Impossible Epistles

Without understanding it, by 1983 CS had fallen under the spell of her female psychoanalyst and entered a regressed state that would imperil her. When her analyst terminated the treatment instantly and without warning in September, it left CS in an almost feral state of anxiety and obsessive thinking. For a full year, she kept replaying the analysis in her mind, especially the various points when things went terribly wrong.

These are the letters CS wrote to her analyst during that time. Their feverish tone is a testament to a traumatized state. However frenzied, the letters accurately catalog the various points of failure in the treatment.

The letters make many references to the fee CS was paying. She was a low-fee patient whose insurance originally covered half the fee while she paid a small portion of the other half, a proportion that would have to increase as she negotiated for raises at work; she caved in to the "creative accounting," although it seemed unethical to her. When she left her job at S&S, her husband's insurance was not as generous. CS realizes, in retrospect, that Dr. B couldn't handle all this. Nor could she. It came to pass that she was making so little money that her low fee represented half her income -- as Dr. B put it, the fee diminished to "half a crust of bread." She told CS that she was guilty of blackmailing! When reading these letters, though, keep in mind that CS was paying Dr. B exactly what she was being billed.

There is much blaming in these letters; a misguided self-blaming gives way to angry accusations directed at Dr. B. This long-ago episode in CS's life perplexes her still. She is dismayed by that young woman's fury, to be sure. Now, though, she can look back in calmness and state matter-of-factly that this doctor never understood her or saw what was transpiring right right in front of her over three years' time. Dr. B's glib, saccharine affect and her meddling created an atmosphere that made analysis impossible—and these are impossible epistles.

September 13, 1983

Dear Dr. B,

I have just torn up a letter to you. Shreds of green stationery prove beyond a shadow of a doubt that your negative counter-transference (in the form of feelings of blackmail) laid a foundation for our analytic stalemate. Then I read it over. I thought I sounded like a yapping dachshund who, though he didn’t have a chance of sending his analyst jumping out the window in despair, certainly risked having his case thrown out the window in exasperation! [The image makes reference to a cartoon in CS's humor book WHEN BAD DOGS HAPPEN TO GOOD PEOPLE.]

I have about a hundred thousand things to mull over now and integrate—all the new perspectives and insights that are the bittersweet rewards of our work together. I am quite amazed by my own strategies, by how insistently I have tried to wear you down and how I have schemed to strangle the very patience, interest and empathy I need so much.

I am mixed up about my apparent success in wearing you down though. And it feels like a loss to have pieced together some of the oedipal and infantile puzzles alone. I wonder why we didn’t effectively do so together, or if you hoarded your insights, perhaps as a retaliatory measure. And I chafe when you refer to my unfreedom as simple stubbornness or entitlement. In less charged areas, you have acknowledged that such observations are of little or no help. That is one reason why I can’t quite stifle a hunch that my admittedly difficult transference has dredged up some old boggy mud of your own that you hoped you had scraped off your shoes forever. (You gave us slippers. To avoid such mud?) Not that that proves anything except that, even for analysts, the work of self-creation is never finished.

I have just been reading a short story in which the protagonist overhears a mother telling her child, “You had better stop this or you’ll get nothing. Nothing at all.”

Indeed.

September 24, 1983 (My 33rd birthday)

Dear Doctor B,

I have been flustered, these last few days following our final session; I am experiencing a real addlement of the brain. It is as if I just learned that I am right-handed after a lifetime of using my left hand for everything. I know my right hand will work much better, but for a time habit will compel me to depend on the incompetent left.

I have also experienced a lot of anguish. I think that’s inevitable. I still keep looking back at all the times the door shut. Why didn’t I say this, why didn’t you say that? Was I unable to say certain things aloud or was it a misguided obstinacy on my part? It was certainly a misfortune to have regarded the free association rule as a dictate to obey instead of an opportunity to seek and search.

Then again, many things really were unspeakable for me. To speak of loving feelings for you, to give you the details of idle days, to admit a desire to stiff you—all these things would have led to an end of that strange gratification my hungry unconscious was demanding. Then, too, as I said at our last session, the analysis pacified me, you pacified me! I felt very little anxiety this last year, no tears, no stomach pains. And when we terminated so suddenly, it all returned, even the “colic”! But the tears and the pain were good. You sent me back to my own bed, you removed the rubber nipple, and my unconscious went into full gear. I figured things out.

