Love's Executioner and Other Tales of Psychotherapy

by Irvin D. Yalom

  And evolution? Penny had said she was no longer feeling a connection with Chrissie in her cemetery visits (now down to two or three a week). Perhaps evolution, I suggested, signified that Chrissie had indeed left and gone on to another life.

  Perhaps, but Penny had a better explanation for the sadness in both the blackout and the dreams. When she woke up from the blackout in the drugstore, she had the strongest sense that the graduation card in her hand was not for Chrissie (who would have graduated from high school at this time) but for herself. Penny had never finished school, and Chrissie was going to do it for both of them (and was also going to attend Stanford for both of them).

  The dream about the wedding and the search for a changing room was, Penny thought, about her own bad marriages and her current attempt to change her life. Her associations to the building in the dream corroborated this view: the dream building bore a striking resemblance to the clinic that housed my office.

  And evolution, too, referred to her, not to Chrissie. Penny was ready to change into something else. She was fiercely determined to evolve and to succeed in the genteel world. For years, between customers in her taxicab, she had listened to self-improvement cassette tapes on vocabulary improvement, great books, and art appreciation. She felt that she was talented but had never developed her talents because, since the age of thirteen, she had had to earn a living. If only she could stop working, do something for herself, finish high school, go to college full-time, study “nonstop,” and “take off” from there (there was the dream train “taking off” into the air!).

  Penny’s emphasis began to change. Instead of talking about Chrissie’s tragedy, she spent the next two hours describing the tragedy of her own life. As we approached our ninth, and last, hour, I sacrificed the rest of my credibility and offered to see Penny three additional hours, right up to the time of my sabbatical departure. For a number of reasons, I found it difficult to terminate: the sheer enormity of her suffering compelled me to stay with her. I was concerned by her clinical condition and felt responsible for it: week by week, as new material emerged, she had grown progressively more depressed. I was impressed by her use of therapy: I had never had a patient who had worked as productively. Lastly—I might as well be honest—I was transfixed by the unfolding drama, as each week offered a new, exciting, and entirely unpredictable episode.

  Penny remembered her childhood in Atlanta, Georgia, as relentlessly bleak and impoverished. Her mother, an embittered, suspicious woman, had been hard-pressed to feed and clothe Penny and her two sisters. Her father made a fair living as a department-store delivery man but was, if her mother’s account were to be trusted, a callous, joyless man who died of alcoholism when Penny was eight. When her father died, everything changed. There was no money. Her mother worked twelve hours a day as a laundress and spent most nights drinking and picking up men at a local bar. It was then that Penny’s latchkey days began.

  Never again did the family have a stable home. They moved from one tenement flat to another, often being evicted for nonpayment of rent. Penny went to work at thirteen, dropped out of school at fifteen, was an alcoholic at sixteen, married and divorced before she was eighteen, remarried and escaped to the West Coast at nineteen, where she proceeded to bear three children, buy a home, bury her daughter, divorce her husband, and put a down payment on a large cemetery plot.

  I was particularly struck by two powerful themes in Penny’s account of her life. One was that she had been gypped, that the cards were stacked against her by the time she was eight. Her fondest wish for the next life, for both herself and Chrissie, was to be “stinking rich.”

  Another theme was “escape,” not just physical escape from Atlanta, from her family, from the cycle of poverty and alcoholism, but escape from her destiny of becoming a “poor crazy old lady” like her mother, Penny having recently learned that her mother had, over the last several years, had several psychiatric hospitalizations.

  The escape from destiny—from social class destiny and from her personal poor-crazy-old-lady destiny—was a major motif in Penny’s life. She came to see me to escape becoming crazy. She could take care, she said, of not being poor. Indeed, it was her drive to escape her destiny that fueled Penny’s workaholism, that kept her working long grueling hours.

  It was ironic, too, that her drive to escape the destiny of poverty and failure was halted only by a deeper destiny—the finitude inherent in life. Penny had, more than most of us, never come to terms with the inescapability of death. She was a quintessentially active person—I thought of her careening down the highway after the drug dealers—and one of the most difficult things to face during Chrissie’s death was her own helplessness.

  Despite the fact that I was used to Penny’s making new major disclosures, I was not prepared for the bombshell she dropped in our eleventh, penultimate, session. We had been talking about the end of therapy, and she described how accustomed she had become to meeting with me and how difficult it would be to say goodbye next week, how losing me would become another in her string of losses, when she mentioned, casually, “Did I ever tell you I had twins when I was sixteen?”

  I wanted to shout, “What? Twins? At sixteen? What do you mean ‘Did I ever tell you?’ You know damn well you didn’t tell me!” But, having available only the rest of this session and the next, I had to ignore the way she made this revelation, and deal with the news itself.

  “No, you never told me. Fill me in.”

  “Well, I got pregnant at fifteen. That’s why I dropped out of school. I didn’t tell anyone till it was too late to do anything about it, so I went ahead and had the baby. Turned out to be girl twins.” Pausing, Penny complained of a pain in her throat. Obviously this was much harder to talk about than she pretended.

  I asked what happened to the twins.

