Nonetheless, it was with regret that I passed up the opportunity of working in depth with him: the dynamics of his situation fascinated me. I was certain that my first impression had been close to the mark: that his impending retirement had stoked up much fundamental anxiety about finitude, aging, and death, and that he was attempting to cope with this anxiety through sexual mastery. So much was riding on the sexual act that it was overtaxed and, ultimately, overwhelmed.
I believed that Marvin was entirely wrong when he said that sex was at the root of his problems; far from it, sex was just an ineffective means of trying to drain off surges of anxiety springing from more fundamental sources. Sometimes, as Freud first showed us, sexually inspired anxiety is expressed through other devious means. Perhaps just as often the opposite is true: other anxiety masquerades as sexual anxiety. The dream about the giant auger could not have been more clear: the ground under Marvin’s feet was liquefying (an inspired visual image for groundlessness), and he was trying to combat that by drilling, with his penis, sixty-five feet (that is, sixty-five years) down!
The other dreams gave evidence of a savage world beneath Marvin’s placid exterior—a world seething with death, murder, suicide, anger toward Phyllis, fears of dirty and menacing phantoms erupting from within. The blindfolded man in the room where he and Phyllis were to make love was particularly intriguing. When investigating sexual problems it is always important to ask, Are there more than two people present during lovemaking? The presence of others—phantoms of parents, rivals, other lovers—vastly complicates the sexual act.
No, behavioral therapy was the best choice. It was best to keep the lid of this underworld sealed. 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.
But rationality and precision in psychotherapy are rarely rewarded. A few days later, Marvin called and asked for another appointment. I had expected that Phyllis would accompany him, but he arrived alone, looking anxious and haggard. No opening ceremonies that day. He came right to the point.
“This is a bad day. I feel miserable. But first, I want to say that I appreciate your recommendation last week. To be honest, I’d expected you to advise me to come to see you three or four times a week for the next three or four years. I’d been warned that you psychiatrists did that regardless of the problem. Not that I blame you—after all, you guys are running a business and gotta earn a living.
“Your advice about couples therapy made sense to me. Phyllis and I do have some communication problems, more than I really told you about last week. Actually, I understated the case to you. I’ve had some difficulties with sex—not as bad as now—which caused me to flip back and forth in my moods for twenty years. So I decided to take your advice, but Phyllis will not cooperate. She flat out refuses to see a shrink, a marriage therapist, a sex therapist—anyone. I asked her to come in one time today to talk to you, but she has dug in her heels.”
“How come?”
“I’ll get to that but, first, there are two other things I want to cover today.” Marvin stopped. At first I thought it was to catch his breath: he had been racing through his sentences. But he was composing himself. He turned away, blew his nose, and wiped his eyes surreptitiously.
Then he continued. “I’m way down. I had my worst migraine ever this week and had to go to the emergency room night before last for an injection.”
“I thought you looked drawn today.”
“The headaches are killing me. But to make things worse, I’m not sleeping. Last night I had a nightmare which woke me up about two in the morning, and I kept replaying it all night long. I still can’t get it out of my mind.”
“Let’s go over it.”
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. Marvin put aside his notepad and from memory recited:The two men are tall, pale, and very gaunt. In a dark meadow they glide along in silence. They are dressed entirely in black. With tall black stovepipe hats, long-tailed coats, black spats and shoes, they resemble Victorian undertakers or temperance workers. Suddenly they come upon a carriage, ebony black, cradling a baby girl swaddled in black gauze. Wordlessly, one of the men begins to push the carriage. After a short distance he stops, walks around to the front, and, with his black cane, which now has a glowing white tip, he leans over, parts the gauze, and methodically inserts the white tip into the baby’s vagina.
I was transfixed by the dream. The stark images took form immediately in my own mind. I looked up in amazement at Marvin, who seemed unmoved and unappreciative of the power of his own creation, and the notion occurred to me that this was not, could not be, his dream. A dream like that could not have sprung from him: he was merely the medium through whose lips it was expressed. How could I, I wondered, meet the dreamer?
Indeed, Marvin reinforced that whimsical notion. He had no sense of familiarity with the dream and related to it as though it were some alien text. He still experienced fear as he recited it, and shook his head as though he were trying to get the dream’s bad taste out of his mouth.
I focused on the anxiety. “Why was the dream a nightmare? Precisely what part of it was frightening?”
“As I think about it now, the last thing—putting the cane in the baby’s vagina—is the horrible part. Yet not when I was having the dream. It was everything else, the silent footsteps, the blackness, the sense of deep foreboding. The whole dream was soaked in fear.”
“What feeling was there in the dream about the insertion of the cane into the baby’s vagina?”
“If anything, that part seemed almost soothing, as though it quieted the dream—or, rather, it tried to. It didn’t really do it. None of this makes any sense to me. I’ve never believed in dreams.”
