by T Cooper
“Your Thursday 2 o’clock?”
“Yes. I was telling him that it was the most extreme form of transference I have ever seen. How her sexual obsession with me, and her desire to reconceive her dead child, led her to have actual intercourse with a substitute for me, my own patient, who she met in my waiting room at the clinic.
“Did you have an erection? Lublin asked.
“No. I told him that it was not erotic. It was more exciting from a therapeutic perspective. And right then, Franny starts to cry. And out of the blue, Ruth says, she says, Honey, can you get that? And I know she’s sabotaging me, right?
“So, of course Lublin asks, Is that your daughter? I’d love to see her.
“And we all have to go traipsing into the bedroom. Franny is crying, of course. And I pick her up. But of course I don’t know what to do, so I start jiggling her. Patting her on the back. Ahah baby. Ahah baby. And Dr. Lublin, he … Lublin …he starts … he says, No, no. Like this. He takes my baby in his arms, while I’m standing there watching.
“You see, Dr. Fuchs, I mean, clearly, I mean. My unresolved competition with Dr. Lublin is interfering with my child’s ability to bond with me. She’s almost three months old now, and all of her patterns are being established for the future.”
“At three months, of course, it’s early, but in order for her to be a successful mother and wife, she will have to learn to bond with her father, so that the Oedipal period will be successfully conducted.”
“Yeah, Dr. Fuchs, of course.” He was insulted that Anna would imply that he didn’t know that. “And here, at the crucial moment where I was given responsibility for my child, Dr. Lublin interfered. Precisely as he was beating me at chess and being served by my wife, while discussing an erotic transgression. I felt that I was being temporarily castrated and that I had to reassert myself as a strong father figure before the unhealthy symptoms of a compromised masculinity developed any further. That night, after he left, I resolved to separate from Dr. Lublin.
“This is Tuesday night. Wednesday, I get two calls from Dr. Lublin, I ignore them. Thursday morning, I see him on rounds and cut him dead. Like I never knew the man. He leaves two more messages with my secretary and I throw them away. So, Thursday night, after the clinic, I come home and Ruth wants to have a talk. She starts telling me that she went to the pediatrician, and that Franny’s early childhood development is progressing rapidly. She is a very aware, intelligent baby. She has independent response and a low level of suggestibility. Right then, the doorbell rings. Ruth answers the door. It’s Dr. Lublin. He’s enraged.
“You fucker, he says in that accent. Why have you cut me off?
“RUTH! I yell. Call the police! And she does. Which is good, because I asked her to.
“Coward, Dr. Lublin says. Cutting off is a neurotic way to deal with conflict. What’s so terrible about discussing your feelings? You know I’ll listen. Cutoff leads to an aggravated conflicted relationship. Resolution is a healthier approach to relationships.
“RUTH! I say again. Call the police.” He paused. He wanted Anna to take it in.
“Why did you ask her that a second time?”
“The first time I asked her, she did it. I felt loved. Like everything was going to be okay. Can I have another piece of cake?”
“Of course.”
He reached for the slice with his hand. Anna took a second forkful, got up from her chair. Refilled the kettle, put it on the hot plate. If she was with a patient, she would never have done any of those things, but even though he was behaving like a patient, Larry was her student.
“See, Ruth knew that I was really in trouble in that moment, and that in that moment I needed her support. Love.
Loyalty. Whatever you want to call it. So, when he started encouraging me toward resolution, I felt so threatened that I called up the first thing of comfort that came to mind, which was the moment, a second before, when I knew that Ruth loved me. And in fact, I was right because she had called the police the first time, and didn’t need to do it again. This support, this love, gave me the strength to face Dr. Lublin. I could stand up to him because someone loved me. Someone believed in me, so I could face and deal with problems.”
“Good.”
“I explained to Dr. Lublin that I did not want him to get involved in my child rearing, and he agreed.”
“Good.”
“The police arrived and I told them that I had overreacted.”
“Good.”
“Dr. Lublin said that I had explained to him clearly and honestly what was bothering me in a way that he could understand. And so the problem was resolved. No need to escalate. No need. And I realized that it was better to talk than to act out impulsively, destructively, and then get rigidly fixed in a cruel and destructive stance. That doesn’t help anybody.”
“Good.” Anna had praised him into a place where he could learn. This was the psychoanalytic project. To fully face the event in order to fully understand it. Only by saying what really happened—the sequence, the patterns, the conflicts— was what was being represented and denied revealed. Only this way could the nature of human suffering and cruelty be understood. Things happen for reasons, reasons usually located in the past that get misplaced to the present. “To know these reasons,” she said, “is to be able to create communication, negotiation, reconciliation, and healing. To understand WHY.”
“Some people don’t want to know why. They just want to keep doing it.”
“Yes, knowledge brings responsibility. Refusing that responsibility is to embrace the tragedy of repression, projection, and denial.”
“Anna?”
Ah. He’d used her first name. He must feel deserving.
“Yes.”
“Why are we the ones willing to do this work, the work that the rest of the world wants to avoid?”
