`You feel that your dreaming of self-destructive acts s normal because…'
The intelligent reader gets the picture. The effect of non-directive therapy is to encourage the patient to speak more and more frankly, to gain total confidence in the non-threatening, totally accepting clod who's curing him, and eventually to diagnose and resolve his own conflicts, with old thirty-five dollars-an-hour echoing away through it all behind the couch.
And it works. It works precisely as well as every other tested form of psychotherapy. It works sometimes and fails at others, and its success and failures are identical with other analysts' successes and failures. Of course at times the dialogue resembles a comedy routine. My patient the second hour, that morning was a hulking heir to a small fortune who had the build of a professional wrestler and the mentality of a professional wrestler.
Frank Osterflood was the most depressing case I'd had in five years of practice. In the first two months of analysis he had seemed a rather nice empty socialite, worried half-heartedly about his inability to concentrate on anything. He tended to drift from job to job averaging two or three a year. He talked great deal about his jobs and about a mousy father and two disgusting brothers with families, but all with such cocktail party patter that I knew we must be a long way from what was really bothering him. If anything was bothering him. The only clue I had to indicate that he was anything but a vacuous muscle was his occasional spitting hissing remarks - usually of a general nature - about women. When I asked one morning about his relations with women he hesitated and then said he found them boring. When I asked him how he found fulfillment for his sexual needs, he answered neutrally, `Prostitutes.'
Two or three times in later sessions he described in detail how he liked to humiliate the call girls he hired, but he would never make any effort to analyze his behavior; he seemed to feel in his casual man-of-the-world way that humiliating women was good, normal, all American behavior. He found it more interesting to analyze why he left his last job; the office he worked in `smelled funny.'
About halfway through the session that August day he interpreted his seemingly pleasant recollections of having single-handedly destroyed an East Side bar by sitting up on the couch and looking intensely but in my professional opinion, dumbly, at the floor. Even his face seemed bulging with muscles. He sat there in the same position for several minutes, grunting quietly to himself with a sound like a noisy refrigerator. Finally he said:
'I get so tied up inside I just have to . . . to do something or I'll explode,' he said.
'I understand.'
[pause]
`Do something. . , sexually or I'll explode.'
`You get so tense you feel you must express yourself sexually.
`Yes.'
[Pause] `Don't you want to know how!' he asked.
`If you'd like to tell me.'
`Do you want to know? Don't you need to know to help me?'
`I want you to tell me only what you feel like telling me.'
`Well, I know you'd like to know, but I'm not going to tell you. I've told you about the fuckin' women I've fucked and
how they make me want to puke with their snaky wet orgasms, but I guess I'll keep this to myself.'
[Pause]
`You feel that although I'd like to know, you've already told me about your relations with women sand so you won't
tell me.'
`Actually, it's sodomy. When I get tense - it might be right after I've fucked some white-satin slut, I get … I need … I
want to ram the Goddam insides out of some woman .. . some girl . . . young . . . the younger the better.'
`When you're very keyed up you want to ram the insides out of some woman.'
`The Goddam insides. I want to sink my prick up that intestine into that belly through the esophagus up that throat and
come right out the Goddam top of her head.'
[Pause]
`You'd like to penetrate through her whole body.'
`Yeah, but up her ass. I want her to scream, to bleed, to be horrified.'
[Pause. Long pause]
`You'd like to penetrate her anus and make her bleed, scream and be horrified.'
'Yeah, but the whores I tried it with chewed gum and picked their nose.'
[Pause] `The whores you tried it with were neither hurt nor horrified.'
`Shit, they took their seventy-five bucks, shot their ass into the air and chewed gum or read a comic book. If I tried to
get rough some guy six inches taller than me would appear in the doorway with a sledgehammer or something. [Pause]
I found sodomy, per se [he smiled awkwardly] didn't end my tenseness.'
