Love's Executioner (20 page)

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Authors: Irvin D. Yalom

Tags: #Psychology, #Movements, #Psychoanalysis, #Research & Methodology, #Emotions

BOOK: Love's Executioner
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I had secretly hoped that her appearance would be offset in some way by her interpersonal characteristics—that is, by the sheer vivacity or mental agility I have found in a few fat women—but that, alas, was not to be. The better I knew her, the less interesting she seemed.
During the first few sessions, Betty described, in endless detail, problems she encountered at work with customers, co-workers, and bosses. She often, despite my inner groans, described some particularly banal conversation by playing several of the roles—I’ve always hated that. She described, again in tedious detail, all the attractive men at work and the minute, pathetic machinations she’d go through to exchange a few sentences with them. She resisted every effort on my part to dip beneath the surface.
Not only was our initial, tentative “cocktail chatter” indefinitely prolonged, but I had a strong sense that, even when we got past this stage, we would remain fused to the surface of things—that as long as Betty and I met, we were doomed to talk about pounds, diets, petty work grievances, and the reasons she did not join an aerobics class. Good Lord, what had I gotten myself into?
Every one of my notes of these early sessions contains phrases such as: “Another boring session”; “Looked at the clock about every three minutes today”; “The most boring patient I have ever seen”; “Almost fell asleep today—had to sit up in my chair to stay awake”; “Almost fell off my chair today.”
While I was considering shifting to a hard, uncomfortable chair, it suddenly occurred to me that when I was in therapy with Rollo May, he used to sit in a straight-backed wooden chair. He said he had a bad back, but I knew him well for many years afterward and never heard him mention back trouble. Could it be that he found
me——
?
Betty mentioned that she hadn’t liked Dr. Farber because he often fell asleep during their hour. Now I knew why! When I spoke to Dr. Farber on the phone, he did not mention his naps, of course, but he did volunteer that Betty had not been able to learn how to use therapy. It was not hard to understand why he had started her on medication; we psychiatrists so often resort to that when we cannot get anything going in therapy.
Where to start? How to start? I struggled to find some handhold. It was pointless to begin by addressing her weight. Betty made it clear immediately that she hoped therapy would help her get to the point where she could seriously consider weight reduction, but she was a long way from that at this time. “When I’m this depressed, eating is the only thing that keeps me going.”
But when I focused on her depression, she presented a persuasive case that depression was an appropriate response to her life situation. Who wouldn’t feel depressed holed up in a small furnished apartment in an impersonal California suburb for eighteen months, torn away from one’s real life—one’s home, social activities, friends?
So I then attempted to help her work on her life situation, but I could make little headway. She had plenty of daunting explanations. She didn’t make friends easily, she pointed out: no obese woman does. (On that point I needed no persuasion.) People in California had their own tight cliques and did not welcome strangers. Her only social contacts were at work, where most of her co-workers resented her supervisory role. Besides, like all Californians, they were jocks—into surfing and skydiving. Could I see her doing that? I swept away a fantasy of her slowly sinking on a surfboard and acknowledged she had a point—those did not seem to be her sports.
What other options were there? she asked. The singles world is impossible for obese people. To prove that point, she described a desperation date she had had the month before—her only date in years. She answered an ad in the personal section of
The Bay Guardian,
a local newspaper. Although most of the ads placed by men explicitly specified a “slim” woman, one did not. She called and arranged to go out to dinner with a man named George, who asked her to wear a rose in her hair and to meet him in the bar of a local restaurant.
His face fell, she reported, when he first caught sight of her, but, to his everlasting credit, he acknowledged that he was indeed George and then behaved like a gentleman throughout dinner. Though Betty never again heard from George, she often thought about him. On several other such attempts in the past, she had been stood up by men who probably spotted her from afar and left without speaking to her.
In some desperation, I stretched for ways to be helpful to Betty. Perhaps (in an effort to conceal my negative feelings) I tried too hard, and I made the beginner’s mistake of suggesting other options. Had she considered the Sierra Club? No, she lacked the stamina for hiking. Or Overeaters Anonymous, which might provide some social network? No, she hated groups. Other suggestions met a similar fate. There had to be some other way.
The first step in all therapeutic change is responsibility assumption. If one feels in no way responsible for one’s predicament, then how can one change it? That is precisely the situation with Betty: she completely externalized the problem. It was not
her
doing: it was the work transfer, or the sterile California culture, or the absence of cultural events, or the jock social scene, or society’s miserable attitude toward obese people. Despite my best efforts, Betty denied any personal contribution to her unhappy life situation.
Oh yes, she could, on an intellectual level, agree that, if she stopped eating and lost weight, the world might treat her differently. But that was too far removed from her, too long term, and her eating seemed too much out of her control. Besides she marshaled other responsibility-absolving arguments: the genetic component (there was considerable obesity on both sides of her family); and the new research demonstrating physiological abnormalities in the obese, ranging from lower basal metabolic rates to the present, programmed, relatively un-influencible body weight. No, that would not work. Ultimately I would have to help her assume responsibility for her appearance—but saw no leverage for achieving that at this time. I had to start with something more immediate. I knew a way.
The psychotherapist’s single most valuable practical tool is the “process” focus. Think of
process
as opposed to
content.
In a conversation, the content consists of the actual words uttered, the substantive issues discussed; the process, however, is
how
the content is expressed and especially what this mode of expression reveals about the relationship between the participating individuals.
