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In Treatment, Week 6
In Treatment -- Paul, week 6
Kate and Paul arrive together. They are waiting for their daughter, Rosie, to check in with them so their cell phones are left on. They are concerned about where Rosie has actually been.
Rosie has been out for 24 hrs. Gina asks if this didn't happen before a few weeks ago. Kate talks about the shelter she runs, that Rosie volunteers there four times a week. Paul says she is a born social worker, always has been. And Gina asks how he knows that. Paul talks about ways Rosie mediated among friends. Paul somewhat hostilely interprets Gina's question to indicate that Rosie also mediates at home. Kate concludes that Rosie's volunteer work 4 times a week is too much. Gina asks when she started volunteering and they answer around 6 months ago. Kate thinks maybe Rosie should do more ordinary teenage stuff. Paul again interprets what he thinks Gina is actually asking. Gina tells him to stop that.
Kate calls Rosie and she answers. Paul says he wants to talk to her. Kate lies about where she and Paul are, telling her they are with an accountant. Paul says Rosie is not staying with that friend again. And then says he would ask why this now and turns the issue into a reaction to the problems between Paul and Kate. Gina points out that when Rosie vanishes, they work together. She asks if Rosie senses the conflict. Kate thinks they have concealed it well. Paul says he thinks it is more tense now because Kate ran into Laura.
Kate ays she saw Laura and says she is not some poor innocent thing. Kate describes her as like a girl Paul was once involved with, a very seductive woman. She accuses Paul of being just like every other middle aged man, falling in love with the beautiful young woman.
She describes Laura as having a spoiled aloof look about her, that she was very fake. They bicker about Laura and Kate says she is threatened because she is the kind of woman who always gets her man and that Paul has always wanted a woman like Laura. She says she is not Paul's fantasy. Gina reflects that even so he married Kate. Kate ays he wanted the trophy wife and got the homemaker.
Paul says he fell in love with her not just because of her beauty but also her strength, that she was grounded and strong and he needed that. Kate says she does not need him anymore. Paul looks stricken. He says he needs her and has always wanted and needed her. Kate says not like he wants Laura. And Paul asks why she does that, jumps to those conclusions.
Gina asks how it is that Kate no longer needs Paul. She says she would like a partner who was present and available but she lives without that and no longer needs it. Gina asks her what kind of partner she would like. She can't say in detail, then says she would like someone who would tell her about his day. She ays it isn't just about being wanted, that she wants to be a part of something. Then she says women like Laura are all about sex and she can't compete with that. Gina tries to tell Kate that Laura isn't the same threat that she imagines. The danger is that Paul may have fallen in love with Laura. That Kate fell in love with the way their relationship was a lot like a therapy relationship before and now she doesn't need that. And that confuses Paul. Laura loves Paul because he listens to her with attention. She admires him.
Gina says Kate is trying to redefine herself as independent within the marriage. Paul interrupts. Gina tells him that it is not all him, that Kate is part of the problem too. That being needy was what Kate did to attract Paul. Paul is angry at Gina and accuses her of trying to push Kate out, that Kate is reacting out of her childhood issues. Gina says maybe he doesn't want to talk about childhoods because then he would have to talk about his. Kate says she can't take this, that she knew it would turn into the history between them but that isn't helpful to her and she leaves. Paul follows.
I was leery of Gina's agreement to see both Paul and Kate for precisely the reason this session fell apart. The issues between Gina and Paul are completely unresolved. He cannot be open to what she says because he is engaged in resistance to her all the time out of his unresolved anger at her and his resentment that she has, quite accurately, persisted in linking his behavior to his father's. I can't see how any therapist, no mater how gifted, could surmount this problem. My choice would have been to refer the couple to another therapist, someone who neither has a prior history with and someone both can feel safe with.
That said, Gina's observations about Kate and Paul, how they came together and what is happening now, seem spot on to me. Paul has always been able to enact his therapist role with Kate, to be the strong one and once Kate no longer needs that to feel secure, they are both left not knowing how to be with each other. But instead of dealing with that -- because neither one has seen it -- they act it out; Kate with her affair and Paul by allowing himself to develop feelings for Laura. And underlying all of this are their childhood issues. It's almost never simple with couples.
Kate's action, leaving because she cannot deal with the conflict between Paul and Gina, is clear and direct. She is right that it is not helpful to her now to their problems as a couple.
Will Kate come back? Your guess is as good as mine.
In Treatment -- Jake & Amy, week 6
Did you see Gabriel Byrne on Charlie Rose last night?
