When he realised I was observing he shouted out, “Voyeur! Damned voyeur! Let me alone! Get out!” and he broke down and cried. There was a clear fantasy on the screen for several seconds of himself breaking the arm and head clamps and kicking the apparatus to pieces and rushing out of the building, and there, outside, there was a wide hilltop, covered with short dry grass, under the evening sky, and he stood there all alone. While he sat clamped in the chair sobbing.
I broke session and took off the crown, and asked him if he wanted some tea, and he refused to answer. So I freed his arms, and brought him a cup. There was sugar today, a whole box full. I told him that and told him I’d put in two lumps.
After he had drunk some tea he said, with an elaborate ironical tone, because he was ashamed of crying, “You know I like sugar? I suppose your psychoscope told you I liked sugar?”
“Don’t be silly,” I said, “everybody likes sugar if they can get it.”He said, “No, little doctor, they don’t.” He asked in the same tone how old I was and if I was married. He was spiteful. He said, “Don’t want to marry? Wedded to your work? Helping the mentally unsound back to a constructive life of service to the Nation?”
“I like my work,” I said, “because it’s difficult, and interesting. Like yours. You like your work, don’t you?”
“I did,” he said. “Goodbye to all that”
“Why?”
He tapped his head and said, “Zzzzzzt!—All gone. Right?”
“Why are you so convinced you’re going to be prescribed electroshock? I haven’t even diagnosed you yet.”
“Diagnosed me?” he said. “Look, stop the playacting, please. My diagnosis was made. By the learned doctors of the TRTU. Severe case of disaffection. Prognosis: Evil! Therapy: Lock him up with a roomful of screaming thrashing wrecks, and then go through his mind the same way you went through his papers, and then burn it... burn it out. Right, Doctor? Why do you have to go through all this posing, diagnosis, cups of tea? Can’t you just get on with it? Do you have to paw through everything I am before you burn it?”
“Flores,” I said very patiently, “you’re saying ‘Destroy me’—don’t you hear yourself? The psychoscope destroys nothing. And I’m not using it to get evidence, either. This isn’t a court, you’re not on trial. And I’m not a judge. I’m a doctor.”
He interrupted—“If you’re a doctor, can’t you see that I’m not sick?”
“How can I see anything so long as you block me out with your stupid keep out signs?” I shouted. I did shout. My patience was a pose and it just fell to pieces. But I saw that I had reached him, so I went right on. “You look sick, you act sick—two cracked ribs, a temperature, no appetite, crying fits—is that good health? If you’re not sick, then prove it to me! Let me see how you are inside, inside all that!”
He looked down into his cup and gave a kind of laugh and shrugged. “I can’t win,” he said. “Why do I talk to you? You look so honest, damn you!”
I walked away. It is shocking how a patient can hurt one. The trouble is, I am used to the children, whose rejection is absolute, like animals that freeze, or cower, or bite, in their terror. But with this man, intelligent and older than I am, first there is communication and trust and then the blow. It hurts more.
It is painful writing all this down. It hurts again. But it is useful. I do understand some things he said much better now. I think I will not show it to Dr. Nades until I have completed diagnosis. If there is any truth to what he said about being arrested on suspicion of disaffection (and he is certainly careless in the way he talks) Dr. Nades might feel that she should take over the case, due to my inexperience. I should regret that. I need the experience.
7 SEPTEMBER
Stupid! That’s why she gave you De Cam’s book. Of course she knows. As Head of the Section she has access to the TRTU dossier on F.S. She gave me this case deliberately.
It is certainly educational.
