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Chapter One

Riggs

When I was eighteen my parents were faced with a problem: what to do with a sullen, disorganized daughter who had failed to graduate high school and who had returned home to Washington, D.C., wrists bandaged, from an extended stay with her boyfriend's mother in Indianapolis. They took me in tow to the psychiatrist I'd been seeing off and on through my high school years, who recommended that I spend some time in a "therapeutic environment." He suggested Austen Riggs, a hospital in Stockbridge, Massachusetts, where patients--none of them too sick, he reassured us--were free to come and go, and where I might spend some months away from the immediate source of my confusion, the boyfriend and his mother.

I stayed at Riggs for three years, one as an inpatient, two as an outpatient, living in apartments with various roommates. These were years I should have been in college, and they were so empty and aimless that when I remember Riggs now, my mind pans around the corridors of the big comfortable patient residence, the Inn, as we called it, and in my imagination it is absolutely uninhabited. I drift through the central hall and into the dining room, where the fruit bowl and the iced tea urn rested on a polished sideboard, replenished by the staff at regular intervals. I cross the hall to the living room with its twelve couches, grand piano, and tall windows hung with flowered chintz curtains. Then I withdraw to the wide central hall and approach the reception desk below the great curving central staircase, and wander in memory through the back door to the grounds, where deck chairs were arrayed in pairs under the trees. I skim by the volleyball and tennis courts and across the parking lot behind the medical building, where patients met with therapists, past the patient-run, staff-supervised nursery school and the greenhouse.

Riggs was an anachronistic institution even then. (I often wonder what it's like there now; the patients are a lot sicker, I'm told, and they stay for shorter periods of time.) The population was very young, very bored. A few middle-aged people were there, but we younger ones tended to avoid them. They looked baggy and defeated, truly sad in a way we sensed had more to do with life than diagnostic categories. Years later, when I actually went to college, I read The Magic Mountain in a seminar, and I felt I had a certain advantage over the other students. How well my Riffs experience prepared me to understand the convalescent languors of the tuberculosis patients, reclining on their deck chairs, blankets draped over their knees, eyes fixed on the middle distance. Now, whenever I see one of those chairs, the white-painted wooden Adirondack type that seem to show up in soft-focus lithographs on the walls of so many doctors' offices, I feel a familiar jelly-limbed ennui.

My suicidal gesture had been feeble, a few swipes with a pair of nail scissors. I knew when I arrived at Riggs that I was quite sane and only mildly sick; I had no business being there. But I had no business anywhere else either--no diploma, no prospects, and no ambitions.

I arrived excited; going to Riggs was the fulfillment of an adolescent fantasy. The status of mental patient would invest me with significance. The frantic little act that landed me there had been my entrée to a process; life would work on me in this particularly colorful way, and who knew what might happen? Riggs had a special interest for me because by coincidence I had spent some time hanging around there at age fifteen, when I visited the home of my friend Caroline, whose father was the financial manager of the institution. We had seen the movie David and Lisa , a tearjerker about a love affair between two adolescent mental patients, and we were smitten with the romance of madness. I think we believed that if we cultivated dissociation we would become as beautiful as Lisa: Our complexions would turn luminous, our faces grow expressive hollows, our hair lie flat and glossy. We spent our days edging cautiously around the grounds, taking drags on shared cigarettes and muttering "a touch can kill," hoping to be noticed by the patients, drawn into their glamorous orbit by the magic of proximity. The patients frustrated us by staying indoors, their windows open to the July breezes, playing "Mockingbird" on their stereos. We heard this song constantly, from multiple windows under which we passed, and for us its refrain became the perverse anthem of mental illness:

Mock, yeah! Ing, yeah! Bird, yeah! Yeah, yeah! Mock-ing-bird!

When the psychiatrist in Washington recommended that I be sent to Riggs, I quivered inwardly, afraid to blow it all by showing my pleasure, and the moment I got home and free of my parents I called Caroline long-distance." Guess what?" I whispered. "Guess where I'm going?" Caroline was going to college, but I was going to Riggs, and I knew by the envy in her voice that I had double-trumped her.

At community meetings patients sat cross-legged on couches, or lay sprawled on the carpet, and were encouraged to ventilate their feelings by the nurses and a small, round-eyed man named Richard, a nondoctor whose function I couldn't understand at first, a kind of professional gadfly and controversialist. Years later I found a category for him; he was a protofacilitator, perhaps the first of his kind to emerge from the fledgling family-systems school of psychiatry.

