Part One
Nothing is more desirable than to be released from
an affliction, but nothing is more frightening
than to be divested of a crutch.
âJames Baldwin
1
Idiots
Chart note, John:
Have compassion.
Deep breath.
Have compassion, have compassion, have compassion . . .
Iâm repeating this phrase in my head like a mantra as the forty-year-old man sitting across from me is telling me about all of the people in his life who are âidiots.â Why, he wants to know, is the world filled with so many idiots? Are they born this way? Do they become this way? Maybe, he muses, it has something to do with all the artificial chemicals that are added to the food we eat nowadays.
âThatâs why I try to eat organic,â he says. âSo I donât become an idiot like everyone else.â
Iâm losing track of which idiot heâs talking about: the dental hygienist who asks too many questions (âNone of them rhetoricalâ), the coworker who only asks questions (âHe never makes statements, because that would imply that he had something to sayâ), the driver in front of him who stopped at a yellow light (âNo sense of urgency!â), the Apple technician at the Genius Bar who couldnât fix his laptop (âSome genius!â).
âJohn,â I begin, but heâs starting to tell a rambling story about his wife. I canât get a word in edgewise, even though he has come to me for help.
I, by the way, am his new therapist. (His previous therapist, who lasted just three sessions, was ânice, but an idiot.â)
âAnd then Margo gets angryâcan you believe it?â heâs saying. âBut she doesnât tell me sheâs angry. She just acts angry, and Iâm supposed to ask her whatâs wrong. But I know if I ask, sheâll say, âNothing,â the first three times, and then maybe the fourth or fifth time sheâll say, âYou know whatâs wrong,â and Iâll say, âNo, I donât, or I wouldnât be asking! ââ
He smiles. Itâs a huge smile. I try to work with the smileâanything to change his monologue into a dialogue and make contact with him.
âIâm curious about your smile just now,â I say. âBecause youâre talking about being frustrated by many people, including Margo, and yet youâre smiling.â
His smile gets bigger. He has the whitest teeth Iâve ever seen. Theyâre gleaming like diamonds. âIâm smiling, Sherlock, because I know exactly whatâs bothering my wife!â
âAh!â I reply. âSoââ
âWait, wait. Iâm getting to the best part,â he interrupts. âSo, like I said, I really do know whatâs wrong, but Iâm not that interested in hearing another complaint. So this time, instead of asking, I decide Iâm going toââ
He stops and peers at the clock on the bookshelf behind me.
I want to use this opportunity to help John slow down. I could comment on the glance at the clock (does he feel rushed in here?) or the fact that he just called me Sherlock (was he irritated with me?). Or I could stay more on the surface in what we call âthe contentââthe narrative heâs tellingâand try to understand more about why he equates Margoâs feelings with a complaint. But if I stay in the content, we wonât connect at all this session, and John, Iâm learning, is somebody who has trouble making contact with the people in his life.
âJohn,â I try again. âI wonder if we can go back to what just happenedââ
âOh, good,â he says, cutting me off. âI still have twenty minutes left.â And then heâs back to his story.
I sense a yawn coming on, a strong one, and it takes what feels like superhuman strength to keep my jaw clenched tight. I can feel my muscles resisting, twisting my face into odd expressions, but thankfully the yawn stays inside. Unfortunately, what comes out instead is a burp. A loud one. As though Iâm drunk. (Iâm not. Iâm a lot of unpleasant things in this moment, but drunk isnât one of them.)
Because of the burp, my mouth starts to pop open again. I squeeze my lips together so hard that my eyes begin to tear.
Of course, John doesnât seem to notice. Heâs still going on about Margo. Margo did this. Margo did that. I said this. She said that. So then I saidâ
During my training, a supervisor once told me, âThereâs something likable in everyone,â and to my great surprise, I found that she was right. Itâs impossible to get to know people deeply and not come to like them. We should take the worldâs enemies, get them in a room to share their histories and formative experiences, their fears and their struggles, and global adversaries would suddenly get along. Iâve found something likable in literally everyone Iâve seen as a therapist, including the guy who attempted murder. (Beneath his rage, he turned out to be a real sweetheart.)
