"So what would you have done in this situation, Ernest? What? Wouldn't have been there in the first place? Yeah, yeah, I know.
i4 '"^ Lying on the Couch
Facile answer. You disappoint me. Tell me, Ernest, if you wouldn't have been there, where would you have been? Back in your lab? Or in the library? You'd be safe. Proper and comfortable. But where would the patient be? Long gone, that's where! Just like Belle's twenty therapists before me—they all took the safe route, too. But I'm a different kind of therapist. A saver of lost souls. I refuse to quit on a patient. I will break my neck, I'll put my ass on the line, I'll try anything to save the patient. That's been true my whole career. You know my reputation? Ask around. Ask your chairman. He knows. He's sent me dozens of patients. I'm the therapist of last resort. Therapists send me the patients they give up on. You're nodding? You've heard that about me? Good! It's good you know I'm not just some senile schnook.
"So consider my position! What the hell could I do? I was getting jumpy. I pulled out all the stops: I began to interpret like mad, in a frenzy, as if my life depended on it. I interpreted everything that moved.
And I got impatient with her illusions. "For example, take Belle's loony fantasy of our being married and her putting her life on hold waiting all week, in suspended animation, for an hour or two with me. 'What kind of life is that and what kind of relationship?' I asked her. It was not a relationship—it was shamanism. Think of it from my point of view, I'd say: What did she imagine I'd get out of such an arrangement? To have her healed by an hour of my presence—it was unreal. Was this a relationship? No! We weren't being real with each other; she was using me as an icon. And her obsession with sucking me and swallowing my sperm. Same thing. Unreal. She felt empty and wanted me to fill her up with my essence. Couldn't she see what she was doing, couldn't she see the error in treating the symbolic as if it were concrete reality? How long did she think my thimbleful of sperm would fill her up? In a few seconds her gastric hydrochloric acid would leave nothing but fragmented DNA chains.
"Belle gravely nodded at my frenetic interpretations—and then returned to her knitting. Her Narcotics Anonymous sponsor had taught her to knit, and during the last weeks she worked continuously on a cable-stitched sweater for me to wear during our weekend. I found no way to rattle her. Yes, she agreed that she might be basing her life on fantasy. Maybe she was searching for the wise old man archetype. But was that so bad? In addition to her MBA program, she was auditing a course in anthropology and reading The
Lying on the Couch ^ 2.5
Golden Bough. She reminded me that most of mankind hved according to such irrational concepts as totems, reincarnation, heaven, and hell, even transference cures of therapy, and the deification of Freud. 'Whatever works works,' she said, 'and the thought of our being together for the weekend works. This has been the best time in my life; it feels just like being married to you. It's like waiting and knowing you'll be coming home to me shortly; it keeps me going, it keeps me content.' And with that she turned back to her knitting. That goddamned sweater! I felt like ripping it out of her hands.
"By the twenty-two-month mark, I hit the panic button. I lost all composure and began wheedling, weaseHng, begging. I lectured her on love. 'You say you love me, but love is a relationship, love is caring about the other, caring about the growth and the being of the other. Do you ever care about me? How / feel? Do you ever think about my guilt, my fear, the impact of this on my self-respect, knowing that I've done something unethical? And the impact on my reputation, the risk I'm running—my profession, my marriage?'
'"How many times,' Belle responded, 'have you reminded me that we are two people in a human encounter—nothing more, nothing less? You asked me to trust you, and I trusted you—I trusted for the first time in my life. Now I ask you to trust me. This will be our secret. I'll take it to my grave. No matter what happens. Forever! And as for your self-respect and your guilt and your professional concerns, well, what's more important than the fact that you, a healer, are healing me? Will you let rules and reputation and ethics take precedence over that?' You got a good answer for that, Ernest? I didn't.
"Subtly, but ominously, she alluded to the potential effects of my welching on the wager. She had lived for two years for this weekend with me. Would she ever trust again? Any therapist? Or anyone., for that matter? That, she let me know, would be something for me to feel guilty about. She didn't have to say very much. I knew what my betrayal would mean to her. She had not been self-destructive for over two years, but I had no doubt she had not lost the knack. To put it bluntly, I was convinced that if I welched, Belle would kill herself. I still tried to escape from my trap, but my wing beats grew more feeble.