These meetings, meals, and therapy sessions were the only real structure of our days. We were assigned tasks, called "work-jobs," in the mornings, but most patients slept through the hour reserved for them. It felt a little gratuitous to spend an hour sponging down baseboards when that hour was being charged to one's account. The issues of work-jobs and DNR, or day-night reversal (this was the late 1960s, and already we were using acronyms--Riggs was both anachronistic and ahead of its time) were the staples of discussion at community meetings--not so much discussion, really, as nagging and resistance. The nurses and the protofacilitator kept after us. Why couldn't we take pride in our environment? Could we get to the bottom of this, please? The patients sank deeper into silence and into the contorted positions young bodies assume in shamed repose.

The essential passivity of life at Riggs, a life lived to be examined in therapy, worked against the staff's attempts to get us to clean up after ourselves and keep sensible hours. The domestic staff in the Inn--the nurses, the aides, and Richard the protofacilitator--operated at cross-purposes with the therapists, those austere beings in the big white building across the way who received us singly in their offices and were seen in the Inn only when a patient was having what the nurses called an "upset," with the accent on the first syllable of the word, late at night. The therapists viewed our sloth as symptomatic, and we all tacitly understood that any attempt to expunge what was symptomatic in our behavior was antitherapeutic. The therapists were the radicals, the staff the exponents of realpolitik. The conflict between these factions was never open, and perhaps it was never a real one but rather a deliberately engineered tension, a therapeutic master plan, a good-cop, neutral-cop ploy. But even if that was true, I know that like most master plans it was often lost sight of, even by its designers.

Not all of us were normal late adolescents. Some were seriously depressed, not just sluggish. Some were harmlessly odd, like L, a lapsed seminarian who carried on a constant internal debate about the supremacy of the papacy. He would emerge from his room to keep a running score on the blackboard above the mailboxes--L 24, Pope 17. Some of the elderly outpatients seemed beyond hope. The parameters of their worlds shrank as they aged; their compulsiveness stiffened. Never quite accepted by the townspeople, they shuffled up and down Main Street, stopping for the lunch special at the drugstore, ducking into the library for a nap.

A few patients were mad. I recall two in the early days of my stay there; one somehow got her hands on an antique cannon, fiddled with it to make it operational, and fired it out her bedroom window. She also pulled a gun on her therapist, made him plead for his life. The other, a young man who could have doubled for Charles Manson, stuffed hard-boiled eggs into his rectum and laid them publicly, dropping his pants and squatting in the hallway.

Still, making allowance for the effects of idleness and boredom, I think most Riggs patients were much like people in the outside world. Graduate students, for example, don't seem much saner as a group, or even much happier. The striking difference between Riggs patients and comparable young people living outside was that Riggs patients were richer. I believe I came from the least wealthy family of any patient while I was there.

My mother delivered me to Riggs. She spent the first night with me in the local guest house. We were shown into our room, with its flounced twin beds and space heater, its view of Stockbridge's famous Main Street, the one painted by Norman Rockwell. She closed the door and took her flask from her purse. "I guess the sun's over the yardarm," she said.

The next morning was frosty and bright; we said our farewells in the parking lot of the therapy building, and she alarmed me by bursting into tears, very uncharacteristic behavior. "Goodbye, my dear," she said, and clutched me. The sun bounced off the lenses of her dark glasses and blazed in car windshields. I remember staring over her shoulder blankly, eager to see her go, eager to get started.

I was led from office to office in the warren of small rooms in the basement of the therapy building, tested and interviewed by five or six of the psychiatrists on staff. I was given the standard Wechsler intelligence quotient test for adults. (What is the Koran? What does the following quotation mean: "A single swallow does not a summer make?" Assemble these blocks so that the result exactly reproduces the pattern in this booklet. Tell me a story that explains this picture--a boy stands at the head of the stairs, a broken violin in his hand. A man stands over him.) I was given a Rorschach, a personality inventory. When I hesitated, the examiner leaned back in his chair, drummed the desk with his thumbs, took a furtive look at his stopwatch. "Take your time," he said.

When my diagnostic workup was complete, I became the subject of a full-dress staff conference in which my prognosis was discussed and my treatment plan drawn up. I think I may have been the last patient at Riggs to be brought into her own conference. The custom was dropped, probably because it had an unenlightened, nineteenth-century feel about it.

I remember entering that room, led in by a nurse, shown to a chair at the head of a polished oval table that seemed to me the size of a fishing boat. The nurse withdrew. Seated there, looking down the rows of faces that looked back inquiringly into mine, I was visited with an impulse to say, "Perhaps you gentlemen were wondering why I called you all together today." That made me smirk inappropriately. "Emily," said one of the doctors, "I'm interested in this detached feeling you described in your interview--that floating, disengaged sensation. Are you feeling that way right now?"

