Last Lie (13 page)

I had a question for Hella. I was wondering if--during those initial moments when she was trying to sort out her responsibility for what had happened--her patient was already certain that it had been her host who was responsible for the sexual contact. If she was, how was she so certain? Did she remember something? See something? Smell something? Was it simple process of elimination? Or had the certainty come later?

I waited.

Hella went on. "She said she even tried to calculate her menstrual cycle, but she was so upset she couldn't remember the first day of her last period. She still couldn't get her brain to work right. Her memory. Her concentration.

"Then she said it all hit her, all at once. What had happened to her the night before became clear. She said she felt like she was suddenly immersed in the reality. The words she used were 'I was dunked in the truth. It was like a baptism.'

"She thought,
Dear, dear Lord--
those are her words, not mine--
I was raped.
Just like that. No 'What if I was raped?' Just,
Dear, dear Lord, I was raped.

"She said her very next thoughts were,
He raped me. He drugged me, and he made me give him a blow job, and he raped me.
She used his name, Alan. She said his name to me then.
My own goddamn friend raped me.
"

"Her host?" I clarified.

"Yes."

"With conviction?" I asked.

Hella hesitated. "Yes."

I came back around to one of my questions from earlier. I asked it. "Did she have a specific memory, Hella? Of the rape? Of the oral sex? Of the rapist? Or did she reach a conclusion because of what she felt the next morning?"

Hella didn't answer.

"Did she identify her host because . . . he was there?"

Hella's breath caught momentarily in her throat. She coughed. She narrowed her eyes as she looked at me. She shrugged. She shook her head. She made a perplexed face. "He was the only man in the house, Alan."

I kept my tone idling in neutral. "Was it memory? Or conclusion?"

"I don't . . . know. She said that at that moment she knew her friend had raped her. And had drugged her. I didn't question that. Should I have questioned that?"

I reviewed the pieces that felt factual. She remembered her host serving her the port. If she had been drugged--and I assumed a toxicology screen would determine whether that was true--it seemed likely that the drug was delivered in the port. If that were true, it certainly meant that her host had drugged her.

The rape? It seemed obvious that the same man who drugged her would be the prime suspect responsible for raping her.

I said, "I'm not saying you should have or shouldn't have questioned her. Your role with her isn't as an investigator. I'm trying to help you see that something that your patient was saying is still, apparently, unclear--even to her--yet you seem to be comfortable encouraging her to adopt a specific explanation as final. I'm wondering if that is the best way to help her through this ordeal. Do you see what I'm saying? Do you feel you need to agree to accept a certain version as true in order to help her?"

"What's the alternative?"

"Accepting that she is telling you what feels true to her."

Hella pondered the distinction. "I guess I want to believe her. I think I
do
believe her. There was nothing insincere about what she was telling me."

"Why do you want to believe her? What's that about?"

"I need to be supportive of her. Of what she's been through. Don't I? Because it was so apparent to me at the end that she believed that she'd been assaulted. And drugged. By her
friend
."

"Then believe that. Believe that she believes it. But in these circumstances, with the facts that you've described, believing that she believes it is a very different thing from believing she knows exactly what happened. It sounds to me as though she was desperately trying to make sense of some horrendous circumstances. Anyone in the same circumstances would have felt similar desperation. You need to be available to help her with that, too. The doubt, if it's there. The desperation to find certainty, if it's there. She found an explanation that helped her make sense of the memories she has currently. Is it the right explanation? Perhaps it is. Could there be another one? I don't know. But I don't think you know either. I'm trying to help you see that you have latitude here as her therapist, and that you need to make sure that you allow that latitude to be of the most possible help to your patient."

"You don't believe her?" Hella asked.

I leaned forward a little. "Is it important that I believe her, Hella? Is it important that you believe her? Is that how you see this, clinically?"

She opened her eyes wide. My questions were completely baffling to her.

I said, "What's going on here? Between you and your patient? Between you and me? She wants you to believe that her construction of events is accurate. You apparently want me to believe you that her construction of events is accurate. See the process? The parallel?"

"I don't know what you want me to do next. I don't get--I'm not sure what you're telling me to--" Hella sat back, turned her head away. She looked out the window in the general direction of the Flatirons.

"What?" I asked.

"It's kind of ironic. I was just reflecting on what she said next. What she was thinking about after she realized she'd been raped. And forced to have oral sex. And after she knew she'd been drugged. She said she started thinking about TV shows.
CSI
and
Law & Order
. Do you know them?"

"I know of them."

"She watches them all the time. She said that's what she started thinking about. Those shows."

"Anything in particular?"

"Yes. She said, 'I know nobody is going to believe me.' "

"Because?" I asked.