I didnât even mind the week before, at our first session, when John explained that heâd come to me because I was a ânobodyâ here in Los Angeles, which meant that he wouldnât run into any of his television-industry colleagues when coming for treatment. (His colleagues, he suspected, went to âwell-known, experienced therapists.â) I simply tagged that for future use, when heâd be more open to engaging with me. Nor did I flinch at the end of that session when he handed me a wad of cash and explained that he preferred to pay this way because he didnât want his wife to know he was seeing a therapist.
âYouâll be like my mistress,â heâd suggested. âOr, actually, more like my hooker. No offense, but youâre not the kind of woman Iâd choose as a mistress . . . if you know what I mean.â
I didnât know what he meant (someone blonder? Younger? With whiter, more sparkly teeth?), but I figured that this comment was just one of Johnâs defenses against getting close to anybody or acknowledging his need for another human being.
âHa-ha, my hooker!â he said, pausing at the door. âIâll just come here each week, release all my pent-up frustration, and nobody has to know! Isnât that funny?â
Oh, yeah, I wanted to say, super-funny.
Still, as I heard him laugh his way down the hall, I felt confident that I could grow to like John. Underneath his off-putting presentation, something likableâeven beautifulâwas sure to emerge.
But that was last week.
Today he just seems like an asshole. An asshole with spectacular teeth.
Have compassion, have compassion, have compassion. I repeat my silent mantra then refocus on John. Heâs talking about a mistake made by one of the crew members on his show (a man whose name, in Johnâs telling, is simply The Idiot) and just then, something occurs to me: Johnâs rant sounds eerily familiar. Not the situations heâs describing, but the feelings they evoke in himâand in me. I know how affirming it feels to blame the outside world for my frustrations, to deny ownership of whatever role I might have in the existential play called My Incredibly Important Life. I know what itâs like to bathe in self-righteous outrage, in the certainty that Iâm completely right and have been terribly wronged, because thatâs exactly how Iâve felt all day.
What John doesnât know is that Iâm reeling from last night, when the man I thought I was going to marry unexpectedly called it quits. Today Iâm trying to focus on my patients (allowing myself to cry only in the ten-minute breaks between sessions, carefully wiping away my running mascara before the next person arrives). In other words, Iâm dealing with my pain the way I suspect John has been dealing with his: by covering it up.
As a therapist, I know a lot about pain, about the ways in which pain is tied to loss. But I also know something less commonly understood: that change and loss travel together. We canât have change without loss, which is why so often people say they want change but nonetheless stay exactly the same. To help John, Iâm going to have to figure out what his loss would be, but first, Iâm going to have to understand mine. Because right now, all I can think about is what my boyfriend did last night.
The idiot!
I look back at John and think: I hear you, brother.
Wait a minute, you might be thinking. Why are you telling me all this? Arenât therapists supposed to keep their personal lives private? Arenât they supposed to be blank slates who never reveal anything about themselves, objective observers who refrain from calling their patients namesâeven in their heads? Besides, arenât therapists, of all people, supposed to have their lives together?
On the one hand, yes. What happens in the therapy room should be done on behalf of the patient, and if therapists arenât able to separate their own struggles from those of the people who come to them, then they should, without question, choose a different line of work.
On the other hand, thisâright here, right now, between you and meâisnât therapy, but a story about therapy: how we heal and where it leads us. Like in those National Geographic Channel shows that capture the embryonic development and birth of rare crocodiles, I want to capture the process in which humans, struggling to evolve, push against their shells until they quietly (but sometimes loudly) and slowly (but sometimes suddenly) crack open.
So while the image of me with mascara running down my tear-streaked face between sessions may be uncomfortable to contemplate, thatâs where this story about the handful of struggling humans you are about to meet beginsâwith my own humanity.
Therapists, of course, deal with the daily challenges of living just like everyone else. This familiarity, in fact, is at the root of the connection we forge with strangers who trust us with their most delicate stories and secrets. Our training has taught us theories and tools and techniques, but whirring beneath our hard-earned expertise is the fact that we know just how hard it is to be a person. Which is to say, we still come to work each day as ourselvesâwith our own sets of vulnerabilities, our own longings and insecurities, and our own histories. Of all my credentials as a therapist, my most significant is that Iâm a card-carrying member of the human race.