You know, it’s very mysterious. For a long time, perhaps since January, I felt as if something was pursuing me, some knowledge that kept slipping through my fingers. Sometimes when I awoke from a nap, I got the feeling that, in those moments between waking and sleeping, I had understood something and now it was lost. My speculation is that I had been “remembering” my real pacifier days. The memory was lost on waking because the remembered experience was pre-verbal. On some level I was in deep regression, I think.

Recent events have been most illuminating for John, by the way. He had an interesting image to describe the analytic stalemate. He said it was like fueling an air conditioner with hot coals from a vast forge; the more you fed it coal, the hotter it got; the hotter it got, the more the machine needed coal. That’s as good description of a voracious unconscious as I can think of!

Dear, beautiful Dr. B—how I have treated you . . . . and even when I leeched you, I loved you. Leeching and loving. I have to tell you I am feeling quite humbled. To discover how much I am like my mother fills me with confusion and pain. At the same time, for the first time, I feel some real compassion for that lonely, misguided woman whose name I share.

Even with all this new perspective, I still wonder if there wasn’t some way the analysis might have been helped along—or that at least there might have been more helpful ways for you to have reacted now and then. I am not fabricating anything when I point out that your analytic approach—one of beautifully interested neutrality—didn’t always operate when the subject was money and fees. At the moment, though, there’s really only one thing I strongly wish you had said, at one of the times the door was open a crack: “You know, it’s interesting, but it sounds as if you don’t want me to get paid.” I am so damned articulate, but that is one thing I needed help with.

Behind the above paragraph lies a wish for reciprocity, I think. I am a wiser, stronger person because of you. Perhaps, because of me, you are a better analyst?

About the fee for the final three sessions. I appreciate your leaving it open the way you did; I’ll remember your encouraging intentions. But you know what? I’m absolutely exhausted by the symbolic meaning of fees! I want to walk now in a world where a fee is a fee, where I can charge and be charged without travail. So I’m paying you the $50 per session we originally agreed to because, after all is said and done, that was our contract. [Note: In 1980, Dr. B's full fee was $90 for 45 minutes, $360 for the required 4 sessions a week. She was not an M.D.]

With optimism,

November 4, 1983

Dear Dr. B,

I wrote my last letter as a form of therapy. I thought that if I could sit down and put into words the mature things I wanted to feel then perhaps it would bring me nearer to health. It didn’t; it hasn’t.

You have to understand something. The puzzle pieces fell into place for me after the termination and the effect was horrifying. I realized I had repeated something with you—I had you in my bed four times a week, just as once I had my mother in my bed (very likely, four times a week), and I kept doing that, and having you, and getting you until even the outcome was repeated. You threw me out, just as she did. [Lest it not be clear: "in my bed" is a metaphor here; Dr. B's continued acceptance of CS as a low-fee patient made her feel safe, snug and chosen, the way she felt in her childhood when her mother left the marital bed and slept with her instead.]

This knowledge did not feel like a breakthrough. It felt like hell. Instead of being flooded with light, I was plunged into darkness. I sure did get what was coming to me, eh? No new brain cells were built in this analysis. Instead, the old ones grew fatter and fatter and here I am, one glutton of a bad child-woman with a new full-time job: Hating You. It’s volunteer work, and there are no known benefits, and there’s no time off.

My view of the analysis remains sour. I can’t shake the thought that you just didn’t see the light. You seemed to think that I was in some stage of analysis I wasn’t in at all—some stage where I could just take the bad things I encountered in life and “dump them there.” There? There was everywhere. And how could I have ever gotten to such a stage when I felt it was too unacceptable to dump the really bad stuff there?

You often said that some things just take their own time. I believe that. I know in my gut, for instance, that I would not have been able to get to the heart of the transference and address the question of my greedy feelings toward you until late spring or so. I remember taking baby steps in that direction then—by bringing up the fee problem, talking about termination, and addressing the issue of reciprocity. I can only guess that by last spring you were sick to death of the whole thing. Your replies, when there were any, were full of gall. (“You’re only paying me 25% of my fee,” you snapped, “and that’s something you just don’t want to look at.”) At times like that, the door slams and the assertion that I “don’t want to look at something” becomes a self-fulfilling prophecy. But you know that. That is Analysis 101.