"'I'm seventy years old—you're thirty-four,' I told her. 'There's something unnatural about us sleeping together.'
2-6 ' ^ Lying on the Couch
"'Chaplin, Kissinger, Picasso, Humbert Humbert and Lolita,' Belle responded, not even bothering to look up from her knitting.
"'You've built this up to grotesque levels,' I told her; 'it's all so inflated, so exaggerated, so removed from reality. This whole weekend cannot fail to be a downer for you.'
"'A downer is the best thing that could happen,' she replied. 'You know—to break down my obsession about you, my "erotic transference," as you like to call it. This is a no-loser for our therapy.'
"I kept weaseling. 'Besides, at my age, potency wanes.'
"'Seymour,' she chided me, 'I'm surprised at you. You still haven't gotten it, still haven't gotten that potency or intercourse is of no concern. What I want is you to be with me and hold me—as a person, a woman. Not as a patient. Besides, Seymour,' and here she held the half-knitted sweater in front of her face, coyly peeked over, and said, 'I'm going to give you the fuck of your life!'
"And then time was up. The twenty-fourth month arrived and I had no choice but to pay the devil his due. If I welched, I knew the consequences would be catastrophic. If, on the other hand, I kept my word? Then, who knows? Perhaps she was right, perhaps it would break the obsession. Perhaps, without the erotic transference, her energies would be freed to relate better to her husband. She'd maintain her faith in therapy. I'd retire in a couple of years, and she'd go on to other therapists. Maybe a weekend in San Francisco with Belle would be an act of supreme therapeutic agape.
"What, Ernest? My countertransference? Same as yours would have been: gyrating wildly. I tried to keep it out of my decision. I didn't act on my countertransference—I was convinced I had no other rational choice. And I'm convinced of that still, even in the light of what has happened. But I'll cop to being more than a little enthralled. There I was, an old man facing the end, with cerebellar cortical neurons croaking daily, eyes failing, sexual life all but over—my wife, who's good at giving things up, gave sex up long ago. And my attraction toward Belle? I won't deny it: I adored her. And when she told me she was going to give me the fuck of my life, I could hear my worn-out gonadal engines cranking up and turning over again. But let me say to you—and the tape recorder, let me say it as forcefully as I can— that's not why I did it! That may not be important to you or the ethics board, but it's of life or death importance to me. I never broke my covenant with Belle. I never broke my covenant with any patient. I never put my needs ahead of theirs.
Lying on the Couch r""^ ^7
"As for the rest of the story, I guess you know it. It's all in your chart there. Belle and I met in San Francisco for breakfast at Mama's in North Beach on Saturday morning and stayed together till Sunday dusk. We decided to tell our spouses that I had scheduled a weekend marathon group for my patients. I do such groups for ten to twelve of my patients about twice a year. In fact, Belle had attended such a weekend during her first year of therapy.
"You ever run groups like that, Ernest? No? Well let me tell you that they are powerful . . . accelerate therapy like mad. You should know about them. When we meet again—and I'm sure we will, under different circumstances—I'll tell you ab
out these groups; I've been doing them for thirty-five years.
"But back to the weekend. Not fair to bring you this far and not share the climax. Let's see, what can I tell you? What do I want to tell you? I tried to keep my dignity, to stay within my therapist persona, but that didn't last long—Belle saw to that. She called me on it as soon as we had checked into the Fairmont, and very soon we were man and woman and everything, everything, that Belle had predicted came to pass.
"I won't lie to you, Ernest. I loved every minute of our weekend, most of which we spent in bed. I was worried that all my pipes were rusted shut after so many years of disuse. But Belle was a master plumber, and after some rattling and clanging everything began to work again.