We begin this week as Amy is outside the office talking on her cell phone. Paul comes out and she says she is a little early. Paul asks if she can wait a few minutes and goes back inside.
Then we seeAmy is alone. She gets up to close the curtain. Then fluffs the pillow on the couch. Paul asks how she is and she says good. She says she rushed to get there. She says Jake is not coming. She tells Paul that they are together, that everything is fine and they are seemingly in love.
Amy says she was miffed that Paul asked her to wait outside and wonders if he would let another patient, someone he likes more, come in early. She says she knows she and Jake are not easy as patients. Paul asks how she would describe herself. She says maybe she would like for him to be different -- Harrison Ford. Paul asks how he would behave if she arrived early for a session. Amy says he wouldn't make her wait outside like a naughty schoolgirl. And she acts a bit flirty.
Paul asks what has happened since last week. She says everything is fine. Paul asks why she said they were seemingly in love. Amy says Jake is meeting with someone who might commission some music and sent her alone because talking does her good. She says he is so sweet, but she sounds like she does not believe him. Paul asks if sweet is not good and she replies that sweet is fattening. Paul asks if this is worse than whispering that he was going to kill her. And she says much worse. She says even when they were having trouble together they had angry sex, that no matter what they had that. She blames Paul for that being replaced with sweetness. She says maybe she deserves being knocked around a bit.
Amy asks if Paul likes her necklace and tells him that it was a gift from Ben, her boss. She tells Paul that Ben is picking her up after her session and they are not going back to the office. She alludes to an affair. Paul asks why she doesn't say it, does she want him to stop it. She says it can't be stopped. That no one can stop it, that it is a ticking time bomb. He asks what set it off and she says the lousy sex, which she blames on therapy and Paul. She wonders why she can't stop it. He asks her if she likes Ben.
Paul goes back to the previous week and Amy saying se was overweight as a child. She says she was fat, not overweight, that her sister was gorgeous. She says that right after her father died she decided to stop eating and the next thing she knew she was 45 pounds lighter. She describes ow much she liked the control over her eating she had, that it made her feel high.
She described her father as a lovely man. And when asked about her mother, she replies that her mother is dead. She says her mother became like the evil stepmother and her sister like the evil stepsister. She grows silent after telling an incident about a dress. Paul asks if she had talked with her father about it or could she have talked with her mother. She says no and that her mother would say she was making it up.
She tells of getting even with her sister by meeting a boy she had gone out with some time before and having sex with him. Paul says she evened her account in bed and now she is evening the account with Jake in the same way. She says her father was kind and would come into their room at night and kiss them on the eyes. She says he would tell her how he loved her and hold his face in his hands. Paul points out that when Jake is tender she finds him disgusting. Does she think that tenderness is scary because she is afraid they will leave her, die on her. So she provokes Jake and gets him to treat her badly.
She says Ben will be there any moment. What should she do? Paul asks if she really wants him to tell her it's okay to have sex with her boss. Paul says he thinks it would be a really big mistake. Then she asks him to tell Jake she can't help it because she is fucked up. Paul asks if she thinks that sex with Ben will go unpunished? Isn't she maybe starting the punishment herself. She says Jake's tenderness is not love, it's neediness, weakness. Paul says she needs to look at it more closely. Amy says she feels it has happened already. Paul says it hasn't, that nothing happens without her. She says she has to go to the bathroom.
She gets her phone and calls Jake. She leaves a message that she just wanted to hear his voice. The hour ends with her sitting in the bathroom.
I underestimated the power of conflict to hold a couple together because I would not have guessed that Jake and Amy would be back together. But together is perhaps not the right word here as nothing has been dealt with at all. Jake has done a 180 and become sweet, which I suspect Amy may be right in seeing as arising from his neediness. And Amy can't feel attraction to a man who treats her well or with tenderness. We get some tantalizing insight into her as she talks about how she sees herself as having been Cinderella at the hands of her mother and sister. But unlike Cinderella, she does not seem to feel she got the prince, though we don't know much about her first husband or what he was like. Did he become soft and tender too, driving her into Jake's arms?
And we detect in Amy, as in Sophie, control over chaos through restricted eating. Sweet makes you fat, she tells Paul and I wonder if she is also saying that if she accepts Jake in his new attitude, she will become as she used to be, fat and undesirable?
And what about Jake, who believes that therapy will cause his divorce? He sends Amy to see Paul because he says talking helps her, but he doesn't come. Because maybe if he came, the wound would be opened again and the fragile peace broken?
I believe more strongly than ever that each of these people should be in individual therapy probably more than in marital therapy. The problems in the marriage reflect the problems in each of them. Amy's history with men, with her mother and father, with her feelings about herself and her body and her use of sex to get even with those who have hurt her. Jake's issues are also present with his dependence on Amy, his sense of himself, his difficulty succeeding.