What you also learn in Analysis 101 is the importance of analytic neutrality. When it came to money, you violated the precept from day one. Money is great, money is grand, you should make it and make lots of it and go to tax accountants and get raises and that’s what analysis is for. (“The accountant doesn’t charge that much; he needs an analysis” . . . . “Salary—that’s the easiest thing to change” . . . . “$75,000—a nice annual income!” .... and so on, and so on.) I was right to complain about this bias of yours. Something healthy in me knew what I needed, knew instinctively that your bias was shutting doors . . . . One reason I’m so furious with you now is because, on our last day together, you sat there and said it didn’t matter how you responded. Do you honestly believe that it doesn’t matter how an analyst responds? If so, I might as well have gone to a computer.

I know I sound bitter. I am. I used kinder language in my previous letters, but now by god I’m going to mess up your carpet. I have a fantasy. I will send you a Christmas present, beautifully wrapped, anonymous. You will be excited when you see it, it will be so diaphanous. Then you will undo the pale ribbons, slide your nails under the tape, remove the glamorous paper, and unveil a glimmering-with-mylar silver box. Off comes the lid, off come the layers of soft tissue, and there it is. Your present. A small oriental carpet; color: [a color that echoed her name]. It is piled high with stinking excrement. Brown cigarette butts, stained with red lipstick are ground into the shit. I wonder if you smile at the extravagance of this gesture. I promise you, when you open the box, you will not smile.

What I really want to tell you is this: A patient needs you to love her shit, needs you to help her reveal it, needs to be safe from really drawing you into a struggle though she’ll try and try to, again and again and again. Your good intentions are not enough, nor is it enough to laugh at her jokes and remember her dreams and make observations such as “You’ve been talking in topic sentences.” She needs some help tying those sentences together. She needs help understanding that telling jokes and being witty is related to her transference. She needs the perspective that all those dreams can be a way of avoiding what really needs to be talked about. What she doesn’t need, I swear it, are little slips of paper with helpful names on them. To refer a patient to one’s own accountant or to a literary agent (especially when she is herself an editor) seems especially wrong-headed. I really don’t doubt your good intentions here but, believe me, such actions only served to undermine my autonomy or make me angry or slam doors. How, for instance, could I discuss the feelings I had about the tax refunds when in a funny way they came from you? Believe me, if my ego had been strong enough to break past those roadblock-feelings, I would not have needed you at all.

About patients: they will feed you everything they think you want. They’ll give you dreams, talk intelligently about matters analytic, start referring to their demons as twerps. They’ll fool you. You must not be fooled.

About patients: they ask important things in cagey ways. A patient will talk about the mental patient she is reading about, and how the patient resorts to physical violence. You patient’s unconscious is asking you, is it safe to be mean here or what? The worst reply: “In my hospital, we made sure the patients behaved.”

. . . . Or, your patient says she knows that Anne Sexton would call her shrink up after office hours. Her unconscious is telling you that she too has such desires. That worst response: a humph and a groan.

. . . . I hate what you’ve done to me. I hate what I’ve done to you, and yet, rationally, I know that all I did was have my rightful transference. Yet the analysis with you wasn’t a safe place to have my transference, it seems. Why? Why? Is my unconscious greedier or needier or rottener than anybody else’s? No? No? Then why am I ruined.

I am sorry that the greed took such a literal form, but then again I suppose that is a special hell reserved for low fee patients and their doctors. I hope you are up to the challenge the next time it arises in your office, for surely it will, and surely, in spite of my current outrage, I know that you really wanted to go the distance with me and that you invested a lot in me. And I mourn and moan when I realize that we both had such high hopes and they were dashed.

Promise yourself one thing. The next time a patient makes you feel, say, blackmailed, don’t give in. It’s your clue! Ask yourself, when has that patient been involved in something like blackmail before? I feel certain that had you done that, it would have brought you straight to the oedipal situation with my mother. Your anger would have been defused, and you would have known how to proceed with the analysis.

. . . . For the record: I know my continuing, delicious, obsessional rage means I am in trouble. In fact (and I never thought I’d say it), my feelings are so poisonous I feel only a priest could help me. Nevertheless, the fact remains that I am right about your tragic mistakes. The thing is, I think I really could accept all this if you would just admit you made them. I guess that still leaves me a bad child-woman, holding her breath until her mommy apologizes for the crime of being her mommy.

