by Frank Tallis
‘Are you religious in any way?’
‘No. I’m not a churchgoer—never have been. George neither.’
‘Do you believe in an afterlife now?’
It crossed my mind that she might find some consolation in faith—or at least find companionship and support as part of a congregation.
‘I’m not sure. I don’t know what I believe.’ One of Freud’s great theoretical contributions was to suggest that contradictory beliefs can co-exist in the unconscious. In fact, human beings are even more perverse. We can be knowingly inconsistent. For Mavis, her dead husband’s appearances in the bedroom didn’t seem to have any spiritual implications.
‘All right.’ I made some unnecessary notes, while I thought of my next question. ‘Has George ever spoken to you?’
‘No. He just appears… and then fades away.’
‘Are there any alternative explanations for these experiences?’ She didn’t grasp what I was getting at. ‘Is it possible that what you’re seeing isn’t really George, but rather, a kind of illusion?’
I wasn’t seeking to challenge her. I was simply trying to get a better understanding of how she was appraising the situation. She was peculiarly unreflective and passive—disinclined to question and analyse what was happening to her.
She answered plainly: ‘No.’
‘You don’t think it’s possible that maybe you’re missing George so much that your mind is playing tricks?’
She pressed her lips together and frowned before repeating: ‘No.’
‘Mavis,’ I put my pen down and leaned forward. ‘How do you feel when you see George?’
‘I’m not frightened…’
I could see that my questions were confusing her so I didn’t persevere. Besides, her hallucinations didn’t seem to be doing her any harm. Perhaps PBHEs are not so much a symptom of poor adjustment, but rather the product of a protective and adaptive stress response. They must, at some level, make death seem less absolute and ease loneliness.
Mavis came to see me for about ten sessions in total. I did exactly what I was asked to do—bereavement counselling and some Cognitive Behavioural Therapy for her depression. The latter involved encouraging her to perform simple experiments to test some of her rigid and unhelpful beliefs. These beliefs mostly concerned what she thought she could and couldn’t do. She didn’t, for example, feel that she could cope with social situations.
While I was seeing her, she became a little more active and even started to attend a social club run by a mental health charity. But the gains she made were relatively small, because in reality, she didn’t want to make friends, improve the quality of her life, or even feel happier. What she wanted, more than anything else, was sex. Ghostly visitations are usually invested with spiritual significance—they confirm that the soul survives death and promise a heavenly reunion. For Mavis, the opposite was true. Mavis didn’t—or couldn’t—think in this way. Her husband’s ghost, shaped by carnal desires, offered no prospect of transcendence, only deeper and deeper entrenchment in the flesh.
The psychiatrist Elisabeth Kübler-Ross identified five stages of grief: denial, anger, bargaining, depression and, finally, acceptance. Even though her work has been extremely influential, there’s isn’t a great deal of evidence to support the notion that grief can be neatly partitioned. Loss is experienced uniquely and can have different meanings and different consequences—depending on the individual. There is no one-size-fits-all approach to bereavement and no right way to grieve.
It was raining again when I saw Mavis for the last time. She picked up her umbrella in the hallway and I opened the door for her.
‘Goodbye,’ I said. ‘And if you ever want to talk again, all you have to do is telephone the psychology department.’
We shook hands. She didn’t smile. Looking up at the sky, she pressed a button on the handle of her umbrella and the black canopy expanded. She descended the stairs and walked towards the pub on the corner. I thought she might glance back—but she continued walking and disappeared from view.
I went back inside and stood by the window overlooking the bleak space between the hospital and the research institute. The eccentric physiologist—in his polyester suit and trainers—sprinted through the deluge. No one else appeared and the paving stones began to glisten as the lamps came on. I thought about Mavis for some time.