`You were unable to release, your tension by relations with prostitutes when the women seemed to experience no pain
or humiliation.'
`So I knew I had to find someone who would scream.'
[Pause]
[Long pause]
`You sought other alternatives to relieve your tensions.'
`Yeah. Fact is I began raping and killing young girls.'
[Pause]
[Long pause] [Longer pause]
`In an effort to relieve these tense feelings you began raping and killing young girls,'
`Yeah. You're not allowed to tell, are you? I mean you told me professional ethics forbid your telling anything I say, right?'
'Yes.'
[Pause]
'I find the raping and killing' of girls helps relieve the tension quite a bit and makes me feel better again.'
`I see.'
`My problem is that I'm beginning to get a little nervous ..about getting caught. I sort of hoped maybe analysis might help me find a little more normal way to reduce my tensions.'
`You'd like to find a different way to reduce tensions other than raping and killing girls.'
`Yeah. Either that or help me to stop worrying about getting caught ….'
The alert reader may now be feeling that this stuff is slightly too sensational for a typical day at the office, but Mr. Osterflood really exists. Or rather existed - more of that later on. The fact is that I was writing a book entitled The Sado-Masochistic Personality in Transition, a work which was to describe cases in which the sadistic personality developed into a masochistic one and vice versa. For this reason my colleagues always sent me patients with a markedly strong sadistic or masochistic bent. Osterflood was admittedly the most professionally active sadist I'd treated, but the wards of mental hospitals have many like him.
What is remarkable, I suppose, is Osterflood's walking around loose. Although after his confession I urged him to enter an institution, he refused and I couldn't order his being committed without breaking professional confidence; moreover no one else apparently suspected that he was an `enemy of society.'
All I could do was warn my friends to keep their little girls away from Harlem playgrounds (where Osterflood obtained his victims) and try hard for a cure. Since my friends all kept their children out of Harlem playgrounds because of the danger of Negro rapists even my warnings were unnecessary.
After Osterflood left that morning I brooded a little on my helplessness with him, made a few notes, and then decided I ought to work on my book.
I dragged myself to it with the enthusiasm of a man with diarrhea moving toward the toilet: I had a compulsive need to get it out but had some months earlier come to the conclusion that all I was producing was shit.
My book had become a bore: it was a pretentious failure. I had tried a few months before to get Random House to agree to publish it when it was finished, imagining that with extensive advertising the book would achieve national and then international fame, driving lake Ecstein to fury, women and reckless losses in the stock market. Random House had hedged, hawed, - considered and reconsidered . . . Random House wasn't interested. This morning, as on most recent mornings, neither was I.
The flaw in the book was small but significant: it had nothing to say. The bulk of it was to be empirical descriptions o
f patients who had, changed from primarily sadistic behavior patterns to masochistic ones. My dream had been to discover a technique to lock the behavior of the patient at that precise point when he had passed away from sadism but had not become masochistic. If there were such a point. I had much dramatic evidence of complete crossovers; none of `frozen freedom,' a phrase describing the ideal mean state that came to me in an explosion of enlightenment one morning while echoing Mr. Jenkins.
The problem was that Jake Ecstein, car-salesman front and all, had written two of the most rational and honest books about psychoanalytic therapy that I'd ever read, and their import essentially demonstrated that none of us knew or had any likelihood of knowing what we were doing. Jake cured patients as well as the next fellow and then published clear, brilliant accounts demonstrating that the key to his success was accident, that frequently it was his failure to follow his own theoretical structure which led to a `breakthrough' and the patient's improvement. When I ended my early-morning dialogue with Miss Reingold joking that Jake's reading the 1967, get record sheets might lead to a breakthrough I was partly serious. Jake had shown again and again the significance of chance in therapeutic development, perhaps best dramatized in his famous `pencil-sharpening cure.'