I wanted to linger with the dream but had to return to the needs of the moment. The fact that Phyllis was unwilling to talk to me, even once, to help her husband, who was now in extremis, belied Marvin’s account of his idyllic, harmonious marriage. I had to proceed with delicacy here because of his fear (which Phyllis obviously shared) that therapists snoop out and fan marital problems, but I had to be certain that she was inexorably opposed to couples therapy. Last week I had wondered if Marvin hadn’t felt rejected by me. Perhaps this was a ploy to manipulate me into seeing him in individual therapy. How much of an effort had Marvin really made to persuade Phyllis to participate with him in treatment?
Marvin assured me that she was very set in her ways.
“I told you she doesn’t believe in psychiatry, but it goes far beyond that. She won’t see any doctor, she’s not had a GYN exam in fifteen years. It’s all I can do to get her into the dentist when she’s got a toothache.”
Suddenly, when I asked for other examples of Phyllis being set in her ways, some unexpected things came pouring out.
“Well, I might as well tell you the truth. No sense of spending good money and sitting here and lying to you. Phyllis has her problems. The main thing is that she’s afraid of going out of the house. That has a name. I’ve forgotten it.”
“Agoraphobia?”
“Yeah, that’s it. She’s had it for years and years. She rarely leaves the house for any reason unless”—Marvin’s voice grew hushed and conspiratorial—“it’s to escape another fear.”
“What other fear?”
“The fear of people visiting the house!”
He went on to explain that they had not entertained guests at home for years—indeed, for decades. If the situation demanded it—for 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.
Moreover, Phyllis did not permit Marvin to entertain at home
either. A couple of weeks ago, for example, some out-of-town guests called to ask if they could view his collection of political buttons. He said he didn’t bother to ask Phyllis: he knew she’d raise hell. If he tried to force the issue, it would be, he said, “a month of Sundays” before he “got laid again.” Consequently, as he had done many times before, he spent the better part of a day packing up his whole collection to exhibit it in his office.
This new information made it even more clear that Marvin and Phyllis very much needed marital therapy. But there was a new twist now. Marvin’s first dreams had so teemed with primitive iconography that, the week before, I had feared individual therapy might break the seal of this seething unconscious and thought marital therapy would be safer. Now, however, with this evidence of severe pathology in their relationship, I wondered whether couples therapy might also unleash demons.
I reiterated to Marvin that, all things considered, I still believed the treatment of choice to be behaviorally oriented couples therapy. But couples therapy requires a couple, and if Phyllis was not yet willing to come in (as he immediately reaffirmed), I told him I would be willing to see him in a trial of individual therapy.
“But be forewarned, individual treatment will most likely require many months, even a year or longer, and it will not be a rose garden. Painful thoughts or memories may emerge which will temporarily make you more uncomfortable than you are right now.”
Marvin stated that he had thought about it during the last few days, and wished to begin immediately. We arranged to meet twice weekly.
It was apparent that both he and I had reservations. Marvin continued to be skeptical about the psychotherapeutic enterprise and showed little interest in an inner journey. He agreed to therapy only because the migraine had brought him to his knees and he had nowhere else to turn. I, for my part, had reservations because I was so pessimistic about treatment: I agreed to work with him because I saw no other viable therapy option.
But I could have referred him to someone else. There was another reason—that voice, the voice of that being who had created those astonishing dreams. Buried somewhere within Marvin’s walls was a dreamer tapping out an urgent existential message. I drifted back into the landscape of the dream, back into the silent, dark world of the gaunt men, the black meadow, and the black-gauzed baby girl. I thought of the incandescent tip of the cane and the sexual act that was not sex but merely a futile attempt to dispel the dread.
I wondered, If disguise were unnecessary, if the dreamer could speak to me without guile, what might he say?
“I am old. I am at the end of my life’s work. I have no children, and I approach death full of dread. I am choking on darkness. I am choking on the silence of death. I think I know a way. I try to pierce the blackness with my sexual talisman. But it is not enough.”
But these were my reflections, not Marvin’s. I asked him to associate to the dream, to think about it, and to say anything that came to mind. Nothing came. He merely shook his head.
“You shake your head no almost instantaneously. Try again. Give yourself a chance. Take any part of the dream and let your mind wander with it.”
Nothing whatsoever.
“What do you make of the white-tipped cane?”
Marvin smirked. “I was wondering when you’d get around to that! Didn’t I say earlier that you fellows see sex at the root of everything?”
His accusation seemed particularly ironic because, if there were one conviction I had about him, it was that sex was not the source of his difficulty.
“But it’s your dream, Marvin. And your cane. You created it, what do you make of it? And what do you make of the allusions to death—undertakers, silence, blackness, the whole atmosphere of dread and foreboding?”
Given the choice of discussing the dream from the perspective of death or of sex, Marvin, with dispatch, chose the latter.
“Well, you might be interested in something sexual that happened yesterday afternoon—that would be about ten hours before the dream. I was lying in bed still recovering from my migraine. Phyllis came over and gave me a head and neck massage. She then kept on going and massaged my back, then my legs, and then my penis. She undressed me and then took off all her clothes.”