"For three years I had chided Belle for living in illusion and had imposed my reality on her. Now, for one weekend, I entered her world and found out that life in the magic kingdom wasn't so bad. She was my fountain of youth. Hour by hour I grew younger and stronger. I walked better, I sucked in my stomach, I looked taller. Ernest, I tell you, I felt like bellowing. And Belle noticed it. 'This is what you needed, Seymour. And this is all I ever wanted from you— to be held, to hold, to give my love. Do you understand that this is the first time in my life I have given love? Is it so terrible?'
"She cried a lot. Along with all other conduits, my lachrymal ducts, too, had unplugged, and I cried too. She gave me so much that weekend. I spent my whole career giving, and this was the first time it came back, really came back, to me. It's like she gave for all the other patients I've ever seen.
"But then real life resumed. The weekend ended. Belle and I went back to our twice-weekly sessions. I never anticipated losing that
*■ 8 Sz-- Lying on the Couch
wager, so I had no contingency plans for the postweekend therapy. I tried to go back to business as usual, but after one or two sessions I saw I had a problem. A big problem. It is almost impossible for intimates to return to a formal relationship. Despite my efforts, a new tone of loving playfulness replaced the serious work of therapy. Sometimes Belle insisted on sitting in my lap. She did a lot of hugging and stroking and groping. I tried to fend her off, I tried to maintain a serious work ethic, but, let's face it, it was no longer therapy.
"I called a halt and solemnly suggested we had two options: either we try to go back to serious work, which meant returning to a non-physical and more traditional relationship, or we drop the pretense that we're doing therapy and try to establish a purely social relationship. And 'social' didn't mean sexual: I didn't want to compound the problem. I told you before, I helped write the guidelines condemning therapists and patients having post-therapy sexual relationships. I also made it clear to her that, since we were no longer doing therapy, I would accept no more money from her.
"Neither of those options were acceptable to Belle. A return to formality in therapy seemed a farce. Isn't the therapy relationship the one place where you don't play games? As for not paying, that was impossible. Her husband had set up an office at home and spent most of his time around the house. How could she explain to him where she was going for two regular hours a week if she were not regularly writing checks for therapy?
"Belle chided me for my narrow definition of therapy. 'Our meetings together—intimate, playful, touching, sometimes making good love, real love, on your couch—that is therapy. And good therapy, too. Why can't you see that, Seymour?' she asked. Isn't effective therapy good therapy? Have you forgotten your pronouncements about the 'one important question in therapy'? Does it workf And isn't my therapy working? Aren't I continuing to do well? I've stayed clean. No symptoms. Finishing grad school. I'm starting a new life. You've changed me, Seymour, and all you have to do to maintain the change is continue to spend two hours a week being close to me.'
"Belle was a smart cookie, all right. And growing smarter. I could marshal no counterargument that such an arrangement was not good therapy.
"Yet I knew it couldn't be. I enjoyed it too much. Gradually, much too gradually, it dawned on me that I was in big trouble. Anyone looking at the two of us together would conclude that I was exploit-
ing the transference and using this patient for my own pleasure. Or that I was a high-priced geriatric gigolo!
"I didn't know what to do. Obviously I couldn't consult with anyone—I knew what they would advise and I wasn't ready to bite the bullet. Nor could I refer her to another therapist—she wouldn't go. But to be honest, I didn't push that option hard. I worry about that. Did I do right by her? I lost a few nights' sleep thinking about her telling another therapist all about me. You know how therapists gossip among themselves about the antics of previous therapists—and they'd just love some juicy Seymour Trotter gossip. Yet I couldn't ask her to protect me—keeping that kind of secret would sabotage her next therapy.
