Infidelity

Jeffery throws himself in the chair across from me looking more disheveled and distraught than his usually calm, poised presentation of a mid-forties successful financial advisor.  

“I couldn’t wait to get here. I almost called and asked if you had a double session available today or any more sessions available today at all. Do you?”

Thinking about how reluctant Jeffery has been to increase his therapy sessions to more than once a week, I say, “I’m sure I can see you later this afternoon, but first why don’t you tell me what’s going on.”

“My wife told me she wants us to have an open marriage.”

Many thoughts go through my mind, including the sarcastic, ‘so now the shoe’s on the other foot.’ Instead I say, “Her request obviously disturbed you.”

“Hardly difficult to figure that out. Can you imagine?! My wife! The prissy little woman who left me begging for sex.”

“Jeffery, what’s so disturbing about her asking for an open marriage?”

“That’s a dumb question.”

“You could look at her request as freeing you to see as many women as you wanted without having to sneak around.”

“But she could also see as many men! In fact, she already has. She told me at first she wanted to get back at me for all the women I saw on the side – even though I never admitted to seeing any other women. So she went online and started going out on dates when she knew I’d be out. And then she’d have sex with them. It almost made me throw up to hear that. And then she told me she’s come to enjoy it and wants to be able to do it openly. Ugh!”

“Jeffery, I know you might think these are dumb questions, but why is a man who never followed his marriage vows, so disturbed about his wife wanting the same freedom?”

“It’s not the same. She said she did it because she wanted to get back at me, meaning she must have been angry at me.”

“And does that give you an idea about your own motivation?”

“I wasn’t angry at my wife.”

“’A prissy little woman who left me begging for sex’ doesn’t sound not angry, but maybe it’s more than just your wife you’re angry at.”

“That theory again. I’m angry at my mother for dying and leaving me and therefore I’m angry with all women. I don’t buy it.”

“Can you think seriously for a moment why you might not buy that theory?”

“It’s just a cliché.”

That’s not a moment’s worth of thought, I think. Then I realize I’ve had several sarcastic thoughts this hour. Am I angry with Jeffery for being unfaithful? But I’m not angry with other unfaithful patients. Am I feeling Jeffery’s conscious or unconscious anger at me? Certainly a possibility. Am I angry with Jeffery for not accepting anything I offer be it a question, an interpretation or a request? Another possibility.

“Have you ever noticed Jeffery that you rarely take in anything I offer?”

“For heaven’s sake, my wife just told me she wants an open marriage and you want to talk about us.”

I think, ‘well, there’s an example,’ but I swallow that sarcastic response and say, “Perhaps there’s a connection between the two, Jeffery.”

“What!?” he says, roiling his eyes towards the ceiling.

“I wonder, Jeffery, if the reason you feel angry with women is that you’re afraid of being dependent on them, of needing them.”

“That’s ridiculous.”

“Again, I’m going to ask you to think about what I just said and to try and take it in.”

“It doesn’t make sense to me,” he responds immediately.

“Okay. Let me ask you something else. Do you still want that second session today?”

“What!? You’re more scattered than I am. If it’s going to be like this, no, no I don’t want it.”

“I think you’re afraid of having to rely on women – particularly your wife and me - because either you’re afraid you’ll lose us or become so dependent on us that you’ll feel the extent of your own neediness. And if you reject my idea without considering it you’ll have proven my point.”

Jeffery laughs. “I guess I can’t win.”

“It depends what you want to win,” I say very seriously. “If you want to get to the place where you can have close, meaningful relationships with women, you can definitely win.”

“And what would I need to do to make that happen?”

“I guess you could start by accepting that session later this afternoon.”

“That was a trick.”

“No, it wasn’t a trick. When you were extremely distressed you wanted to see me as much as possible, but once you were here, you had to reject your desire to rely on me by refusing the second session, just as you’ve rejected coming more than once a week.”

“Okay, okay. I’ll come in later this afternoon.”

“I’m glad.”   

Divorce?

“I’m considering getting a divorce,” 52 year old Evelyn says, starting the session.

Although her marriage has been rocky for some time, this pronouncement surprises me given that her husband recently had a heart attack and by-pass surgery. She seemed genuinely concerned about him and committed to helping him through the rehabilitation process. I remain silent.