In Treatment -- Sophie, week 6
Pizza delivery arrives and Paul asks who ordered it. Paul says okay he'll take it but the delivery guy makes him say what kind of pizza.
Sophie is eating pizza. She says she realized she was hungry when she was on the way so she sent a text message and ordered it delivered to his office. She says she needs to gain weight. She asks how he is, how his mood is. She says he was grumpy the week before. She seems cheerful. Sophie asks if he was having a bad week and he says yes, and maybe some of it spilled over into this room. Sophie says she likes that side, the no bullshit side of him.
Paul asks why she said she needs to gain weight. Sophie says she has lost a little and she should be gaining because she is working with weights. Sy won't let her lift weights until she gains back what she lost.
Sophie asks if she can eat there because she knows there are a lot of rules. Paul asks what rules. She says the no suicide rule which Paul says is a pact. And she says also the one that he can't undress her. Paul says she can eat, and that he thought she was enjoying eating, with gusto. Then she stops and she says she doesn't want more. She has eaten only half a piece.
Paul asks if she knows what gusto means. And she says it's how fat people eat. She tells him about a model her father dated who used to bring chocolate to her and tell her father she was anorexic. Sophie says she has heard a thousand times before that she has an eating disordered. She protests that she is not anorexic, that this is just how her body is. Paul asks if her father took seriously when he was told that she was anorexic. She says no, that her father likes how she looks, tells her that she could be a model. Paul asks how she feels about her weight. She says she likes being light and thin, that she could slip away through a crack. Paul asks if there was ever a time when she wished she could slip away, like when the boy took her into the bedroom. Sophie says he doesn't get the slipping away thing -- that it is a girl thing. She stops and won't talk more about it.
Sophie asks about his daughter. He says she is fine and she asks if she is still with that guy. Paul turns back to the fact that her father still doesn't know about the suicide attempt. Sophie angrily says she does not want to talk about it. He asks what she is thinking about and she says her test tomorrow. Paul observes when they get close to something important, she retreats into thinking. She says she has a stomach ache now. Paul says he thinks she was enjoying the pizza until he commented on her gusto.
Paul asks what food means to her. She says it is the enemy. She says that is what happens to gymnasts. Paul asks why she didn't tell Paul that her father is in Miami. She says her father would decide that Paul was a quack if he knew. He would be devastated if he knew, she says. Paul says she tried to kill herself and she doesn't want to tell the most important person in her life. Sophie is angry and tells him to get off her back. She wants the session to end. They look at each other. She looks at a book on the shelf, Image/Archetype. They remain silent. Paul reminds her that in the first session she had mentioned those book. He says he realized that one of the books has photographs by her father and he takes down the book. It has images of breasts on it. She says he photographs the women he fucks. Paul makes a connection between eating and sex. He asks her to stay with it and she says "Eat shit, Paul." She is very angry and upset. Paul points up that the very first time she came she talked about the books. She accuses him of trying to ruin the one good thing in her life, her father. How could you, she screams, you are just like everyone else and she goes to the door. Paul asks her please not to leave.
She returns to the couch. Why did you do that, she asks. He asks if she means the book. He says he thinks that the book is connected to her wound and that opening a wound is painful and frightening. "I have never been sexually abused", she says. Paul says he never said anything like that. Paul tells her she wanted him to see the book. He thinks she is angry, very angry at her father. He tells her she can't slip through the cracks, her mind tries but her body can't. She tells herself that it isn't happening to her but it is. He knows she will try to regain control when she leaves. And that when she gets up on the beam, that is where she detaches and that she doesn't have to go there to be safe, that she can be safe in that room. Sophie is quiet and tears run down her face. She goes to the door and leaves, with a little wave.
Paul picks up the office ad he hears the phone ring in the house. It continues to ring as the credits roll.
Again, Paul is at his best with Sophie. He slowly teases out her eating disorder and the door is opened to sexual abuse, which we can pretty safely predict was at the hands of her father. She wanted to run but Paul keeps passing her tests even though he makes her very angry.
We see in this episode the way a good therapist ha harp observation skills so Paul can knit together Sophie's comment about the books the first time she came with her look at the book of her father's photographs and make the necessary links. This is what we do when we are doing good work.
There is not a lot else to say about this episode. Sophie will be back. More of her story will unfold.