Many people complain about sexless marriages. But Mavis’s relationship with George was based primarily on sex. They should have been beached by the retreating tide of testosterone—stranded together with nothing to talk about—two strangers, waking up each morning next to each other before going their separate ways. Instead, they were like lotus-eaters, inhabiting a bedroom paradise of sensual, indolent pleasures—emerging only to face a dull reality that, at best, could only offer them the poor consolation of tea and sponge fingers. Sex shouldn’t have retained its adhesive properties. They should have fallen out of love, because sex isn’t love—only a part of it. But Mavis and George had demonstrated that if passion doesn’t flag or die, the other components of love become expendable.
Why was that surprising? It shouldn’t have been really. In the first throes of a relationship, when desire is at its strongest, couples are bound together more closely by sex than by conversation. Desire is more powerful than liking.
I remembered a famous Woody Allen quote: ‘Sex without love is a meaningless experience, but as far as meaningless experiences go it’s pretty damned good.’
Mavis and George’s indestructible passion must have had consequences for their poor son. Originally, I’d thought of Terry as mean and selfish, but I found myself feeling sorry for him. We all want our parents to love each other—but not too much. Parents who love each other passionately—and keep on loving each other passionately—produce orphans.
Was that why Terry was still living at home in his forties? Had he been waiting all his life to be loved? Well, now that his father was gone, perhaps there was a chance.
The grim reaper always throws a sly glance as he exits the stage—hinting that his secret gift is renewal.
Chapter 3
The Woman Who Wasn’t There
Suspicion and destructive love
My patient hadn’t materialised.
I wrote the date in the margin of his notes followed by the letters DNA—‘Did Not Attend’. Clinicians often use abbreviations: SSRI (Selective Serotonin Reuptake Inhibitor), CBT (Cognitive Behavioural Therapy), PTSD (Post Traumatic Stress Disorder). The main reason why abbreviations are so popular is because much of the clinical vocabulary involves long, compound terms and using them in conversation quickly becomes tiresome. Abbreviations are a form of exclusive communication between health professionals and they can acquire the properties of slang. I once worked in the children’s department of a hospital where I learned the meaning of FLK—funny looking kid. Sometimes, it isn’t always possible to attach a diagnosis to a child but there’s something about them that nags at the back of the mind and suggests things aren’t quite right. This elusive something is almost always reducible to facial characteristics and can signify neurodevelopment problems. Peculiarities of gesture and gait are also significant markers. Although FLK is an insensitive abbreviation it is by no means the worst. Some stressed doctors use LLS: looks like shit.
I put the case notes of my DNA aside and picked up another folder. On opening it, I discovered a terse and uninformative referral letter. My next patient was a woman in her late thirties with relationship problems. After reading the single paragraph I spent forty minutes either flicking through an academic journal or pacing around the room. A high number of patients fail to attend mental health appointments, which means a psychotherapist spends many hours hanging around, drumming fingers, checking wall clocks and staring out of windows. It feels a little like having been stood up—only it happens every day. The telephone rang and my secretary announced the arrival of my eleven o’clock patient.
Anita was a striking woman—a tall,
leggy blonde with eyes an astonishing shade of violet. She was dressed casually in jeans and a jumper but managed to look very elegant. It was as though she’d grabbed whatever first came to hand and by chance the combination happened to be perfect. I learned later that she was an interior designer.
‘So…’ I said, opening her folder. ‘I understand that you’ve been having relationship difficulties.’
‘Yes.’ She looked as if she might say more but her expression changed and the hesitation became silence.
‘What’s your partner’s name?’
‘Greg.’
‘And how long have you been together?’
‘About a year.’
They had met at a dinner party of a mutual friend. Greg was a games programmer who had started his own company. It was a lucrative business and one of his games had won an award. ‘Computer games aren’t really my thing,’ Anita said, wrinkling her nose. ‘I thought he was going be a nerd, but we got talking and something clicked. The chemistry was right.’
People often employ the word ‘chemistry’ when they can’t explain mutual attraction. Goethe’s extraordinary novel Elective Affinities, which was published in 1809, explores the idea that romantic attachments might obey the same laws that predict the formation of chemical bonds. Men and women are certainly responsive to each other’s bodily secretions, which autograph the air with unique, molecular signatures. When inhaled, these molecules can promote hormonal changes associated with sexual readiness—even when there is no conscious detection of smell. In the sixteenth century, women placed peeled apples under their armpits to impregnate the flesh with perspiration. These saturated fruits would then be presented as a gift to prospective lovers who subsequently eased the pangs of separation by sniffing the sweet, musky scent.
