In Treatment -- Paul, week 3

Paul arrives, looking edgy. Gina says he looks antsy and he says he is having urinary problems. Gina expresses empathy about it and the stress and he jumps to the conclusion that she thinks it is a psychosomatic problem -- perhaps because he thinks so? He goes to the bathroom and returns complaining there is no soap.

He says he is angry for having taken her advice, blaming what happened with Laura on Gina. It is all Gina's fault that Paul handled things with Laura the way he did -- Gina isn't willing to buy that. She tells him she thinks he acted hastily to deal with his own problems.

He admits to finding Laura attractive and that he has fantasized about her. He says he knows how to engage her and that he could manipulate her. Gina asks if she is the nurse there to keep Paul from crossing the line.

Gina confronts him with his defensiveness around talking about his feelings about Laura. He starts to tell her about Alex and that Laura has met him. Gina asks Paul why he is the betrayed man and not Andrew, Laura's fiance. And would his feelings change if Laura were to lose the transference to him? How does Laura see him, she asks?

Paul says she sees an older man, an authoritative strong man, a man whose strength she could take on, and that he will disappoint her. And that sex is what she uses to get concern. She thinks Paul is a coward and in love with her. 

And then how Paul sees her. She's 30, beautiful. Smart. Good laugh. His face softens as he speaks of her -- she is childlike and vulnerable, fascinated with the power of sex.

Gina connects Laura's experience of having to take care of her father with Paul's having to care for his mother after her breakdown. 

Then he tells Gina about Kate going to Rome with the other man. And he can't sleep in the marital bedroom. The kids seem to be falling apart, though he and Kate have not talked with them.

Gina confronts him with her sense that it is Paul who wants to run away, who wants to get away from his patients and using Gina as an accomplice, a way to shed his practice.


It really is a puzzle why Paul went back to Gina. Of course we can see that there is a powerful emotional connection there and we know they have a history together, but he steadfastly resists everything she suggests and each session is spent in a jousting match. I am puzzled about why she doesn't ask more directly why he has come back to her and steer them into dealing with the the lingering issue from the past. But I also know that it is for Paul to open that door.

I have often had the experience of patients returning to work with me, even when we ended on a difficult note. So it isn't strange that Paul would do this. Or even that he has conflicted feelings about Gina and their prior work together. So one can guess that fighting with Gina is part of the reason he is back, that the sparring is important to him as a way of defending against what he calls her pet theories, about his father and how he is replicating his father's pattern and still struggling against his own unresolved childhood issues. 

© Cheryl Fuller, 2018. All  rights reserved.