In Treatment -- Alex, week 6
We open today with Paul carrying in the mail. Kate remarks that he never gets the mail and she asks if he is expecting a love letter. She tells him she saw Laura. Kate says she thought Laura quit therapy. Paul says she did but that she had called and asked to see him because her father was in the hospital. Kate angrily tells him he should have told her she was back. Paul says all she had to do was ask. She asks if he thinks he deserves her because of what she, Kate did to him. Then the time for the next patient arrives and she says he is saved by the bell again.
Alex arrives. Paul tells him he is glad he came back. Alex says it went against all of his instincts. Paul ask what were his instincts. First was to come back and beat up Paul and then he said he fell back on something he learned in the Navy, think like the enemy. Alex says he believes Paul is threatened by him, that he thinks of him as a murderer.
Paul asks if there is something people see in him that they react to. Alex says he believes Paul wanted to strangle him as soon as he came in the door and finally he had a chance to try last week. Paul says Alex treated Paul as he did in order to get the response he expects. Alex denies that it was important to him.
Alex demands an apology which Paul gives. He tells Alex he was very offended by what Alex said. Alex tries to claim the I-can-say-anything card. Paul says that Alex wanted to hurt him and he was hurt. Alex invaded Paul's privacy, spoke of his family disrespectfully. Alex reacts by saying he guesses therapy is over. And that if he were Paul he would have kicked himself out long ago. Paul says that isn't going to happen.
Then Alex remembers a dream. He is on the ground, on a road to the airport in Iraq. He sees a MIG being followed by an American fighter and he wonders why the American isn't firing. It drives him crazy that the American isn't completing the mission. Then they both fly away.
Who is the pilot, asks Paul. Alex says maybe it's him. Maybe he didn't shoot because the other pilot isn't dangerous. Paul presses for who the other pilot is, who is the enemy. Alex says maybe it's his father. Paul suggests that Alex is the other pilot also, which Alex grabs and starts to respond to. He says he sees the other pilot as a coward because he runs away, where he, Alex, wants t kill him, wants to put a missile up his rear. Then Alex pauses and says, "Say it, say I am a faggot" and says his father thought that. Alex looks stricken, as he grasps his own dream. He says it fits, it all fits.
He talks about having seen his wife over the weekend and she wanted to get back together. And he tells her he can't. He tells Paul he was going to spend the time with his gay friends. Paul asks why and he says he likes their humor and he likes being around them. Paul asks if Alex envies his out friends for being so open? He says he likes that they don't demand anything of him. Then he tells Paul they watched some gay porn and his friend told him he hadn't lived until he had had anal sex.
Alex looks at the boats Paul has on his shelves and asks what they mean about him.
He says his father was a lifetime Democrat and he knew when he went off to the Navy and became a pilot that would bother his father. Paul says he keeps doing things that bother his father, that he never does things for himself and doesn't know what he wants.
Paul asks if he has ever had a homosexual fantasy. He denies it. Alex characterizes as gay talking about feelings, being in therapy. Paul asks how he gets along with his father.
Alex talks about having gone to an elite private school and on the weekend his father took him into the city to see the difference between what he had and how others lived. One weekend his father was talking to someone and he went out to play basketball and another kid beat him up and stole his shoes. He went to tell his father who slapped him and made him walk around barefoot the rest of the day. Paul asks how old he was. Alex says he was 11. The next weekend his father took him to a gym where the instructor told him he would learn to fight. And for four days a week he went and learned to fight because he was not going to let that happen again. And the next time a kid came after him, he beat him to a pulp. Alex, now upset, says you have to control your fear to control your life. He gets up and goes outside and starts to cry. Paul remains in his seat. Alex looks around to see if Paul is there. He returns to the office and closes the door again.
Paul asks if he is all right. Alex says he doesn't think he can do this, therapy. That he needs a break, it is too much for him. He says it isn't leading anywhere. Paul asks where he wants it to lead. And he says someplace where he isn't ashamed of himself. He misses flying, because he can focus on the mission and it is quiet, Paul asks if it is possible to get that feeling on the ground. Alex says he doesn't know.
Alex says he got a call from his wing commander to see how he is doing, if he is ready to return. That there are all sorts of tests first and he asks if Paul thinks he is ready. Paul says no, he isn't. Alex says maybe he should go back to his wife because his gay friends don't understand the Navy and the Navy doesn't understand them. Paul suggests that what came up today is important and they should look further. Alex says he is going to call to schedule some of the tests and will be in touch. He leaves.