“I was listening to this program on NPR, On Point, and there was this doctor on who wrote a book about solving medical mysteries. I don’t remember his name, but it was interesting.”

I heard a small part of that program too, but I wait to hear what led Evelyn from that program to her considering divorce.

“There was a man who had a heart attack who’d had a bad heart so his heart attack was no surprise, kind of like Jack. But then the doctor went on to say that like the very next day or something like that, his wife had a heart attack too. And she had been perfectly healthy. And the doctor said it was the stress, almost like being too close to her husband and having to have a heart attack just like him. Well, I don’t want that to be me. I know this might sound awful, but Jack’s not worth my health. He hasn’t been a good enough husband for me to lay down my life for him.”

Feeling unsure what to say, I continue to remain silent.

“Do you think I’m awful?” Evelyn asks.

“No, of course not, but I am a little confused. I heard a small part of that program too…”

“Do you remember the doctor’s name? I thought I could get his book.”

“No, I didn’t hear much of the program, but what I remember is that he was talking about a couple that was extremely loving and close and that it was that closeness that led to the wife’s distress and her perhaps unconscious need – those are my words, not his – to identify with her husband and go through the same experience he had.”

“Well I guess if that was true, I wouldn’t have to worry about that.”

“Evelyn, am I mistaken or do you feel particularly angry today?”

She shrugs. “I guess.”

“Can you say what’s going on?”

“I’ve been busting my butt taking care of Jack and do you think I even get so much as a thank you?!” All he does is bitch and complain – I’m in so much pain, I’m scared, what if this happens again, why does my right arm still hurt. Complain, complain, complain. I’m sick of it.”

Jack has definitely been a less than ideal husband - inattentive, otherwise preoccupied and, most likely, unfaithful. Still, Evelyn has stayed with him, continually hoping that she could make him different, just as she longed to do with her absent and eventually abandoning father. Still, right after a major scare and trauma seems an unusual time to be considering divorce. Then a thought comes to me.

“Evelyn, do you think this time you especially thought it would be different? Jack was scared and vulnerable. Maybe he’d need you in a different way? Maybe he’d let you in as he hadn’t before?”  

Evelyn hangs her head. “Stupid of me, wasn’t it,” she says, her anger now turned on herself.

“No, definitely not stupid. It was you hoping again, hoping you – or something – could make Jack different, just as you hoped with your father.”

“But it is stupid! How many times do I have to go through the same thing to know it’s not going to work? It’s like continually hitting my head against the same brick wall.”

“It’s hard to give up hope. It’s hard to mourn what never was and never will be.”

“I can’t stand when you talk about mourning. Who wants to mourn, who wants to be sad all the time?”

“So you’d rather be angry.”

“Damn straight.”

“Well, it’s reasonable to be angry, but if you’re only angry you can’t ever finish the process of letting go.”

Evelyn’s eyes pierce me with fury.

“And,” I continue, “to end up being angry at everyone – yourself, me, your children, your friends - that doesn’t lead to a very fulfilling life.”

“So should I stay with Jack?”

“That’s a decision only you can make, Evelyn. But I do know regardless of what decision you make, you will have to mourn the impossible.”

To Wed or Not to Wed

“I can’t understand it,” says Beverly, an attractive 48 year old attorney, passing her hand through her short, curly black hair. “I’ve been with Joanne for over 20 years and now that there’s the possibility that we might be able to get married, I’m getting cold feet. We love each other, we get along. I just don’t understand myself. I haven’t said a word to Joanne. She’s floating on air. I don’t want to burst her bubble. 

“She’s such a good person,” she continues, warmly. “I never want to hurt her, although I know I have. There were those years that I had lots of affairs. Looking for more exciting sex. But I’m really committed to Joanne now. You and I worked on it and I haven’t seen another woman for a long time. I promised Joanne I wouldn’t and I’d never go back on my word. We have a decent sex life. It’s not what it was 20 years ago, but what couple who’s been together for 20 years does?”

Beverly and I have worked together for several years. She was initially a difficult patient, challenging, argumentative, defensive. But she’s now far more thoughtful and open.   

“Does it seem to you that if you get married you’ll be more tied down, less able to turn to other women if you chose?” I ask.