“We? You mean psychoanalysts? We’ve made a commitment—”
“No. The Jews. Why are we willing to face what other people want to hide?”
The tea kettle whistled. She got up and lifted it off the hot plate. Refilled the pot.
“Because we have always been so vulnerable. For 5,700 years we have had no army. We were not made stupid by the poison of nationalism. We had no guns. We were at the mercy of those who do. No Jew ever marched into a village, committed an atrocity, and bullied a child. We have always been on the receiving end of the cruelty. It is the person who is being blamed and punished who wants understanding, wants some kind of conversation ending in truth. It’s the other who clings to a static, disordered reasoning and refuses to discuss. He found a way to act out his pain and he does not care if the person on the other end deserves it or not. These are the Fascists. You see, I know them. I know them.”
“I wish I understood my father’s pain,” Larry said, vulnerably but narcissistically. “Why was he so cruel? I need to understand so that I can be a better father than he was.”
“To say what happened, and why. That is the only hope.”
“Anna. I could not have understood my behavior toward Dr. Lublin without the help of you and Dr. Rechtschaffen, and without Ruth. Without her love. I want to be able to give that to a patient someday.”
“I also wish that for you.”
“I’m so afraid that—” Larry stopped. He looked up at her. He was selfish, but he had the ability to reason. Her son Leo was losing his ability to reason. That was a fact she had to accept. “I’m afraid that I won’t know what to do.”
“Listen with compassion and with an open heart. Don’t tell them how to feel or what to do. Give the other a chance to speak, to say everything. Don’t compare their life to yours or you will have a narcissistic projection onto their treatment. Just listen with compassion until you can say something helpful to them, not to you.”
“Thank you.”
He put the cake in his mouth. She poured the tea. It was almost time to bring up the paper. But she could still help him be a better father.
“Let’s go back to
Ruth.”
“Okay.”
“You were telling me about your love for her. Your appreciation.”
“Yeah, that’s right. So, Dr. Lublin and I reached an understanding and we’re all friends again. We have more gin and tonics and he goes home. So then Ruth picks up the conversation she’d started hours before when I first walked through the door.”
“About Franny’s development?”
“Yeah. Only, I’m exhausted. But she insists. She has something to tell me.”
“What?”
“Ruth tells me she wants to be an analyst.”
“She’s a … social worker?”
“Right. The Jewish Board of Guardians. So then she tells me, and it’s like midnight. That that day she took the El back to Brownsville and talked it over with her father. Before we even discussed it. He washes other people’s clothes for a living. He told her that he didn’t have the kind of money for that sort of thing, but that he would help her any way he can. I was devastated. She did this whole thing before we talked about it. It reminded me of the time she cheated on me. I felt that same way. Like when I watch her play with Franny. I felt left out.”
“When did she cheat on you?”
“When I was in the navy. Her father had a heart attack. I was overseas. I didn’t know anything. She thought she was going to lose her father. He was in the hospital. I was in the navy, and she needed someone to take care of her. So she called up her old boyfriend, Tommy O’Hara. A real sheygis, let me tell you. She told him she was going to lose her father, so he came over and she gave him a blowjob. She told me a couple of years later and I flipped out. I kept saying, You sucked off Tommy O’Hara? I couldn’t get over it.”
“Why did she tell you?”
“She said it was explainable. She called it explainable. Here she was, doing it again. Going behind my back. Excluding me, really. Having something intimate with someone else and then telling me later. It hurts.”
“Good.”
“That it hurts?”
“That you can say so.” Her tea was cool enough to drink now. “You can acknowledge the humiliation and disappointment. That is the first step toward healing. Truthfully acknowledging the nuance of feeling. What did you say to her?”
“I said, If you needed someone to help you, why did you end up servicing him sexually? He should have been caring for you.”
“That’s very compassionate. But I mean about her becoming an analyst.”
“We have a three-month-old. But if she can do it, I’m all for it.”
“Larry, I’m very proud of you.” Anna had trained first. After her father died she married Rabinovich and had two children. Even when she and Leo had suffered through Istanbul, she tried to see other exiles in private practice. There was no point to thinking about what would have happened if what had happened had never been. It was an unknowable and stupid projection. “Larry, you have deep feelings. You feel ashamed, you feel inadequate, as all people do, but you try to understand these feelings. You want to know. By acknowledging your inadequacies, you make relationships with all people. You accept yourself, and then you accept others.”
“No one in my family ever talked this way,” he said, receiving her praise. Reveling in it. “I had to … I have to learn all of it.”
“How do you feel?”
“Better.”
“Good.”
“Thank you, Anna.”
“You’re welcome. Now I will evaluate your paper.”
“You failed me.” He panicked.
She was disappointed again in his lack of grace. He would never learn this, to not be so affected by everything. “No, you pass. But the bad news is that you failed me.” There—she assured him that his materiality would not be affected, but that regardless of lack of punishment she had an intellectual disappointment. Would he ever be able to hold that contradiction, or would everything always be so falsely black-and-white?
“What? You said you loved it.”
