I'm willing to entertain other views

 

Steven Levenkron, New York therapist, claims a ninety percent success rate healing his anorexic clients (mostly teen and pre-teen girls). A local (Las Vegas) marital therapist claims a ninety percent success rate transforming troubled couples into happy ones. Inspired by these folks (and by those stupid Lysol and other disinfectant cans that tout a ninety-nine percent germ killing rate and never any more), I’ve decided that I have a one-hundred percent success rate with all of my clients. This includes (obviously) those who left me not just early but quickly, and those whose mothers (it’s never the fathers) have texted me acerbic, rejecting messages after I’ve refused to reschedule their teen owing to their no-show irresponsibility or too many shoddy excuses.

How have I helped them all? In a hierarchy of ways. Some, very substantially re: depres­sion, anxiety, self-esteem, autonomy, facing the truth about their botchy parents and setting limits on them, self-affirmation of anger, the quiet capacity of mastery that comes from insight, etc., etc. But those that look like complete failures? They came to therapy with a great deal of ignorance, and left with less, though they may feel worse for a while. Take “Sylvia,” who departed in a huff after I gave a half-hour psychoeducational lecture. She had wanted that particular half-hour to blab her crap, was not in the market to learn anything. Yes, she was Borderline. Yet even she would be incensed by true facts about emotional pain and what moves it out of the system. I believe that anyone, short of the deep psychotic, whose delusion bounces against reality is the better for having suffered that bruise. They are now slightly different. And in their case, different is better because everything else is the same.

When I learned, twenty-eight years ago, that I was an ungrown child in a lost head and aged body, the pain was so excruciating that I laughed, sincerely. I sat down and wrote my story, my pen as microscope. I would not be a therapist, and would have no capacity for happiness, had that not happened.

I realize this is projection, but as a person who lived in sickness and ignorance for most of my life, I cannot help but see that anything is better than essential ignorance. Is it better for a 17-year-old to live a nameless dread as he has to travel to the adult, non-child world, or to know what burden he is carrying? Maybe that is debatable, but I know that my obliviousness at that age didn’t leave for another twenty-some years, deceiving every decision I made and thought I had. People have asked me if I inform a client that she has Borderline* personality. I do. And that means to describe the earliest factors – mother-and-infant factors – that caused the global problem. She learns that she is not a born-, God- or genetics-defective person, but an injured one. And I’ve never known any­one who, upon learning that, “blamed” their mother.

What I’m saying, at the worst, is that facts even without compassion (as some people are not receptive to it) are improvements even if delusions feel better. I am one-hundred percent sure that I have never thought I was causing anyone any harm by disrupting his equilib­rium with the realities of his childhood. I believe my heart is accu­rate enough to know what “causing harm” would feel like.

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* “Borderline,” the word that “strikes terror in the heart of the middle-aged comfort-seeking psychiatrist.” From Irvin Yalom, MD’s Love’s Executioner, chapter: “Therapeutic Monogamy.”