"I guess I am," I said, and I lifted my lowered eyes to hazard a smile at the assembled doctors. They smiled back encouragingly, and at that moment I felt a desolate certainty that now there would be no backing out. Now I had left home for good.

I was a hog for attention and welcomed nearly any kind, but the doctors' questions, the nurses' charting of my moods and actions, all this had the feel of the speculum about it.

Within a few months, though, the staff's vigilance had dissipated, and I took my place among the other patients, lounging on the leather sofas in the entrance hall, ashtray balanced on my knee, running my eyes over back issues of Horizon . I learned to scorn the activities Riggs offered, ceramics and woodworking in the shop, repotting plants in the greenhouse. I learned to pretend that I hated the food, which was actually the best institutional food I had ever eaten or ever have since. My adjustment was quick and unproblematic.

I was assigned to a therapist, a research psychologist. I learned later that I was only his second clinical patient. He was a man in his middle thirties, amiable, earnest, eager. He had a spade-shaped, high-cheekboned, luminous face--a beautiful face, really--that sat at an odd angle to his neck, a disc facing up rather than out, and he stood rocked forward on his toes, his shoulders so hunched they were nearly level with his ears. My adolescent sensors instantly registered something alien and slightly goony in his aspect, and I never fully accepted him. Now I understand him better; experience has provided me with a context into which I can place him. He came from the Bronx, a yeshiva bucher from a Yiddish-speaking household. When I think of him now, I put a yarmulke on his balding head and append Hassidic curls to his temples, and I see his face as a throwback to visionary and ecstatic ancestors.

I was retested a year after I arrived, and my IQ had declined significantly--how much, my therapist wouldn't tell me. He would only say the test results were "disappointing." My diagnosis was altered. Now my anxiety neurosis had become a "schizoid personality disorder with borderline trends." This is a bad diagnosis, and an insulting one, I've been told since, but at the time I rather liked the sound of "borderline trends." It made me think of a stylish flourish, an extra, like piping on a jacket or whitewall tires on a car.

Apathy wasted us. I had been a failure as a student, but I had always read voraciously. At Riggs I stopped. We lost our normal adolescent interest in sex--for the most part, at least. We hung out in groups, but we tended not to form real friendships; we saw one another as fundamentally inaccessible, three-quarters submerged. We wore kimonos and hair curlers, jeans and slippers, as we padded around the Inn--half dressed, half there. News of the Vietnam War protests reached us; we crowded into the patient library where the record player was kept to listen to Blonde on Blonde, Music from Big Pink , and Abbey Road , but still we felt wistfully peripheral. The great countercultural storm was rising but far away from us. Actually, to the degree that a therapeutic view of life has been a legacy of the 1960s, we seem in retrospect to have been an advance guard. But at the time we viewed ourselves as the last of the stragglers.

Many of us got worse rather than better, and for some, getting worse was dangerous. By the time some patients ran out of money, and this was bound to happen eventually, even to the multimillion-dollar trust-funders, their parents and doctors had come to view them as too debilitated to go back into the world. Instead they moved on to state institutions, where sometimes they stayed for life.

Toward the end of my first year as a Riggs patient, my therapist became inappropriately attached to me. Our meetings were charged with feeling, and every session seemed to end in an epiphany. But it was Dr. S's eyes that beaded with tears, not mine. My parents, we acknowledged in therapy, had rejected and abandoned me. I had known this for years, but pretended it was a revelation because I found his emotion too gratifying not to play on. At the same time, I felt itchy and uncomfortable, instantly sated with his love, made queasy by it. I'm not sure whether this was because I felt myself to be in bad faith or whether I was unaccustomed to this kind of moony empathy, this cherishing pity. I was not the kind of young girl a lot of men fell in love with. And I always felt that the object of Dr. S's love was not me but some phantasmal waif who only half inhabited the chair in which I sat.

"Thank you," I would say as we paused at the door of his office at the end of an hour. "No, thank you ," Dr. S said. I had opened up the world of feeling for him, he told me. The years of charts and statistics and rat mazes were over for him now. We began to take walks on autumn days. Dr. S taught me to drive and accompanied me when I took my driving test. I taught him to smoke cigarettes.

Around the time Dr. S's wife was due to deliver a baby, I became an outpatient. Dr. S began to appear at my door. One evening we drank a lot of wine, he and my roommate and I, and we all took a tipsy walk after dinner. Dr. S put his arm around my waist. This was the first physical contact between us, and the only, but it changed things unalterably. I woke the next morning charged with a theatrical anger and teased by doubts about its legitimacy.