“That doesn’t seem right. I promised Joanne and my word means more to me than a piece of paper.” 

We sit thoughtfully in silence. I think about the wonderful gay wedding I attended last year, the glorious celebration of love and possibility. I think about my lesbian friend who died suddenly many years ago and whose partner could not speak of her loss in the school system where she worked. I’d like Beverly to be able to get married, but that’s my desire, not necessarily hers. 

“I was thinking about my parents.” She laughs. “I do that a lot here. My sisters and I have already begun planning their 50th anniversary party. It makes me nauseous. What’s to celebrate in 50 years of misery! I still don’t understand why they’re together. My father’s this horrible, authoritarian person who bosses around my meek, mousy mother who is constantly depressed and bemoaning her life. I know, I know, they must get something out of it to have stayed together. I think they enjoy torturing each other. Besides, no one else would have either of them.” She sighs. “Am I afraid my marriage would end up like theirs?”

“That’s a good question, are you?”

“Not consciously. One of the good things about being gay was that I knew my relationship could never look like theirs, at least not literally.”

“So how about figuratively?” I ask, hoping to help get beyond the conscious.

“When my sister got married, my mother decided to tell her about her own wedding night. I mean she knew my sister wasn’t a virgin, so I don’t know why she had to tell her all that stuff. She said how painful sex was and how my father didn’t care about her, just his own pleasure. So what else is new? He takes what he wants and she cries about it. Ugh! It’s such an awful relationship.”

I think about my own parents who shared some similarities with Beverly’s. My father was explosive and tyrannical; my mother was compliant, but definitely a competent, capable person, who saw both the world and my father through rose-colored glasses. They loved each other and, although I would have disagreed, they both would have said they had an excellent marriage. Unlike Beverly, I had a mother I could identify with, without getting stuck in a passive, depressed position. For Beverly to propel herself into the world, she needed to identify with her father, an identification that has carried some negative consequences for her. 

“I was thinking, Beverly, that you said at the beginning of the session how you never wanted to hurt Joanne but that you did with sexual relationships with other women. And now you’re talking about how your father took his pleasure sexually and was unconcerned about your mother. Do you think you’re concerned that marriage will give you more of a license to hurt Joanne, sexually or some other way?”

“Hmm. I know that makes no sense logically, but I don’t know. I’ve certainly learned about the power of the unconscious. So if I get married, I’ll be more like my father – married – and therefore more likely to act like him. I’ll have to give that more thought.”

“Not to negate your possible fear of being more like your father, I’d say that your thoughtful, non-defensive interaction with me today indicates how far you’ve moved from being the authoritarian your father is.”

“Thank you. That means a lot to me.”

I Don’t, Session 2

“I wasn’t sure I wanted to come today,” Patrick begins.

Having realized in our first session that Patrick can put me in an adversarial position, I say nothing.

“I mean, what is there to talk about? Angela and I are engaged and getting married. I know she loves me, even though she says she doesn’t.”

Unable to resist I say, “Didn’t you tell me at the end of our last session that once Angela agreed to marry you you got scared and weren’t sure if she didn’t love you or if you didn’t love her?”

“I said I got scared,” he says with an edge to his voice. “Of course I love her. And, as I said, I know deep down she loves me.”

Already feeling stymied, I change course. “Patrick, I’m not here to talk you out of marrying Angela. I’m here to help you figure out what it is you want; what it is you feel. My sense is you think you have to argue with me. Except we’re on the same side. So I wonder if what you’re doing is arguing with yourself.”

Patrick smiles. “Occupational hazard. I’m a lawyer.”

Realizing that Patrick’s style of interacting is a very effective way of keeping distance, I ask, “Patrick, who in your life have you been really close to?”

“Wow! That came out of left field. Well, I guess my Dad and my brother. I had a girlfriend in college, except she was never really interested in me. And Angela, of course.”

“Can you tell me about your relationship with your Dad and your brother?” I ask, aware that he’s described as “close” two women who didn’t or don’t love him.

“Well, John, my brother, was 10 years older than me, so I guess we didn’t have that much of a chance to be close. But I always knew he had my back. And my Dad, he was a rock, holding it all together after my mother died. He worked a lot, tried to do as much overtime as possible.  But he’d make time to toss a football around with me.”

