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Wednesday, 19 July 2006 00:00

Use Eagles if Necessary, Chapter 16: Sometimes We Make Mistakes

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Shrinks, like other professionals, are a kaleidoscope of humanity. They are fat, skinny, tall, short, handsome, beautiful, ugly. Some have bombastic personalities and others are terribly shy. If there is a common thread, and of course there is, shrinks, like their patients, knew they weren’t quite right. That’s why they entered the mental health field. Psychoanalysis has been called the only profession where people pay you — so you can cure yourself.

When we choose a profession it is our powerful unconscious minds that are doing the choosing, often utilizing the defense mechanism known as “Counterphobia.” This simply means we are unconsciously frightened by something and to counter that fear we incorporate it into our lives and put a positive spin on it. Following are psychoanalytic truisms about chosen careers that often have merit: Pilots are afraid of heights; school teachers were traumatized as students; medical doctors are hypochondriacs; nurses want to be nursed; lawyers grew up with too many, or not enough, laws; salesmen are insecure; clergy know they are basically bad people who are plagued with guilt. There’s a fine line between the cop and the robber, the fireman and the firebug.

Jean Rosenbaum told a story about meeting Mel Brooks in the Green Room before appearing on The Tonight Show. (Rosenbaum was touting a book he’d written.) When Brooks learned Jean was a psychiatrist he said, “Tell me, Doctor, isn’t everything in life counterphobic?”

A psychoanalyst’s job is to “make right.” To put some kind of order into the 10,000-piece jigsaw puzzle of ironical, paradoxical and conflicting emotions that we carry around. And we practitioners must begin with ourselves. When Freud was training analysts, he did not spend a lot of time with them. Six days a week for a few months and they were on their own. So they got a feel for the basics and dynamics of the discipline but did not experience its depth as it pertained to their own histories.

The story is told about two of Freud’s newly trained shrinks who were practicing on each other. The one lying on the couch said something which prompted the one in the chair behind him to make an interpretation. It was way off the mark. The one on the couch said, “That was really stupid. You’re a lot more fucked up than me.” The one in the chair said, “I think you’re right. Let’s trade places.” And they did. Psychotherapists today are highly trained, especially the heavy-duty psychoanalysts who undergo years of personal analysis. But all of us are still human beings and can indeed make mistakes.

Our mental health institute in the Midwest held regularly scheduled seminars where cases were discussed. Once a week psychoanalysts and therapists took turns presenting their cases in order to teach the students, and to get feedback from other therapists. These sessions were lively, informative, good for the therapists and, therefore, good for the patients. The patients were unaware they were being discussed and their real names were never used to protect their privacy. I will never forget one of these cases related by one of the institute’s most experienced analysts. The presenting symptom (“I came to see you because ...”) was a marriage problem.

“Elizabeth’s” husband’s occupation was in a prestigious profession but one that did not, and never would, pay well. But he was devoted to it, and was very happy in his work. When Elizabeth married “Jerry” she knew that riches would never be theirs, but that was four years ago. Now she wanted out. “I want nice things and a bigger house,” she told her therapist. “All our friends are getting big raises and moving to the suburbs. We’re stuck in the city and will never go anywhere but Jerry won’t consider changing careers. It isn’t fair!” When a patient uses the expression, “It isn’t fair,” the first thing therapists say to themselves is, “Oh shit. A 5-year-old.”

And Elizabeth had numerous other complaints: “I think Jerry loves Mary (their dog) more than me — he spends more time with her than me. He used to take me out to dinner and dancing but now he rarely takes me anywhere because he tells me it’s too expensive. I want him to take me on a cruise to Hawaii, but he told me it’s out of the question. He says ‘You know we couldn’t afford that.’ Sometimes he has to go to work on Saturday and leaves me home alone. He never brings me surprise gifts anymore. He used to bring me gifts all the time but that ended years ago.”

Elizabeth’s marital complaints were seemingly endless, but by the third session her shrink was able to begin getting her personal history. An only child, Elizabeth was doted upon. Her father was an engineer and her mother did not work out of the home. They were not wealthy but lack of money was rarely an issue. They lived in a large house in an upscale suburb. When she went away to college, her parents gave her a new car and paid all her college expenses. She described her parents’ marriage as “romantic and stable,” an expression we don’t hear often.

