by The Naked Lady Who Stood on Her Head: A Psychiatrist's Stories of His Most Bizarre Cases
She stood, angry again. “So you’re going to stonewall me and just tell me to talk to Ray. Well, I can’t do that because he’s away on his yacht again, and his cell phone doesn’t work at sea.”
That didn’t make sense—I thought cell phones worked at sea. I remember that Gigi and I called my parents at least three times during our cruise to Mexico while they were watching our kids.
“I’m sorry, Francesca,” I said. “There’s nothing else I can do.”
She grabbed her purse and stormed out of the office. I suspected that she wouldn’t be able to confront Ray until the weekend, when he left Susan for one of his so-called business trips. But I had a session scheduled with the Wagner couple I knew the following day, and I could hardly wait to confront Ray about this misplaced-bill incident.
Ray was quite the operator. Not only had he conned Susan and Francesca, but he had pulled me into his ruse as well. Had my countertransference partly blinded me to his sociopathic maneuvering? He sure had me going—shrewdly dictating my therapeutic responses. Susan should be on meds, Susan should have her own psychotherapy, Susan should explore her career ambivalence, Susan should do this and Susan should do that—but Ray was a saint with a heart of gold and deserved his time alone on his boat. It was one thing for Ray to pull the wool over my eyes for a few sessions, but he had managed to dupe Susan, a trained psychologist, for years. He had been so smooth that I had actually fantasized about going on his yacht.
I knew why Ray had been able to fool everyone for so long. He was a quintessential sociopath. Sociopaths, or what psychiatrists call antisocial personalities, have lifelong patterns of deceitfulness for personal gain. They lack remorse and empathy and are wizards at rationalizing away how they hurt and mistreat others. Usually people think of sociopaths as being habitual criminals—thieves, thugs, and murderers. However, intelligent sociopaths sometimes never get caught and can end up running major companies or billion-dollar Ponzi schemes. It’s the less organized sociopath who can’t hold down a job, is unable to sustain a long-term relationship, and often ends up in jail.
When a relatively successful sociopath like Ray gets caught, those he’s fooled are initially shocked and outraged—they can’t believe that this person whom they trusted for years has betrayed them. They experience shame because they feel they should have known better or sooner. Ray was skilled in recognizing his victims’ emotional needs and fulfilling them in order to get what he wanted. Neither of his wives—at least the two I knew about—wanted to believe that he was capable of living a double life, so they ignored the clues and were quick to embrace his rationalizations.
Most of us have come into contact with people who have sociopathic tendencies—that’s one reason we usually take time to get to know people before we trust them. And even people who do have the capacity for empathy might act in an antisocial manner on occasion, whether it’s fudging on an income tax return or not bothering to go back and pay for a magazine that was forgotten at the bottom of a shopping cart.
However, no one knows what causes extreme sociopathy, which afflicts 6 percent of men and 1 percent of women. The condition begins in childhood, kids who set fires or torture animals are sociopaths. It persists into adulthood with chronic lying and cheating, and lasts throughout life. Depending on the severity of antisocial personality disorder, some of the symptoms can be treated with medication, psychotherapy, or both. However, when sociopathy is severe, there is no cure.
If, as I suspected, Ray was a true sociopath, why did his bigamy start so late in life? Perhaps he had been cheating on Susan throughout their marriage and gotten away with it. Maybe the empty-nest syndrome or some type of midlife crisis escalated his behavior to a new level of deceit. I didn’t know if I would ever get answers from Ray—he was pretty smooth at avoiding the truth.
I FOUND MYSELF CLOCK WATCHING BEFORE THE Wagners’ appointment, anticipating my showdown with Ray. At five after, I got worried that they wouldn’t show, but my assistant buzzed and said my appointment had arrived. I opened the door and saw only Susan standing there.
“Is Ray running late?” I asked.
“He won’t be coming.”
“Oh, no?” I was disappointed.
“I need to sit down. Then I’ll fill you in.” She headed for the couch.