This must have been an unusual event: Marvin had told me he initiated sex almost all of the time. I suspected that Phyllis wanted to expiate her guilt for refusing to see a couples therapist.
“At first, I wouldn’t respond.”
“How come?”
“To tell you the truth, I was scared. I was just getting over my worst migraine, and I was afraid I’d fail and get another migraine. But Phyllis started sucking my cock and got me hard. I’ve never seen her so persistent. I finally said, ‘Let’s go, a good lay might be just the thing to get rid of some of this tension.’” Marvin paused.
“Why do you stop?”
“I’m trying to think of her exact words. Anyway, we started making love. I was doing pretty well, but just as I was getting ready to come, Phyllis said, ‘There are other reasons for making love than to get rid of tension.’ Well, that did it! I lost it in a second.”
“Marvin, did you tell Phyllis exactly how you felt about her timing?”
“Her timing is not good—never has been. But I was too riled up to talk. Afraid of what I’d say. If I say the wrong thing, she can make my life hell—turn off the sexual spigot altogether.”
“What sort of thing might you say?”
“I’m afraid of my impulses—my murderous and sexual impulses.”
“What do you mean?”
“Do you remember, years ago, a news story of a man who killed his wife by pouring acid on her? Horrible thing! Yet I’ve often thought about that crime. I can understand how fury toward a woman could lead to a crime like that.”
Christ! Marvin’s unconscious was closer to the surface than I thought. Remembering I hadn’t wanted to take the lid off such primitive feelings—at least not this early in treatment—I switched from murder to sex.
“Marvin, you said you’re frightened also by your sexual impulses. What do you mean?”
“My sex drive has always been too strong. I’ve been told that’s true of many bald men. A sign of too much male hormone. Is that true?”
I didn’t want to encourage the distraction. I shrugged off the question. “Keep going.”
“Well, I’ve had to keep it under rein all my life because Phyllis has got strong ideas about how much sex we will have. And it’s always the same—two times a week, some exceptions for birthdays and holidays.”
“You’ve got some feelings about that?”
“Sometimes. But sometimes I think restraints are good. Without them I might run wild.”
That was a curious comment. “What does ‘running wild’ mean? Do you mean extramarital affairs?”
My question shocked Marvin. “I’ve never been unfaithful to Phyllis! Never will be!”
“Well, what do you mean by ‘running wild’?”
Marvin looked stumped. I had a sense he was talking about things he had never discussed before. I was excited for him. It had been one hell of an hour’s work. I wanted him to continue, and I just waited.
“I don’t know what I mean, but at times I’ve wondered what it would have been like to have married a woman with a sex drive like mine, a woman who wanted and enjoyed sex as much as me.”
“What do you think? Your life would have been very different?”
“Let me back up a minute. I shouldn’t have used the word enjoy a few minutes ago. Phyllis enjoys sex. It’s just that she never seems to want it. Instead, she . . . what’s the word? . . . dispenses it—if I’m good. These are the times when I feel cheated and angry.”
Marvin paused. He loosened his collar, rubbed his neck, and rolled his head around. He was getting rid of tension, but I imagined him to be looking around the room, as though to assure himself no one else was listening.
“You look uncomfortable. What are you feeling?”
“Disloyal. Like I shouldn’t have been saying these things about Phyllis. Almost like she’ll find out about it.”
“You give her a lot of power. Sooner or later we’re going to need to find out all about that.”
Marvin continued to be refreshingly open during the first several weeks of therapy. All in all, he did far better than I had expected. He was cooperative; he relinquished his pugnacious skepticism about psychiatry; he did his homework, came prepared for the sessions, and was determined, as he put it, to get a good return on his investment. His confidence in therapy was boosted by an unexpected early dividend: his migraines mysteriously almost disappeared as soon as he started treatment (although his intense sex-spawned mood swings continued).
During this early phase of therapy, we concentrated on two issues: his marriage and (to a lesser extent, because of his resistance) the implications of his retirement. But I was careful to tread a fine line. I felt like a surgeon preparing the operative field but avoiding any deep dissection. I wanted Marvin to explore these issues, but not too searchingly—not enough to destabilize the precarious marital equilibrium he and Phyllis had established (and thus drive him immediately out of therapy) and not enough to evoke any further death anxiety (and thus ignite further migraines).
At the same time as I was conducting this gentle, somewhat concrete therapy with Marvin, I was also engaged in a fascinating discourse with the dreamer, that vastly enlightened homunculus housed—or, one might say, jailed—by Marvin, who was either ignorant of the dreamer’s existence or allowed him to communicate with me in a spirit of benign indifference. While Marvin and I strolled and casually conversed on superficial levels, the dreamer drummed out a constant stream of messages from the depths.
Perhaps my discourse with the dreamer was counterproductive. Perhaps I was willing to permit Marvin a slower pace because of my encounter with the dreamer. I remember beginning every hour not with excitement about seeing Marvin, but with anticipation about my next communiqué from the dreamer.
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