I had a dream during those horrible days after you terminated me instantly. . . . I dreamed I wanted to make an appointment with you, but you were far away, riding a grim merry-go-round. Then I finally got near you. One of your eyes was bulbous and entirely white; the other rolled blindly in its socket. My interpretation is that you were a kind of Tiresias figure to me, the blind messenger who sees all and who brought me horrible news about myself. The interpretation has great dignity, and I cherish it.

I also doubt it.

Were you blind Tiresias, Dr. B, or were you just blind?

November 21, 1983

Dear Dr. B,

. . . .My imaginary Dr. B has answered my previous letter thusly: “You know, it’s interesting, but it sounds as if you don’t want me to take pleasure in my work with you.”

No, I did not, and do not, and the venom is all but destroying the quality of my life. Please listen. I can’t stop thinking that you terminated me for self-serving reasons. The money wasn’t the crucial factor; rather it was how the money situation was eating you, how it had undermined your ability to analyze. You were getting drawn into saying and doing unprofessional things, and you could not bear the anxiety. Hence you took the easy way out and sent me packing. I wish you could tell me this isn’t true. I wish you could tell me that it is true, but that it doesn’t undermine the progress we made together.

I’m beginning to see that my own inner truth played a large part in my “agreeing” (unfreely) to the termination. It must have seemed “familiar” to me, as if this were my fate and I could not elude it. And then I got home and understood why. I haven’t explained to you exactly what has happened, have I? Let’s just say I know why horror movies end with the suggestion that the horror is going to start all over again. That is what it was like for me. To have repeated something with you from my childhood to the letter, to have reaped the same banishment, to realize how that secret thing has eaten away at my life, to understand the extent of my own delusions—how I had thought I was well and all-powerful and how it was all just a masquerade for my childish clinging to you, how my self-esteem (or was it self-aggrandizement) was completely contingent on your being there! Yes, horrible. I would wake up at night in a sweat, thinking I was back in the analysis and it was all happening again.

. . . . I will get you for this. I will take your advice and go and work as a highly paid secretary at the Exxon Corporation. I will save money until I have enough to hire a killer. I will give him the combination to your office door. He will silently come in and strip you and stab you and stab you and stab you, and when your husband finds you, he’ll find you soaked in blood, and the red claws of a lobster will be reaching out of your vagina. Everyone who enters will vomit on your expensive carpet.

I’ve been thinking about those red claws, which appeared in a dream the time I silenced you. What were they, the claws of my own greed, reaching from my voracious other mouth? Only it was your “mouth” in the dream; you pointed to the wound, but that was my wound and every woman’s. In October, I went to Maine again, keeping the truth about my mental state carefully hidden. But the truth worked its way out. I ate lobster, and my throat closed, my lip swelled, my body erupted in hives. I had never had an allergic reaction to lobster before, but I was allergic then and I am allergic now. I’m trying to put the incident into a story. I describe eating the lobster—”sucking and slurping, determined to hollow out every crevice the red ungiving thing contained.” Will I finish the story? Will I get back to my poetry? Don’t you know that that’s my real hunger, that’s what I want so badly. Dr. B., a lovely old-world apartment on Central Park West, and beautiful furniture, and maybe even a child—these “rewards” are nothing compared to literary accomplishment and success. How much I wanted you to affirm that—and maybe you tried to—but you also kept affirming the wrong quest. After all, up until the very end you advised the Exxon Corporation—and why? Because they have great benefits and they could pay you; that working for Exxon would shrivel my soul counted not a whit.

Dr. B, occasionally you shrinks are going to be treating patients for whom health is not necessarily accompanied by high salaries. I don’t understand why you didn’t take this into consideration. And I don’t understand why you didn’t ask me to sit up one day a year ago and simply tell me that you couldn’t see your way to continuing on a $20 an hour basis. You could have said that, in your professional opinion, continuing that way would be detrimental to the analysis anyway. I would have appreciated that; I was probably begging you to set limits. Of course, I may have also been temporarily enraged, but that would have been okay, wouldn’t it? It may have opened the crucial door.

