“In fact, I do.”
“Well, there’s a start. We are learning already. Why don’t you tell me your story?”
“You mean my life story?” I asked.
“Any story you want to tell me,” Max replied. I actually do believe he’d have been just as happy if I told him the story of Goldilocks and the Three Bears. He was all about getting you to say whatever you wanted to say.
“I meant, wouldn’t my life story help you in making the referral?”
“Probably not,” Max said. “But telling me your life story will help you. Do you know how rarely a person gets to tell his life story to someone else? Most people die before they get around to doing it.”
“Is that what happens in psychoanalysis?”
This time he played it straight. “Sometimes, but not always. I once analyzed a Holocaust survivor. The analysis took five years and not once, not one single time, did the man mention the Holocaust in his analysis. But it was a very successful analysis.”
“What does that mean?” I asked, feeling excited again. “What’s a successful analysis?”
“You tell me,” Max answered. “What are you looking to buy?”
“Is what I am looking for for sale?”
“It depends what you’re looking for,” Max replied. “Most people are looking for happiness.”
“I’d settle for that.”
“That’s not the usual result,” he said. “Take pills if you want happiness.”
“So what’s the best I can hope for?”
“You tell me. What is the best you hope for?”
“I just want to be happy, and not in the superficial way you’re referring to when you talk about pills. I want to get rid of the problems I carry around from my childhood.”
“That would be a successful analysis,” Max said, finally answering my question, before adding, “Just don’t bet the ranch on getting it.”
“Thanks for your honesty,” I replied, instead of telling him what I wanted to say, that he was a real jerk for being so—what’s the word?—realistic, pessimistic, dour, a downer?
“So now, please, tell me your story,” Max said.
For the next hour—I don’t know how much time he had blocked out for me, but I got the feeling I could have taken as long as I needed—I talked and Max listened.
He was a good listener. There’s a reason people called him “the great Max Day.” His quizzical, enigmatic style, while at times infuriating, and at times seeming manipulative (I guess it was intentionally manipulative), did cause me to think, and it did, as they say, “manage my expectations,” which were, as usual for me, ridiculously, unrealistically, almost unmanageably high. Max proved to be an adept manager.
Also, as I told my tale, something about him made it not only easy to talk but also easy to go into dark places and not feel awkward, even though Max was a total stranger. He’d give off little cues—a slight turn of his head, a movement of his mouth, a slight shift in his gaze or a leaning back in his chair—that would reinforce my desire to go on, and invite me to go deeper.
I actually cried at one point during that hour, when I was talking about the bad luck my mother had and how she’d slipped into a life of drinking. He let me cry—which I almost never do—and said nothing, but slid a box of tissues toward me.
When I finished my story, he said, “Of course, that’s just the beginning, isn’t it?”
“There’s a lot more. Yes, there is.”
“There always is. That’s why it’s too bad more people don’t take the time to tell their stories.”
“Why don’t they?”
“No one asks them to.”
“Will you be giving me the name of an analyst?” I asked.
“Of course,” Max said. “That’s what you came here looking for, isn’t it?”
“Yes.”
“But that’s not what you found, is it?” he said, writing something on his yellow pad, the first time he’d written anything our entire session.
His question put me on the spot, like on rounds when the attending is playing Guess What I’m Thinking. I didn’t want to play a game, I was feeling pretty spent after telling my story, so I just said, “I don’t know what you mean.”
“You came here looking for a name, but you found something else,” Max said.
“Well, I found you.”
“It’s not about me,” Max said.
“OK, I give up. What did I find?”
Max put down his pen and looked up from his pad. He took off his glasses and wiped them with his ridiculous tie. “You found a door. A door you’ve been looking for for a long time.”
A few days later I got a call from Max. “Dr. Hallowell, it’s Max Day. I have a name for you.”
I was standing in my living room looking out the window of the Brook House down at Brookline Avenue, Fenway Park in the distance.
“Do you have a pen?” he asked. “His name is Ed Khantzian.” Max gave me Dr. Khantzian’s phone number and told me he’d briefly spoken to him about me. “The main thing is he’s in town and has time. I told you that would be the most important factor.”
“Thanks, Dr. Day. I really appreciate it.”
“Let’s hope it works out well for you. Goodbye.”
So my choice of analyst was governed by, of all things, availability. At least that’s what Max Day told me. My fantasy—my wish—was that he thought long and hard about exactly what kind of person would be best for me. I wanted this decision to matter. I wanted Max Day to use all his brilliance and experience to plumb my depths and find the perfect person to conduct my psychoanalysis. I wanted to matter. You could say that in that wish my psychoanalysis began.
52.
When I met Dr. Khantzian, I did so with the grandest expectations imaginable. I hoped he could sort out my childhood and make me a happy person.
Our first meeting was, therefore, destined to be anticlimactic. I walked into his office on the third floor of a nondescript brick building next to Cambridge City Hospital. He was tallish, mostly bald, swarthy, wore glasses, and had a mustache. When I shook his hand I noticed he had a Boutonniere contracture, a hardened sheath of tissue around a tendon, on the pinky of his right hand.