Today’s session: F.S. still angry and sulky. Intentionally fantasized a sex scene. It was memory, but when she was heaving around underneath him he suddenly stuck a caricature of my face on her. It was effective. I doubt a woman could have done it, women’s recall of having sex is usually darker and grander and they and the other do not become meat-puppets like that, with switchable heads. After a while he got bored with the performance (for all its vividness there was little somatic participation, not even an erection) and his mind began to wander. For the first time. One of the drawings on the desk came back. He must be a designer, because he changed it, with a pencil. At the same time there was a tune going on the audio, in mental puretone; and in the Uncon lapping over into the interplay area, a large, dark room seen from a child’s height, the windowsills very high, evening outside the windows, tree branches darkening, and inside the room a woman’s voice, soft, maybe reading aloud, sometimes joining with the tune. Meanwhile the whore on the bed kept coming and going in volitional bursts, falling apart a little more each time, till there was nothing left but one nipple. This much I analysed out this afternoon, the first sequence of over 10 sec. that I have analysed clear and entire.
When I broke session he said, “What did you learn?” in the satirical voice.
I whistled a bit of the tune.
He looked scared.
“It’s a lovely tune,” I said, “I never heard it before. If it’s yours, I won’t whistle it anywhere else.”
“It’s from some quartet,” he said, with his “donkey” face back, defenseless and patient. “I like classical music. Didn’t you—”
“I saw the girl,” I said. “And my face on her. Do you know what I’d like to see?”
He shook his head. Sulky, hangdog.
“Your childhood.”
That surprised him. After a while he said, “All right. You can have my childhood. Why not? You’re going to get all the rest anyhow. Listen. You tape it all, don’t you? Could I see a playback? I want to see what you see.”
“Sure,” I said. “But it won’t mean as much to you as you think it will. It took me eight years to learn to observe. You start with your own tapes. I watched mine for months before I recognised anything much.”
I took him to my seat, put on the earphone, and ran him 30 sec. of the last sequence.
He was quite thoughtful and respectful after it. He asked, “What was all that running-up-and-down-scales motion in the, the background I guess you’d call it?”
“Visual scan—your eyes were closed—and subliminal proprioceptive input. The Unconscious dimension and the Body dimension overlap to a great extent all the time. We bring the three dimensions in separately, because they seldom coincide entirely anyway, except in babies. The bright triangular motion at the left of the holo was probably the pain in your ribs.”
“I don’t see it that way!”
“You don’t see it; you weren’t consciously feeling it, even, then. But we can’t translate a pain in the rib onto a holoscreen, so we give it a visual symbol. The same with all sensations, affects, emotions.”
“You watch all that at once?”
“I told you it took eight years. And you do realise that that’s only a fragment? Nobody could put a whole psyche onto a four-foot screen. Nobody knows if there are any limits to the psyche. Except the limits of the universe.”
He said after a while, “Maybe you aren’t a fool, doctor. Maybe you’re just very absorbed in your work. That can be dangerous, you know, to be so absorbed in your work.”
“I love my work, and I hope that it is of positive service,” I said. I was alert for symptoms of disaffection.
He smiled a little and said, “Prig,” in a sad voice.
Ana is coming along. Still some trouble eating. Entered her in George’s mutual-therapy group. What she needs, at least one thing she needs, is companionship. After all why should she eat? Who needs her to be alive? What we call psychosis is sometimes simply realism. But human beings can’t live on realism alone.
F.S.’s patterns do not fit a
ny of the classical paranoid psychoscopic patterns in Rheingeld.
The De Cams book is hard for me to understand. The terminology of politics is so different from that of psychology. Everything seems backwards. I must be genuinely attentive at P.T. sessions Sunday nights from now on. I have been lazy-minded. Or, no, but as F.S. said, too absorbed in my work—and so inattentive to its context, he meant. Not thinking about what one is working for.
10 SEPTEMBER
Have been so tired the last two nights I skipped writing this journal. All the data are on tape and in my analysis notes, of course. Have been working really hard on the F.S. analysis. It is very exciting. It is a truly unusual mind. Not brilliant, his intelligence tests are good average, he is not original or an artist, there are no schizophrenic insights, I can’t say what it is, I feel honored to have shared in the childhood he remembered for me. I can’t say what it is. There was pain and fear of course, his. father’s death from cancer, months and months of misery while F.S. was twelve, that was terrible, but it does not come out pain in the end, he has not forgotten or repressed it but it is all changed, by his love for his parents and his sister and for music and for the shape and weight and fit of things and his memory of the lights and weathers of days long past and his mind always working quietly, reaching out, reaching out to be whole.