In therapy I remained mostly silent after this incident, and glared. Dr. S became frantic. He told me one day that he had spent the morning weeping in his parked car on a farm road in Lenox, one of the routes we often took on our drives. Hearing this confession puffed me up with scorn like a blowfish. I was thrilled and enraged. Inwardly, I felt some alarm at this reaction; it seemed partly out of my control. My disgust at Dr. S had something to do with the way his clammy feelings for me entwined with professional ambition--at my second staff conference he presented our work together as a new way of doing therapy in which the therapist makes himself vulnerable, fully embraces his own transference, drops his therapeutic distance. A triumph, except for my unfortunate deterioration, documented in testing. But that was easily finessed with the familiar psychoanalytic rationalization that explains an increase in symptoms as a necessary precursor to a breakthrough. As for my baleful new diagnosis, that was drawn from the testing. Having forsworn objectivity in his dealings with me, Dr. S took no part in it.

I was witnessing the final collapse of adult authority, and my anger was a cover for fear. But it also served to conceal a kind of sexual frustration. I think my semiconscious thought process went something like this: If I'm going to do something so extreme and destructive as to have an affair with my married therapist, I want him to be so powerful, so seductive, that my culpability is washed away. I want his passion to overwhelm me and leave me blameless. But Dr. S's feeling for me was more emotional than sexual, more tender than passionate. I could feel a smug slackness in the arm that encircled my waist, tentativeness in his dangling fingers as they brushed against my hip, and it made me mad. I never fully acknowledged this to myself at the time. But let me give my former self the highly qualified credit she deserves; my self-suspicion was like a thready, persistent extra pulse.

I began an unsystematic search for a new therapist, approaching doctors who looked sympathetic and explaining guardedly that I felt I would do better with somebody more experienced than Dr. S. The answer was always the same: This is an issue to be worked out in therapy.

The new director arrived, startling us all with his appearance. He was tall and bony, with a comic villain's brilliantined black hair and a waist that seemed to begin six inches below his lantern jaw. He wore cowboy boots and string ties, and he brought with him a bevy of beautiful psychotic young girls from the hospital he had directed in Washington, D.C. He was a swashbuckler, a florid, impulsive personality, famous for his hands-on treatment: If the patient crawled under a bed, the story went, he crawled under too and conducted the session right there.

But those girls! They were like a team of NBA all-stars trooping in to watch a junior college practice. They quickly showed us their tricks: One inserted needles in the pupils of her eyes; another plastered her face with chalky makeup and walked around the Inn with her eyes closed and arms extended, a Kabuki somnambulist. A third became a member of my therapy group (Subgroup C), and she enlivened the proceedings by screaming at unpredictable intervals, full-throated operatic screams that lasted for fifteen seconds. The arrival of these girls precipitated an avalanche of competitive upsets among the patients, and the nurses had their hands full for a few months. Then these patients, too, "settled in," being human as well as mad.

Dr. Leslie Farber came to Riggs with the new administration. He was an old friend of the director, who lured him with promises of time to spend on his writing. I first saw him when he visited our community meeting, which began with the usual nagging by the nurses and Richard about the work-jobs left undone, the unwholesome hour at which most of the inpatients had gone to bed, followed by the usual silence and then the dribble of patient complaints. Sue M, the lanky Floridian, wanted to know why scrambled eggs could not be substituted for the food offered at every meal, not just breakfast. Howard Z, a new patient housed in the east wing of the Inn, complained that trucks making early morning deliveries to the kitchen were waking him.

Diana D spoke next, from her cross-legged position on the floor, leaning forward from the waist, arching her neck and gesturing extravagantly. Diana's speaking style was expressive and tormented. She would make a stab at saying something, fail, erase the air with flailing palms, cover her face with her hands and rock back and forth on her haunches, then try again. Today she said: "I ... I don't feel very good about this, but I'm just so uncomfortable. I don't think this is something I can say."

"We're listening, Diana," said Richard. "We want to hear what you have to say."

Diana hesitated. "It's the outpatients," she said. "The outpatients are making me depressed. Especially John Haviland. I wish he didn't have to come into the Inn. I wish he didn't have to eat with us. He's so depressing, the way he eats." John Haviland, wearing a soiled windbreaker, looked up from the piano bench by the window. He was a little man with a built-up shoe. He was often the object of imitations by the late-night crew in the patient kitchen; stuffing a roll of toilet paper down the front of one's pants and locking one knee helped to evoke his off-center lumpiness and his fractured gait. "When they're around, the older ones, I feel like that's how I'm going to end up, and I don't want to have to look at that. I don't really think I should have to."