Feeling the absence of emotional connection in Patrick’s life, but not wanting to get into a battle of words, I proceed cautiously. “When you said you got scared when Angela agreed to marry you, can you say more specifically what you were scared of?” 

“I don’t know. Marriage. It’s a big step.”

“That’s true,” I say nodding. “And what does marriage mean to you?”

“Well, it means being with the same person for the rest of your life. It means being responsible for that person and having to take care of her. It means “for better or for worse.” It means …” Patrick stops and swallows hard.

“What just happened there, Patrick?”

“I was about to say, it means there’s no way out. I didn’t like that I thought that. And thinking it scared me. But it’s not like that with Angela. I love being with her. We have lots of fun together.”

“Your brother has your back, your father was a rock who tossed a football around with you, and you have fun with Angela,” I summarize. “You have relationships with these people, but I don’t know if they’re emotionally close relationships. I think the idea of an emotionally close relationship really scares you.”

“Why should it?” Patrick asks.

“Well, both because it feels so foreign and what’s foreign is scary and also because a really close relationship might open up feelings inside you that you’ve kept buried for a very long time.”

“And you think that’s why I want to be with Angela? I thought it was because I was supposed to be trying to save her like I couldn’t save my mother.”

“The reasons we do whatever we do is always multi-determined, Patrick.”  

“What other reasons?” Patrick asks, challengingly. 

“I’ll answer that, Patrick, but first let me say that my sense is that your need to challenge and dispute is also a way of maintaining distance. You can’t be close to someone you’re always arguing with.”

“Makes sense. But you said you’d answer my question.”    

“I think you also pick unavailable women to try to win in the present with women who are similar to the women you lost with in the past. Let me say, Patrick, that I’m concerned that we’ve covered so much ground today. It feels overwhelming so me, I can only imagine how it feels to you.”

“I’m okay. It’ll give me lots to think about.”

“And maybe if we can slow it down a bit, it will also give you lots of feel about.” 

I Don’t

“I appreciate your seeing me,” says Patrick Monahan as he seats himself in the sage chair across from me. Medium build, with curly brown hair and a few extra pounds, I’d guess him to be in his mid-thirties. 

“My brother John said I should talk to someone. He’s a psychologist too. He thinks I’m making a big mistake. You see, I finally got engaged. I’ve been trying for years to get Angela to marry me and she finally agreed. I was really, really happy.”     

I look at him quizzically.

He laughs uncomfortably. “I know, what’s the problem? The problem is she says she doesn’t love me.”

“I can see that would be a problem,” I respond, trying to remain neutral, but wondering why Patrick would want to marry someone who didn’t love him.

“But I don’t believe her. I think she does love me and just doesn’t know it yet.”

“How long have you and Angela been dating?”

“About six years. With some short break-ups scattered in there. She’s always said she didn’t love me, that she cared about me, but didn’t love me. But I just think she’s closed off to her feelings and that if she gives me a chance I can get through to her.”

I flash on a man I dated almost forty years ago, someone who told me he loved me in “his way,” a relationship that ended with much pain and heartache. Those were the days I was still trying to win the love and approval of unavailable men who, unsurprisingly, resembled my father. 

“She had a pretty traumatic background,” Patrick continues. “Abusive parents, foster care. That’s why I’m sure once she learns to really trust me, she’ll love me.”

“Can you tell me what attracts you to Angela?” I ask. “And why she decided to accept your proposal now?”

“It’s her biological clock. She wants to have a baby before she gets too old.”

I groan internally. Definitely not a reason to get married, nor to bring a child into such a tenuous relationship.

“But why I’m attracted to her? That’s easy, she’s perfect. She smart and pretty and funny and determined. We have the same values, the same politics, the same everything.”

“Except she doesn’t love you.”

“She thinks she doesn’t love me.”

“Can you tell me a bit about your background, Patrick?” I ask, changing gears.

“I grew up outside of Detroit. My father worked for the auto industry. In those days there was pretty good money to be made. My brother is 10 years older than me. When I was three my mother got breast cancer. I actually don’t remember her not being sick. And she was pretty sick. She’d have times when she’d be better, but then it was back to chemo, and days and weeks of being in bed. She died when I was 11.”

“Sounds very painful.”

