Creatures of a Day: And Other Tales of Psychotherapy

by Irvin D. Yalom

  In our second meeting Justine thanked me for my advice. She did tell her two friends about her melanoma, and they responded generously and lovingly. She seemed warmer, thanked me with a fleeting smile, and then turned to the topic of her son. For the rest of the session she related the nightmarish tale of her only child.

  “Perhaps I should never have married. I never expected to. I was born clunky and awkward. I was never attractive, had no innate feminine guile and no female mentors. My mother died of cervical cancer when I was nine. I had no siblings and a mostly absent father, a gruff uneducated man, a truck driver who was only home weekends. My paternal grandma, an immigrant from Yugoslavia, raised me. She was an unhappy woman who barely spoke English. Men didn’t look at me, and though I had some one-night stands, I never had a good relationship with a man. I probably never would have married if I hadn’t gotten pregnant and, with the help of my grandmother, forced the father to marry me. That was about five years after nursing school. Marriage was a mistake: he was a brutish, alcoholic lout who was so abusive to James and me that one day when he was at work I packed my suitcases and left with James, then age three, and moved several hundred miles away to Chicago, where I had been offered a job at Michael Reese Hospital. I never looked back. I never contacted my husband again. I doubt if he searched very hard for us. He probably was relieved we were gone.”

  “Keep going. Tell me about you and James.”

  “I did my best for him. I was a nurse forty hours a week and a mother the rest of my time. I had no other life. Zero. And James was a problem every step of the way: problems sleeping, walking, speaking, playing with other children. And major disciplinary problems all the way through his life. I’ve read a lot now, and I think he was born a sociopath, something deep, inbuilt, genetic, unchangeable about him. Also major learning problems. He just couldn’t concentrate, never learned to read well, always in special schools. I suspect today he’d also be diagnosed as severe attention deficit disorder.

  Justine went on for much of the hour telling me in detail about James’s medical and psychological problems and all the treatments attempted. “We tried lots of meds, including Ritalin, anticonvulsants, and even antipsychotics. Nothing helped. I spent all my money on medical and psychological help. All in vain.

  “When he entered adolescence, he hit the recreational drugs big-time and used anything he could find. I sent him to detox centers, rehab ranches, and wilderness retreats. He ran away from each of them. He fought everything. Then, around sixteen or seventeen, he met the hard drugs, especially heroin, and he was gone for good. He stole everything he could from me, including thousands of dollars from my credit cards. He robbed my neighbors and friends, and I finally threw him out and disowned him. The next and last I heard was that he was in San Quentin. That’s the story. And I am exhausted telling it.” Justine leaned back in her chair and wiped her eyes with a tissue.

  After a few moments, she looked up and added, “I’ve been imagining this whole week telling you this story. I rehearsed this conversation with you, and I imagined your response.”

  “Which was? . . .”

  “I imagined you inquiring about positive memories as a young child, about putting him to bed at night, about warm feelings I had about him or the good times we shared. And my answer to you is that I cannot remember a single one. I mean it. Not a single one.”

  “You’re right. You nailed it: that is what I would have asked. And your answer is very heavy, very dark. I’m saddened by what you’ve told me. Saddened for James but even more saddened for you. Tell me, have you shared all of this with Connie and Jackie?”

  “Everything. They’ve been aboard from the very beginning, when James was born, and followed every step of the way. But it’s a different experience here today telling the entire story all at once. I’ve never done that with anyone. I’m wiped out.”

  “I feel uneasy asking you more, but it’s best to get it all out—like excavating an abscess. Tell me, what are you experiencing right now, here with me?”

  “Shame. It’s like your coming into my home and seeing nothing but filth and rags.” She paused briefly and then asked, “Do you have children?”

  “Four. I know what it is to be a parent, and I’m able to get in touch with how unbearably painful this is for you. But still, don’t stop. I want you to keep expressing it all.”

  “I must have been a ghastly mother, but believe me I tried—I did everything in my power. But it is shame. It . . . James . . . that creature in San Quentin . . . however you put it, he is a part of me. He’s wrapped in a banner for all to see, saying, ‘Made by Justine Casey.’”

  “Do you think that others think that?”

  Justine sobbed and nodded, “Yes, anybody who knows my story.”

  “I know your story, and I don’t think that. Try to keep talking. What other questions are there for me?”

  “Am I ghastly? Am I a horror of a mother? Am I James? Is he me?”

  “None of the above. I want you to know I’m on your side, Justine. I’m here to help you. Not once, not for an instant, did such thoughts enter my mind. What I am thinking about a lot now is how relentlessly harsh you are on yourself. We’ve got to stop today, but I’d like to focus some of our final session on the topic of being kinder to yourself.”

  A week later Justine arrived at my office with a folded sheet of paper in her hand. “I had a dream last night, and I know from reading your work that you pay attention to dreams. This one woke me up about four am. I think it had something to do with you.”

  “Let’s go over it.”