I took my chair and noticed that Susan’s demeanor had changed. She seemed serious but confident.
“I feel like a giant weight has been lifted,” she said. “If I was depressed, I’m not anymore.”
“What are you feeling?” I asked.
“Rage,” she said. “That son of a bitch has another family. Can you believe that? I need therapy? He needs jail.”
“What happened?” I asked.
She laughed bitterly. “I had a little visit from Mrs. Ray Wagner number two, who has an adorable one-year-old son, by the way. Apparently, she’s been enjoying Ray’s charms Fridays through Mondays. Oh, and she loves yachts. I’ve spent thirty years living with a liar and a cheater, a goddamn sociopath. Who knows how many women he’s wooed or married during our relationship.”
“Susan, I wanted to tell you that this other Mrs. Wagner visited me yesterday too. Apparently she discovered one of my billing statements in Ray’s jacket pocket,” I said.
“Yes, I know,” Susan said bitterly. “She told me all about it. It’s infuriating, but it’s confusing too. I feel so embarrassed. How could I not have known for so long? The man I thought I was married to, raised three children with, never really existed. And you’ll love this—he actually tried to tell me it was my fault because I was too involved with my work and not paying enough attention to him.”
“So what now?” I asked.
“I kicked him out. I’ve wasted enough of my life with that pompous liar. I never want to see him again. I just feel bad for the kids.”
Even though I didn’t get my chance to confront Ray, I felt satisfaction from Susan’s account of how she dealt with him. I knew that some of my satisfaction stemmed from my own countertransference. My failure to recognize the extent of Ray’s deceit may have had to do with my over-identification with him as a happy family man. Also, at some level, I didn’t want to accept that a professional therapist—Susan or I—could be duped. But I was gaining perspective on it. In fact, my falling for Ray’s scam, even briefly, helped me empathize with what Susan was going through, and I was able to help her gain some insight as well.
Susan continued in psychotherapy with me for the next six months. She kept in touch with Francesca Wagner in San Diego. I wasn’t surprised, since people who have been victimized by the same individual often form a bond.
Soon after both Susan and Francesca kicked Ray out, he disappeared from their lives. Susan and I speculated that Ray had started up a new life in some other state or part of the world with who knows how many wives. As a therapist herself, Susan understood that a sociopath like Ray would never change, but she still needed to grieve the Ray she thought she knew and loved for so many years. It took her some time to deal with the shame she felt about ignoring the clues to his infidelity that now had become so obvious to her. Ironically, Ray’s theory about Susan’s upbringing and feelings about her career had some truth to it, and I helped her get a better understanding of those issues.
I hadn’t thought about Ray again until about a year after Susan left therapy. Gigi and I were watching TV in the den. It was one of those rare evenings when she had control of the remote and she was flipping from station to station. I was just about to grab it from her when she stopped on the classic movie channel. I recognized Charles Boyer and Ingrid Bergman.
“Oh, this is so great,” Gigi said. “I love this movie.”
“What’s it called again? I asked.
“Gaslight. This guy’s such a liar. He actually makes his wife believe that she’s the one who’s crazy.”
I wondered what had ever happened to Ray. I imagined he was still wandering the oceans in his getaway yacht, victimizing various Mrs. Wagners. Maybe t
he port authorities had finally caught up with him, or perhaps he had been captured by pirates. Little did Ray realize that even on land, he was hopelessly lost at sea.
CHAPTER THIRTEEN
Shop Till You Drop
Winter 2004
IT WAS EARLY DECEMBER AND EVERYONE was preparing for the holiday break. I had just received great news from the National Institutes of Health—a large grant proposal I had submitted was getting funded. That meant that my research staff and I would not have to worry about funding for at least another five years. In the world of research, these are some of the few moments of celebration. When you submit the grand proposal, you worry that it won’t get funded; then after you do get funded, you worry that you won’t be able to complete the study or, worse, your results will not be what you’d hoped. But tonight was for celebrating. I was taking the family to a hip Japanese restaurant on La Cienega. We all loved sushi, and this was a chance for the kids to try an upscale place.
