Lying on the Couch (18 page)

"Can you go on.'"

"Well . . . I'm very uncomfortable talking about this. . . . I'm afraid you'll judge him. I should never have mentioned his name. I know therapy is confidential. But . . . but ..."

"Is there a question in there for me, Carolyn.'" Ernest wanted to waste no time letting her know that he was a therapist whom she could question and who would answer all questions.

Dammit^ Carol thought, squirming with irritation in her chair. "Carolyn, Carolyn, Carolyn." Every goddamned sentence he has to say "Carolyn"!

She continued, "A question . . . well, yes. More than one. First, is this entirely confidential? Not to be shared with anyone? And, second, will you judge or stereotype him?"

"Confidential? Absolutely. Count on me."

Count on you^ Carol thought. Yeah, like I could count on Ralph Cooke.

"And as for judging, my task here is to understand, not to judge. I'll do my best and I'll promise to be open with you about it. I'll answer any of your questions," said Ernest, weaving his truth-telling resolve tightly into the fabric of this first session.

"Well, I'll just spit it out. Dr. Cooke and I became lovers. After I

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had seen him for a few sessions, he began to hug me from time to time to comfort me, and then it just happened—there on that glorious Persian rug in his office. It was the best thing that ever came my way. I don't know how to talk about it except to say it saved my life. Every week I saw him and every week we made love, and all the pain and all the misery just vanished. Finally he didn't think I needed any more therapy, but we kept on being lovers for another year. With his help I graduated college and got into law school. The best: University of Chicago Law."

"Your relationship ended when you went to law school?"

"For the most part. But a few times when I needed him I flew into Providence, and every time he was there and he gave me the comforting I needed."

"He still in your life?"

"Dead. He died young, about three years after I graduated law school. I think I've never stopped looking for him. I met my husband, Wayne, shortly afterward and decided to marry him. A hasty decision. And a bad one. Maybe I wanted Ralph so much I imagined I saw him in my husband."

Carol grabbed more Kleenex, emptying Ernest's box. She didn't have to squeeze tears out now; they flowed of their own accord. Ernest reached into a desk drawer for another box of tissues, tore off the plastic cover, and started the paper flow by pulling out the first tissue, which he handed to Carol. She was astounded at her tears: a tragic and romantic view of her own life swept over her as her fiction became her truth. How sublime to have been loved so much by this all-giving, magnificent man; and how awful, how unbearable—here Carol wept harder—never to have seen him again, to have lost him forever! When Carol's sobbing subsided, she put away the Kleenex and looked up expectantly at Ernest.

"Now I've said it. Aren't you judging? You said you'd tell me the truth."

Ernest was in a jam. The truth was that he felt little charity toward this dead Dr. Cooke. He quickly considered his options. Remember, he reminded himself: total disclosure. But he balked. Total disclosure in this instance would not have been in his patient's best interests.

His interview with Seymour Trotter had been his first exposure to therapist sexual abuse. In the ensuing eight years he had worked with several patients who had been sexually involved with previous

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therapists, and in every case the resuh had been calamitous for the patient. And, despite Seymour's photograph, despite his arm raised jubilantly toward the sky, who can say what the outcome was for Belle? Of course there was the money she was awarded at the trial, but what else? Seymour's cerebellar deterioration was progressive. Probably after a year or two she had been trapped into full-time caretaking for the rest of his life. No, no way one could say the outcome was good, in the long run, for Belle. Nor for any patient he had ever heard of. And yet, here today, Carolyn says that she and her therapist had an ongoing sexual relationship and it saved her life. Ernest was stunned.

His first impulse was to discredit Carolyn's claim: maybe the transference to this Dr. Cooke was so strong that she hid the truth from herself. After all, it was clear that Carolyn wasn't home free. Here it is, fifteen years later, and she is still sobbing about him. Furthermore, as a result of her Dr. Cooke encounter, she made a bad marriage, which has plagued her since.

Careful, Ernest warned himself, don't prejudge this. Take a moralistic, righteous stand and you'll lose your patient. Be open; try to enter Carolyn's experiential world. And above all, don't bad-mouth Dr. Cooke now. Marshal had taught him that. Most patients feel a deep bond toward the offending therapists and need time to work through the remnants of their love. It is not unusual for sexually abused patients to go through several new therapists before they find one with whom they can work.

"So your father and brother and husband ended up abandoning or betraying or trapping you. And the one man you really cared for died. Sometimes death feels like abandonment, too." Ernest was disgusted with himself, with this therapy cliche, but under the circumstances it was the best he could do.

"I don't think Dr. Cooke was too happy about dying."

Carol immediately regretted her words. Don't be stupid! she chastised herself. You want to seduce this guy, to suck him in, what in hell are you doing getting testy and defending this wonderful Dr. Cooke, who is a sheer figment of your imagination^

"Sorry, Dr. Lash ... I mean, Ernest. I know that wasn't what you meant. I guess I'm missing Ralph a lot now. I'm feeling pretty much alone."

"I know that, Carolyn. That's just why it's important for us to be close."

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Ernest noted Carolyn's eyes widen. Careful, he warned himself, she could see that statement as seductive. In a more formal voice, he continued: "And that's precisely why the therapist and patient must examine all the things that get in the way of their relationship—like, for example, your irritation at me a couple of minutes ago." Good, good, much better^ he thought.

"You said you'd share your thoughts with me. I guess I was wondering if you were being judgmental of him or me."

"Is there a question in there for me, Carolyn?" Ernest was stalling for time.

Good God! I have to spell it out in big letters? thought Carol. ^'Were you being judgmental? How do you feel?"

"About Ralph?" More stalling.

Carol nodded, silently groaning.