I had been stealing looks at Dr. Farber, who sat quietly in the wing chair by the fireplace. I had noted that he was slightly plump, balding, and middle-aged, with an elfin-Semitic face and an air of masculine elegance that none of his constituent physical parts accounted for. (Later I learned from him how he felt about his embodiment: "a fat little Jewish dentist," he said, quoting a former patient.) In the silence after Diana's remarks, I slid my eyes in his direction again and saw on his face an unmistakable expression of shocked contempt. His eyebrows were arched, his lip curled, his nostrils distended.

This look jolted me. I knew instantly that Dr. Farber was a different kind of being from the other therapists. His was not the neutral watchfulness I had become so used to; he judged, and revealed his judgment. This was striking enough, but it was really just the first layer of my reaction. I also sensed, if obscurely, that he was a person whose way of looking at the world--unlike that of any therapist I had encountered--was integrated with, and undetachable from, his self.

I learned later that Dr. Farber was well known not only in psychoanalytic circles but in the wider intellectual world as well. He was a maverick, humane and cultivated, who challenged his colleagues to confront what the science of psychology had refused to acknowledge--the inextinguishable presence of will in human behavior.

In one of his essays Dr. Farber compared the psychoanalyst to Kierkegaard's "systematizer," a man who has spent decades building a splendid mansion, a great multistoried edifice with wings flung out in every direction. But when the man has finally completed his dream house, he settles contentedly into a shack next door. In Dr. Farber's view, the house of psychoanalysis was impressive but unfit for human habitation.

Dr. Farber's face, its expression that afternoon, was a life lesson for me, the first I had received since I willingly immured myself at Riggs, a very dense, impacted lesson that I would spend years absorbing and have yet to learn completely.

I made an appointment with Dr. Farber immediately, and once seated in his office I wasted no time in blurting out the story of Dr. S and the driving lessons and the baby Mrs. S had just given birth to and the arm around my waist and his tears. I felt some terror as I spoke; Dr. Farber's dour expression was not encouraging. He heard me out without interruption, though, and when I was finished he agreed it would be impossible for me to continue in therapy with Dr. S. Which doctors on the staff would I consider compatible? I didn't really know, I said. They seemed kind of indistinguishable from one another. Would he, Dr. Farber, take me on as a patient? No, he said; his docket was already full. We sat in silence for a few minutes.

Next Dr. Farber startled me by asking what I thought of Washington, D.C. He had just come from there, he said, and he had noticed a Washington address in my file. I stalled, floundered. What could this question mean? Finally I said that I liked Washington, although it was kind of a weird city. He nodded gravely. It is kind of weird, and I like it too, he said. He added that he was having some trouble adjusting to Stockbridge. Did anybody actually work around here, or were the townspeople all models for Norman Rockwell? I laughed explosively. A joke!

We went on to talk about other subjects. Poetry: Did I like John Crowe Ransom, a special enthusiasm of his? Yes, I did, I replied, although I had never read or heard of John Crowe Ransom. Dr. Farber stubbed out his Camel and propelled himself headlong out of his chair so abruptly that for a moment I feared he was having a seizure. He rummaged in one of the cardboard boxes that surrounded his desk--he was still unpacking his library--and drew out a book. He tossed it to me, and I caught it two-handed. Take it, he said. You can return it when you come back to talk to me next week. He moved to the door and opened it. What about therapy? I asked, rising from my seat. Do without therapy for a while, he said, ushering me out. Just come back next week and we'll talk.

My father was understandably outraged when he learned that I had gone without therapy for three weeks. Just talking, he shouted over the phone, at eighty dollars a day? Just chatting? He handed the receiver to my mother.

I read the Ransom anxiously, preparing myself to be quizzed, but when I awkwardly rose from my chair in Dr. Farber's office to hand back the book--even the simplest physical transactions between patient and therapist made me self-conscious--Dr. Farber took it, opened and leafed through it, reading passages aloud in his fine deep voice, smiling, shaking his head in confounded admiration. "The curse of hell upon the sleek upstart," he read,

That got the Captain finally on his back And took the red red vitals of his heart And made the kites to whet their beaks clack clack.

(I copy these lines from the same Vintage paperback Dr. Farber threw at me more than thirty years ago, one of many books he lent me and that I never returned.) Involuntarily, in a burst of delight, I clapped my hands and repeated "clack clack." I blushed. Dr. Farber smiled his odd, wounded smile, and we lapsed into a long, for me unnerving, appreciative silence.