"So my small-craft warnings were up but, even so, I was absolutely unprepared for the fury of the storm when it finally broke. One evening I returned home to find the house dark, my wife gone, and four pictures of me and Belle tacked to the front door: one showed us checking in at the registration desk of the Fairmont Hotel, another of us, suitcases in hand, entering our room together, the third was a close-up of the hotel registration form—Belle had paid cash and registered us as Dr. and Mrs. Seymour. The fourth showed us locked in an embrace at the Golden Gate Bridge scenic overlook,
"Inside, on the kitchen table, I found two letters: one from Belle's husband to my wife, stating that she might be interested in the four enclosed pictures portraying the type of treatment her husband was offering his wife. He said he had sent a similar letter to the state board of medical ethics and ended with a nasty threat suggesting that if I ever saw Belle again, a lawsuit would be the least important thing the Trotter family would have to worry about. The second letter was from my wife—short and to the point, asking me not to bother to explain. I could do my talking to her lawyer. She gave me twenty-four hours to pack up and move out of the house.
"So, Ernest, that brings us up to now. What else can I tell you?
"How'd he get the pictures? Must've hired a private eye to tail us. What irony—that her husband chose to leave only when Belle had improved! But, who knows? Maybe he'd been looking for an escape for a long time. Maybe Belle had burned him out.
"I never saw Belle again. All I know is hearsay from an old buddy of mine at Pacific Redwood Hospital—and it ain't good hearsay. Her husband divorced her and ultimately skipped the country with the family assets. He had been suspicious of Belle for months, ever
3 o '~=^-. Lying on the Couch
since he had spotted some condoms in her purse. That, of course, is further irony: it was only because therapy had curbed her lethal self-destructiveness that she was willing to use condoms in her affairs.
"The last I heard. Belle's condition was terrible—back to ground zero. All the old pathology was back: two admissions for suicidal attempts—one cutting, one a serious overdose. She's going to kill herself. I know it. Apparently she tried three new therapists, fired each in turn, refuses further therapy, and is now doing hard drugs again.
"And you know what the worst thing is.' I know I could help her, even now. I'm sure of it, but I'm forbidden to see her or speak to her by court order and under the threat of severe penalty. I got several phone messages from her, but my attorney warned me that I was in great jeopardy and ordered me, if I wanted to stay out of jail, not to respond. He contacted Belle and informed her that by court injunction I was not permitted to communicate with her. Finally she stopped calling.
"What am I going to do? About Belle, you mean? It's a tough call. It kills me not to be able to answer her calls, but I don't like jails. I know I could do so much for her in a ten-minute conversation. Even now. Off the record—shut off the recorder, Ernest. I'm not sure if I'm going to be able to just let her sink. Not sure if I could live with myself.
"So, Ernest, that's it. The end of my tale. Finis. Let me tell you, it's not the way I wanted to end my career. Belle is the major
character in this tragedy, but the situation is also catastrophic for me. Her lawyers are urging her to ask for damages—to get all she can. They will have a feeding frenzy—the malpractice suit is coming up in a couple of months.
"Depressed! Of course I'm depressed. Who wouldn't be? I call it an appropriate depression: I'm a miserable, sad old man. Discouraged, lonely, full of self-doubts, ending my life in disgrace.
"No, Ernest, not a drug-treatable depression. Not that kind of depression. No biological markers: psychomotor symptoms, insomnia, weight loss—none of that. Thanks for offering.
"No, not suicidal, though I admit I'm drawn to darkness. But I'm a survivor. I crawl into the cellar and lick my wounds.
"Yes, very much alone. My wife and I had been living together by habit for many years. I've always lived for my work; my marriage
Lying on the Couch .^^ 3 i
has always been on the periphery of my life. My wife always said I fulfill all my desires for closeness with my patients. And she was right. But that's not why she left. My ataxia's progressing fast, and I don't think she relished the idea of becoming my full-time nurse. My hunch is that she welcomed the excuse to cut herself loose from that job. Can't blame her,
"No, I don't need to see anyone for therapy. I told you I'm not clinically depressed. I appreciate your asking, Ernest, but I'd be a cantankerous patient. So far, as I said, I'm licking my own wounds and I'm a pretty good licker.
"It's fine with me if you phone to check in. I'm touched by your offer. But put your mind at ease, Ernest. I'm a tough son of a bitch. I'll be all right."
And with that, Seymour Trotter collected his canes and lurched out of the room. Ernest, still sitting, listened to the tapping grow fainter.