There is no question yet of formal co-analysis, it is far too early, but he cooperates so intelligently that today I asked him if he was aware consciously of the Dark Brother figure that accompanied several Con memories in the Uncon dimension. When I described it as having a matted shock of hair he looked startled and said, “Dokkay, you mean?”
That word had been on the subverbal audio, though I hadn’t connected it with the figure.
He explained that when he was five or six Dokkay had been his name for a “bear” he often dreamed or daydreamed about. He said, “I rode him. He was big, I was small. He smashed down walls, and destroyed things, bad things, you know, bullies, spies, people who scared my mother, prisons, dark alleys I was afraid to cross, policemen with guns, the pawnbroker. Just knocked them over. And then he walked over all the rubble on up to the hilltop. With me riding on his back. It was quiet up there. It was always evening, just before the stars come out. It’s strange to remember it. Thirty years ago! Later on he turned into a kind of friend, a boy or man, with hair like a bear. He still smashed things, and I went with him. It was good fun.”
I write this down from memory as it was not taped; session was interrupted by power outage. It is exasperating that the hospital comes so low on the list of Government priorities.
Attended the Pos. Thinking session tonight and took notes. Dr. K. spoke on the dangers and falsehoods of liberalism.
11 SEPTEMBER
F.S. tried to show me Dokkay this morning but failed. He laughed and said aloud, “I can’t see him any more. I think at some point I turned into him.”
“Show me when that happened,” I said, and he said, “All right,” and began at once to recall an episode from his early adolescence. It had nothing to do with Dokkay. He saw an arrest. He was told that the man had been passing out illegal printed matter. Later on he saw one of these pamphlets, the title was in his visual bank, “Is There Equal Justice?” He read it, but did not recall the text or managed to censor it from me. The arrest was terribly vivid. Details like the young man’s blue shirt and the coughing noise he made and the sound of the hitting, the TRTU agents’ uniforms, and the car driving away, a big grey car with blood on the door. It came back over and over, the car driving away down the street, driving away down the street. It was a traumatic incident for F.S. and may explain the exaggerated fear of the violence of national justice justified by national security which may have led him to behave irrationally when investigated and so appeared as a tendency to disaffection, falsely I believe.
I will show why i believe this. When the episode was done I said, “Flores, think about democracy for me, will you?”
He said, “Little doctor, you don’t catch old dogs quite that easily.”
“I am not catching you. Can you think about democracy or can’t you?”
“I think about it a good deal,” he said. And he shifted to right-brain activity, music. It was a chorus of the last part of the Ninth Symphony by Beethoven, I recognised it from the Arts term in high school. We sang it to some patriotic words. I yelled, “Don’t censor!” and he said, “Don’t shout, I can hear you.” Of course the room was perfectly silent, but the pickup on the audio was tremendous, like thousands of people singing together. He went on aloud, “I’m not censoring. I’m thinking about democracy. That is democracy. Hope, brotherhood, no walls. All the walls unbuilt. You, we, I make the universe! Can’t you hear it?” And it was the hilltop again, the short grass and the sense of being up high, and the wind, and the whole sky. The music was the sky.
When it was done and I released him from the crown I said, “Thank you.”
I do not see why the doctor cannot thank the patient for a revelation of beauty and meaning. Of course the doctor’s authority is important but it need not be domineering. I realise that in politics the authorities must lead and be followed but in psychological medicine it is a little different, a doctor cannot “cure” the patient, the patient “cures” himself with our help, this is not contradictory to Positive Thinking.
