Lying on the Couch (35 page)

he following evening Carol called Ernest at home, saying she felt panicked and needed an emergency session. Ernest spoke to her at length, gave her an appointment

for the next morning, and offered to phone in a prescription for an

anxiety-relieving drug to an all-night pharmacy.

As she sat in the waiting room, Carol read through her notes of

the previous session.

called me an attractive, a very attractive, woman . . . gave me his home phone, asks me to call him there . . . probed deeply into my sex life .... reveals his personal life, his wife's death, dating, singles world . . . hugged me at end of session — longer than last time . . . says he enjoys me having sex fantasies about him, runs ten minutes over . . . strangely uncomfortable at accepting my money.

Lying on the Couch . ^^ 2,2 5

Things were progressing well, Carol thought. Inserting a micro-cassette into her miniature recorder, she slipped it into a porous straw purse bought especially for the occasion. She entered Ernest's office excited by the knowledge that the trap was set, that every word, every irregularity, would be captured.

Seeing that the urgency of the previous evening had disappeared, Ernest turned his attention to understanding the panic attack. He and his patient, it quickly became apparent, held very different viewpoints. Ernest thought Carolyn's anxiety had been evoked by the previous session. She, on the other hand, claimed she was exploding with sexual tension and frustration, and continued her attempts to pry suggestions about possible sexual outlets from him.

When Ernest inquired more systematically into Carol's sexual life, he got more than he bargained for. She described, in graphic detail, many masturbatory fantasies in which he played a prominent role. Without a trace of self-consciousness, she related her arousal at unbuttoning his shirt, kneeling before his chair in the office, unzipping his pants, slipping him into her mouth. She enjoyed the thought of bringing him, again and again, just to the point of orgasm and then slowing and waiting till he softened and then beginning over again. That, she said, was usually sufficient to bring her to orgasm as she masturbated. If not, she continued the fantasy by dragging him to the floor and imagining him lifting her skirt and hurriedly sliding her underpants to the side and pounding into her. Ernest listened attentively and tried not to squirm.

"But masturbation," Carol continued, "has never really been satisfying to me. Partly, I believe, it's the shame attached to it. Except once or twice with Ralph, this is the first time I've talked about it with anyone—man or woman. The problem is that often it doesn't culminate in a full orgasm but, instead, I get a lot of minor sexual spasms that leave me still in a state of heightened arousal. I'm beginning to wonder if it might be my masturbation technique. Could you can give me some instruction about that?"

Carol's question brought the blood to Ernest's face. He was getting used to her casualness about sex. In fact, he admired her ability to speak of her sexual practices—for example, the way she had, in the past, picked up men in bars whenever she traveled or was angry with her husband. It seemed all so easy, so natural for her. He thought of the hours of agony—and futility—he had endured in singles bars and at parties. He had spent a year in Chicago during his

2- 2.6 ^ Lying on the Couch

internship. Why, oh why, Ernest thought, couldn't I have run into Carolyn when she was prowling Chicago barsf

As for her question about masturbatory technique, what did he know about that? Virtually nothing, except for the obvious necessity of clitoral stimulation. People so often assumed psychiatrists knew more than they did.

"I'm no expert in that, Carolyn." Where, Ernest wondered, did she imagine he could have learned about female masturbation? Medical school? Perhaps his next book should be Things They Didn't Teach You in Medical Schooll

"The only thing that comes to mind now, Carolyn, is a lecture I heard by a sex therapist recently on the advisability of freeing the clitoris of all adhesions."

"Oh, is that something you can check in a physical examination, Dr. Lash? That's okay with me."

Ernest flushed again. "No, I hung up my stethoscope and did my last physical exam seven years ago. I'd suggest you bring this up with your gynecologist. Some women find it easier to speak of such things to a female gynecologist."

"Is it different for men. Dr. Lash, I mean do you ... do men have a problem in masturbation with partial orgasm?"