Anita repeated her assertion. ‘The chemistry was right.’ Her tone of voice suggested that she was confirming something that she had come to doubt.
Anita and Greg were happy together for about six months. So happy, in fact, that Anita invited Greg to move in with her, which he agreed to do. Anita was a divorcée and she lived with her eight-year-old identical twins.
‘How did that work out?’ I asked.
‘Bradley and Bo love Greg. They got on right from the start. The fact that Greg arrived with an Xbox certainly helped.’
‘Do the twins have much contact with your former husband?’
‘Not much. They look forward to seeing him but he’s very unreliable. He’s always letting them down.’
Anita’s former husband was a city trader with a cocaine habit. ‘I tried to save the marriage but the situation became intolerable.’ She saw my look of concern and pre-empted my question. ‘No, he didn’t hit me or anything like that. Christ, I’d have walked. He just became impossible to live with. Moody—deceitful—I had to think of the boys.’
Soon after Greg moved into Anita’s flat their relationship began to deteriorate. ‘We stopped talking,’ Anita said, her eyebrows tilting severely. ‘He doesn’t seem that interested in us any more. He stays out late and when I text him he never replies.’ They were growing apart. ‘He’s always going out. He’s never there for me.’ Anita became less interested in sex. ‘I need to feel close to someone—to be intimate.’ And Greg became irritable. ‘He called me a control freak.’ She gave me a complicit look and laughed. ‘I didn’t know what to do,’ she continued. ‘It’s a big thing, deciding to live with someone—especially when you’ve got kids. I thought maybe I’d made a mistake and felt quite low, so I went to see my GP, who put me on Prozac, but I got horrible side-effects and he suggested I come to see you instead.’
Anita was obviously upset but her voice was steady. She didn’t become tearful and knew exactly what she wanted. ‘Look, I just want to get things sorted out.’
‘Would Greg be willing to see me?’ I asked. ‘I’d like to see him on his own first. Then we can arrange some joint sessions?’
Anita stood. ‘I’ll get him to give you a call.’
Couples therapy has murky origins. It was initially developed as part of a Nazi health initiative. Stable, racially pure and large families were considered desirable if the broader objectives of the Third Reich were to be achieved. Needless to say, couples therapy evolved into something quite different after the war. Today, several forms exist, but most share common elements such as training in communication and problem-solving skills. Unhappy couples have few rewarding exchanges but a large number of punishing ones (most of which are angry or accusatory); patterns of reciprocal negative behaviour escalate; sex becomes less frequent; and time spent together ceases to be pleasurable.
I’d noticed that Anita was fond of using words like ‘always’ and ‘never’. Greg was always staying out late and he never replied to her texts. Use of unqualified language is rarely accurate and usually reflects a style of thinking strongly associated with distorted perceptions. The German-born psychoanalyst Karen Horney was one of the first psychotherapists to connect language with psychological vulnerability. She referred to the ‘tyranny of shoulds’ to underscore how uncompromising inner speech can create stress and guilt: I should be perfect, I should be thin, I should be successful. Encouraging patients to develop a more nuanced vocabulary can help them to achieve a better match between their inner speech and reality. This simple corrective frequently leads to more measured assessments and improved mood. I made a quick technical note: overgeneralisation.
The following week I was able to see Greg—a well-groomed, mild-mannered man with a first-class degree in mathematics from Cambridge. I summarised Anita’s grievances and waited for Greg’s response. His lips twisted to form a mirthless smile. ‘She hasn’t told you, has she?’
‘I’m sorry?’