“No I didn’t.”
She was disappointed again. He was not listening with precision, as she had for him.
“Doctor, you have been sitting here pretending to be on my side, but all along you … know. You tricked me.”
“Don’t overreact.” It was an order. She had no time for that. “We talked about some things one way, and now we’re talking about something else.”
“All right, all right. Why did you hate it so much?”
Anna picked up a copy of his article. It was on her bookshelf. She needed another tabletop, but where? She switched her glasses, held the paper away from her face, and read out loud.
THE NEW DRUGS (CHLORPROMAZINE AND RESERPINE):ADMINISTRATIVE ASPECTS
by Lawrence Proshansky, MD
Use of the “new drugs”—chlorpromazine and reserpine— have been effective for large numbers of patients in large hospitals. A larger proportion of patients are being treated with them than we have so far been able to treat by other means. As a result, the whole hospital has to be reorganized.
First of all we need a new kind of doctor in a psychiatric hospital—one who is not afraid of medicine. Such problems require a new kind of attitude in addition to the psychiatric point of view, and this new attitude we might perhaps call a medical or pharmacologic understanding of what is going on.
“Right.” Larry had come back to life at hearing his own words out of his teacher’s mouth.
“Well, I profoundly disagree with you.”
“Things change,” Larry said. “New discoveries are made and they help patients.” He was so energized. This was his game. She’d never seen him so masculine. This was the father and husband she’d only heard described.
“How does this new fashion help patients? This is an efficiency action. There is no merit to the medicalization of psychiatry.” Rechtschaffen would have remembered these old arguments. They had been settled long ago.
“Anna, you know very well that there are patients who do not respond to talk therapy.”
“I don’t believe that, doctor.” The tables were turned. She was Anna; now he was doctor. Funny how quickly medication distorted human relationships.
“But you’ve met them,” he said. And for the first time all afternoon, Larry was standing, walking around the small apartment, finally looking out the window at what she had been watching alone. The rain on the street. “Of all the thousands of people you have treated, in Germany and here, in hospitals, in private practice, there must have been a significant number who did not get better.”
Anna thought about her own mother, reading to her, sitting beside her, touching her face. A person never stops wishing for their mother to love them.
“That is because … either …” Thankfully, her mother’s awful, painful, helpless deterioration from cancer preceded the Nazis. She died in a rage against God instead of numbed by human cruelty. “I did not listen closely enough … or the patient had not made a sincere commitment to getting better. And I agree, Larry, it is an evolving method … Not perfect. Filled with mysteries. But we are all human. We all have pain. And we all can resolve that pain. With compassion and understanding. Understanding.”
“Some psychic pain is biological in nature. It must be.” This made him happy.
“Not only do I disagree with that claim,” Anna said, her words cast in iron, “but I would argue that much biological pain is psychic in nature.”
“How do you know? How can you know that catastrophic anxiety can be brought to a place of comfort and order, by you and you alone?”
“It is not by me. It is by me and my patient. The two of us. Together.”
“Some pain is just too large for the two of you.”
This is where Larry was wrong, and would always be wrong. Anna knew that any pain that the experience of being human could create, could be healed—also—by human relationship. There were fundamental things that must be in place for someone to heal. Anna knew what these things were. The person must discuss—with another huma
n being—the origins and nature of his pain. They must stay in relationship to another person. And, finally, that person must believe that he can get better.
“But what if he doesn’t want to stay in the relationship?”
Anna looked up. Larry was vulnerable again, childish.
“Are you thinking of yourself or your patient?”
“Both,” he said. “My wife.”
“And your daughter.” Anna flashed on her daughter’s exterminated mouth, sucking, then she moved on.
“What if I don’t stay? In the marriage? Then what? What if the family is the cause of my anxiety? That child? Some things cannot be corrected. If I have to stay, some medication that would make it bearable—that would be better than abandonment. Don’t you think?”
“What is so unbearable?”
“That I’m not good enough.”
Her heart opened now because he had told her the truth.
Whatever the fears, if the patient faces them truthfully, he will recover. “It is in relationship that healing takes place. Only in relationship. No pill will ever compensate for a human relationship. Watching you, listening to you, is a process. Understanding what I am seeing. How can I know who you are unless I think about you? Regression … unlearning what you already know, unknowing, emotional amnesia, emotional rewriting—this is a desperate, albeit incapacitating, effort to feel more safe, even though it is actually very dangerous. Repression is dangerous. Bringing the fear to the surface makes a person’s life better.” Her daughter’s sucking mouth. Leo’s disorder. He seems irrational, in terrible pain. He babbles. Reads cultish writers obsessively. Quotes them. Lords them over other people’s conversations. He is lost. “In order for the truth to come out, it must be faced, not medicated.”
“What truth? That I’m not good enough?”
“Every human being is good enough.”
“Even the Nazis?” This was Larry’s low blow. When he wanted to unsettle her. She’d heard him say the word Nazis repeatedly with no reality behind it. “Would you sit down with Nazis and try to understand them?”
“Of course.”