But revealing this humanity is another matter. One colleague told me that when her doctor called with the news that her pregnancy wasnât viable, she was standing in a Starbucks, and she burst into tears. A patient happened to see her, canceled her next appointment, and never came back.
I remember hearing the writer Andrew Solomon tell a story about a married couple heâd met at a conference. During the course of the day, he said, each spouse had confessed independently to him to taking antidepressants but didnât want the other to know. It turned out that they were hiding the same medication in the same house. No matter how open we as a society are about formerly private matters, the stigma around our emotional struggles remains formidable. Weâll talk with almost anyone about our physical health (can anyone imagine spouses hiding their reflux medication from each other?), even our sex lives, but bring up anxiety or depression or an intractable sense of grief, and the expression on the face looking back at you will probably read, Get me out of this conversation, pronto.
But what are we so afraid of? Itâs not as if weâre going to peer in those darker corners, flip on the light, and find a bunch of cockroaches. Fireflies love the dark too. Thereâs beauty in those places. But we have to look in there to see it.
My business, the therapy business, is about looking.
And not just with my patients.
A little-discussed fact: Therapists go to therapists. Weâre required, in fact, to go during training as part of our hours for licensure so that we know firsthand what our future patients will experience. We learn how to accept feedback, tolerate discomfort, become aware of blind spots, and discover the impact of our histories and behaviors on ourselves and others.
But then we get licensed, people come to seek our counsel and . . . we still go to therapy. Not continuously, necessarily, but a majority of us sit on somebody elseâs couch at several points during our careers, partly to have a place to talk through the emotional impact of the kind of work we do, but partly because life happens and therapy helps us confront our demons when they pay a visit.
And visit they will, because everyone has demonsâbig, small, old, new, quiet, loud, whatever. These shared demons are testament to the fact that we arenât such outliers after all. And itâs with this discovery that we can create a different relationship with our demons, one in which we no longer try to reason our way out of an inconvenient inner voice or numb our feelings with distractions like too much wine or food or hours spent surfing the internet (an activity my colleague calls âthe most effective short-term nonprescription painkillerâ).
One of the most important steps in therapy is helping people take responsibility for their current predicaments, because once they realize that they can (and must) construct their own lives, theyâre free to generate change. Often, though, people carry around the belief that the majority of their problems are circumstantial or situationalâwhich is to say, external. And if the problems are caused by everyone and everything else, by stuff out there, why should they bother to change themselves? Even if they decide to do things differently, wonât the rest of the world still be the same?
Itâs a reasonable argument. But thatâs not how life generally works.
Remember Sartreâs famous line âHell is other peopleâ? Itâs trueâthe world is filled with difficult people (or, as John would have it, âidiotsâ). Iâll bet you could name five truly difficult people off the top of your head right nowâsome you assiduously avoid, others you would assiduously avoid if they didnât share your last name. But sometimesâmore often than we tend to realizeâthose difficult people are us.
Thatâs rightâsometimes hell is us.
Sometimes we are the cause of our difficulties. And if we can step out of our own way, something astonishing happens.
A therapist will hold up a mirror to patients, but patients will also hold up a mirror to their therapists. Therapy is far from one-sided; it happens in a parallel process. Every day, our patients are opening up questions that we have to think about for ourselves. If they can see themselves more clearly through our reflections, we can see ourselves more clearly through theirs. This happens to therapists when weâre providing therapy, and it happens to our own therapists too. We are mirrors reflecting mirrors reflecting mirrors, showing one another what we canât yet see.
Which brings me back to John. Today, Iâm not thinking about any of this. As far as Iâm concerned, itâs been a difficult day with a difficult patient, and to make matters worse, Iâm seeing John right after a young newlywed whoâs dying of cancerâwhich is never an ideal time to see anyone, but especially not when you havenât gotten much sleep, and your marriage plans have just been canceled, and you know that your pain is trivial compared to that of a terminally ill woman, and you also sense (but arenât yet aware) that itâs not trivial at ...