enigma. When he seduced Thelma (or permitted himself to be seduced—same thing), he had just finished graduate school and thus must have been in his late twenties or early thirties. So why ? Why does an attractive, presumably accomplished young man select a sixty-two-year-old woman who has been lifeless and depressed for many years? I thought about Thelma’s speculation that he was gay. Perhaps the most reasonable hypothesis was that Matthew was working on (or acting out) some personal psychosexual issues—and using his patient(s) to do it.
It’s precisely for this reason that we urge trainees to be in prolonged personal therapy. But today, with brief training courses, less supervision, a relaxation of training standards and licensure requirements, therapists often refuse, and many patients have suffered from a therapist’s lack of self-knowledge. I feel little charity for the irresponsible professionals and have urged many patients to report sexually offending therapists to professional ethics boards. I considered, momentarily, what recourse I had with Matthew, but supposed he was beyond the statute of limitations. Still, I wanted him to know about the damage he had done.
I turned my attention to Thelma and dismissed, for the time being, the question of Matthew’s motivation. But I was to struggle with that question many times before the dénouement of this therapy, and could not have guessed then that, of all the riddles in the case of Thelma, it was the riddle of Matthew I was destined to solve most fully.
I was struck by the tenacity of her love obsession, which had possessed her for eight years with no external reinforcement. The obsession filled her entire life space. She was right: she was living her life eight years ago. The obsession must draw part of its strength from the impoverishment of the rest of her existence. I doubted whether it would be possible to separate her from her obsession without first helping her to enrich other realms of her life.
I wondered about the amount of intimacy in her daily life. From what she had so far told me of her marriage, there was apparently little closeness between her and her husband. Perhaps the function of the obsession was simply to provide intimacy: it bonded her to another—but not to a real person, to a fantasy.
My best hope might be to establish a close, meaningful relationship between the two of us and then use that relationship as a solvent in which to dissolve her obsession. But that would not be easy. Her account of therapy was chilling. Imagine being in therapy for eight years and not talking about the real problem! That takes a special type of person, someone who can tolerate considerable duplicity, someone who embraces intimacy in fantasy but may avoid it in life.
Thelma began the next session by telling me that it had been an awful week. Therapy always presented a paradox for her. “I know I need to be seen, I can’t manage without it. And yet every time I talk about what’s happened, I have a miserable week. Therapy sessions always just stir the pot. They never resolve anything—they always make things worse.”
I didn’t like the sound of that. Were these previews of coming attractions? Was Thelma telling me why she would ultimately leave therapy?
“This week has been one long crying jag. Matthew’s been on my mind nonstop. I can’t talk to Harry because I’ve got only two things on my mind—Matthew and suicide—and both topics are off limits.
“I will never, never talk about Matthew to my husband. Years ago I told him that I briefly saw Matthew once by chance. I must have talked too much because later Harry stated that he believed that Matthew was in some way responsible for my suicide attempt. If he ever were to know the truth, I honestly believe he would kill Matthew. Harry is full of Boy Scout honor slogans—the Boy Scouts, that’s all he thinks about—but underneath he’s a violent man. He was a British commando officer during