Can you see what I’m saying here, between the lines? I’m saying that even though I am sure your seeing me at such a reduced fee was kind and generous, it harmed me in the end. I wasn’t protected from my greed’s taking a literal form, and that has caused me terrible remorse, and it made it all the more difficult, when I was there, to discuss the things that really mattered. It seems it didn’t protect you from ongoing resentment either, and surely that too made analysis almost impossible. And in the end, I was not protected from losing two or more months of my life to a virtual madness. Dr. B., really, there were good reasons for my resistance. It was saving my life. How is it that it wound up nearly taking my life?

Can you see what I’m saying here, between the lines? Your seeing me for such a low fee was a good thing, but it turned into a bad thing for us both, and I’m asking, are we bad people, Dr. B, or are we good people to whom a bad greedy dog has happened?

Did you giggle a little? How I loved to make you laugh! That was my currency, I think.

What happened?

Why do I have to go through this terrible period of discrediting you?

Why do I want you to go down in history as the bad analyst who kicked Catherine Shaw out of her practice?

Why do I want you to go down in history as the good analyst who helped Catherine Shaw find her own voice?

Why, even though I understand it so well, do I persist in saying to you, “Go away, I need you.”

What a hodgepodge of a hating/loving letter. This one was lots more free-associative than the other. I have so many wants right now.

I want you to be strong enough to have all this abuse heaped on you (for I still have fears of what might have happened if I’d railed like this on your couch. Could you have standed the muddy carpet? ‘Cause I am smart enough, wily enough, to find your jugular, to say things about your technique that are cutting and true).

I want you to like me again, even though I am working hard to be your life-long nemesis.

I want you to be blind Tiresias, and not just blind, and then again I want you to be just blind so I can scorn you all the more.

I want you to love my poison pen.

I want you to know that I have found a miraculous, light peace in some other aspects of my life, that I have written some amazing letters that tap resources of love and forgiveness I didn’t know I had. . . . One was to Savvy magazine, in quiet criticism of an article they published that was scolding and intolerant of a young woman’s innocent mistake.

I want you to know that some mistakes are innocent, that some you made were innocent, and that mine too, I know now, were innocent . . . . Therefore—

I do want you to take some pleasure in your work with me, and marvel with me that I can say that, and empathize with my difficulty in doing so.

Most of all I want you to admit you were a stupid, inexperienced pseudo-doctor who was no match for me! Bitch! Bitch! I walked into your office and immediately I had to compromise my values and engage in insurance fraud. And when I brought up my misgivings about that, you just pointed out the “error” in my thinking (which was all you ever did when I talked money) instead of helping me concentrate on the deeper issues. You made me compromise my values and so I found a way to make you compromise yours. You blind, greedy, avaricious tart, fucking people over with money—that’s what lies behind your sweet personality. You always were a regular Rebecca of Sunnyshit Farm.

Did you groan at the last paragraph? Cringe? Turn away? You always said it was okay to repeat things, but I was afraid you would groan, cringe, turn away. So I made you laugh instead, or made you talk to me like a girlfriend about the tribulations of getting one’s hair done, or made you like me for creating twerps. I ran away form the dark areas—as I ran away from the mushroom cloud in that remarkable vision-dream, ran away in my high heels over the beach . . . . and into the ocean, through the portholes, back to the fulcrum of birth, back to the Eden of the womb. . . . Oh, Dr. B, mourn with me, for I am lacerated, thinking of how weak of will I was, and how I preferred stagnancy over change.

Tell me, would you still lecture me about my advanced sense of entitlement? (Maybe you didn’t intend this, it’s just that I’ve been feeling that you wanted to leave me with a very limited view of my psychological condition.) Anyway, I did, I suppose, act entitled to you (as I once acted entitled to my mother), only the secret is, I never did believe myself entitled to your services at a reduced fee, not really. I craved you on those terms, but I didn’t feel entitled. You, my love, held the deed.

And, of course, the picture is not complete until we remember what you were to me (and here you and the analysis itself are intertwined): a bad breast, a mere pacifier that soothed my anxieties but gave me no nourishment. . . . (Shouldn’t you have provided this perspective, by the way? You see—and let me try to phrase this without rancor—I do feel you took some things upon yourself that weren’t an analyst’s job—such as sending me to an accountant, a literary agent, a dentist, referring me to books, advising megadoses of the B vitamins—but were gun-shy when it came to the analytic work of interpretation and focus. I mean, you do want to be an analyst and not a counselor, no?)