"Again, I'm no expert but I believe men generally have an all-or-nothing experience. Have you discussed this with Wayne?"

"With Wayne? No, we don't talk about anything. That's why I ask you these questions. You're it. Right now you're the main man, the only man, in my life!"

Ernest felt lost. His resolution to be honest offered no direction. Carolyn's aggressiveness was confusing him; he was losing his bearings. He turned to his touchstone, his supervisor, and tried to imagine how Marshal might have responded to Carolyn's question.

The proper technique. Marshal would have said, was to obtain more data: to conduct a systematic, dispassionate sexual history, including the details of Carolyn's masturbation practice and accompanying fantasies—both current and past.

Yes, that was the right approach. But Ernest had a problem: Carolyn was beginning to arouse him. All his adult life Ernest had felt unattractive to women. All his life he believed he had to work hard, to use his intellect, sensitivity, and charm, to overcome his nerdy appearance. It felt wildly exciting to hear this lovely woman describe masturbating to the thought of undressing him and dragging him to the floor.

Lying on the Couch ^ 2.2 7

Ernest's arousal limited his freedom as a therapist. If he asked Carolyn for more intimate details of her sexual fantasies, he could not be clear of his motives. Would he be doing this for her benefit or for his own titillation? It would feel like voyeurism, like getting off on verbal sex. On the other hand, if he avoided her fantasies, would he be shortchanging his patient by not allowing her to talk about what was uppermost in her mind? And wouldn't avoidance be saying to her that her fantasies were too shameful to discuss?

And what about his self-disclosure contract? Should he not simply share with Carolyn exactly what he was thinking? But, no, he was certain that would be an error! Was there another principle of therapist transparency in there? Perhaps therapists should not share things about which they are heavily conflicted. Best that the therapist first work out those issues in personal therapy. Otherwise the patient gets saddled with the task of working on the therapist's problems. He jotted that principle down on his notepad—it was worth remembering.

Ernest grasped the first opportunity to shift the focus. He returned to Carolyn's anxiety attack the previous night and wondered whether she might also have been anxious because of some of the hard questions he had raised in the previous session. For example, why she had stayed so long in a bitter, loveless marriage? And why she had never tried to improve the marriage in couples therapy?

"It's hard to convey how utterly, utterly hopeless I feel about my marriage, or about marriage in general. There hasn't been a spark of happiness or respect in our marriage for years. And Wayne is as nihilistic as I am: he's had many, many expensive, fruitless years of therapy."

Ernest was not to be so easily thwarted.

"Carolyn, as I think about your despair about your marriage, I can't help wondering what role the failed marriage of your parents has played in your own. When I asked you last week about your parents, you said that you never heard your mother mention your father in any but a hateful and contemptuous manner. Maybe your mother did you no service by feeding you such a steady hateful diet. Maybe it wasn't in your best interests to have drilled into you day after day, year after year, that no man could be trusted to look after anything but his own self-interests?"

Carol wanted to get back to her sexual agenda but couldn't help rushing to her mother's defense: "No picnic for her, raising two children, all alone, no help from anyone."

2-^8 ■ ^ Lying on the Couch

"Why all alone, Carolyn? What about her own family?"

"What family? Mother was all alone. My mother's father took off, too, when she was young—one of the pioneer deadbeat dads. And she had little help from her mother—a bitter, paranoid woman. They hardly ever spoke."

"Your mother's social network? Friends?"

"Nobody!"

"Did your mother have a stepfather? Your grandmother remarry?"

"No—out of the question. You'd have to know Grandma. Wore black forever. Even black handkerchiefs. Never saw her smile."

"And your mother? Other men in her life?"

"Are you kidding? I never saw a man in our house. She hated men! But I've been over all this before in therapy. This is ancient history. Thought you said you weren't a rummager."