I was desperately eager to please Dr. Farber, but the open-endedness of our arrangement made me so anxious that my conversational timing was thrown off. I sensed that he was wavering in his refusal to accept me as a patient, that I was being auditioned, and the more urgently I wished to pass this obscure test, the more clumsy and aggressive my efforts to win him became. Too shy and fearful of rejection to plead, I sometimes veered off into truculence, imposed my own attention-demanding silences. I wanted to talk about Dr. S, my parents, myself. So we talked about these things, but in a novel kind of way. I told him the particulars of the mess that had precipitated my suicidal gesture--the boyfriend and his mother, the train ride from Indianapolis to Washington when I lay in a roomette and wept myself sick. And instead of inviting me to continue with a receptively neutral psychoanalytic silence, he forthrightly responded with an anecdote from his own life. He told me about the breakup of his first marriage, the car trip he took from San Francisco to New York, driving for eighteen hours a day and collapsing in roadside motels for six. I hung on these stories, these amazing offerings, but when they ended I lapsed into panic. What now? How was I to respond? And could any response be adequate? I wanted to lift Dr. Farber's confidences out of the hour, out of their contextual bedding, and take them home with me to gnaw on in private, extract all the nourishment to be had from them.

Did I like Joanne Woodward? This one came from far left field. Did I? I asked myself, and rummaged frantically in the underused opinion-forming sector of my mind. Finding no readymade response, I asked myself what movies I had seen in which Joanne Woodward appeared. I knew I'd seen some, but my memory was clouded and roiled with anxiety. I called up an image of Joanne Woodward's face. Yes, I said. It's her face I like. It's plain and handsome at the same time. It's very direct. Yes, said Dr. Farber, with gratifying emphasis. That's the thing about her, all right. And we went on to talk about Joanne Woodward movies, a few of which, now that I had relaxed, bobbed up naturally onto the surface of my recollection.

Thus does the despairer appear before us to ask that most extraordinary and truly diabolical question--especially when addressed to a psychotherapist--"is there any good in talking?" After this, we may recover our composure and succeed in engaging him imaginatively, so that real talk does, after all, begin to come about. Despite his absolute certainty of a few moments before that even momentary relief from the torment of despair was no longer possible, his despairing self-absorption may yield to forthright interest in the subject at hand, a yielding which goes beyond mere distraction. Relief has, in spite of everything, actually been granted him; his despairing certainty has been exposed to the real world of discourse and proved false. We might even say that a minor miracle has occurred. What are we to answer then, when, as the hour nears its end, our patient or friend, preparing to take his leave, turns to us and asks, "But haven't you something useful to say to me--something I can use after I leave here?" If there is an answer to this question, it has not occurred to me.

This passage comes from Dr. Farber's essay "Despair and the Life of Suicide," and it describes exactly the experience of therapy--or friendship; for him the two were inseparable--with Dr. Farber. "The real world of discourse"--this is where we are all free to live when we live outside of systems, but I had lived inside one for a long time. Years of psychotherapy had made me smoothly practiced at collapsing into my components, exposing them for convenient inspection on cue. I had learned to "assume the position" so automatically that Dr. Farber's requirement that I come to our talks as pulled together as possible--ready to exercise judgment, to make distinctions, to listen and respond, to view myself first as a moral and then a psychological being, most important, to tell the truth; to accept the high value he placed on tact, empathy, intellectual substance, wit--all this bewildered me at first. It bewildered me later too. In fact, it bewilders me now all over again, having lived for nearly twenty years after Dr. Farber's death in a culture that has become saturated with therapy, in a world that has become a hospital.

The patient or friend in this passage is in despair, for Dr. Farber a very specific state, which he vividly describes and carefully documents as a drastic spiritual condition that presents its sufferer with an opportunity for redemption at the same time that it provides "fertile soil" for the "intrigues" of suicide." What bothers me when I read this passage is a nagging sense that, at least while I was a patient at Riggs, I never was the patient or friend of whom Dr. Farber speaks here. "[D]espair seems to afflict only those whose relation to life is a serious and potentially responsible one," he remarks later in his essay. I hope I was "potentially responsible," but I don't believe I was "serious" in the way Dr. Farber's hypothetical friend was serious. Despair was not my condition; neediness was. In fact, from my perspective now, in middle age, the story of my attachment to Dr. Farber would seem drawn more likely from the annals of primatology than from philosophy or theology (the latter was Dr. Farber's real stomping ground). It seems plain to me now that while I felt the purest and most ardent admiration for him that I had ever felt for anybody, I was also an unprotected young female trying to find refuge in the care of a "silverback," a dominant male.

Dr. Farber was extremely sedentary; his idea of exercise was to fumble energetically for his lighter when it fell between the cushions of his red leather chair. Now that he and his family had moved to the country, his wife persuaded him to buy a bike and ride it to Riggs in the morning. He fell off the bicycle almost immediately, cracked a rib and broke an arm.