(I’m no longer gleeful when it comes to a criticism like that. I’m just trying to make sense of it all. And I do think something went wrong in the analysis, and I’m not willing to take the entire rap for it, you know? I have to trust that you’ll hear and integrate any comments that are valid, and not be hurt, and empathize with my abandonment-caused, pacifier-gone wailing, for I do wail. Oh, my hunger!)

I have an impossible question: Did you cooperate with me in order to help me get well, or did you collude with me so I would never get well? Now there’s a question for the impossible profession from an impossible patient writing an impossible epistle.

Oh, Dr. B, Dr. No-Such-Place, these last months I have swung back and forth on an awful pendulum. I have wanted you to fry in the same hell you sent me to, I have wanted us both to be borne into the clouds. But now, at the end of this letter, I have said everything that needs saying, and I realize it isn’t about heaven or hell at all. It’s about walking in the sand in your high heels, on this imperfect earth, and holding your head high.

It would be nice to have some word from you, at some point.

The following is CS's final letter to Dr. B. Though it railed like the previous letters, this one was more reasoned. CS did not mail the letter; she kept it on file as on artifact of her wrath, and a reminder to never again capitulate to someone else’s personality.

And you felt “blackmailed” (your admission) for intrapsychic reasons of your own—isn’t that so? Perhaps you started feeling that way when I came into your office one day—in acute distress—and told you that I had been so undone by the original misrepresentations on the insurance forms that I called someone involved in professional standards, Dr. H, to find out if you hadn’t truly give me the power to ruin your practice. I did do that. And as I look back over the analysis, I realize it’s the only time I stood up for myself and my values. But the courage was momentary. I defined my doubting you on that issue as “paranoia” and I said as much. And you sat there and allowed me to feel that I was paranoid . . . that there was something horribly sick about me for doubting the insurance lies. That was self-serving of you and injurious to me. After that, everything fell apart.

Dr. B, I have researched this insurance business and discovered a few things. One is that not all psychoanalysts approve of such misrepresentations. Others do it sometimes but not to the extreme degree it was done in our case. All reputable doctors acknowledge that it puts a special burden on the patient—a real burden, not a fantasy burden.

. . . . I am the first to admit that my original misgivings about the insurance misrepresentations, which I considered fraud, were not necessarily indicative of high moral views and had as much to do with getting “caught” as anything. But knowing what I know now—that some doctors do fudge and some insurers do turn a blind eye to it—I still would never participate in such misrepresentations again. It seems dead wrong to begin a process devoted to the truth by colluding in lies. Yet you made such a collusion a condition of the treatment, just as you made it a condition of the treatment that I make a vow to stay for two years. Not only did you begin a process devoted to the truth by drawing your patient into a collusion of lies, you began a process devoted to human freedom by putting your patient in chains!

And I knew I could depend on you for only two years too; after that, I was living on borrowed time—and the fee arrangement played a deadly role there too. You had made your own adoration of money crystal clear to me from the start and you’d reinforced that view again and again. Naturally I wound up wanting you to see me for as little as possible—that would mean you loved me and I desperately needed your love. But the fact that I wound up only able to pay you $20 per session—and the fact that I had quit my job, one reason being (I can see now) that I simply hated the protracted insurance lies and no longer wanted you to benefit from them—scared me to death. I didn’t know what was going on at the time. Apparently, neither did you. But it was a lethal situation. I had maneuvered myself into a position in which I could get kicked out at any time—just as once my mother could abandon my silly little bed and go back to father. All the love and nearness I had with mother was also borrowed time. And you helped me repeat that horrible situation—one of the things that has sapped my whole life—to the letter. Repeat it, not repair it.

Are you sitting there, skimming this letter, scoffing at it the way you scoffed at me so many times in the past:

When I told you that in naming temporomandibular joint syndrome I felt you “gave” it to me; but you laughed and struck me dumb. (I actually had molded my symptoms to meet your “diagnosis”; it turned out I didn’t have TMJ at all, I needed a root canal!)

When I told you I had heard frightening “noises” in my ears as a child that sometimes still returned in adulthood and they reminded me of the schizophrenic girl’s voices in I Never Promised You A Rose Garden, but you laughed and struck me dumb.

When I first mentioned feminism.

When I told you that as a child I’d dreamed my sister got caught in the washing machine; and again you laughed and struck me dumb, dumb, dumb.

