In Treatment -- Walter, week 4

The phone is ringing as Paul comes into his apartment. He finds out that his father has fallen and is in the hospital. As he puts the phone down, he sees in the paper that Walter has lost his job.

Walter is dressed in a sweater and looks depressed. He tells Paul he should be glad he no longer has his phone or Blackberry. He finally has the time to talk but believes that Paul can no longer help. Paul suggests maybe he can. Walter says he has lost his job, his good name and when he leaves the house, a pack of reporters mobs him. He says he followed the Johnson & Johnson model for handling the crisis, that he did everything right. And so the class action lawyers and his enemies within the company came after him. He says now he feels like an old man too long in the ring.

Paul asks if he is eating and sleeping all right. He is eating some and sleeps with medication. He is taking clonapine -- he takes maybe 3 a day and Paul asks if that is the prescribed dosage. He says he wants to wake up and find the past two months have been a nightmare. Paul gently asks about suicidal ideation. Walter denies he would do that because of what it would do to his wife, who bursts into tears every time she looks at him.

His wife had called Paul because she is worried about him. Walter does not find it comforting that people are expressing sympathy and he had to promise his wife he would come to see Paul. Paul suggests that he imagines it must feel like he is going through some kind of crucible. An old friend who has gone through something similar has reappeared in his life and tells him about having taken up photography. He gave him a book of photos of a town in PA that is burning from underground fires. He says he threw the book out a soon as his friend left, thinking he was an old fool for having made it. 

Paul says it sounds like he believes his life is over now. Walter asks Paul what he thought of him when he first came to see him and then proceeds to tell him that Paul saw him as greedy, a man who let babies die. Paul says on the contrary he is angry about what has happened to Walter, at how he has been treated. He tells Paul about trying to teach students that once a company loses its name, it has lost everything. Paul asks if that is what has happened to him and what of loyalty -- why hasn't Mr. Donaldson been loyal to him? Walter wants to believe the father didn't want it but had to yield to pressure. When Walter went to see him, all he did was say too bad and wished him luck. After 35 years, that was it. Paul is astonished -- Walter made him one of the richest men in the country and that is all he got? Donaldson also asked him why his daughter was in Rwanda. Paul suggests that by going to Natalie when he did, he was trying to bring both crises -- the business and with Natalie -- to a head. Natalie thinks he was guilty and Walter believes Paul and everyone else thinks so too -- because, as Paul points out, Walter believes he is responsible despite having done everything he could. Paul points out that Walter talks about the elder Donaldson as if he were a father. And that he does not want to look at his role in it. Walter did the same thing when his brother died. Walter says it was his fault, his fault that his brother died. Tommy came to him before he went out one night to jump into he quarry and he told him he could do it. Tommy died that night and Walter felt responsible because he told him he could do it. And with that his family was destroyed.

"There are lots of them, destroyed families", Walter says. Paul asks if he is all right. He urges Walter to come in the next day. Or soon thereafter. Walter refuses and leaves. 


Walter is deeply depressed and unwilling to accept any help. He actively rebuffs any effort Paul makes to express empathy for his situation or to ally with him. This has been a consistent theme with Walter who is determined to be the one responsible for whatever goes wrong. Working with someone like Walter is very difficult because of his efforts to thwart any efforts by the therapist to align with him. The relationship with the therapist is the vehicle for what happens in therapy and when the patient insists on keeping the therapist away, it is easy to become frustrated and discouraged. Therapists are not free of the normal desire to feel wanted and accepted, even though we do our best to be conscious of this and not act based on it.

The whole session has an ominous air to it. Walter's depressed mood. His efusal to allow Paul to help at all. His rejection of any more positive way to view his situation. His remark at the end -- "There are lots of them, destroyed families." And his outrage at Paul's suggestion that he was not responsible for his brother's death nor solely responsible for what happened with his company. Paul is clearly concerned about Walter's risk for suicide which is why he tried to get him to commit to an appointment the next day or to let him consult with his physician. The circumstances make it allowable and even expectable that Paul should warn Walter's wife of his concern, though given the tenuous nature of the therapeutic relationship with Walter could be a risky thing to do.


© Cheryl Fuller, 2016. All  rights reserved.