Lying on the Couch (16 page)

"So? Then you'd bring that to his attention."

"You're right, Paul. The truth is that the real risk is not to the patient, but to me. How can I be supervised by Marshal and do something he's so opposed to? And I certainly can't lie to a supervisor. Imagine paying a hundred sixty dollars an hour to lie."

"Maybe you're grown up professionally. Maybe the time has come to stop seeing Marshal. Maybe he'd even agree. You've served your apprenticeship."

"Hah! In the world of analysis I haven't even started. I need a full training analysis, maybe four or five years, years of classes, years of intensive supervision on my training cases."

"Well, that neatly takes care of the rest of your life," Paul responded. "That's the modus operandi of orthodoxy. They smother a blooming, dangerous young brain in the manure of doctrine for a few years until it goes to seed. Then when the last dandelion fluff of creativity has blown away, they graduate the initiate and rely on him in his dotage to perpetuate the holy book. That's the way it works, isn't it? Any challenge by a trainee would be interpreted as resistance, wouldn't it?"

"Something like that. For sure. Marshal would interpret any experimentation as acting out or, as he puts it, as my therapeutic incontinence."

Paul signaled the waiter and ordered an espresso. "There's a long history to therapists experimenting with self-disclosure. I just started to read the new Ferenczi clinical diaries. Fascinating. Only Ferenczi of Freud's inner circle had the courage to develop more effective treatment. The old man himself was too concerned with theory and the care and preservation of his movement to pay much attention to outcome. Besides, I think he was too cynical, too convinced of the inexorability of human despair, to expect that any real change could occur from any form of psychological treatment. So Freud tolerated Ferenczi, loved him in a way, as much as he could love anyone—used to take Ferenczi on vacations with him and analyze him as they walked together. But any time Ferenczi went too far in his experimentation, any time his procedures threatened to give psychoanalysis a bad name, then Freud came down hard, very hard. There's a letter of Freud's chastising Ferenczi for entering his third puberty,"

"But didn't Ferenczi deserve that? Wasn't he sleeping with his patients?"

"I'm not so sure. It's possible, but I think he was after the same goal as you: some way of humanizing the therapeutic procedure. Read the book. I think it's got some interesting stuff on what he calls 'double' or 'mutual' analysis: he analyzes the patient one hour, and the next hour the patient analyzes him. I'll lend you the book—once you return the other fourteen. And all overdue fines."

"Thanks, Paul. But I already have it. It's on my nightstand waiting its turn. But your offer of loan ... I am touched, not to mention staggered, by it."

For twenty years Paul and Ernest had recommended books to each other, mainly novels but also nonfiction. Paul's specialty was

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contemporary novels, especially those overlooked or dismissed by the New York establishment, while Ernest was delighted to be able to surprise Paul with dead, largely forgotten writers like Joseph Roth, Stefan Zweig, or Bruno Shulz. Lending books was out of the question. Paul didn't like to share—even food, always frustrating Ernest's wish to share entrees. The walls of Paul's house were lined with books and he frequently browsed through them, pleasantly reexperiencing old friendships with each. Ernest did not like to lend books either. He read even evanescent page turners with pencil in hand, underlining sections that moved him or made him think, possibly to use in his own writing. Paul scavenged for interesting poetic words and images, Ernest for ideas.

When he got home that night, Ernest spent an hour skimming Ferenczi's journal. He also began thinking about Seymour Trotter's comments about truth telling in therapy. Seymour said we must show patients that we eat our own cooking, that the more open, the more genuine we become, the more they will follow suit. Despite Trotter's terminal disgrace, Ernest sensed that there was something of the wizard in him.

What if he followed Trotter's suggestion? Revealed himself totally to a patient? Before the night was out, Ernest made a bold decision: he would conduct an experiment using a radically egalitarian therapy. He would reveal himself entirely, having one objective only: to establish an authentic relationship with that patient and assume that the relationship, in and by itself^ would be healing. No historical reconstruction, no interpretations of the past, no explorations of psychosexual development. He would focus on nothing but what was in between him and the patient. And he would begin the experiment immediately.

