads of illusion to be severed. I’d almost totally destroyed the obsession. It was time to finish the job.
“Thelma, what I have to say now is not pleasant, but I think it’s important. Let me try to get my thoughts out clearly. If two people share a moment or share a feeling between them, if they both feel the same thing, then I can see how it might be possible for them, as long as they are alive, to re-establish that precious feeling between the two of them. It would be a delicate procedure—after all, people change, and love never stays—but still, perhaps, it is within the realm of possibility. They could communicate fully, they could try to achieve a deep authentic relationship which, since authentic love is an absolute state, should approximate what they had before.
“But suppose it was never a shared experience! Suppose the two people had widely different experiences. And suppose one of them mistakenly thought her experience was the same as his?”
Thelma’s eyes were fixed on me. I was certain that she understood me perfectly.
I continued. “What I heard in the session with Matthew was precisely that. His experience and your experience were very different. Can you see how impossible it would be for each of you to re-create the particular mental state you were in? The two of you can’t help one another with this because it was not a shared state.
“He was in one place and you were in another. He was lost in a psychosis. He didn’t know where his boundaries were—where he ended and you began. He wanted you to be happy because he thought he was the same as you. He wasn’t having a love experience, because he didn’t know who he was. Your experience was very different. You cannot re-create a state of shared romantic love, of the two of you being deeply in love with one another because it was never there in the first place.”
I don’t think I’ve ever said a crueler thing, but to make myself heard, I had to speak
in words so strong and so stark that they could be neither twisted nor forgotten.
There was no doubt my comment struck home. Thelma had stopped crying and just sat there stock still considering my words. I broke the heavy silence after several minutes:
“How do you feel about what I said, Thelma?”
“I can’t feel anything any more. There’s nothing else to feel. I have to find a way to live out my time. I feel numb.”
“You’ve been living and feeling one way for eight years, and now suddenly in twenty-four hours all that is pulled away from you. These next few days are going to feel very disorienting. You’re going to feel lost. But we have to expect that. How could it be otherwise?”
I said this because often the best way to prevent a calamitous reaction is to predict it. Another way is to help the patient get outside of it and move into the observer role. So I added, “It will be important this week to be an observer and recorder of your own inner state. I’d like you to check in on your internal state every four hours, when you are awake, and jot down your observations. We’ll go over them next week.”
But the next week Thelma, for the first time, missed her appointment. Her husband called to apologize for his wife, who had overslept, and we agreed upon a meeting two days later.
When I went to the waiting room to greet Thelma, I was dismayed at her physical deterioration. She was back in her green jogging suit and had obviously not combed her hair or made any other attempts to groom herself. Moreover, for the first time, she was accompanied by her husband, Harry, a tall, white-haired man with a large bulbous nose, who sat there squeezing a grip strengthener in each hand. I remembered Thelma’s telling me about his teaching hand-to-hand combat in wartime. I could picture him strangling someone.
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