In Treatment 2 -- Gina, week 6

Paul is on the phone talking with someone about his father's estate.  Every place he calls puts him on hold and he becomes frustrated and throws his phone which starts to ring just as Gina comes to the door.

Paul tells Gina that he is trying to get his father's estate settled but he keeps being put on hold. Paul asks if Gina will proofread a letter he wrote -- then tells her about meeting with Alex's father. She is astonished that Paul wrote the letter. Paul says his attorney says the letter will end the lawsuit and the insurance will pay everything. Otherwise it could go to court and he will lose because according to the lawyer, everyone hates therapists. Gina expresses skepticism about the lawyer. Paul tells her he thinks he is not helping anyone anyway and he wants to send the letter and find something else to do. Gina corrects him and says he does more than just listened to. Paul says they want love, a parent, things he can't give them.

Gina asks if what he wants to do is make people happy. He says absolutely yes, he does. He says he will become a life coach and give advice. Gina says to Paul that if Mia, as an example, were able to accept love, she wouldn't be coming to him. Paul attacks Gina for not being willing to accept responsibility for her patients. She says that doing what he says makes patients dependent on therapists and unable to decide for themselves.

Gina reflects that she let him down because she failed to protect him from the pain he is experiencing now. Paul says no, he has disappointed her. She judges him, he says. He demands she tell him what she really thinks. She says she really thinks he is acting like an asshole, has little insight into his own behavior. She says she is furious with him. And that maybe that is exactly what he wanted, for him to become the authority figure who failed him so he can again be the innocent victim.

Gina says he would always rather yell than think. She asks him why he thinks she has stuck by him because despite what he thinks she believes he is a good therapist. That he has a great ear and a great sense of empathy. Paul becomes quiet.

Gina tells him he isn't failing them, that they are human beings in great need. She tells him he has to become able to tolerate that therapists don't save people, we can't. Paul tells her Walter tried to kill himself. Gina wonders why he didn't tell her. Paul believes if he had succeeded in killing himself, it would have been his fault. He knew Walter's daughter is like he was and how he wanted to tell her to get out now and make her life. He understands why Walter would want to kill himself to take control. Gina asks if he thinks about this himself and he denies it because he has children. He tells her he vowed he never would do anything like that when his own mother died. Paul asks Gina if she has ever thought about suicide and she says yes. Gina asks about April. Paul stops early -- he says he is exhausted. He has become quiet. Gina says she will keep the letter and he should think about it for a week and if he decides he wants it back next week she will give it to him. She tells him to see his patients and to act as if he believes.


Years ago a friend of mine said that we become therapists because we fail with our first patient -- our mother or father -- and then set out to do with others what we could not do with him or her. Paul was unable to keep his mother alive. No matter how hard he tried, no matter how much he loved her, he was not enough to keep her from killing herself. And we learn tonight that Paul has been trying to be enough to fix his patients all these years, just as he tried with his mother. And that effort, in most ways, is as doomed to failure as his childhood efforts were. 

Paul wants to be able to take responsibility for his patients' lives -- to give Laura enough love, Alex reason to live, Mia the holding and love she wants, April the good father, Oliver the loving caring parent. And he cannot do it, not literally. And underneath it all, on some level he is also angry at them as at his mother for not making him feel better by allowing him to heal them. 

As Guntrip said, Paul would rather be bad than weak, rather believe that it is his failing that has kept his patients from getting what they want and need, rather than that he is powerless to give it to them as he was powerless to make his mother want to stay alive. 

It can take a long time, even while working well as a therapist, to come up against these unconscious forces at play in our work. It has taken the confluence of events -- the lawsuit, his divorce, his father's death -- to bring Paul to the point of having to recognize what he has been trying to do and why it has failed. And that in his efforts to be what his patients needed and wanted and failing, he has not see his actual gifts of being very good at listening and being empathic. Gina is right on the money with this. This is Paul's dark night of the soul for himself as a therapist. He needs to become willing to sit with his patients, to listen, to interpret *and* to allow them to feel their pain and discover that the way out is through it. And in order to do this, he must feel his own suffering and find his way through it with the support  from but not rescue by Gina. 

We also see here that Paul has a maternal transference to Gina. He has tried so hard to be good, be what he thought she wanted and he has failed and he is furious with her, as he has not been able to be with his mother. His fury goes to Gina because of all that she now stands for in his life.

Someone may well ask if it was all right for Gina to get angry, to let her anger show. And while it would not work a a deliberate therapeutic technique, it was the right thing at the time because it opened up something between them. Paul needed to know he could not jab at Gina as he was without consequence. She is not, after all, his punching bag there to take whatever abuse he wants to dish out. The exchange between them was areal rather than therapeutic and these moments do happen in long term therapy. It is important that the therapist also be as skilled as Gina in then seeing what just happened and understanding it and be able to interpret it, as she did with Paul.





© Cheryl Fuller, 2016. All  rights reserved.