But who would be the experimental patient? Not one of his ongoing patients; the transition from his old to his new method would be awkward. Better, much better, to make a fresh start with a new patient.

He picked up his appointment book and looked at the next day's schedule. There was a new patient coming in at ten A.M.—a Carolyn Leftman. He knew nothing about her other than that she was self-referred, having heard him lecture at the Printer's Inc. Bookstore in Palo Alto. "Well, whoever you are, Carolyn Leftman, you're in for a unique therapeutic experience," he said, then turned out the light.

S I X

//t 9:45 Carol arrived at Ernest's office and, following f y(/ the instructions given her when she phoned for an Z_^,y^^^-~j^ appointment, let herself into the waiting room. Like most psychiatrists, Ernest used no receptionist. Carol had deliberately come early to allow a few minutes to calm herself, to rehearse the clinical history she had invented, and to sink into her role. She sat down on the same green leather sofa that Justin habitually used. Only two hours previously Justin had jauntily bounced up the stairs and creased the very cushion upon which Carol now sat.

She poured some coffee, sipped it slowly, and then took several deep breaths to savor Ernest's antechamber. 5o this is it, she thought, as her eyes circled the room; this is the war room where this odious man and my husband have plotted against me for so long.

She scanned the furnishings. Hideous! The tacky woven wall hanging—a refugee from a '60s Haight Street fair—the musty armchairs, the amateur photos of San Francisco, including the manda-

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tory scene of the Victorian homes at Alamo Square. God spare me from any more psychiatrist home photos, Carol thought. She shivered at the memory of Dr. Cooke's Providence office, of lying on that worn Persian rug and staring at wall photos of bleary Truro sunrises while her doctor cupped her buttocks with his frosty hands and, with joyless, muted grunts, thrust into her the sexual affirmation he insisted she needed.

She had spent over an hour dressing. Wanting to appear sensuous, yet needy and vulnerable, she had gone from silk slacks to long, patterned skirt, from sheer satin blouse to magenta cashmere sweater. Finally, she decided on a short black skirt, a tight ribbed sweater, also black, and a simple twisted gold chain. Under that a brand-new lace bra, heavily padded and smartly uplifting, purchased specially for the occasion. Not for nothing had she studied Ernest's interaction with Nan in the bookstore. Only a blind fool would have missed his puerile interest in breasts. That unctuous creep—and those quivering, spittle-dripping lips. He had practically leaned over and started suckling. Worse yet, he was so pompous, so full of himself, that it probably had never even occurred to him that women notice his leering. Since Ernest was not tall, about Justin's height, she wore flats. She considered black patterned stockings but rejected them. Not yet.

Ernest entered the waiting room and offered his hand. "Carolyn Leftman? I'm Ernest Lash."

"How do you do. Doctor?" said Carol, shaking his hand.

"Please come in, Carolyn," said Ernest, gesturing for her to sit in the armchair facing his. "This being California, I'm on a first-name basis with my patients. 'Ernest' and 'Carolyn' okay with you?"

"I'll try to get used to it. Doctor. It may take me a while." She followed him into the office and quickly took in her surroundings. Two cheap leather armchairs set at ninety-degree angles so that both doctor and patient had to turn slightly to face each other. On the floor a worn, fake Kashan rug. And against one wall the mandatory couch—good!—over which hung a couple of framed degrees. The wastepaper basket was full, with some crumpled, grease-stained tissues visible—probably straight from Burger King. A ratty, piss-colored Mexican floor screen made of plywood and frayed rope stood in front of Ernest's disheveled desk, which was piled high with books and papers and crowned with a huge computer monitor. No evidence of any aesthetic sensibility. Nor the slightest trace of a woman's touch. Good!

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Her chair felt stiff and uninviting. At first she resisted putting her full weight on it by bracing herself with her arms. Justin's chair. For how many hours—hours she had paid for—had Justin sat in this chair and violated her? She shivered when she imagined him and this ass, sitting in this office, fat heads together, scheming against her.

In a most grateful voice she said, "Thank you for seeing me so quickly. I felt I was at the end of my rope."

"You sounded pressed on the phone. Let's start from the beginning," said Ernest, taking out his notepad. "Tell me everything I need to know. From our brief conversation I know only that your husband has cancer and that you called me after hearing me read at a bookstore."