"Because, she said, that's what happens on the shows. When they do cases like this. She said, at first nobody believes the victim." Hella turned back to me. On her face was a tenuous smile. "And apparently that's what happens in supervision, too."

17

I
was tempted to give Hella a version of my "patients lie" soliloquy. At one point or another, all of my supervisees heard it from me.

I consider the reality that patients lie to be an essential truth about psychotherapy. Patients lie frequently. Some, of course, more than others. Most of the time, the lies are irrelevant to anything but the therapy and, from a therapeutic process perspective, are often as valuable, and sometimes more valuable, than an initial recounting of truth. But the truth for young therapists to remember is: patients lie.

Occasionally, the stories patients tell are just that, stories. More often the stories are true, but some details are false. Every lie has permutations. The intent behind every mistruth is different. Some are unconscious, some are inadvertent. Some are flat-out sociopathic.

But I decided it wasn't the time for that speech with Hella. I didn't think that Burning Man Lady was lying to Hella. I didn't even think she was lying to herself. Nor was I seriously entertaining the possibility that her story was just flat-out untrue. Neither, unfortunately, was I sure that it was entirely true. My concern was that Burning Man Lady was stretching the facts that she did know in order to cover the void that encompassed all that she did not know.

We all extrapolate, every day. As an exercise in truth-seeking, it is a reasonable strategy. In therapy, especially the kind of therapy of discovery that I do, factual issues like these shake themselves out over time, usually revealing important facets of the character and emotional state of the patient doing the shaking. Only in rare circumstances do I feel any short-term imperative about sorting truth from fiction in therapy.

But the story Hella was telling me about Burning Man Lady wasn't only about therapy. It was also about felonies: a rape, a drugging, maybe a burglary. And already about cops and lawyers. An accused. Soon, courts, maybe, and jails.

I had a question or two that I hoped would clarify for me how things were stacking up on the veracity scale. I started with the one that felt like it might be simplest to answer. I was wrong, it turned out, about the simple part.

I asked, "Does she know if the man who raped her wore a condom?"

Hella's sudden glance at me was a few degrees shy of a glare. I didn't think she liked my question. The fact that she didn't like my question was undoubtedly as significant as the answer she might provide.

Hella said, "She did not . . . find semen that morning. When she . . . examined herself. He either wore a condom, or he didn't ejaculate inside her. Or it's possible he didn't ejaculate at all. I've done some reading. That happens . . . during rape."

Hella was right; it does happen. Although it was clear that Hella and I needed to discuss the dynamics of rape--that it's a crime of violence and domination, not a crime of sex--I didn't want to get sidetracked right then with a tutorial on the behavior of rapists. "Yet the next morning she was sure she'd been penetrated vaginally--probably against her will--hours before? Was there an indication other than semen?"

"She said she just knew. That she could tell."

I sat in silence, allowing Hella a moment to digest the assumptions buried in those simple declarations.

I eased off the accelerator, tapped the brakes, and slowly depressed the clutch. I allowed my voice to find neutral. I said, "How do
you
feel about your patient's assertion, absent memory, that she had engaged in intercourse--without her consent--the night before?"

My rephrased question changed the climate in the room. The atmosphere altered suddenly, as if a low-pressure ridge had blown into the apartment and parked over the compact kitchen. Hella looked as uncomfortable as she had during our entire conversation. Maybe even more uncomfortable. She squirmed. She swallowed. She opened her mouth twice to speak before she finally managed to say, "I feel that she was telling the truth, Alan."

"That's not my question, Hella."

More silence. I gave her time. I knew she was determined to outwait me. My time was not unlimited. I said, "You seem comfortable accepting your patient's assertion that she knew she'd had intercourse--nonvolitional intercourse--despite having no memory of the act, and despite the absence of any semen or other . . . evidence."

Hella was ready. "I think she's being . . . objective about it. What she remembers. She maintains she can tell." Hella then nodded her head, as though she was pleased with her reply.

"Still doesn't answer my question, Hella."

"She only remembers what she remembers."

"And that is where I keep getting lost," I said. "The
objective
part about what she remembers. Can you help me with that? So I can understand your certainty about her . . . certainty."

I suddenly felt a different doubt about the woman's certainty. Was the certainty something women would know, would be familiar with, but that I wouldn't know? I tried to remember whether I had ever had a similar conversation with a woman before. About whether she could tell hours later that she'd had intercourse with a condom-wearing man. I didn't believe that I had.

This could all have been about my ignorance. I backed off my confrontation and asked for some information. "Hella? Can you provide any guidance to me? I'm ignorant about this. I'm sorry. I need to understand it better." I was also thinking that Hella needed to understand it better.