Ernest threw caution to the winds and told the truth. Mostly. "I admit that I am thrown off balance by what you tell me. And I guess I do feel judgmental of him. But I'm working on it—I don't want to close down; I want to stay entirely open to your experience.

"Let me tell you why I'm thrown off balance," Ernest continued. "You tell me he was enormously helpful to you, and I believe you. Why would you come here, pay me a great deal of money, and not tell the truth? So I don't doubt your words. Yet what am I supposed to do with my own experience—not to mention a large professional literature and powerful clinical consensus—which leads to different conclusions: namely, that sexual contact between patient and therapist is invariably destructive to the patient—and ultimately to the therapist as well."

Carol had prepared well for this argument. "You know. Dr. Lash . . . sorry, Ernest—I'll get it soon; I'm not used to shrinks being real people with first names. They usually hide behind their titles. They're usually not up front with their humanity like you. What was I saying . . . oh, yes, I took the liberty, while in the process of deciding to see you, of checking out your bibliography in the library—old work habit: checking out the credentials of doctors who are testifying in court as expert witnesses."

"And?"

"And I found out you were well trained in the natural sciences and published a number of reports of your psychopharmacological research."

"And?"

Lying on the Couch ^^ 117

"Well, is it possible you're neglecting your scientific standards here? Consider the data which you're using to form conclusions about Ralph. Look at your evidence—a totally uncontrolled sample. Be honest: Would it pass any kind of scientific muster? Of course your sample of patients who have been involved sexually with therapists consists of injured or dissatisfied patients—but that's because they're the ones that come for help. But the others—satisfied customers like me—they don't come in to see you, and you have no idea how large a population that might be. In other words, all you know is the numerator, just those who come for therapy. You know nothing about the denominator—the number of patients and therapists who have sexual contact or the number who were helped or the number for whom the experience was irrelevant."

Impressive, Ernest thought. Interesting to see her professional persona; I would not like to be on the wrong side of this woman in a courtroom.

"Do you see my point, Ernest? Is it possible I'm right? Be honest with me. Have you ever run into someone before me who wasn't harmed by such a relationship?"

His mind again drifted to Belle, Seymour Trotter's patient. Would Belle fit into the category of those who were helped^ Again, the faded picture of Seymour and Belle flitted across his mind. Those sad eyes. But maybe she was better off. Who knows, maybe they both ended up better off? Or temporarily better off. No, who can be sure of anything in that case, least of all how they ended up together? For years Ernest had wondered when they first decided to retreat to an island together. Had Seymour decided at the very end to rescue her? Or had they schemed together much earlier? Perhaps from the very beginning?

No, these were not thoughts to be shared. Ernest swept Seymour and Belle out of his mind and gently shook his head in response to Carolyn's question. "No, I haven't, Carolyn. I've never seen a patient who wasn't harmed by it. But nonetheless your point about objectivity is well taken. It will help me not to prejudge." Ernest took a long look at his watch. "We're already over our time, but I still need to check in with a couple of questions."

"Sure." Carol brightened. Another hopeful sign. First he asked me to ask him questions. No reputable shrink does that. There's even an implication he will respond to personal questions about his life — I'm going to test that next time. And now he's bending the rules by running well over the fifty minutes.

She had read the APA guideHnes to psychiatrists about how to avoid charges of sexual abuse: hold firm to all boundaries, avoid the slippery slope, don't call your patients by first names, start and end sessions promptly. Every single therapist abuse case she had been counsel for had started with the therapist extending the fifty minutes. Aha, she thought, a little slip here, a slope there, who knows where we'll be after a couple of sessions?

"First, I want to know about any discomfort you're going to be taking home from today's session. What about the powerful feelings earlier when we talked about Jed?"

"Not Jed—M."

"Sorry. Jeb. You felt faint briefly when we spoke of him."

"I'm still a little shaky, but not upset. I think you were on to something important."

"Okay. Second, I want to find out something about the space between us. You worked hard today, you took some big risks, revealed really important parts of yourself. You trusted me a great deal and I appreciate your trust. Do you think we can work together? How are you feeling about me? What's it like to have revealed so much to me?"

"I feel good about working with you. Real good, Ernest. You're personable and flexible; you make it easy to talk, and you have an impressive ability to focus on the wounded spots, spots I don't know about myself. I feel I'm in very good arms. And here is your fee." She handed him three fifty-dollar bills. "I'm in the midst of switching banks from Chicago to San Francisco, and it's more convenient to pay everything in cash."

In good arms, mused Ernest as he escorted her to the door. Isn't the expression ''in good hands"f

At the door Carol turned. With moist eyes she said, "Thank you. You're a godsend!"

Then she leaned over, gave the surprised Ernest a light hug for two or three seconds, and walked out.

As Carol descended the stairs, a wave of sadness crashed over her. Unwanted images from long ago passed through her: she and Jeb having a pillow fight; jumping and yelling in her parents' bed; her father carrying her books as he walked her to school; her mother's casket sinking into the ground; Rusty's boyish face grinning at her as he fetched her books from her high school locker; her father's calamitous reentry into her life; the sad, worn Persian rug in Dr.

Cooke's office. She squeezed her eyes to brush them all away. Then she thought about Justin, perhaps at this very moment walking hand in hand with his new woman somewhere else in the city. Perhaps near here. She reached the front entrance of the Victorian and looked up and down Sacramento Street. No sign of Justin. But a young, attractive man with long blond hair, dressed in sweat pants, a pink shirt, and an ivory sweater jogged by and charged up the stairs two at a time. Probably Lash's next sucker, she thought. She began to walk away, then turned to glance up at Ernest's office window. Goddamnit, she thought, that son of a bitch is trying to help me!

Upstairs, Ernest sat at his desk recording his notes from their session. The pungent citrus aroma of Carolyn's perfume lingered for the longest time.

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