“Yeah. It was. My grandmother came to live with us, to take care of us, of me really. My brother was in college already. But I hardly knew her. And she sure wasn’t the warm, cuddly grandmother type. I counted the years – the months really – before I could go to college and get out of the house.” 

“So you’ve never really had a mother.”

“No, I had a mother. She didn’t die ‘til I was 11.”

“But you didn’t have a mother who was able to take care of you, to nurture you, to love you. Not because she didn’t want to, but because she was understandably involved with her own illness.”

“Yeah. I guess that’s true.”

The connection between a sick, unavailable mother and Angela, who is also unable to fully love Patrick is blatantly obvious to me, but I hesitate to verbalize what might be a premature interpretation. 

“I know where you’re going to this,” Patrick says. “John says the same thing. I’m trying to save Angela, when I couldn’t save my mother.”  

Thinking that is part of the issue, I say, “And what do you think about that?”

“I say, so what if I am? I love Angela. And if I can help her, so much the better.”

Feeling that something is missing from this story I ask, “Why did you decide to come today Patrick? I know your brother said you should talk to someone, but why did you come?”

Patrick looks at me sheepishly. “Truthfully, once Angela said she’d marry me, I got scared. I don’t know if I got scared that she didn’t love me, or scared that maybe I didn’t love her.”

“So when you don’t feel like everyone else is questioning your decision, you can question it yourself. That’s good. Because you clearly do have lots of questions that we’ll need to look at.” 

The Caretaker

“My grandfather died last week,” Melinda says as she settles herself into the chair.

“Oh, I’m so sorry. I know how important he was to you.”

“Yes, it’s hard. I know he was 95 and failing, but I loved him so much. He was always there for me. And I always knew he loved me.”

As she talks, childhood images of my own grandfather pass through my mind: his joy at baking my birthday cakes; our walking for what seemed like miles to find my wished-for record, “I’m a Lonely Little Petunia in an Onion Patch;” his traveling roundtrip by subway almost every weekend to pick me up in Brooklyn and bring me back to my grandparent’s apartment in the Bronx; the twinkle in his blue, blue eyes whenever he saw me. He’s been dead for over 40 years, but he lives with me still.

“His funeral was Sunday. My sisters came in which was good, but there just aren’t many people left. He used to have so many friends, but they’re all gone. And my uncles have been dead for years. Some of my friends came, but having so few people made it feel even sadder, emptier. My parents, of course, and Ron and the kids, but when we got home everyone left.”

“Everyone left?” I ask surprised. 

“Yeah. The kids wanted to go be with their friends and my sisters are staying at my parents and Ron went to play basketball.”   

“How did you feel about Ron leaving, about being alone?”

“That’s just how Ron is. He can’t sit with his feelings. He loved Pop too and he can’t just sit around and be with his feelings. He has to keep moving. He has ADHD. I get it.”

“But how did you feel about his leaving?” I persist. I “get it” too, but having known profound loss myself, I cannot imagine being without kind, loving people after the death of a loved one.  Am I being overly sensitive? Am I imposing my experience and values onto my patient? Regardless, I feel angry with Ron and wonder if I am feeling Melinda’s anger as well as my own.

“That’s Ron. Would I have preferred if he was able to cuddle with me on the couch? Sure. But if he sat there playing with his phone, that would have driven me crazy. Better that he not be there. It’s like a month or so ago when Haley had her appendectomy, and he couldn’t sit in the waiting room. I told him to go.”

I remember Melinda and I discussing that incident and my being equally incredulous – and angry - that a parent wouldn’t have needed to be present during a daughter’s surgery. There again I found it hard to believe my patient’s apparent equanimity. 

Now I think about my anger and say, “Melinda, do you notice that when I ask you how you feel, you tell me how you understand why Ron is doing whatever he may be doing. I think it’s great that you’re able to be compassionate towards your husband, but that doesn’t tell us what you’re feeling.”

She sits thoughtfully. “That’s what I always do, isn’t it? I focus on Ron or the kids or whoever else, rather than on me. I always thought it was because I was such a caretaker, but maybe I’m just avoiding what I feel.”

“And what do you feel?”

“Sad. I feel sad. Here I just lost Pop and my own husband can’t even be there for me.”

“Sounds like there’s some anger there as well.”