I expected her resistance to take a respite as I backed off. I was wrong. Hella turned red. I waited as the red faded to pink, then as the pink began to fade to something cadaver-like. I wondered again if I'd inadvertently crossed some line with my question.

"My blood sugar is low," she said. "I need something to eat."

She rushed to the kitchen and went straight to the refrigerator. She poured and chugged a few ounces of orange juice. I watched her use a big french knife to whack off a chunk of hard cheese--Parmigiano, maybe. With her back to me, she ate the cheese in quick, small, bunny-like bites.

I pulled out my phone to check the time. It was getting late. I had a text from Lauren. I hadn't even noticed that the phone had vibrated in my pocket.

Much longer
? my wife wanted to know. She'd sent the text almost thirty minutes earlier.
Fraid so
I replied before I hit SEND.

Good night
she wrote back almost immediately.
Dogs need out.

In my office, doing supervision or therapy, I never would have stolen a moment for a text exchange with my wife. I realized that I, like Hella, was taking advantage of the unusual circumstances of our meeting.

After a swallow, before the next bite of cheese, still standing at the counter in the kitchen, and still facing away from me, Hella said, "My manners? God. Can I get you something, Alan?"

"I'm good," I said. What I was thinking was,
I'd really love to see the replay. What just happened here?

When Hella returned to the sofa a few minutes later, some color had returned to her face. She sat this time with her knees up, her legs pulled tight against her upper body, her arms around her legs. The bicolor toenails were peeking out from beneath the draped skirt. Other than crouching behind the couch and peeking at me over the cushions, it was the most protected posture I could imagine for her.

"Sorry about that," she said. "It ambushes me sometimes. My blood sugar. Sometimes it just drops, out of the blue. All my life. I'm sorry."

"You're okay?" I said.

"Yes, thanks. What you were asking? Your question? Earlier? Well, the truth is that . . . I don't know the answer," she said.

"Okay. Does that mean that the question of your patient's certainty about sexual activity on Friday night is an open one in your mind, too?"

Hella shook her head. "No, it's not. I think . . . she's telling the truth."

"What she believes to be true? Or what she knows to be true?"

Hella hesitated. With absolutely no assurance in her tone, she said, "Both."

"No filling in of blank spaces?"

"We all do that, don't we?" Hella asked.

"Again, doesn't answer my question," I said. The process was starting to make me spin.

"You want me to be objective?" The way she spoke the last word left it hanging in the air lonely and forlorn. I wondered where Hella was heading. She sighed.

To my ear, it was a frustrated sigh. I hoped that it was a sign that the resistance she was mounting with me was feeling some strain. She continued, "Actually, I can't provide that guidance. Not . . . right now. Maybe . . . I don't know."

I was unsure what Hella was telling me. But I had a sudden feeling that she was telling me something that was much more significant than the answer to the relatively simple question I was asking. In doing psychotherapy, and occasionally in doing supervision, there are innocuous-appearing moments that are actually laden with immense affective mass.

To an outside observer, those moments may seem inconsequential. But, sometimes in an instant, the emotional gravity in the clinical interaction goes from negligible to extraordinary. From one G to six G's. This was one of those moments. Because of Hella's innocuous words--
I'm not sure I can provide that guidance
--and her simple admission that she could not help me understand something that was happening between her and me, let alone between her and her patient, I suspected that my supervision with Hella was changing in an essential way that I didn't yet comprehend.

I couldn't predict what would happen next in the room. I suspected that the supervision session would turn out to be as much about Hella as a therapist as about her therapy of Burning Man Lady.

The stakes for me as a supervisor were high right then. Part of my role had nothing to do with Burning Man Lady's psychotherapy. A big part of my role as supervisor involved assisting Hella to reveal what she needed to reveal, so that whatever limitations or conflicts she was feeling in the current treatment wouldn't impact, or afflict, her care of future patients.

I absolutely needed to make the supervisory moment safe for her to do that. I decided to say what I needed to say, but nothing more. I said, "I don't think I understand, Hella. But I think this is a very important moment. Between you and me."

Initially, she seemed to be content with the silence that followed my words. We each waited almost motionless, our breathing so controlled that neither of our exhales would have budged a candle flame held in front our faces.

My expression was as neutral as I knew how to carve it. Hella's was not so neutral. Her countenance appeared wounded.

Supervision is not a relationship between equals.

The silence between us lasted a minute. Then another one. Before a third one was complete, Hella finally spoke. "I'm not ready to talk about that . . . tonight."

I waited to see where she would go.

Her vote was nowhere. She said, "I'd like to stop for . . . now."