Week 7: Paul & Adele

Paul is talking with Adele -- he has told her about Sunil. He says Sunil is being deported because he did what she urged him to do. And then he says that should teach her to stay out of second hand diagnosis and to let qualified people do what they their work. Adele asks if he includes himself among those qualified people. She says he has been talking for weeks about his concerns about his work. She says she thought it had been important to address the risk and how does he know the threat was not real. She says she is not sure how Paul decided which story to believe, the one Sunil told him at the jail or the one he said in session. Paul says he knew. So she asks why then he is so upset if what happened was what Sunil wanted?

Adele refers to Paul’s strong identification with Sunil. Does he feel angry at having been betrayed by someone he sees as a friend? She asks if he is envious of Sunil for having found a way to change his life.

Paul says he has been going over and over Sunil’s treatment and can’t get it out of his head. He asks himself how does he know what he is being told is not bullshit, what is he being blind to now. He had a call from a patient wanting to see him and he hasn’t gotten back to him again. Paul wants to say he is not taking new patients. Adele asks what that means, is he cutting back on his practice or closing it? 

Paul says she looks more pregnant. She says yes. Paul asks what she is going to do when the baby is born, will she keep working. She says yes, she wants to. She asks if he is thinking of closing his practice. 

He says when he was with Jesse, Jesse said he was quitting therapy. Adele asks why and Paul says because he feels he has to choose between Paul and his father. He doesn’t believe that what he says matters  anymore. That people hear what they want or are capable of hearing. Adele reflects that these setbacks feel like terrible blows. She asks if they can talk about them.

He asks what she thinks. She says because it is he blurs boundaries. Why does he think Sunil was able to fool him? And two weeks ago he saw Jesse late at night and now he is upset that Jesse is leaving. Paul says he needs to stop seeing patients. Adele asks if that is what he wants, that there are many ways to make changes.

She asks what would come next? He asks if he has to have a plan. He wonders what would have happened in his life had he not become a therapist? He says he cannot stand 10 or 20 years more of this, locked in a room listening. She reflects he is talking about a longer life and he says he is taking the doctors seriously. She asks if anything comes to mind about what he wants. He says no.

He says he broke up with Wendy at breakfast yesterday. Paul says she seems surprised. He says he wanted to free himself, he knows he was never in love with Wendy. And he wonders if he was ever in love with Kate or if he is capable of love. Wendy wanted to talk and she started to cry and inside he felt nothing. He knew he should feel but he couldn’t move, he wanted her to leave. Adele says to free himself, she says he has always sought out safe relationships with small risk. But inside he seeks intimacy. But they are all substitutes. She says she thinks he is saying he is ready to stop doing that. But she is not sure ending his practice is the right answer. That it is the right direction to go in. 

Paul says he is not coming back. He asks if she sees their relationship as a relationship. He asks if she sees it as transference and countertransference, and he can’t do that because he can’t tell what is real. He can’t go on seeing her because she epitomizes the conflict. Paul says to her she is having a baby, having it with someone but he has the feeling that might not be true, he doesn’t know her situation. He feels though she is alone. She says that last week he thought she had a happy  growing family and now… he says that this is the chance for her to tell him the truth so it doesn’t go one for years with him not knowing and that is too painful. She says the solution is not running away. Paul says it isn’t a relationship, that it is an artifice in that room and he can’t distinguish it from reality and he still feels she is meant to be with him. He asks isn’t what he needs to do to go experience for himself? She says that doesn’t mean he can’t come in and talk about that experience. 

Paul says he is 57 and has lost his way. She says she wants to help him find his way. He asks her if she thinks about them being together. He says he is not in treatment now and she can answer. She does not. He tells her she is a good therapist. She asks if he will think about coming next week. He says he can’t, he has to stop and  he reaches out and shake hands with her. She says her door will always be open to him. He says it is okay, she can close it behind him.

Paul is on the street walking among others. He walks away.


This was a striking session, the best of the week in my opinion. We see Paul’s hostility right from the beginning, because it is what he leads with when he feels vulnerable. In this way he is not unlike Jesse with Paul. Paul wants to make it Adele’s fault that he breached confidentiality and called Julia last week. But Adele holds to telling him that she had believed it was important to look at the risk and what he might do. And she is right -- that issue needed to be explored, not as a matter of supervision but because of Paul’s intense feelings and identification with Sunil.

Paul finally opens to looking at what he is doing in his life, which seems to have been enabled at least in part by Adele’s question about his envy of Sunil for having found a way to make change happen. We have seen Paul this week be unable to do much with any of his patients, seeming unable to forge a solid connection with them and maintain a therapeutic stance with them. When Sunil tells Paul what happened, Paul experiences it as something done to him personally rather than seeing it clinically as the way Sunil knew to get what he wanted in his life. Similarly with Jesse, Paul feels personally rejected and the good work they have done tossed aside because he cannot maintain his therapeutic stance. This has happened to him before -- with Alex and Laura among others. Paul is prone to a common occupational hazard for therapists in that he seeks to have his own intimacy needs met through his relationships with his patients. This makes it very difficult to see clearly what is happening and thus avoid the kinds of entanglements we have seen him get into in previous seasons. Note that in every case this year, a family member criticizes Paul for what he is doing. They are picking up on an element in the therapy that is off.

Paul is finally at the point where he must face into his own loneliness, his fatigue with his work, the huge questions he has about himself and his life. In this respect the work with Adele has been successful because it is through his work with her that he came to this point. Psychotherapeutically, this is not the end of the therapy, but in a way the beginning because this is where the real and very hard work would begin. But Paul has lived his adult life in and through therapy -- his own and his patients -- and he may be right that he needs to get out of it and into life in order to even begin to sort out what he wants and needs.

My secret wish is that Paul will take a few years off and do things completely different from what he has done before in his life. And that maybe in a few years come back to being a therapist. But that is my wish. What is yours?



I will be writing a long piece looking at Paul and these patients later this week.



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