What I had to do was to get away from the content—to stop, for example, attempting to provide simplistic solutions to Betty—and to focus on process—on how we were relating to each other. And there was one outstanding characteristic of our relationship—
boredom.
And that is precisely where countertransference complicates things: I had to be clear about how much of the boredom was
my
problem, about how bored I would be with
any
fat woman.
So I proceeded cautiously—too cautiously. My negative feelings slowed me down. I was too afraid of making my aversion visible. I would never have waited so long with a patient I liked more. I spurred myself to get moving. If I were going to be helpful to Betty, I had to sort out, to trust, and to act upon my feelings.
The truth was that this was indeed a boring woman, and I needed to confront her with that in some acceptable way. She could deny responsibility for anything else—the absence of friends in her current life, the tough singles scene, the horrors of suburbia—but I was
not
going to let her deny responsibility for boring me.
I dared not utter the word
boring
—far too vague and too hurtful. I needed to be precise and constructive. I asked myself what, exactly, was boring about Betty, and identified two obvious characteristics. First of all, she never revealed anything intimate about herself. Second, there was her damned giggling, her forced gaiety, her reluctance to be appropriately serious.
It would be difficult to make her aware of these characteristics without hurting her. I decided upon a general strategy: my basic position would be that I wanted to get closer to her but that her behavioral traits got in the way. I thought it would be difficult for her to take offense with any criticism of her behavior when framed in that context. She could only be pleased at my wanting to know her better. I decided to start with her lack of self-revelation and, toward the end of a particularly soporific session, took the plunge.
“Betty, I’ll explain later why I’m asking you this, but I’d like you to try something new today. Would you give yourself a score from one to ten on how much revealing about yourself you’ve done during our hour together today? Consider ten to be the most significant revealing you can imagine and one to be the type of revealing you might do, let’s say, with strangers in a line at the movies.”
A mistake. Betty spent several minutes explaining why she wouldn’t go to the movies alone. She imagined people pitied her for having no friends. She sensed their dread that she might crowd them by sitting next to them. She saw the curiosity, the bemusement in their faces as they watched to see whether she could squeeze into a single narrow movie seat. When she began to digress further—extending the discussion to airline seats and how seated passengers’ faces grew white with fear when she started down the aisle searching for her seat—I interrupted her, repeated my request, and defined “one” as “casual conversation at work.”
Betty responded by giving herself a “ten.” I was astonished (I had expected a “two” or “three”) and told her so. She defended her rating on the basis that she had told me things she had never shared before: that, for example, she had once stolen a magazine from a drugstore and was fearful about going alone to a restaurant or to the movies.
We repeated that same scenario several times. Betty insisted she was taking huge risks, yet, as I said to her, “Betty, you rate yourself ‘ten,’ yet it didn’t
feel
that way to me. It didn’t feel that you were taking a real risk with me.”
“I have never told anybody else these things. Not Dr. Farber, for example.”
“How do you feel telling me these things?”
“I feel fine doing it.”
“Can you use other words than
fine
? It must be scary or liberating to say these things for the first time!”
“I feel O.K. doing it. I know you’re listening professionally. It’s O.K. I feel O.K. I don’t know what you want.”
“How can you be so sure I’m listening professionally? You have no doubts?”
Careful, careful! I couldn’t promise more honesty than I was willing to give. There was no way that she could deal with my revelation of negative feelings. Betty denied any doubts—and at this point told me about Dr. Farber’s falling asleep on her and added that I seemed much more interested than he.
What
did
I want from her? From
her
standpoint she was revealing much. I had to be sure I really knew. What was there about her revealing that left me unmoved? It struck me that she was always revealing something that occurred elsewhere—another time, another place. She was incapable, or unwilling, to reveal herself in the immediate present that we two were sharing. Hence, her evasive response of “O.K.” or “Fine” whenever I asked about her here-and-now feelings.
That was the first important discovery I made about Betty: she was desperately isolated, and she survived this isolation only by virtue of the sustaining myth that her intimate life was being lived elsewhere. Her friends, her circle of acquaintances, were not here, but elsewhere, in New York, in Texas, in the past. In fact, everything of importance was elsewhere. It was at this time that I first began to suspect that for Betty there was no “here” there.
Another thing: if she was revealing more of herself to me than to anyone before, then what was the nature of her close relationships? Betty responded that she had a reputation for being easy to talk to. She and I, she said, were in the same business: she was everyone’s therapist. She added that she had a lot of friends, but no one knew
her.
Her trademark was that she listened well and was entertaining. She hated the thought, but the stereotype was true: she was the jolly fat woman.
This led naturally into the other primary reason I found Betty so boring: she was acting in bad faith with me—in our face-to-face talks she was never real, she was all pretense and false gaiety.
“I’m really interested in what you said about being, or rather pretending to be, jolly. I think you are determined, absolutely committed, to be jolly with me.”
“Hmmm, interesting theory, Dr. Watson.”
“You’ve done this since our first meeting. You tell me about a life that is full of despair, but you do it in a bouncy ‘aren’t-we-having-a-good-time?’ way.”
“That’s the way I am.”
“When you stay jolly like that, I lose sight of how much pain you’re having.”
“That’s better than wallowing in it.”
“But you come here for help. Why is it so necessary for you to entertain me?”
Betty flushed. She seemed staggered by my confrontation and retreated by sinking into her body. Wiping her brow with a tiny handkerchief, she stalled for time.
“Zee suspect takes zee fifth.”
“Betty, I’m going to be persistent today. What would happen if you stopped trying to entertain me?”

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