  She unfolded the paper. “This is just a fragment—I couldn’t remember most of it . . . I’m walking along a path and climb through a window into a large, dark room. Somehow that path reminds me of the path to your office, but it’s night and I can’t see much. Then once I enter the room, I hide behind a very small chair and wait. I’m holding a weapon in my hand. Suddenly I notice that the chair is gone. Someone has removed it, and I am totally visible, totally unprotected. I am scared shitless. That’s when I woke up drenched with sweat.”

  “You have hunches about this dream?”

  “I’ve no clue about how to even start. How do we proceed?”

  “Since we have only this last session, we don’t have time to explore it in depth, but generally I’d ask you to think about certain parts of the dream and just free-associate. That is, just ruminate out loud; let your thoughts run free. But given our shortage of time, let me pitch in first. What strikes me about the dream is the location. You say it resembles the path to my office. Moreover, it was dreamt the night before our appointment. Any thoughts about that?”

  “It was your path. I could hear the crackly pebbles just like your walkway. But the window and the very large room: they’re not familiar. A big room, maybe a movie set? I don’t know where that comes from.”

  “And then you try to hide but behind a very small chair, which doesn’t seem to give you much protection. And then that soon disappears. So you’re in my office, and suddenly your hiding place is gone. What’s that make you think of?”

  “I see where you’re going. I’m here in this office, maybe it was your office, and my cover is yanked away, and I can’t hide, and I get very scared.”

  “You say your cover was yanked, but you yanked it by your decision to come.”

  “It was tougher than I thought. I couldn’t or didn’t hide from you and was bare-breasted.”

  “Bare-breasted?”

  “I didn’t mean that . . . ” Justine blushed. “What I meant was I got everything off my chest.”

  Strange slip and probably loaded with meaning, but there was no time to explore it in this last session. I tagged it and put it into storage, in case Justine opted to return for longer therapy, and responded, “Another aspect of the dream is that it is night, you are entering surreptitiously by going through a window, and you h
ide inside. I wonder if that refers to the unusual way you contacted me. Meeting at Astrid’s memorial and making an appointment there is somehow not the same as coming into my office through my front door. And then you make sure it will be for a very few sessions.”

  “Yes, that’s right on: I see your point.”

  “But I keep thinking about that pistol you’re carrying. What hunches do you have about that?”

  “I never said anything about a pistol. I said I had a weapon.”

  “Tell me: Do you still see the dream in your mind’s eye?”

  Justine closed her eyes and seemed to drift off, “Right, it’s there. I can see it, but it’s a little faded, but I can see that I’m carrying a weapon, and it’s definitely not a pistol. I’m carrying something large, huge. It’s a bazooka—no, no, it’s an atomic bomb.” She opened her eyes and shook her head.

  “Lot of feeling there. Stay with it; keep going. What about that huge weapon?”

  “The dream says I am dangerous.”

  “Say more about being dangerous.”

  “Truth is, I am dangerous. Venomous. I’m full of anger. Bad, angry thoughts about everyone circle through my mind. That’s why I stay away from people. That’s why I’m so alone.”

  We remained silent for a minute or two. The time had come. I hesitated while I formulated what I wanted and needed to say to her. “There’s something I’ve wanted to tell you. I’ve hesitated until now because of my discomfort about patient confidentiality. It’s something Astrid told me during our therapy, and usually I’d never repeat anything told to me by a patient. But this may be so important for you to hear that I can’t be silent. Moreover I’m certain Astrid would not have minded my sharing this.”

  Justine’s eyes were riveted on me.

  “Astrid told me about a time when she was at her worst, full of terror, certain she was dying, unable to control her sobbing. She was awaiting the arrival of her family when a nurse bent over and whispered in her ear, ‘Show some class for your kids.’”

  I stopped and glanced at Justine. Her face, her whole body was deathly still, as though frozen in time.

  “She gave me no name but only said it was a nurse who was tough but whom she highly respected. Was it you, Justine? Did you say that to her?”

  “Yes, I said that to her.”

  “Astrid told me that those words, your words, were ‘transformative.’ She called it the turning point in her ordeal. She said those were the most helpful words she had ever heard.”

  “Why? How?”

  “She said it immediately, miraculously, brought her out of herself, that it made her think of others, that it gave her a sense of meaning, that it told her that, even if she were dying, she still had something to offer her family—she could model how to face death. You gave her a priceless gift.”

  Justine sat silently for a long time until she said, “Good God. This is the cruelest joke.” She looked away staring out of my office window, and she spoke as though in a trance. “The cruelest of jokes. You see, I didn’t whisper that into Astrid’s ears. I hissed it. Yes, hissed it. Astrid had everything—a room full of beautiful vases and flowers, a golf-ball-sized diamond ring . . . beautiful grandchildren, big family and friends gathered around her. I’d have given anything to have had her life—even with her disease. She held court in her powder blue cashmere robe for an endless stream of beautiful visitors and friends. Her husband told me about his goddamn yacht a hundred times, and her therapist and chum was the important Dr. Yalom with his signed books spread all around her bedside, and yet, despite all that, all she could do was whimper and sob, day after day. She was pitiful. I was spiteful, viciously envious, and totally exasperated by her.”

