Love's Executioner
eight years ago —an arresting phrase. I stored it for future use.
    “Tell me about the therapy you’ve had in the last eight years—since your suicide attempt.”
    “During that time I’ve never been without a therapist. They gave me lots of antidepressants, which don’t do much except allow me to sleep. Not much other therapy has gone on. Talking treatments have never helped. I guess you could say I didn’t give therapy much chance since I made a decision to protect Matthew by never mentioning him or my affair to any other therapist.”
    “You mean that in eight years of therapy you’ve never talked about Matthew!”
    Bad technique! A beginner’s error—but I could not suppress my astonishment. A scene I hadn’t thought of in decades entered my mind: I was a student in a medical school interviewing class. A well-meaning but blustering and insensitive student (later, mercifully, to become an orthopedic surgeon) was conducting an interview before his classmates and attempting to use the early Rogerian technique of coaxing the patient along by repeating the patient’s words, usually the last word of the statement. The patient, who had been enumerating ghastly deeds committed by his tyrannical father, ended by commenting, “And he eats raw hamburger!” The interviewer, who had struggled hard to maintain his neutrality, was no longer able to contain his outrage, and bellowed back, “Raw hamburger? ” For the rest of that year, the phrase “raw hamburger” was often whispered in lectures and invariably cracked up the class.
    I, of course, kept my reverie to myself. “But today, you’ve made a decision to come to see me and to be honest about yourself. Tell me about that decision.”
    “I checked you out. I called five former therapists and told them I was going to give therapy one last chance and asked them who I should see. Your name appeared on four of their lists—they said you were a good ‘last ditch’ therapist. So that was one thing in your favor. But I also knew they were your former students, so I checked you out some more. I went to the library and checked out one of your books. I was impressed by two things: you were clear—I could understand your writing—and you were willing to speak openly about death. And I’m going to be open with you: I’m almost certain I will eventually commit suicide. I’m here to make one final attempt in therapy to find a way to live with some iota of happiness. If not, I hope you’ll help me die and help me find a way to cause as little pain as possible to my family.”
    I told Thelma that I thought we could work together, but I suggested we have another consultation hour to consider things further and also to let her assess whether she could work with me. I was going to say more when Thelma looked at her watch and said, “I see that my fifty minutes are up and, if nothing else, I’ve learned not to overstay my welcome in therapy.”
    I was musing on the tone of this final comment—not quite sardonic, not quite coquettish—when Thelma got up, telling me on her way out that she would schedule the next hour with my secretary.
    After this session I had much to think about. First, there was Matthew. He infuriated me. I’ve seen too many patients badly damaged by therapists using them sexually. It’s always damaging to a patient.
    Therapists’ excuses are invariably patent and self-serving rationalizations—for example, that the therapist is accepting and affirming the patient’s sexuality. While plenty of patients may need sexual affirmation—those who are markedly unattractive, extremely obese, surgically disfigured—I have yet to hear of a therapist affirming one of them sexually. It’s always the attractive woman who gets chosen for affirmation. It is, of course, the offending therapists who are in need of sexual affirmation and lack the resources or resourcefulness to obtain it in their own personal lives.
    But Matthew presented somewhat of an
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