We were running late because my twelve-year-old, Rachel, refused to go. She had nothing cool to wear. Gigi managed to pull a few things out of her own closet to satisfy Rachel and promised to take her shopping the next week, now that she was in middle school. It never ceased to amaze me how much clothes can mean to some women, even preteen girls.
The next day a woman named Brenda Livingston called. She had been in treatment with me about ten years earlier, when she was in her mid-thirties and in the midst of an ugly divorce. Now she was sobbing into the phone, saying she was in a crisis and didn’t know who else to call. I calmed her down and scheduled her for the next afternoon.
That night during dinner at home, Rachel said, “I’m going to Caroline’s birthday party on Saturday, and I need to get her a present.”
“She’s going to be twelve, right?” Gigi asked.
“Uh-huh,” Rachel answered.
“Okay, I’ll pick her up something nice,” Gigi replied.
We finished our meal, and the kids cleared the table and then asked to be excused. Gigi and I stayed.
“What’s with you tonight? You seem distracted,” Gigi said.
“I’m just thinking about this woman I used to know,” I said.
“Great, another woman. I see that this family thing is really working for you.”
“It’s a woman I used to treat who called me today in a crisis,” I said.
“I’ll forgive you this time, but you’ll have to rub my feet later.”
As I washed the dishes, I thought about my former patient. Brenda had been a lot like other career-driven women who have high-powered jobs but whose families and marriages suffer. When I was treating her, she worked sixty-hour weeks as vice president of a large advertising agency. She was at the top of her field, yet she was dissatisfied with her life and she didn’t know why. Her way of dealing with her feelings was to overeat.
I remembered that as her marriage fell apart, she became obsessed with eating certain foods according to color throughout the day. Breakfast was brown: coffee, wheat toast, and an occasional bowl of granola. Lunch was white: chicken breast or clam chowder with rice. Late at night she liked to gorge on darker tones—chocolate, brownies, and fudge. Her weight would fluctuate from very thin to overweight. At one point during therapy, she gained almost forty pounds. I recall the humiliation she felt when an associate congratulated her on her “pregnancy.”
Brenda’s mother had been her nemesis. Brenda could never do anything right in her mother’s eyes, yet she lived every moment trying to get her mother’s approval. The outfits she wore, the jobs and accounts she pursued, even the men she chose—none of them were ever good enough for Mom. Yet Brenda had a blind spot when it came to seeing her mother’s flaws. And then, just when I felt we were making some headway in therapy, she suddenly claimed to be “cured” and stopped coming in.
It’s not uncommon for patients to quit therapy when they first become aware of their unconscious conflicts. The painful feelings and memories that might be hiding behind their symptoms can be hard to face. In an attempt to avoid these uncomfortable feelings, their minds often trick them into believing that they are cured and no longer need the therapist. This allows them to continue to suppress or forget what’s really disturbing them, without a therapist hammering away at the real problem.
Back when Brenda announced to me that she was cured, I was pretty sure she was running away from feelings she wasn’t ready to deal with. In those days, I had less experience as a psychotherapist, and I felt somewhat demoralized by her speedy exit. I knew that premature terminators were often chronic patients who might not have the emotional strength to persevere in treatment. However, in reflecting back on her hasty retreat, I realized I might have pushed her too hard while exploring her problems. I made a mental note of this possible misstep and vowed to move at a slower pace with her this time, if I got the chance.
ON FRIDAY AFTERNOON BRENDA WALKED INTO MY office looking chic and svelte, wearing a black suit. She was blond now, with the latest Jennifer Aniston haircut. She placed her huge designer purse next to the couch and sat down. She was about to light a cigarette when she remembered the no-smoking rule. She smiled. “Hello, Dr. Small. It’s nice to see you again. I like that touch of gray in your hair—very distinguished.” I couldn’t help but crack a smile.
