Week 5: Paul & Adele

Paul drives up to a house and says it doesn’t look like a habitrail(a special kind of enclosure for hamsters). It is Steve’s house. Max tells him Steve thinks about the environment and Paul says that is something they have in common. That both he and Steve love Max and it’s okay for Max to love him back.Max is afraid Paul will be lonely. Paul tells him he doesn’t have to worry about him. How do I know, Max asks. Paul says he will call him all the time and they have a week in January. He wants Max to promise he won’t worry about Paul. They go up to the house.Paul declines an invitation from Steve to stay for coffee and leaves. 

Paul arrives a bit frazzled at Adele’s office and is late due to traffic driving back. Paul has ibuprofen that he says he will keep it there for when he needs it. He asks if they have half a session and she says if that. Paul says he talked with Max. He says he did it thanks to Adele. He was clear Max wanted to be in Maryland, that he had come because he was worried about Paul. Adele asks if it happened so fast. Paul says he wanted to get it over with. Paul tells her Steve asked him inside for coffee and that he seemed okay. That he looked like dad -- unlike you, Adele says. She asks if he went in but he says he couldn’t, he had to get out of there. Adele says it was hard to see Steve’s ease with Max. Paul says it was hard to walk away and leave Max there with him. 

Adele asks what happened that let that happen, Paul tells her about when they were making pancakes and Jesse appeared. Paul tells her what happened. Adele asks if it were easier to deal with Jesse in his office than with Max. Adele says he talked with Max after Max set the pan on fire. Paul thinks she is focusing on what she thinks is a mistake he made. She says she is aware of his need for her to see he is in pain. She says the more clearly she sees his pain, the less likely he feels she will criticize it. She says she has some questions about what he did with Max. What made it so urgent…

Paul interrupts and says she is avoiding what he said last week. He wants her to talk about what is happening in the moment and that she has not mentioned what happened last week. He wants her to say what it is. She asks if he is hurt that she hasn’t brought that up. He says he has spent most of the week concentrating on Max, that she wasn’t on his mind at all. But the thoughts about her came back as he was driving back. He realized that the only person he wanted to see in NY was Adele. He is supposed to meet Wendy for dinner but he doesn’t think he can do it. But he knew she would understand. Adele reminds him that he dismissed those feelings as ridiculous last week. He says maybe this is something more than transference, that in some other situation they might make each other happy. She asks how? He says he knows it is impossible. She asks if the impossibility of such a relationship is what makes it possible for him to contemplate it? He says he doesn’t feel safe. She asks what does he mean when he says they might make each other happy? He says he feels they could have dinner after work, a glass of wine, talk about their work. Anything else, romantic? He asks if that is so crazy? He tries to link it to work. She says no, that is not crazy. He says he wants to talk about Sunil. She asks if that is the kind of conversation he imagines were they in a relationship. She tells him they are just about out of time but Paul rolls on about Sunil.  He asks her what he should do and she says she can’t answer that. Adele says they can schedule another appointment. He says he doesn’t need another appointment. He says he knows he is her last appointment. He says he watched last week. He says he needs a few minutes to address Sunil. She says he wants to talk about his patient and not about standing outside her building. She holds the line on time. She offers him several times next week. He says he goes 5 or 10 minutes over as needed with his patients. He pushes hard with her. He yells why is she so rigid? She says that whenever she tries to point out his actions he gets defensive and angry. He tries to make her anything except his therapist. She says he has no idea how paralyzed he has become. She ticks off the things she sees that indicate this but she can only do that with him and within the time frame and she urges he come twice next week. He says he can’t do that. She says they need to stop and she stands up. He goes to leave and she reminds him about the pills. He gets them and leaves, leaving the door open.

Did you think about Laura from Season 1 as you watched this week’s session with Adele and Paul? Because I did. And I am glad because this is a good example of how this kind of transference doesn’t need anything untoward from the therapist  for it to develop. Adele has been quite impeccable with the frame and boundaries. 

Paul tries everything to get Adele to do what he wants, be what he wants her to be -- from bringing his own bottle of ibuprofen to leave there because she didn’t provide it for him to pushing to get her to talk with him about his patients to pushing to go beyond the time limit of the session. I loved his petulant complaint that he often goes 5 or 10 minutes over time with his patients when they need it, just a s a whiny child might complain. I suspect though that Paul’s transference is not particularly erotic, but more likely a maternal one. He wants a good mother who will take care of him, unlike his own mother who required his care when he needed her.

Paul would far rather talk about his patients or about Adele than about his feelings and fears. He changes the subject whenever Adele tries to turn the focus to him. So he resists talking about Max, about what he was feeling when Jesse appeared. And we do not know what made it so urgent tat e drive Max down to Baltimore on Friday, risking missing or being late for his appointment with Adele, rather than waiting until Saturday. 

Adele was able to hold the line with Paul at the end of the session, to stay with the time boundary, despite his efforts to get his way and have more time. This can be very difficult. In this kind of situation, the therapist has to be willing to let the patient be angry and upset and not getting his way and she also has to be willing not to yield to her own impulses to try to comfort or make him feel better. Ultimately by holding the frame as she did, she makes herself more trustworthy. However, some patients will leave when the therapist is firm. Robert Langs talks about such patients as people seeking what he calls “lie therapy”, that is a therapist who will collude with them in what they want rather than confront the patient. It remains to be seen whether or not Paul will respond well to the boundaries Adele has set. Given the way he was with Gina, I am not altogether optimistic.

© Cheryl Fuller, 2018. All  rights reserved.