He sat uncomfortably upright, twisted to shield his injured right side from collisions with the arm of his chair, lighting his innumerable cigarettes one-handedly. He looked miserable. After a few minutes of halting monologue, I reverted to the politeness I had been taught in early childhood and suggested he go home. He thanked me, and we broke off the session.

The next week he greeted me with warmth. His arm was still in a sling, but he looked much better. At the end of the hour he announced almost casually that a space had opened up and he would, after all, be able to take me on as a patient.

Dr. Farber insisted that I have a final, civil talk with Dr. S. I protested that I was too angry at Dr. S to speak to him. Dr. Farber suggested that I consider the connection between guilt and anger. I countered with genuine indignation that Dr. S was far more guilty than I. Dr. Farber allowed that, and observed that the greater guilt did not completely mitigate the lesser. I made the appointment and spent an hour with Dr. S. I think he cried, and I do remember walking into his office with the sullen air of a child forced by adults to apologize. Now I want to say to my former self: You didn't need to apologize, you dolt! You needed to ask to see the baby pictures, and to say good-bye.

I had come to view guilt as a noxious psychic by-product, something to be gotten rid of in the interest of health. It took me a while to grasp that Dr. Farber's idea was different: For him guilt was real. It was a moral state rather than a psychological condition.

Dr. Farber's attitude toward me was never the "unconditional positive regard" with which therapists are charged to view their patients. His regard was highly qualified and partial, and it was as real as rock.

* * *

I studied for and passed my GED certification. I took a few night classes at the local community college. I began to read again, mostly books lent to me by Dr. Farber--Goncharov's Oblomov (appropriate for me), Martin Buber's I and Thou , which I still fail to appreciate, poems by Randall Jarrell and Phillip Larkin. I got a summer job in the kitchen of a summer camp. "Girl, we've got to teach you to work ," said the cook, and I quit after a few weeks.

I also began to get myself in trouble with alcohol and bad companions. When night fell we could be found at the Stockbridge Inn, known to regulars as Simmy's, drinking beer and waiting to be picked up. Simmy's was full of local characters, pool-players laid off from their jobs at G.E., reprobates thrown out of their houses by their wives, glumly stewing at the bar, low-life freeriders on the sexual revolution, buying us drinks and dragging a carpe diem line.

I became promiscuous, and I confessed my promiscuity to Dr. Farber. I think I told him about every encounter. His response was surprisingly muted. Again? he would say. Once he called me a "female jerk." He got truly angry only when the man in question was married.

Why did I behave that way? I can think of psychoanalytic explanations: Perhaps I was "acting out" the unconscious feelings that Dr. S's seductiveness had aroused in me, or, more likely, punishing myself for having rejected him and having won Dr. Farber as a protector. I can think of obvious explanations: I was bored, and getting picked up was fun.

I tried out my hypotheses on Dr. Farber. His response was to cut me off. "I'm not interested in that," he would say. His approach, as always, seemed to steer a slalom course around the causal markers I had put in place. Instead he turned the discussion to my drinking and to drinking in general. We talked about the coarsening of feeling, the blurring of distinctions, and the deadening of thought that habitual drunkenness brings about. He also talked about the joy of another kind of nonhabituated drinking. Stop the bad kind of drinking, he advised me, so that you can regain the good kind. You were meant, he told me during one of those talks, for the conscious life.

I carry that around with me still, and also the "female jerk" remark. One negative, one positive--both were his gifts of confirmation.

Then I got pregnant, not by one of my Simmy's pickups but as a result of a brief re-encounter with another patient who had been my boyfriend for a summer.

I had skipped a period, felt sick in the mornings, but I refused to acknowledge my condition until one of the nurses, a local woman with a pungent sense of humor, whacked me on the rear as I stood serving myself in the Riggs dining room and made a remark about eating for two. Then I panicked.

A Pittsfield gynecologist confirmed my condition. There are certain circumstances in which bringing a pregnancy to term may not be advisable, he told me. Do what you can do on your own, and call me in two weeks if you haven't had any luck. Perhaps they can help you at Riggs. I wonder now why I didn't take this as a veiled and provisional assurance that he would give me an abortion (then illegal). That was surely what he meant. Instead, I put emphasis on his instruction to "do what I could."

When Dr. Farber asked me if I wanted my parents told, I said no . I did tell two of my inpatient friends about the pregnancy, though, and soon everybody knew. The director barged into Dr. Farber's office and demanded that my parents be called immediately. The institution would be liable, he insisted, for anything that happened to me. He picked up the phone receiver. Dr. Farber snatched it away, as he later told me, and a physical struggle ensued. The image of a wrestling match between that aging Mutt and Jeff pair seems hilarious to me now, and Dr. Farber's part in it heroic.