14 SEPTEMBER
I am upset after the long conversation with F.S. today and will try to clarify my thinking.
Because the rib injury prevents him from attending work therapy, he is restless. The Violent ward disturbed him deeply so I used my authority to have the V removed from his chart and have him moved into Men’s Ward B, three days ago. His bed is next to old Area’s, and when I came to get him for session they were talking, sitting on Area’s bed. F.S. said, “Dr. Sobel, do you know my neighbor, Professor Area of the Faculty of Arts and Letters of the University?” Of course I know the old man, he has been here for years, far longer than I, but F.S. spoke so courteously and gravely that I said, “Yes, how do you do, Professor Area?” and shook the old man’s hand. He greeted me politely as a stranger—he often does not know people from one day to the next. As we went to the scope room F.S. said, “Do you know how many electroshock treatments he had?” and when I said no he said, “Sixty. He tells me that every day. With pride.” Then he said, “Did you know that he was an internationally famous scholar? He wrote a book, The Idea of Liberty, about twentieth-century ideas of freedom in politics and the arts and sciences. I read it when I was in engineering school. It existed then. On bookshelves. It doesn’t exist any more. Anywhere. Ask Dr. Area. He never heard of it.”
“There is almost always some memory loss after electroconvulsive therapy,” I said, “but the material lost can be relearned, and is often spontaneously regained.”
“After sixty sessions?” he said.
F.S. is a tall man, rather stooped, even in the hospital pajamas he is an impressive figure. But I am also tall, and it is not because I am shorter than he that he calls me “little doctor.” He did it first when he was angry at me and so now he says it when he is bitter but does not want what he says to hurt me, the me he knows. He said, “Little doctor, quit faking. You know the man’s mind was deliberately destroyed.”
Now I will try to write down exactly what I said, because it is important.
“I do not approve of the use of electroconvulsive therapy as a general instrument. I would not recommend its use on my patients except perhaps in certain specific cases of senile melancholia. I went into psychoscopy because it is an integrative rather than a destructive instrument.”
That is all true, and yet I never said or consciously thought it before.
“What will you recommend for me?” he said.
I explained that once my diagnosis is complete my recommendation will be subject to the approval of the Head and Assistant Head of the Section. I said that so far nothing in his history or personality structure warranted the use of ECT but that after a
ll we had not got very far yet.
"Let’s take a long time about it,” he said, shuffling along beside me with his shoulders hunched.
“Why? Do you like it?”
“No. Though I like you. But I’d like to delay the inevitable end.”
“Why do you insist that it’s inevitable, Flores? Can’t you see that your thinking on that one point is quite irrational?”
“Rosa,” he said, he has never used my first name before, “Rosa, you can’t be reasonable about pure evil. There are faces reason cannot see. Of course I’m irrational, faced with the imminent destruction of my memory—my self. But I’m not inaccurate. You know they’re not going to let me out of here un...” He hesitated a long time and finally said, “unchanged.”
“One psychotic episode—”
“I had no psychotic episode. You must know that by now.”
“Then why were you sent here?”
“I have some colleagues who prefer to consider themselves rivals, competitors. I gather they informed the TRTU that I was a subversive liberal.”
“What was their evidence?”
“Evidence?” We were in the scope room by now. He put his hands over his face for a moment and laughed in a bewildered way. “Evidence? Well, once at a meeting of my section I talked a long time with a visiting foreigner, a fellow in my field, a designer. And I have friends, you know, unproductive people, bohemians. And this summer I showed our section head why a design he’d got approved by the Government wouldn’t work. That was stupid. Maybe I’m here for, for imbecility. And I read. I’ve read Professor Area’s book.”
“But none of that matters, you think positively, you love your country, you’re not disaffected!”
He said, “I don’t know. I love the idea of democracy, the hope, yes, I love that. I couldn’t live without that. But the country? You mean the thing on the map, lines, everything inside the lines is good and nothing out->
The Compass Rose Page 11