  “And yet, despite all that, you were the one who brought such great comfort to her. ‘Transformative,’ she said. You changed her life. What do you do with that knowledge?”

  Justine sat silently, slowly shaking her bowed head.

  I glanced at the clock. “We’re running out of time, and I’m struggling to find closure. Despite all your self-accusations, the better part of you found the right words to say. In the end it is deeds not thoughts that really count. Let’s do a thought experiment, Justine.”

  She raised her head to stare at me.

  “Imagine,” I continued, “right here in my office, a row of people you’ve helped, maybe even transformed. The line starts here”—I pointed to a spot near my chair—“and imagine all the people who are grateful to you, people dead or alive. Can you see folks you remember? Please try hard.”

  Justine silently nodded.

  “I can imagine,” I suggested, “a very long line winding out of the office and down the street. Right?”

  “Yes,” Justine said softly, “I can see them. A few of them back from Michael Reese Hospital days. I see both the living and the dead, the recovering and the moribund. I see Astrid standing there near the head of the line, and yes, it does stretch far—all the way into the distance—as far as I can see.” A long pause and then, “Thank you, this helps. But there’s a lot left. The anger isn’t quelled. The vicious thoughts are there on all sides, lying in wait.”

  “Those thoughts are old, archaic, going back to your early rough, hapless days. And you’ve come by your anger honestly. Of course, much of your anger and guilt is still tethered to your son, who is disowned but, as we both know, not forgotten. All these feelings have to be exhumed, examined, and, finally, scattered. It will take time and a guide, but you can do it. I’m certain of it, and if you wish, I’m glad to be the guide.”

  Justine sat there, tears flowing down her cheeks, no longer forbidding, no longer resembling Miss Markum from olden days but softer now, almost winsome, almost huggable. She raised her chin, “You mean that? What about your comment about being scorched?”

  “Not doing what’s right is worse than being scorched. And what’s more, you’re worth it. Call me whenever you’re ready.”

  Justine rose and collected her things, and I walked with her to the door. As she left, she turned back to me for a last look. I saw pain and sadness in her eyes and perhaps pride as well. I hoped she would call.

  ~ 7 ~

  You Must Give Up

  the Hope for a Better Past

  “I want this to be different from our last consultation. This time I want a complete overhaul. My sixtieth birthday is approaching, and I want to change my life.”

  Those were Sally’s first words. A handsome, forthright woman, she looked straight into my eyes and held my gaze. She was referring to our previous therapy six years earlier, when she had requested four, and only four, sessions to help deal with her protracted grief following her father’s death. Though she had used that time efficiently and explored her stormy relationship with her parents in some depth, I sensed there was much more that needed attention, but Sally had been resolute in her wish for only four sessions.

  “I’m not sure how much you remember about me,” she continued, “but I’ve worked forever as a physics technician and that’s what I want to change. The truth is that my heart’s never been in that work. My real calling is writing. I want to be a writer.”

  “I don’t recall your mentioning that before.”

  “I know. I wasn’t ready to talk about it then. Not even to talk to myself about it. Now I am ready. And I’ve contacted you again because I know you’re a writer and I think you can help me find my way to becoming a real writer.”

  “I’ll do my best. Fill me in.”

  “I’ve made the decision to put my writing first. I’ve got enough money to do that now, with my retirement benefits and my husband’s job. He’s an airline pilot, and even though United has stolen the pilots’ pensions—the CEO really needed his hundred-million-dollar salary and bonus—my husband still makes good money, at least for the next five years. And the most important thing is that I must have talent.”

&nb
sp; “Must have talent? Tell me about that.”

  “I mean I must have some talent. I won a literary guild fiction prize for new writers when I was eighteen. Four thousand dollars. And that was forty-two years ago.”

  “A huge award! Quite an honor!”

  “Quite a curse, it turned out.”

  “How so?”

  “I got this notion I could never live up to that honor. I began to feel like a fraud and was afraid to show my work.”

  “What did you write?”

  “What do I write, we should say, because I’ve never stopped writing. A bit of everything—an unending stream of poetry and stories and vignettes.”

  “And what have you done with all your work? Have you published any of it?”

  “Aside from the novella that won me the prize, I’ve published nothing. Never tried to publish. Not once. But I’ve still got every piece I ever wrote. Couldn’t send anything out and couldn’t throw anything out. I put everything in a big box and sealed it with strong tape. Everything I’ve written since my teens.”

  A big sealed box containing everything she’s ever written! My heart began to race. Slow down, I said to myself, for I was slipping into my identity as a writer and felt myself getting too involved. My curiosity was aflame. And my empathy, too. I shuddered as I imagined my entire life’s work stored away unseen in a large box. Don’t over-identify, I told myself. Nothing good will come of it. I turned back to Sally.