  “The welfare agency said I was an unfit mother—they were right, I guess—but I refused to give ’em up and tried to take care of them but, after about six months, they took them away. I visited them a couple of times—until they got adopted. I never heard anything about them since. Never tried to find out. I left Atlanta and never looked back.”

  “You think about them much?”

  “Not till now. They entered my mind a couple of times right after Chrissie died, but it’s only been this last couple of weeks that I dwell on them. I think about where they are, how they’re doing, whether they’re rich—that was the only favor I asked the adoption agency. They said they’d try. I read stories now in the papers all the time about poor mothers selling their baby to rich families. But what the hell did I know then?”

  We spent the rest of this hour and part of our final one exploring the ramifications of this new information. In a curious way her disclosure helped us to deal with the ending of therapy, since it brought us full circle, back to the beginning of therapy, back to that hitherto mysterious first dream in which her two little sons, dressed like girls, were on display in an institution. Chrissie’s death and Penny’s deep disappointment in her two sons must have kindled her regret at having given up her girls, must have made her feel that not only did the wrong child die, but the wrong children were adopted.

  I asked whether she felt guilty over having given up her children. Penny responded matter-of-factly that what she did was best for her and best for them. If she, at the age of sixteen, had kept her two children, she would have been nailed down to the same life her mother had. And it would have been a disaster for the children; she couldn’t have given them anything as a single mother—and it was here that I learned more about why Penny withheld telling me about the twins earlier. She was ashamed, ashamed to tell me that she didn’t know the identity of the father. She had been highly promiscuous in her teens; in fact, she had been the “school po’ white slut” (her term), and the father could have been any of ten boys. No one in her life now, not even her husband, knew about her past, about either her twins or her high school reputation—that, too, was something she had been trying to escape.


  She ended the hour by saying, “You’re the only person who knows this.”

  “How does it feel to tell me?”

  “Mixed. I’ve been thinking a lot about telling you. I’ve been having conversations with you all week.”

  “How mixed?”

  “Scary, good, bad, up, down——” Penny rattled these off. Intolerant of discussing softer feelings, she was growing irritated. She caught herself and slowed down. “‘Fraid you’ll judge me, I guess. I want to make it through our last session next week with you still having respect for me.”

  “Do you think I don’t?”

  “How do I know? All you do is ask questions.”

  She was right. We were coming to the end of our eleventh hour—no time for me to be withholding.

  “Penny, you’ve got no worries about me. The more I hear from you, the more I like you. I’m full of admiration for what you’ve overcome and what you’ve done in life.”

  Penny burst out crying. She pointed to her watch to remind me our time was up and rushed from the office with her face buried in Kleenex.

  A week later, at our final meeting, I learned that the tears had continued most of the week. On her way home from the previous session, she stopped at the cemetery, sat next to Chrissie’s grave and, as she often did, wept for her daughter. But that day the tears had no end. She lay down, hugged Chrissie’s tombstone, and began to cry harder—now not only for Chrissie but, finally, for all the others, all the other losses.

  She cried for her sons, for the unrecoverable years, for the wreckage of their lives. She cried for the two lost daughters she never knew. She cried for her father—whoever, whatever he was. She cried for her husband, for the young, vanished, hopeful times they had shared. She cried even for her poor old mother and the sisters she had blotted from her life twenty years ago. But most of all she cried for herself, for the life she dreamed and never lived.

  Soon our time was up. We stood, walked to the door, shook hands, and parted. I watched her go down the stairs. She saw me watching, turned, and said, “Don’t you worry about me. I’ll be all right. Remember”—and she held out a silver chain she wore around her neck—“I was a latchkey kid.”

  Epilogue

  I saw Penny once more, a year later, when I returned from my sabbatical. To my relief, she was much improved. Though she had reassured me that she would be all right, I had been greatly concerned about her. Never have I had a patient who was willing to uncover such painful material in such a short time. Nor one who sobbed more noisily. (My secretary, whose office is immediately next to mine, habitually took prolonged coffee breaks during Penny’s therapy hour.)

  In our first session Penny had said to me, “Just get me started. I’ll take care of the rest.” In effect, that was what happened. During the year following our therapy, Penny did not consult the therapist I had suggested to her but had continued to make progress on her own.

  At our follow-up session it was apparent that her grief, which had been so gridlocked, had become more fluid. Penny was still a haunted woman, but her demons now dwelled in the present rather than the past. She suffered now, not because she had forgotten the events surrounding Chrissie’s death, but because of the way she had neglected her two sons.

  In fact, her behavior with her sons was the most tangible evidence of change. Both her sons had returned home; and although the mother-son conflict still raged, its character had altered. Penny and her sons had ceased to fight about cemetery plot payments and birthday parties for Chrissie, but argued about Brent’s borrowing the pickup and Jim’s inability to hold on to a job.

  Furthermore, Penny had continued to detach herself from Chrissie. Her cemetery visits were briefer and less frequent; she had given away most of Chrissie’s clothes and toys and turned her room over to Brent; she removed Chrissie’s last will and testament from the refrigerator, stopped phoning Chrissie’s friends and stopped imagining the events Chrissie would have experienced had she lived—for example, her senior prom or her application to college.