And many other times besides. Are you sitting there, still telling yourself that everything I say to you is only “negative transference” and not to be taken seriously?

What would your colleagues say if they heard that you scoffed at me at the crucial times I just listed? What would they say if they knew you told me that “Jesus was a masochist,” and not once, but three times, three times in a row. No matter what you think about religion, I suggest you sober up and consider that you said this to a patient who had told you she was once a devout child.

How would it fly if they knew that once, early in the analysis, when I was telling you about some minor frustration with my husband’s dubious passivity, you raised your voice very loud, saying “YOU ARE SO ANGRY AT HIM. YOU WANT HIM TO GET UP AND DO SOMETHING?” With that one unconscionable, theatrical act you did two deadly things: ganged up with a patient against a spouse, a real no-no, and told your patient how angry you would be at her if she didn’t hurry up and take action—which I immediately and prematurely and wildly began to do in order to please you. Again, an exact repetition, this time of my early toilet training. Don’t you know that I went scrambling around for raises that first year in order to pay you more, give you money just the way I had to give my mother my bodily products before I was ready to? . . . . Is it any wonder that I wound up wanting, in the end, to “withhold” all I could from you? And yet how I punished myself for that withholding. It was my world that shrunk to the size of a dime under your treacherous “care.”

I believe that the analysis wound up hinging on the money because of your own constant money-loving statements. And I can’t think of one good reason for your saying those things to me unless, on some level, you were defending your own choices to me and needed me, and other patients too, to ratify your values by replicating them in our lives. Because it certainly is true that whenever I said or did anything that mirrored your values, you took it as evidence of my health when, tragically, it was only evidence of my continuing enslavement.

There are other things of your own that you needed me to ratify. The last time we met you even admitted that you took me on because you thought I’d turn out to be a nice, high-fee-paying patient who would write for two hours in the morning, then pack my briefcase and go off to my “career.” I know you have a word processor. You’re the one who writes for two hours a day, or aspires to. You said that the ideal husband for an ambitious woman was one who locks himself in his home office at night and brings home bacon aplenty. I saw your pinstriped, briefcase-toting husband. Whose life does that describe, yours or mine? I myself went so far as to “pad” an editing bill because I knew you’d be pleased (being yourself a diehard padder of your own insurance bills). And sure enough, you loved it. “Good!” you responded, in your best cheerleading voice. Not, “Why did you do it?” Not, “How do you feel about that?” But “Good!” And, yes, I loved your endorsements. But that wasn’t health, it was, once again, enslavement.

Can’t you see why things got so bizarre? Because there I was, echoing back to you everything you said, dreaming about moving into a “clean white box” like yours, and there you were, swallowing it whole, not even asking yourself if your patient was perhaps just feeding you what you wanted to hear! Dr. B, I did not know what I was doing, I swear it. To me, that self-surrender, that false self, is all wrapped up with love. And I just would not have thought to question it. A fish doesn’t ask questions about the sea in which it swims, a person doesn’t ask questions about the air she breathes. It was your job to help me ask those strange, painful questions. But you didn’t. That is the most ironic thing of all. You slam me for “not working,” but it was you who wasn’t working. You never helped with interpretation and focus—your job—but instead put most of your energies into bossing me around in my real life—not your job. I don’t know where you got the idea that you could adopt a cold Brenner-like approach to the nitty-gritty analytic work (and even they offer interpretation and focus) and at the same time be so intrusive in other areas. Can’t you see how that would confuse a patient? You seemed so very interested in my productions, from the very start you seemed so. But then you’d pull back into a very cool stance when the subjects were traditionally analytic, or, as enumerated before, you would make light of things.

You think that “keeping the tone light” helps a patient talk, but, alas, to a patient it seems you are making light of her problems. It’s also a kind of lie you told. You always made me feel as if there were nothing really frightening hiding inside the unconscious—you said that to me in many verbal and nonverbal ways. But there is plenty to be frightened of—and every time you ignore that, you get in the way of a patient’s quest. That is what I mean by your “Rebecca of Sunnyshit Farm” persona. Funny, but that’s a false self too. There we were, two false selves, falsely fumbling around for neurotic gratifications.