Dr. Farber reported to me that the director had suggested a therapeutic abortion. This would require Dr. Farber's assent and his signature on a document attesting to my unfitness to bear and raise a child. Dr. Farber explained his refusal carefully; he could not arrange the abortion because he could not agree with such a statement. I nodded, barely listening. He had raised my hopes and dashed them, but I felt no resentment, no reaction except an acceleration of panic.

I spent a week on the phone, following leads, being scolded long-distance by abortion activists for my past failure to get involved in the issue. Finally I was instructed to dial a New York number, to wait until the phone was picked up and to give my number and area code to the silent person at the end of the line, then to wait for a call. I followed these instructions; the phone rang and a deep, emphysematous male voice told me to be at the Port Authority bus terminal at a certain date and time the following week, standing next to the third phone booth at the Forty-second Street entrance. I was to bring six hundred dollars in cash.

I got the money from the ex-boyfriend, and the two friends in whom I had confided drove me to New York. I waited at the designated place until I was approached by a little man in a green suede cap, who beckoned me out of the terminal and into the back of a limousine, where I was soon joined by an engaged couple from Teaneck, New Jersey. We were all blindfolded and driven to some place in the Bronx (my friends, I learned later, were following in their car). I waited in the parked limousine while the couple was ushered into a building. They emerged a half hour later, the girl walking a little unsteadily, the boy shielding her solicitously with his arm.

Then it was my turn to follow the little man up the back stairs, to shake hands solemnly with "Dr. Adams," to lie down on my back on a linoleum table in a kitchen furnished as sparely as a stage set while five or six radios blared, all tuned to different stations, a crude wall of sound. It was over soon, and I was given pads and an envelope full of antibiotics and allowed to go.

I was delighted to see my friends waiting for me at the end of the block, waving and jumping. They had spent the time eating a late lunch at a nearby Chinese restaurant, and they had saved me an eggroll.

Later that evening I stood dialing Dr. Farber's Stockbridge number, up to my wobbly ankles in sawdust in the back of a West Village bar and steakhouse, full of brandy alexanders and Demerol. Dr. Farber's wife answered and handed the phone immediately to Dr. Farber. "You're all right?" he said. I heard his wife whisper "Thank God!" in the background. Years later, when I got to know her well, she told me that Dr. Farber had spent hours that day in acute anxiety, pacing back and forth in his study.

I launched into a description of my experience, but he cut me off. "Tell me later. You really feel all right?" I feel fine , I said, and I did. I was celebrating my passage through a rite; my friends were treating me with respect and solicitude; the adventure had ended safely and I was high as a kite. At the end of the conversation I said something like "You're really a great guy!" or perhaps "I love you!" I don't remember.

* * *

Many of the things Dr. Farber said have acted on me much later with a "time-release" effect. It was many years after his death when I finally understood his refusal to endorse a therapeutic abortion for me. At the time I had dismissed it, if I thought about it at all, as adult boilerplate, the kind of carefully worded refusal every adolescent recognizes. Now I realized he really meant it . He did not refuse to sign this statement because of a legalistic moral scrupulousness; he refused because he believed I was able, even then, to bear and raise a child.

I'm retrospectively relieved that I had an abortion. I cannot imagine myself in one of my many chaotic apartments, feeding and rocking and changing a baby. Apparently Dr. Farber could, though, and perhaps he was right. But whether or not he was right doesn't matter; what does is his faith in me, which took me more than twenty years to appreciate, or perhaps to accept.

Was Dr. Farber acting out of an antiabortion agenda? He was, after all, a religious man, a private and nonobservant but passionate believer. Was his refusal to endorse a therapeutic abortion an attempt to influence me? No. He was an anti-ideologue and no manipulator. He took the crisis of my pregnancy far more seriously than I did; he understood it as a true dilemma, and he showed a respect for me that I perhaps did not deserve by allowing it to be mine.

Have I found myself, now that I am older and the mother of a living child, capable of guilt about that abortion? Not really. I find I can't advance very far along the path of speculation about alternative fates for that dead fetus without backing up in confusion. The voice of the conceptus is too faint, too garbled and muted by the distance of time and the crosscutting static of possibility for me to hear it clearly. He is no more apparent to me than Dr. Farber's God.

I am just as needy now as I was then. But perhaps by now I've also become the serious friend--the person capable of despair--of whom Dr. Farber wrote. This is the question that continues to haunt me: What would Dr. Farber make of me now? How would he judge the person I've become?

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Mockingbird Years : A Life in and Out of Therapy

046502727X

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