A female patient he'd had under treatment for fifteen months with so little success in changing her neurotic aplomb that even Jake was bored, achieved total and complete transformation when Jake, absentmindedly confusing her with his secretary, ordered her to sharpen his pencils. The patient, a wealthy housewife, went into the outer office to obey and suddenly, when about to insert a pencil into the sharpener, began to shriek, tear her hair and defecate.
Three weeks later, `Mrs. P.' (Jake's choice of pseudonyms is only one of his unerring talents) was cured.
I then, was coming to feel that my elaborate writing efforts were only idle, pretentious playing with words for publication.
I thus spent the hour before lunch: (a) reading the financial section of The New York Times; (b) writing a page-and-a #161;half case report on Mr. Osterflood in the form of a financial and budget report (`bearish outlook for prostitutes'; `bull market in Harlem playground girls'), and (c) drawing a picture on my 'book manuscript of an elaborate Victorian house being bombed by motorcycle planes piloted by Hell's Angels.
Chapter 4
I lunched that day with my three closest colleagues: Dr. Ecstein, whom I mock because he's so intelligent and successful; Dr. Renata Felloni, the only female Italian-born practicing analyst in recent New York history; and Dr. Timothy Mann, the short, fat, disheveled father figure who had psychoanalyzed me four years before and been mentoring me ever since.
When Jake and I arrived, Dr. Mann was hunched over the table chewing heavily on a roll and blinking benevolently at Dr. Felloni seated opposite him. Dr. Mann was a big wheel: one of the directors at Queensborough State Hospital, where I worked twice a week; a member of the executive committee of PANY (Psychiatrists Association of New York), and the author of seventeen articles and three books, one of them the most frequently used text-on existentialist therapy in existence. It had been considered an extraordinary honor to be psychoanalyzed by Dr. Mann and I had appreciated it greatly until my increasing boredom and unhappiness had deluded me into believing that analysis had done me no good. Dr. Mann was concentrating on his eating and may or may not have been listening to the dignified discourse of Dr. Felloni.
Renata Felloni resembles a spinsterish dean of women at a Presbyterian all-girls college: she has gray hair always neatly coiffured, spectacles and a slow, dignified, Italian-cum-New England twang that makes her discussions of penises, orgasms, sodomy and fellatio seem like a discussion of credit hours and home economics. Moreover, she had, as far as anyone knew, never been married and, with less certainty, had never in the seven years we had known her given any indication of ever having known a man (biblical `know'). Her dignity acted to prevent any of us from either direct or indirect investigations into her past. All we felt free to talk with her about were weather, stocks, penises, orgasms, sodomy and fellatio.
The restaurant was noisy and expensive, and, except for Dr. Mann, who loved every trough he had ever fed in, we all hated it and went there because every other restaurant we had tried in the convenient area was also crowded, noisy and expensive. I usually spent so much nervous energy trying to hear what my friends were saying over the clattering of voices, dishes and 'soft' music and trying to avoid watching Dr. Mann eating that I never remember whether the food was good or not. At any rate I rarely got sick on it.
'Only ten percent of our subjects believe that masturbation is "punished by God eternally",' Dr. Felloni was saying as Jake I sat down opposite each other at the tiny table. She was apparently talking about a research project she and I were jointly directing and she smiled formally and equally to her left at Jake and to her right at me, and continued: 'Thirty and a third percent believe that masturbation is "punished by God finitely"; forty percent that it is physically unhealthy two and one-half percent believe that there is danger of pregnancy seventy-five per -'
'Danger of pregnancy?' Jake broke in as he turned from accepting a menu.
'We use the same multiple choices' she explained smiling, 'for masturbation, kissing, petting, premarital and post #161;marital heterosexual intercourse, homosexual petting, and homosexual sodomy So far, subjects have indicated that there is danger of pregnancy only with masturbation, petting to orgasm, and heterosexual intercourse.'
I smiled to Jake, but he was squinting at Dr. Felloni.
'Well' Jake asked her, `what's the question you're reeling off percentages for?'