“It’s good to see you, Brenda,” I said. “So, what’s going on? You mentioned some kind of crisis?”
“Yes. I’ve been married to Richard for three years now, and he’s becoming impossible. I don’t want another divorce, but he’s threatening to leave.”
“Why’s that?” I asked.
“He thinks I have a problem. Ha. He thinks I have lots of problems. My job, my mother, my shopping…Again he’s complaining that I spend too much money. Who is he to tell me? I signed his stupid prenup, and I have my own money.”
“So he had you sign a prenuptial agreement?” I asked.
“Of course, everybody does these days, but he still freaks out every time I spend a dollar. He says he’s just concerned about me, but actually I’m very thrifty. I only shop at sales. Yesterday, everything at Saks was forty percent off, then fifteen percent off that—if you used your Saks First card, which of course I did. What am I, an idiot? I got a gorgeous black Dolce dress for like five dollars…okay, around nine hundred, which is like stealing it. And you know what else? And I swear I have never done this in my life, I bought a purple Versace for peanuts. I swear to God my closet is stuffed with black and gray suits, and an occasional off-white cocktail dress, but I have never bought anything purple! Richard should be happy for me. I’m branching out!”
As I listened to Brenda go on about her shopping victories, I envisioned her trying to jam a three-thousand-dollar purple dress in between forty identical black dresses she had probably never worn. I wondered if her eating issues from a decade ago had now been replaced by a new obsession—shopping. More important, I wondered what underlying feelings or conflicts might have led to her current crisis. She was waiting for me to say something.
“That’s great that you’re branching out, Brenda. Do you think you’ll ever really wear that purple dress?”
“I don’t know,” she replied casually, “maybe in the summer. But it’s really cute and it makes my closet pop!”
I smiled. “Are you still working at the ad agency?”
“I’m senior vice president of new accounts now. And with my new position, I make my own hours. Which gives me plenty of time to shop, return stuff I don’t like, and shop some more.” She laughed.
I was amused as well as concerned by the shopping discussion but wanted to shift our focus to what might be driving this preoccupation. Perhaps bringing the conversation back to her relationships would help us unravel the conflicts underlying her current crisis.
“What’s Richard’s issue about you and your mother?” I asked. Brenda’s version of Richard’s take on the relationship might shed some light on what was really going on.
A general principle of hum
an behavior is that it’s easier for us to see something negative in other people than in ourselves. This mental process sometimes guides therapists when they make interpretations during treatment. Often, the traits that disturb us most in others are those that we ourselves possess. It may upset us to see these qualities in other people, but it’s completely unacceptable to acknowledge them in ourselves. Richard’s complaints about Brenda probably reflected some of his own issues, but the complaints that Brenda had about Richard might lead us to the conflicts behind her current problems.
“Can you believe that a grown man in his fifties is jealous of my eighty-year-old mother? It’s ridiculous! Every time I’m on the phone with her, he goes nuts.”
“How often do you talk with her?” I asked.
“She calls maybe once or twice a day. So what…she’s lonely and I cheer her up. Richard says I give Mom more attention than I give him.”
I wondered if she did.
She continued, “What a baby. And he’s jealous of my job too! He calls my office constantly, saying stupid things like he misses me, but I know he’s only trying to insert himself into my work somehow.”
“Why would he do that?” I asked.
“Because he just can’t stand that I have something going on that doesn’t involve him. All day long I’m getting calls from my mother and my husband. I hardly have any time to get any work done!”
As Brenda went on, I recalled a fundamental problem from her earlier therapy that had obviously not been “cured.” No matter how many people she had in her life who appeared to care about her—husband, mother, co-workers, friends—she always felt lonely. Part of the issue was that she surrounded herself with people much like her narcissistic and needy mother, who were unable to give her the emotional space to feel independent. My opinion was that Brenda didn’t feel deserving of love, so she surrounded herself with people too selfish to deliver it.