He sighed and leaned forward. ‘I don’t go out much—once or twice a week maybe—and when I do go out I usually text Anita. I tell her where I am and when I’ll be back. In the past I did forget to text—that’s true—but I wouldn’t now. Anita gave me such a hard time. I just don’t understand why she’s so insecure. She’s out of my league really, I mean, she could have been a model.’ He looked to me for confirmation and I nodded. ‘But she acts as if she doesn’t have any options.’
According to Greg, Anita had invited him to move into her flat because she wanted to keep him under surveillance.
‘She thinks I’m going to meet another woman and have an affair. But I wouldn’t—it’s not the way I am. Besides, I love her.’
‘Do you tell her that?’
‘Sure, all the time, but it doesn’t have any effect. She still thinks I’m playing away. She’s constantly asking me about where I’ve been and who I’ve been with. It’s like an interrogation. And if I make a tiny mistake—if she thinks she’s found an inconsistency—she gets really upset. And then she shuts down and won’t talk.’ His chin fell to his chest and his eyes glazed over. ‘Gradually, she comes out of it, but I have to reassure her and swear that I’m telling the truth.’ He looked uncomfortable and picked at a loose thread on his jacket. ‘She demands to see my emails and credit card statements.’
‘And you show them to her?’
‘I’ve got nothing to hide. But it isn’t right, is it?’ He leaned back on the sofa and stroked a neatly cultivated sideburn. ‘One night, I got back home and took a shower. I was in the cubicle and Anita came in and removed the laundry basket. She said she was going to run a wash.’ His eyes were questioning, uncertain. He wasn’t sure whether to continue. ‘The thing is—she didn’t run a wash. She just wanted to check my clothes.’
‘How do you know that?’
‘I could be wrong—but I don’t think so.’
‘She was looking for evidence…’
‘She’s obsessed.’
Greg cringed. Thoughts can be like spells. Their potency is only evident when spoken aloud.
It was necessary to clarify one issue before proceeding. ‘Greg, I’m going to ask you a personal question and your answer will be treated confidentially.’
‘Okay.’
‘Have you been unfaithful?’
‘God, no!’ He was offended. ‘I really want this relationship to work. I’ve never been unfaithful to anyone. It’s not who I am.’
Anita fished a rubber band from her shoulder bag, grabbed her hair, and slid it into a ponytail. ‘We’re different people,’ she said. ‘We see things differently.’ I conceded that sometimes it’s difficult to establish objective facts.
‘So how often does Greg go out? Is he out all the time—as you suggested—or is it more like once a week?’
‘Perhaps I was exaggerating. But that’s not the point. The point is that we aren’t spending enough time together.’
‘Have you ever asked to see his credit card statements?’
‘Not recently.’
She continued to be evasive but then said, ‘All right—I suppose I can be quite controlling, possessive—whatever. But so what? If you love someone, isn’t that just natural?’
Jealousy and love are inextricably entangled. The medieval cleric Andreas Capellanus compiled thirty-one rules of courtly love and the second of these is: He who is not jealous cannot love.
‘Yes,’ I agreed. ‘It is natural. Love and jealousy go together. It’s a lot easier to be relaxed about fidelity if you aren’t in love.’
‘Exactly.’ Anita appeared relieved. ‘It shows you care.’ She made a confession. ‘I think about infidelity a lot. I have these awful daydreams—they’re more like nightmares really. I picture Greg meeting someone in town. They find a seedy hotel and book a room for the afternoon.’
‘Who’s the woman?’
‘I don’t know. No one… and anyone. I can’t get the images out of my head.’ She shuddered. ‘I even see them in bed together. It’s horrible—it makes me feel sick. I feel sick right now just thinking about it.’ Her daydreams were accompanied by an overwhelming urge to establish Greg’s whereabouts and discover what he was doing. Anita would call his office and if it wasn’t possible to locate him she would start to entertain the idea that her upsetting fantasies were real. When I returned to the subject later she said, ‘I’m a very intuitive person. Perhaps that’s what it is—this feeling—female intuition? I seem to know instantly if I’m going to get on with someone. It’s really useful to be able to do that in my line of work. You don’t waste time with clients who are going to be hard to please.’