Elizabeth and Jerry met in college and soon after graduation they married. “I guess I knew his career choice wouldn’t pay much but I didn’t care then. I was young and he loved me. Now he doesn’t love me and I want a divorce,” she said, daintily dabbing a tear from her eye. Elizabeth’s therapist sensed there was more to her story than the lack of money. He was also put off by Elizabeth’s “me-me and I-I” talk. Psychotherapy is the most narcissistic of experiences, and we expect to hear lots of “me-me’s and I-I’s,” but Elizabeth had taken it to a new level.

During the fourth session the therapist felt comfortable enough to inquire into Jerry and Elizabeth’s sex life, and that’s when Elizabeth dropped the bomb. “I hate our sex life and I always have.” The therapist figured he would now get to the real reason for Elizabeth’s wish to get out of the marriage. Perhaps Jerry was kinky in his sexual demands or maybe Elizabeth had found a better lover, or perhaps she didn’t like sex. Some people simply don’t like sex but concoct seemingly logical reasons for their dislike. The therapist was about to hear one of these reasons. “What’s wrong with your sex life?” he asked.

“Jerry’s penis is enormous,” Elizabeth explained “You should see it! He hurts me terribly when he puts it in me. I hate it! That’s why we don’t have kids. We quit having regular sex years ago. I just jack him off. It’s not normal for married people to live like that.”

Elizabeth was about 5’8” tall and possessed the normal curvature of a woman. When asked to describe Jerry she said he was 5’6” tall, “skinny as a rail,” and reiterated he had the biggest male member she’d ever seen.

“How many penises have you seen?” was the obvious question from the therapist.

“Just Jerry’s. I was a virgin when we married. But I have seen pictures and statues,” she explained “And he’s way bigger than any of them. He’s even bigger than those guys in X-rated movies. He brings those movies home to try to get me horny. They disgust me.”

At this juncture in the therapy Elizabeth’s analyst decided to present this case at a training seminar. After we had heard the details it was unanimously decided that: A) We should get Jerry in to see a therapist to get his side of the story, if he would consent to this. He did, and another analyst, “Fred,” was assigned to see him. B) Elizabeth sounded like an infantile character in many ways. Not only did she grossly overuse the words “me and I,” but her effect was pouty, and when she talked she ended every sentence on a high note making it sound like a question. She was an attractive woman but this valley girl form of speech gave her the effect of a whiney child. We also agreed that her complaint about the size of Jerry’s penis was, no doubt, an exaggeration.

Fred began to see Jerry and liked him immediately. He was bright, funny, dedicated to his profession, and terribly concerned about the state of his marriage. He told Fred that he loved his wife, even though she was never happy anymore. He said he’d do whatever he could to make the marriage work. Fred reported this to the group and added that Jerry was, indeed, slight of stature.

Diplomacy is necessary when inquiring about patient’s genitalia, so Fred waited until trust was firmly established before he broached the topic with Jerry. Elizabeth and Jerry had given the therapists permission to discuss specific details from each other’s sessions when they felt it be a benefit to the other person, or the marriage. One day Fred asked him about the size of his penis, telling him that Elizabeth told her therapist it was quite large and it hurt her when he penetrated her.

“She has always said that,” he said “but it is not true. I’ve been in the Army and plenty of locker rooms. I know my dick is no bigger than average. Elizabeth doesn’t like sex and never has. I think she’s frigid and uses that as an excuse.”

Fred asked if other women had mentioned it and he said there had never been another woman. He, too, was a virgin when he married.

Unfortunately Elizabeth and Jerry didn’t make it. After a few months of therapy, they divorced. Jerry was devastated. Elizabeth was relieved. Elizabeth terminated her therapy but Jerry continued seeing Fred as they put his new life together. He had been crushed by his failed marriage, but he eventually regained his self-esteem and sense of humor. Fred reported to our group that he had no doubt Jerry would have become whole again, over time, without the aid of psychotherapy. (One aspect of therapy is that it hurries this process.) Within a year Jerry had an active social life. His sense of humor and overall positive outlook made him an appealing person in the singles scene. His therapy terminated.