  Penny was a survivor. I think I had known that from the beginning. I recalled our first meeting and how determined I had been not to get trapped into offering her therapy. Yet Penny had gotten what she had set out to get: therapy, free of charge, from a Stanford professor. How had that happened? Did things just work out that way? Or had I been expertly maneuvered?

  Or, perhaps, it was I who had done the maneuvering? It really didn’t matter. I, too, had profited from our relationship. I had wanted to learn about bereavement, and Penny had, in only twelve hours, taken me, layer by layer, to the very nucleus of grief.

  First, we explored guilt, a state of mind few survivors escape. Penny felt guilty for her amnesia, for not having talked more about death with her daughter. Other survivors feel guilty for other things, for not having done enough, for not having sought medical help sooner, for not having cared more, nursed better. One patient of mine, a particularly attentive wife, hardly left her husband’s side for weeks during his final hospitalization, but tormented herself for years because he had died during the few minutes she had gone out to buy a newspaper.

  The sentiment that one “should have done something more” reflects, it seems to me, an underlying wish to control the uncontrollable. After all, if one is guilty about not having done something that one should have done, then it follows that there is something that could have been done—a comforting thought that decoys us from our patent helplessness in the face of death. Encased in an elaborate illusion of unlimited power and progress, each of us subscribes, at least until one’s midlife crisis, to the belief that existence consists of an eternal, upward spiral of achievement, dependent on will alone.

  This comforting illusion may be shattered by some urgent, irreversible experience, often referred to by philosophers as a “boundary experience.” Of all possible boundary experiences, none—as in the story of Carlos (“If Rape Were Legal. . . “)—more potently confronts us with finiteness and contingency (and none is more able to effect immediate dramatic personal change) than the imminence of our own death.

  Another compelling boundary experience is the death of a significant other—a beloved husband or wife or friend—which shatters the illusion of our own invulnerability. For most people, the greatest loss to bear is the death of a child. Then life seems to be attacking on all fronts: parents feel guilty and frightened at their own inability to act; they are angry at the impotence and apparent insensitivity of medical caregivers; they may rail at the injustice of God or of the universe (many ultimately come to understand that what has seemed injustice is in reality cosmic indifference). Bereaved parents are also, by analogy, confronted with their own death: they have not been able to protect a defenseless child, and as night follows day they comprehend the bitter truth that they, in their turn, will not be protected. “And therefore,” as John Donne wrote, “never send to know for whom the bell tolls; it tolls for thee.”

  Penny’s fear of her own death, while not explicitly emerging in our therapy, manifested itself indirectly. For example, she was greatly concerned about “time running out”—too little time left to get an education, to take a vacation, to leave behind some tangible legacy; and too little time for us to finish our work together. Furthermore, she had showed, early in therapy, considerable evidence of death anxiety in dreams. In two dreams she faced death through drowning: in the first, she clung to insubstantial floating planks while the level of water rose inexorably toward her mouth; in the other, she clasped the floating remnants of her house and called for help from a doctor dressed in white who, instead of rescuing her from the water, stamped on her fingers.

  In working with these dreams, I did not address her concerns about death. Twelve hours of therapy is far too brief a time to identify, to express, and to do useful work with death anxiety. Instead, I used the dream material to explore themes that had already emerged in our work. Such pragmatic use of dreams is commonplace in therapy. Dreams, like symptoms, have no single expla
nation: they are overdetermined and contain many levels of meaning. No one ever exhaustively analyzes a dream; instead, most therapists approach dreams expediently by examining the dream themes that will accelerate the immediate work of therapy.

  Hence I focused on the themes of losing her house and the washing away of the foundations of her life. I also used the dreams to work upon our own relationship. Diving into deep water not uncommonly symbolizes the act of diving into the depths of one’s unconscious. And, of course, I was the doctor clad in white who refused to help her and, instead, stamped upon her fingers. In the ensuing discussion, Penny explored, for the first time, her desire for support and guidance from me and her resentment about my efforts to regard her as a research subject rather than as a patient.

  I used a rational approach to her guilt and her tenacious clinging to the memory of her daughter: I confronted her with the incongruity between her reincarnation beliefs and her behavior. While often such an appeal to reason is ineffective, Penny was fundamentally a well-integrated and resourceful person who was responsive to persuasive rhetoric.

  In the next stage of therapy, we explored the idea that “one must learn to live with the living before one can learn to live with the dead.” By now I have forgotten whether those were Penny’s words or mine or a colleague’s, but I am certain it was she who made me aware of the importance of this concept.

  In many ways her sons were the real victims of this tragedy—as is often true of the siblings of children who die. Sometimes, as in Penny’s family, the surviving children suffer because so much of the parents’ energy is bound up with the dead child, who is both memorialized and idealized. Some surviving children are filled with resentment toward their dead sibling for such claims upon the parents’ time and energy; often the resentment exists side by side with their own grief and their own understanding of the parents’ dilemma. Such a combination is a perfect formula for guilt in the surviving child and to a perceived sense of worthlessness and badness.