I sat nervously in a chair opposite Dr. K. as he took my history, his legs crossed, writing notes on a yellow legal pad held in his lap. He didn’t make many comments, just wrote down the facts, à la Sergeant Friday on Dragnet. With no drum roll or fanfare, we were off to the races. My eagerly anticipated psychoanalysis had begun.
After a few introductory sessions, he asked me if I was ready to “go to the couch.” It sounded like such an intimidating proposal, like “go to the mat,” or even “go to war.” Could I maybe just go to the bathroom instead?
Of course, before sitting down I had immediately noticed that along one wall of his office he had an analytic couch, as they’re called. They come in many shapes and sizes. His was about two feet narrower and a foot shorter than a twin bed. Some such couches, the ritzier ones, are covered in leather, but his was fabric, with a cushion at the head and a little rug at the foot so the analysand’s shoes wouldn’t soil the fabric. Before I arrived for my session he always put a clean paper napkin on the pillow. It reminded me of the dentist draping a napkin around my neck. Would I need Novocain for this as well?
When I was lying on the couch, he sat behind me in a reclining chair and put up his feet. Dr. Khantzian saw to it that he was comfortable, and he did his best to make sure I was comfortable as well.
Lying down on the analytic couch the first few times was discomfiting, but not nearly as awkward as I had expected it to be. I had expected to feel ridiculous, as if I were in a cartoon. But once I got over the unfamiliar sensation of talking to someone sitting behind me while lying flat on my back, I got used to it. Soon I felt completely at ease.
I took to it, a duck to water. I understood why Freud created this arrangement, as it indeed allows the patient to float along mentally, freely associating
without the inhibiting force of eye contact and the other requisites of polite interchange between two people.
I could gas on and on without having to take into account the expression on Dr. Khantzian’s face, his body language, his changing position in his recliner, his blowing his nose, or picking it for that matter. He could have been trimming his nails or doing the Times crossword for all I knew. Now and then I’d hear paper rattle as he turned a page in his spiral notebook. Each patient had a dedicated notebook—rather than a yellow pad.
He was unbelievably attentive. He never lost track of what I was saying, which amazes me to this day. I don’t know how he did it; I couldn’t have. Just his sustaining attention for that long was worth the price of admission.
I started my analysis in 1978, still an era of fairly classical technique, at least in the hands of some. My chief resident, John Ratey’s analyst, one of the most respected and sought-after analysts in the Boston area, was of the classical variety. According to John, he hardly ever said a word. That was the old way. In fact, Freud actually stated that the analyst shouldn’t listen too closely to the words the patient spoke, but rather sit with “evenly hovering attention” over the procedure.
The analysts who trained in New York City under the likes of Charles Brenner and Jacob Arlow were schooled in this blank-screen methodology. The idea was to keep “the field” clear of the analyst’s self, allowing only the patient to introduce new material. Now and then the analyst could speak, usually offering an interpretation, but to speak often would be interfering with the process and deny the patient the chance to develop a relationship and live with it, even suffer with it if need be, before it got interpreted.
Dr. Khantzian had none of that, thank God. He interacted with me the way a normal person would, with three basic differences: First, I was lying on a couch and he was sitting behind me; second, the perpetual subject of discussion was me and my life; and third, I paid him. If I asked him a question about himself, he would give me a chance to wonder—thus developing my version of who he was, which is called transference. But if I really wanted to know, I’m pretty sure he’d have told me. I actually never did really want to know. I preferred to create my own version of him in my mind, to let the transference develop. After all, that’s what I was paying him for, at least in part. It’s what made the relationship unique and useful.
I never asked him personal questions, but over the course of my analysis I did glean, somehow, that he was happily married, that he had four children, that his father died when he was young, that he’d gone to medical school at Albany Medical College and done his residency at MMHC. During one of our sessions, he described himself as a “bald-headed Armenian from a shoe town.” The shoe town in question was Haverhill, Massachusetts, some thirty-five miles north of Cambridge. I also learned he was interested in the treatment of addictions and that he and George Vaillant, another prominent analyst with similar interests, had heated disagreements on the subject. Vaillant had gone to Exeter and Harvard, came from an old New England family, and, on the face of it, might have seemed a better match for me as an analyst. But Max Day had chosen Khantzian. Max chose right.
Would a more classical analyst have been better for me, in that I would have had to bear more frustration, which would have led to growth and insight? I’ll never know. What I do know is that my years with Dr. K. helped me enormously.
I went to see Dr. Khantzian four times a week. Each session lasted fifty minutes. The cost started at something like $80 per session in 1978 and went up gradually as the years went by. I can’t recall how much it cost at the end, maybe $225 or something like that, but by then I was seeing him only once a week. I saw him intensively, four times a week, for about seven years, then tapered off, but never actually terminated.
“Terminate” is the verb analysts use for the process of ending the treatment. It is supposed to be a crucial phase of a psychoanalysis, during which the feelings come up that come up only when you know you will never see a person again. And, in a classical analysis, that’s the rule. Once you terminate, you never meet again. Any hopes you might have of meeting again you address during the process of termination. We never bought into that model. We talked about it, why both of us didn’t like that approach, and left it at that.