There are approximately 6 million people in the Chicago area. A few months later in a singles bar, Jerry met “Catherine,” who was, incredibly, one of Fred’s patients. “Fred, you’re not going to believe who I met last night,” she gushed as the session began. She told Fred she’d met a former patient of his, a guy named Jerry. She said that they really liked each other and had plans for the following weekend. That weekend went great and Catherine was thrilled with her new boyfriend. “He’s so funny! We laugh all the time,” she gushed. But when she arrived at her next session, Catherine was anything but her usually chipper self. “What’s wrong?” Fred asked.

She told him that when she and Jerry checked into a motel and started making out he was gentle and loving and did all the right things, but when they got naked she was shocked. “As you know I have been with many men, but I have never seen anything like this guy’s dick!” She told Fred he was built like a horse and they’d have no future. “Sex with him hurts!” Fred could hardly wait for the next seminar to tell us the news. We had really screwed up.

While we’re on the topic of screwing up, I’ll tell you about a time I made a mistake with a patient. I’m still ashamed of myself and embarrassed by it.

My patient, “Mark,” was an attorney in his mid-20. His wife had recently filed for divorce and he was devastated. They had only been married eight months. It was Mark’s first marriage but his wife’s second. She had two daughters who Mark had legally adopted. Mark had no clue his marriage was ending until he was served with divorce papers at his law office. He immediately called his home and the maid said that his wife, kids, and “some man” had left in the man’s car. Mark learned the “man” was his wife’s first husband.

A friend of Mark’s advised him to come see me. He was unable to work, sleep, or think about anything except the loss of his family. He’d quit shaving, wore the same clothes and showered, I noted, infrequently. Our sessions consisted of Mark expressing his disbelief at what happened to him and his bewilderment at his wife’s behavior. “I had no idea what was going on. Not once did she tell me she was unhappy with me. We could have talked it out. I know we could have. What am I going to do? Oh God, oh God, please help me!” Then he’d break down sobbing.

After three sessions of essentially the same dynamics I was getting frustrated and decided to intervene. One of the most important things people should do when they feel they have been wrongly treated is to express anger at the person who hurt them. In our few sessions I had suggested to Mark that he must be feeling anger at his wife, but he would hear none of that. “No, no,” he wailed, “It must be my fault! I must have done something to offend Jesus and that’s why she left me!”

Mark was an exceptionally religious person. In his mind all elements of life were controlled by God. He firmly believed if someone stayed on the square with God, his life would be smooth sailing. Hard to understand that an intelligent, educated person would believe that (especially a lawyer), but Mark did.

During the fourth session Mark was continuing to blame himself for his misery, because he had unknowingly sinned against Jesus — and I had heard enough. It was time, I thought, for him to quit wallowing in guilt and self-pity and to start getting some perspective. I blithely said to him, “Mark, that is absolute nonsense. Jesus didn’t do this to you.”

His head jerked up and he looked at me. I think it was the first thing I said to him that he actually heard. His eyes got huge as he stared at me and his mouth started moving but no words came out, only guttural sounds. He put his head down, gripped the arms of the chair then looked back up at me — eyes still agape. “You, you Jew atheist,” he said, “I should have known better than to come here. All I had left was my religion and you just tried to take it away!”

I was stunned. “Mark, I’m no atheist, I’m a Christian like you,” I said, breaking at least one rule of analysis. “I just don’t believe Jesus had anything to do with your wife leaving. You’re a good man. You were a good husband. You adopted your wife’s kids. You should not be blaming yourself.”

He did not hear me. Because of my impatience, arrogance, and flippant remarks, Mark’s therapy had just become a disaster. I had grossly underestimated his fragility, and how dare I question his religious beliefs? I was the one who had sinned — against my profession.

“Send me your bill,” he said as he walked out of the office. “I won’t be coming back.”

I have relived that session dozens of times over the years always arriving at the same conclusion: Mark apparently needed to wallow in self pity longer than I was willing to let him. He must have plugged into my own neuroses. I should have realized this and kept my big mouth shut.

Yes, sometimes we make mistakes.

Waynesville resident Jim Joyce’s memoir, Use Eagles if Necessary, is being published in weekly installments in The Smoky Mountain News. Each week we begin a chapter in our print edition and then put the entire chapter on our Web site. All previous chapters are available online. The book can be purchased at


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