Dr. B, you overwhelmed me. You sat on my face. You talked and talked and talked and talked and talked. (The real reason I once silenced you is because you were talking too much, overwhelming me with chatter. Even you kept commenting that I did such “good work” then. Yes, I did do good work, when I finally got my analyst to shut up and listen.) . . . . You gave me your opinions on everything. Either out and out, as with Caribbean travel, or with all those pernicious noises you made, the gasps, the many Mmmmms of shock, the tut noises, the whinnies—very few of your noises were of the neutral variety, and every one of them cut me to the quick. No wonder I felt scared to tell you things. I never knew if you’d listen or if you’d gasp, laugh or whinny! I even told you that I had begun to use one of your noises in my business dealings. I was telling you that, for me, your noise was a weapon of intimidation—but, of course, you and I just had a good giggle about it and you were clearly pleased that I had taken on something of yours. Your narcissism is amazing. You have even decorated your office in the color of your name!

I write all this, I know I’m “right”—but oh I hate being right! Even now, as I yearn for the old idealistic transference (itself such a deep yearning for a good, caring mother), I remember how at last I tried to talk about my love for you and complimented you on your technique. Ah, you recall what you said, yes? You said, “Well, if that’s difficult for you to say, it’s because if you admit that I have a good technique, then you must also admit that your not getting well is your own responsibility.” Knowing what I know now, the response seems monstrous. It’s right up there in the ogre league with what you said after John went into therapy. You’ll recall he had gotten so angry at me (justifiably, for I was in that awful state of omnipotence, fueled by you) that he took a separate vacation. And I started telling you how I missed him, and was so happy when he came home, and he’d shaved his beard and looked so handsome, and now he was going into therapy to help the marriage and work on his own problems, and I was in love with him all over again. And you said, “I hope Mrs. E forgives me for referring John.” Oh, you damn bitch! Then the cycle began all over gain, with no hope for proper analysis. I had you in my bed, as it were, and you and me, we’re better than daddy! You are a feeder of neuroses, you allied yourself with my sick self again and again, and isn’t that a terrible pity for us both?

You kept telling me that I broke our contract (and what a contract: lies and chains) but what about your part of the contract? An analyst is supposed to listen, to interpret, provide focus, provide an office that doesn’t broadcast her personality, make sure that dream interpretation becomes an avenue of insight and not a way of avoiding what’s really going on in the transference. An analyst is never supposed to gang up with a patient against a family member, or be constantly opinionating, or get drawn into “general” conversations, or ask a patient to mirror her own life. If there is a fee problem, then an analyst is supposed to join with her patient in solving it, not let a deadening situation drag on and on to the point of stalemate (and then, when the analysis is over, tell a patient she was “indulged”!)

And—let us really get into ethics—an analyst does not terminate a patient instantly. I mean look, look how you handled that. You said it would be all right with you if I took August off but I should certainly come back in September. And when I did, you kicked me out. That was a terrible thing to do. You robbed me of an opportunity to deal with the forthcoming separation, kept me in the dark about the truth of my situation, guaranteed that the month of July would be unproductive (and no hassle for you)—and broke my heart.

. . . . And I? What I have to live with is the heavy knowledge that I spent three years with a doctor even though, deep down, I knew she was the wrong doctor for me. Your early and immediate exaltation of money and careers was guaranteed to get in the way of my artistic aspirations. Your conditions for treatment . . . . rubbed me the wrong way, but immediately I adored you, so I pushed my misgivings aside and stayed. I guess those things were familiar to me, a part of my experience of love as something that takes more than it gives. I coped with it all by identifying with you, by “becoming” you, as if I could put on your beauty and power like a coat. . . . When you did something that hurt me, I brushed the knowledge aside in order to cling to my view of you as beneficent and infallible. I had a false god before me. When you told me that Jesus was a masochist, I whispered a small protest, but I stayed. I sold my soul to you, and given what I have come to understand about your value as a therapist, I sold it for a crust of bread. And here is my news:

It is fitting and just that you got half of it.

Whew. Should the reader be wondering, Dr. B never replied to CS's letters, nor did she phone her to check on her mental health despite her obvious extreme state and despite something else better left unsaid here. Early in 1994, CS asked for an appointment and was granted it. Her doctor's indifference froze her to the bone. Dr. B referred her to a Dr. K and CS had a few sessions before swearing off shrinkage forever.

CS suffered flashbacks and night terrors for some years. But anguish can open the heart and failure can be grounding. It has been so.