As my analysis went on and on, much longer than most analyses, some of my friends would ask me if I were cured yet. I would reply, “Yes, in the sense that a ham is cured.”
To his face, I always called him Dr. Khantzian and he called me Ned. As time passed, behind his back, talking to friends or girlfriends about him, I’d refer to him as “my analyst,” “Khantzian,” or “Eddie the K.”
His most outstanding quality was sanity. Of course, this is my assessment, and, since I had no contact with him outside our sessions, my assessment falls under the category of transference. But to my mind, he was a very sane and reliable man.
He was there for me, almost always on time, at every session, be it early in the morning or late in the afternoon, be it a sunny summer day or a nor’easter whipping down on us with snow and wind. During the sessions, I never kept track of the time and just kept talking until he said, “Well, it’s about that time …” If I were to interpret that now, I’d say I was letting go of control and letting him take care of me.
Once it was “about that time,” I’d do a quick sit-up from my supine position, put my feet on the floor, and stand, all while Eddie the K was getting up from his recliner and opening the door. I didn’t shake his hand on my way out, not out of rudeness or irritation but out of a sense of not wanting to be chummy with him. This was not a friendship. I’m not sure what it was. But whatever it was, it changed my life in a way I do not believe anything else could have.
I honestly can’t remember a single interpretation he made during my entire psychoanalysis, even though I am sure he made many. What I do remember is our relationship, and the trust I developed in him. He disappointed me a few times, in ways I won’t take the time to go into because they were human errors that didn’t really matter. All I’m saying is that he wasn’t perfect, and I knew it. So did he.
Of course, he knew my myriad imperfections. He listened to me put myself down regularly. Poor self-esteem was one of my biggest issues. I was deeply insecure. I’d joke that if someone complimented my tie, I’d reply, “So you don’t like my shirt?” I gave myself almost no credit for my accomplishments but instead dwelled on what I perceived to be my many shortcomings and failures. Not getting into any medical school the first time weighed heavily on me.
“But you know it’s because you didn’t take the sciences at Exeter, so you didn’t have the foundation to put up top scores in college and on the MCAT,” Dr. Khantzian would say. “And you have to give yourself credit for digging deep, getting a research job, and getting in the second time around.”
“But I didn’t get into Harvard Medical School,” I replied. “That’s where the top people go.”
Dr. Khantzian laughed.
“I know, you went to Albany, so what are you going to say?”
“You got me,” he said. “Don’t you think you’re being a bit of a snob?”
“That’s what going to Exeter and Harvard does to a person, at least to me. Once I didn’t get in anywhere, it’s like I fell off the train to the top and I could never get back on. I’m just second rate. I better get used to it.”
“I think you know that doesn’t make any sense.”
“But it’s how I feel.”
“OK, let’s stick with that and see where it takes us.”
That’s the huge advantage of psychoanalysis. You have enough time—boy, do you ever—to stick with something and see where it takes us, us being a key concept, because, at least the way Dr. Khantzian practiced psychoanalysis, I was not alone.
Where it took us was not to stunning insights, but rather to an ongoing sharing of the problem. Because of the problems that surrounded me when I was growing up, for which, I should add, I blame no one, I pai
d the price of being insecure and low on self-esteem as an adult. To fix those problems, I needed someone to stay with me for a long time in a way my parents hadn’t been able to. Dr. K. couldn’t repair my problems just with clever interpretations or insights, but he could help me, if not “cure” me, by hanging in there and keeping the relationship going until I felt good enough to leave.
As my relationship with Dr. K. evolved, and my psychoanalysis progressed, I found myself regretting less and less and finally not at all my stupid stuff like not getting into Harvard Medical School, and letting myself feel sad about my important stuff, like my dad’s mental illness and my turbulent years in Charleston. Instead of pushing the pain away, I let myself feel it, as Dr. K. listened and made comments, which, in a process I don’t understand, actually dissipated the pain over time. I came to feel a lightness I’d not felt before, at least not since I was a very little boy.
Max Day was right to downplay to me the results of a successful analysis. After he heard my story, I imagine he knew it was going to be a long haul for me no matter what analyst he referred me to, which I believe is why he kept telling me availability would be the deciding factor in his referral. He didn’t want me to believe anyone had the magic touch. As it turned out, though, Khantzian sort of did.
Of course, we talked about my mother. She was drinking heavily, calling me when she was drunk, and I would listen for a while before saying goodbye. Even before I started seeing Dr. K., I had cut myself off from the deepest ties I felt for my mother. I was no longer the little boy who’d prayed every night at Fessenden that she could be happy, nor was I the distraught college student who worried constantly over her drinking and sadnesses.
The deepest part of me must have known—but never articulated—that it was basically a choice between her and me. I could live the rest of my life for her—a losing battle, without any doubt—or I could cut the ties and try to fashion a life of my own.
I didn’t cut off contact or anything like that. I was there for her right up until she died. But I did stop worrying so much about her. I did not consciously decide to do that; it just happened. I still cared for my mother, I still loved her, but I stopped letting her happiness determine mine.
Because I Come from a Crazy Family Page 23