“Yes, there is. But mostly it’s sadness. We’ve talked about this before. I’m the third girl, the unwanted child, everyone too busy for me, except for Pop - and Grandma. And then I pick a man who’s there and not there. I mean I know Ron loves me and he’s there for me sort of, but he has his own problems, and that limits what he can give me.”

“You’re starting to move back towards focusing on Ron. What happens if you stay with your own feelings?”

Her eyes tear. “It’s way too painful,” she says quietly.

“You’re carrying around lots of pain, from the past as well as the present. I know it hurts, but it is important that we look at it and that you try to stay focused on you. Otherwise you’re treating yourself the same way you’ve been treated, not giving yourself and your feelings enough importance.”

“Wow! That’s true. What I feel matters. I’ll work on it.”  

Forever Together

Theirs was a storybook romance. Living in separate cities, their relationship began on the telephone: long conversations about her first two disastrous marriages, uncertain that she’d ever want a new man in her life; his pain about caring for two wives and having them both die. He quoted poetry to her. She told him about her life as a psychoanalyst. A nurse and administrator by profession, he had read all of Freud. He studied philosophy and spoke German. By the time he flew down for them to meet for the first time, they were already in love. He wanted more. She was frightened. He persevered. In time she realized how supportive he was of her professional life, of her connection to her women friends. He wanted to add to her life, not take her over.

This love story is neither about me nor any of my patients. It is about my very good friend Emily and her new man, Paul. When Emily first met Paul she told me he looked like George, my deceased husband with whom I too had a storybook relationship. When I met Paul for the first time, I didn’t think he looked that much like George – except for the same strikingly blue eyes – but I thought he was a lot like George, eager to proclaim his admiration, love and devotion for Emily to anyone who would listen.

So, after much trepidation on her part, a year ago Paul moved into Emily’s house. Emily basked in Paul’s love, her radiance and happiness obvious to all. And Paul couldn’t stop talking about his good fortune. It was a joy to be with them, a joy to see them glow in each other’s presence. After more trepidation and uncertainty, Emily agreed to marry Paul. Their wedding date was set for the last Saturday in June.

In April we spent four days together at a psychoanalytic meeting in Boston with another friend and colleague, Donna, continuing to celebrate their most wonderful connection. Not too long after returning home, Paul was hospitalized. Pneumonia. Not a big deal I thought, I know lots of people who’ve been hospitalized with pneumonia, many much older than Paul. There was some concern about his arrhythmia, but nothing to be alarmed about. Time passed. Emily told me Paul had been admitted to ICU. I was shocked. What happened? His pneumonia was unstable. What did that mean? They didn’t know what was causing it. His breathing wasn’t improving despite four different intravenous antibiotics. I started to feel sick. 

More time passed. Then Emily called to tell me Paul was on a ventilator, that they’d put him in a medically induced coma and had found blood in his lungs. The cardiologist told Emily he might die. The pulmonologist said to wait and see. I called all our friends. We cried together. It was so impossible to comprehend. We mourned for Emily, for Paul.

And so began the vigil, the up and down of his condition, the roller coaster ride of being buoyed by apparently good news, only to be followed by the sickening drop of more negative information. I knew about this roller coaster ride. I’d lived it with George for sixteen months. Images flashed before me – his agonizing pain from metastatic prostate cancer, his heart attack after his first chemotherapy treatment, the cardiologist suggesting I call his children, his determination to survive, his subdural hematoma resulting from a fall, his becoming jaundiced, his final giving up – “It’s enough already.” But as awful as it had been, as awful as it still was, I had George for twenty-nine years. Emily had Paul for only two! It was incomprehensible. It couldn’t be!      

But like their storybook romance, this story has a happy ending. The bleeding in Paul’s lungs was being caused by his blood thinning medication. They took him off, but the drug remained in his body for almost a week. And so the vigil continued, but the hope increased. Finally Emily called and left a message – Paul was off the ventilator, his lungs were improving, he could speak. I burst into tears, tears of relief, of pure joy. I called. Emily put Paul on the phone. He couldn’t speak well, but he could speak! I cried again.

And so, on June 29, 2013 Emily and Paul will be married on Hollywood Beach. And we will all rejoice in their extra-special relationship and good fortune and we will all remember how fragile life is.