'We ask, "For what reasons, if any, do you believe that sexually exciting yourself through fantasy, reading, looking at pictures or manual excitation is bad?"
`Do you give them a choice of reasons for why masturbation flood?'
Dr. Mann asked, wiping his lower lip with a piece of roll.
'Certainly,' Dr. Felloni replied. `A subject can answer that he approves of masturbation for any of six options: (1) It is enjoyable (2) it releases tension; (3) it is a natural way of expressing love; (4) it is something one should experience to be complete (5) procreates the race; (6) it is the social thing to do.'
Jake and I now both began laughing. When we quieted she assured Jake that only the first two choices had been chosen for masturbation, except for one person who had indicated that masturbation was valuable as a way of expressing love. She had determined in a recent interview, however, that the eject had checked that item in a cynical frame of mind.
I don't know why you ever got involved in this thing,' Jake said, turning to me suddenly. `Social psychologists have been turning out studies like yours for decades. You're digging in sterile ground.'
Dr. Felloni nodded politely at Jake's words as she did whenever someone was uttering anything which might vaguely be construed as criticism of her or her work. The more vigorous and direct the criticism the more vigorously she nodded her head. It was my hypothesis that were a prosecuting attorney ever to attack her for a full hour there would be no need for a guillotine: her neck would have melted away, and her head, still nodding, would be rolling on the floor at the prosecutor's feet. She replied to Jake:
`Our plan to evaluate the validity of the multiple choice answers by in-depth interviews of every subject is, however, a genuine contribution.'
`You'll spend - my God - a hundred and twenty hours verifying the obvious: namely, multiple-choice attitude tests are unreliable.'
`Yes, but remember we got a foundation grant,' I said.
`So what? Why didn't you request it fob something original, something worthwhile?'
`We wanted a foundation grant,' I answered ironically.
Jake gave me his I-see-into-your-soul squint and then laughed.
`We couldn't think of anything original or worthwhile,' I added, laughing too, `so we decided to do this: Dr. Felloni
managed to nod and frown, both vigorously.
`You'll
discover that sexual intercourse is more frequently approved after marriage than before,' said Jake, `that
homosexuals approve of homosexuality, that-'
`Our results' Dr. Felloni said quietly, `may not fulfil conventional expectation. We may discover from our in-depth
interviews that subjects misrepresent their attitudes and experiences in a way that previous experimenters did not
guess.'
'She's right, Jake. I agree the whole thing seems a mammoth bore and may lead to the verification of the obvious, but it
might not.'
`It will,' Dr. Mann said.
`What?' I said.
`It will verify the obvious and nothing more.'
He looked up at me for the first time. His jowls were a Santa Claus pink, either from alcohol or anger. I couldn't tell.
'So why do you waste your time? Renata could do the whole thing herself without your help.'
`It's an entertaining time-filler. I often daydream of publishing embellished results to parody such experiments. You
know. "Ninety-five percent of American youth believe that masturbation is a better way of expressing friendship and
love than intercourse."
'Your experiment is a parody without embellishment,' Dr. Mann said.
There was a silence, if you can exclude the cacophony of voices, dishes and music of the surrounding hubbub.
'Our experiment,' Dr. Felloni finally said with a gallop of nods, `will offer new insight into the relations between
sexual behavior, sexual tolerance and personality stability.'
'I read your letter to the Esso Foundation,' Dr. Mann said.
'I know a teen-age girl that could run intellectual rings around most of us here,' Jake said, changing the subject with
out blinking an eye. `She knew everything, brains coming out of her ears. I was within weeks of a major breakthrough.
But she died'
'She died?' I asked.
'Fell from the Williamsburg Bridge into the East River. I confess I see her as one of my two or three possible failures.'
'Look, Tim' I said turning back to Dr. Mann. `I agree our experiment borders on nonsense, but in an absurd world, one
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