"Interesting," said Ernest, ignoring Carol's protests, "how closely your mother's life script followed her mother's. As though there's this legacy of pain in the family being passed down, like a hot potato, from one generation of women to the next."

Ernest caught Carol's impatient look at her watch. "I know we're out of time, but stay with me on this a minute longer, Carolyn. You know, this is really important. I'll tell you why . . . because it raises the urgent question of what you may be passing on to your daughter! You see, maybe the best thing we can do in your therapy is to help you break the cycle! I want to help you, Carolyn, and I'm committed to that. But perhaps the real, the major beneficiary, of our work together is going to be your daughter!"

Carol was absolutely unprepared for this comment and it stunned her. Despite herself, tears welled up and overflowed. Without another word, she rushed out of the office, still weeping, and thinking. Goddamn him, he's done it again. Why am I letting the bastard get to mef

Descending the stairs, Carol tried to sort out which of Ernest's comments applied to the fictional persona she had created and which truly applied to her. She was so shaken and so lost in thought that she almost stepped on Jess, who was sitting on the bottom step.

"Hello, Carol. Jess. Remember me?"

"Oh, hi, Jess. Didn't recognize you." She wiped away a tear. "Not used to seeing you sitting still."

"I love jogging, but I've been known to walk. The reason you

Lying on the Couch ^ 2.2 9

always see me running here is because I'm chronically late—a tough problem to work on in therapy because I always get there too late to talk about it!"

"Not late today?"

"Well, I've changed my hour to eight A.M."

Justin's hour, Carol thought. "So you don't have an hour with Ernest now?"

"No. I stopped by to speak to you. Wonder if we could talk sometime—perhaps jog together. Or lunch? Or both?"

"I don't know about jogging. Never done it." Carol swiped at her tears.

"I'm a good teacher. Here's a handkerchief. I can see you've had one of those hours today. Ernest gets to me, too—uncanny how he knows where the pain is. Anything I can do? Take a walk?"

Carol started to return Jess's handkerchief but began sobbing again.

"No, keep the handkerchief. Look, I've had those kind of sessions, too, and I almost always want time by myself to digest things. So I'll take off. But might I call you? Here's my card."

"And here's mine." Carol fished a card out of her purse. "But I want my reservations about jogging to go on record."

Jess looked at the card. "Noted and entered, counselor." With that he tipped his yachting cap and took off jogging down Sacramento Street. Carol stared after him, at his long blond hair flowing in the wind and at the white sweater tied around his neck which rose and fell with the undulations of his powerful shoulders.

Upstairs Ernest entered his notes on Carolyn's chart:

Progressing well. Hard working hour. Heavy self-disclosure about sex and her masturbatory fantasies. Erotic transference increasing. Need to find a way to address that. Worked on relationship to mother, on family role modeling. Defensive about any perceived criticism of mother. I ended session with comment about the type of family model she will pass on to her daughter. Ran weeping out of office. Expect another emergency phone calU Error to end hour with such a powerful message?

Besides, Ernest thought, as he closed his folder, / can't have her charging out of my office like that —/ missed my hug!

FIFTEEN

fter Marshal's lunch with Peter Macondo the previous week, he immediately sold ninety thousand dollars' worth of stock with the intent of wiring the money to Peter as soon as it cleared. But his wife insisted that he discuss the investment with his cousin Melvin, a tax attorney for the Department of Justice.

Shirley generally played no part in the S'.reider family finances. As she had become involved in meditation and in ikebana, she had grown not only unconcerned about material goods but increasingly contemptuous of her husband's obsession with acquiring them. Whenever Marshal reveled in the beauty of a painting or glass sculpture and lamented the fifty-thousand-dollar price tag, she would respond simply by saying, "Beauty? Why don't you see it there?" And then point to one of her ikebana arrangements—a graceful minuet of a swirling oak branch and six Morning Dawn camellia blossoms—or to the elegant sloping lines of a gnarled and proud five-needle-pine bonsai.