I was thinking as I watched this session if I could have tolerated the return of a patient who had so grossly violated my privacy. For me, that feeling of anger and violation would be very much in the room and needing to be dealt with along with the need to apologize to Alex for having acted out the anger. One way of looking at forgiveness is that it gives future to a relationship, but for that to happen, for the transgression to be able to be put into the past, there must be not only an apology but a real recognition of what was done and how that injured the person it was done to. Alex wants Paul's apology, feels entitled to it -- and he is because acting out that way is not acceptable -- but he wants it without having to deal with his own behavior, his intent to hurt and anger Paul and that what he did in investigating Paul was a serious breach of trust.
Now, Paul did apologize but that transaction -- the dealing with what happened between them the previous week -- is never completed. Once Paul tells him that he is not going to kick him out of therapy, as Alex expects him to do, wants him to do, Alex goes on and tells his dream. And in the dream, the American pilot does not complete his mission. Alex doesn't succeed in his mission to destroy Paul nor does Paul destroy Alex, take him out. Both Paul and Alex though latch on to the homosexual imagery they see in the dream and they turn away from their relationship. Where they do go with it is important, but they leave what seems more immediate, their relationship and how the dream relates to it, untouched. The dream as it relates to their relationship remains unexplored. And in my mind that is perhaps the more important piece of it. I wonder if the homosexual theme, because it is more dramatic, grabs both of them because it is less threatening than dealing with their relationship and what has happened between them.
In Treatment -- Laura, week 6
Paul's daughter opens the door to the office calling for him. The couch has not yet been made up. We hear the shower. She puts his glasses in their case.
Laura arrives and her phone rings before she opens the door. Apparently it is the hospital. She hands Paul a bag and says it is for him, maple syrup from the farmer's market. Your kids eat pancakes, she says.
She called early, before her appointment time. She thought her hour would be filled, but Paul says no. He asks about her father, who is in ICU. They both sit on the couch, at either end. She is weeping as she tells Paul how small her father looks. He puts his hand on her arm then withdraws it.
She says she took Paul's advice and told her father about David last week when she left her last session. Her father said he thought so when she tells him about David. Paul asks if she told him the full story. Paul reflects that her father didn't sound surprised, that maybe he knew all about it. And how does she feel about that? She denies that it could be that way.
Laura says it feels different being there, like she hadn't been there for a year. She remarks on his shoes. Paul says he is glad that she called. She asks if he missed her and he says he did. He says that the prospect of not seeing her again scared him, that losing her is a big deal. Laura asks why he is saying this now. And says she doesn't really believe him.
Paul tells her he thinks she deserves to know how he feels, that he has deep feelings for her. That he thinks about her often and misses her. Laura akss what happens now -- that it isn't therapy so it's okay? And she thinks it feels weird.
She sits down again. He asks what now. She talks about how it was with Andrew, that she slept with him two hours after she met him. She says this is the longest foreplay she has ever known, that she has taken a year getting to know him. He asks what she knows about him. She says he has children. That once or twice he hasn't worn his wedding ring. She takes his hand and caresses it. He asks what she is thinking about.
Paul talks about a crush he had when he was 14, a teacher he fell in love with. That one day he was alone in the lab with her and he said he had to kiss her. She turned out the lights and faced him and said go on. And he got the hell out of there, ran away. He says he thanks her for showing him that what he felt or thought he felt was a fantasy.
She starts to talk about David -- that he didn't turn off the lights and told her how beautiful she was. He told her how proud he was of her, that she was ready and started whispering to her. She starts to cry when she says he spit into his hands. Paul tells her that none of what happened with David was her fault. She says she just wanted to get away from that house not to have sex with him. Paul comforts her.
Laura says she ruined it and that he doesn't want her anymore. Paul tells her that he will not do anything to hurt her. He thinks that David spoiled her ability to have anything but sex with a man. Paul says he will not betray her, will not be another David. She angrily tells him he is just afraid. Her phone rings and she answers because it is her brother reporting that her father is a bit better. Paul kisses her forehead and holds her to comfort her. She leaves.
As Laura is walking to her car, Kate is emptying the garbage. Laura says hi to her and drives off.
Oh shit. Paul has the right idea and executes it in the wrong way, sending incredibly mixed messages. He has it right about Laura and David. And draws the right parallel between his experience with his teacher and hers with him. But totally undermines that by telling her how he feels about her, which she of course hears as an opening to having him as her lover. It was not clear even to me that he was not going to take it further when he was talking about how he felt about her, so it is a very safe assumption that Laura heard it as promising what she thinks she wants. It may still be that she will be as he was with his teacher and back away having come to the brink. But given her history, I don't have a lot of hope and I am quite certain it will have to be Paul who prevents this from becoming worse. And worse it will become before it gets better because now Kate knows who Laura is and that she is still seeing Paul.