"Yes. And then I read your book. I was very impressed. By many things: your compassion, your sensitivity, your intelligence. I've never had much respect for therapy or for the therapists I've met. With one exception. But when I heard you speak, I had a strong feeling that you and only you might be able to help me."

Oh God, Ernest thought, here's the patient I designated for truth-telling therapy, for an uncompromisingly honest relationship, and here we are, in the very first minute, off to the falsest of beginnings. Only too well he remembered his struggle with his shadow that evening in the bookstore. But what could he say to Carolyn? Certainly not the truth! That he shuttled back and forth between his cock and his brain, between lust for Nan and concern for his topic and his audience. No! Discipline! Discipline! Then and there Ernest began developing a set of guiding principles for his truth-telling therapy. First principle: Reveal yourself only to the extent it will be helpful to the patient.

Accordingly, Ernest gave an honest but measured response: "I have a couple of different responses to your comment, Carolyn. Naturally I feel pleased by your compliments. But I also feel uncomfortable with your feeling that only I can help you. Because I am also an author and in the public eye, people tend to imbue me with more wisdom and therapeutic expertise than I possess.

"Carolyn," he continued, "I say this to you because, if we find that we don't work well together for whatever reason, I want you to know that there are plenty of therapists in this community as competent as I. Let me add, though, I'll do my best to live up to your expectations."

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Ernest felt a warm glow. Pleased with himself. Not bad. Not bad at all.

Carol flashed an appreciative smile. Nothing worse, she thought, than ingratiating false humility. Pompous bastard! And if he keeps saying "Carolyn" every other sentence, I'm going to throw up.

"So, Carolyn, let's begin at the beginning. First a few basic facts about yourself: age, family, living, work situation."

Carol had decided to steer a mid-course between deception and truth. To avoid trapping herself in lies, she would stay as close as possible to the truth about her life and would alter the facts only as much as necessary to prevent Ernest from realizing she was Justin's wife. At first she planned to use the name Caroline, but it felt too alien and she settled upon Carolyn, hoping it was sufficiently removed from Carol. The deception came easy to her. She glanced again at the couch. This wouldn't take long, she thought—maybe only two to three hours.

She delivered her well-rehearsed story to the unsuspecting Ernest. She had prepared carefully. She had taken a new phone line at home, lest Ernest notice that she had the same number as Justin. She paid in cash to avoid the trouble of opening an account under her maiden name of Leftman. And she had prepared a story line about her life that was as close to the truth as possible without arousing Ernest's suspicions. She was thirty-five, she told Ernest, an attorney, mother of an eight-year-old daughter, married unhappily for nine years to a man who several months ago underwent radical surgery for prostate cancer. The cancer recurred and he had been treated by orchiectomy, hormones, and chemotherapy. She also had planned to say that the hormones and the surgical removal of his testicles had rendered him impotent and her sexually frustrated. But now that seemed too much all at once. No rush. All in due time.

Instead, she had decided to focus in this first visit on her desperate sense of entrapment. Her marriage, she told Ernest, had never been a satisfying one, and she had been seriously contemplating separation when his cancer was diagnosed. Once the diagnosis was made, her husband fell into deep despair. He was terrified by the thought of dying alone, and she could not bring herself to raise the question of ending the marriage. And then, only a few months later, the cancer recurred. The prognosis was grim. Her husband begged her not to let him die alone. She agreed, and now, for the rest of his life, she was trapped. He had insisted they move from the Midwest

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to San Francisco to be near the University of California cancer treatment center. So, a couple of months ago, she left all her friends in Chicago, abandoned her law career, and moved to San Francisco.

Ernest listened carefully. He was struck by the similarity of her story with that of a widow he had treated a few years before, a schoolteacher who had been on the verge of asking for a divorce when her husband also developed prostate cancer. She promised him that she would not let him die alone. But the horror of it was that he took nine years to die! Nine years of nursing him as the cancer slowly spread through his body. Horrible! And after his death, she was devastated by rage and regret. She had tossed away the best years of her life for a man she did not like. Did that lie in store for Carolyn? Ernest's heart went out to her.