Paul is on the phone and is holding Gina’s book.  He is in a waiting room of another doctor. He and Wendy are discussing arrangements for the evening. Adele comes out and introduces herself and we meet his new therapist.

Paul is on the phone and is holding Gina’s book.  He is in a waiting room of another doctor. He and Wendy are discussing arrangements for the evening. Adele comes out and introduces herself and we meet his new therapist.

Her office is bright, light and modern. Paul comments on that right away and says his office is dark and burrow-like. Paul looks awkward and uncertain about how to begin. Adele reflects that he doesn’t want to be there. He called, he says, because he needs a refill of his Ambien prescription. His doctor in Baltimore had been refilling it but won’t now. So he called her because she is in the neighborhood and had an opening. He reports he has been Ambien every night for 14 months. Paul becomes irritated by Adele’s questions and tells her he had run out on Wednesday and hadn’t slept since Tuesday night. Paul says he didn’t expect her to be so young. She asks about his sleep — he says he wakes up after a few hours. His college friend referred him, he says, and she remarks that his friend is an excellent doctor. He again attacks her age by saying he thinks she couldn’t know how excellent his friend is because she is so young. His hostility is clear. She remarks about his repeated statements about her age. Paul just wants the prescription. He says he has been in therapy for 20 years and when she asks,  he says  it was with Gina whose name she does not recognize. Paul needs to tell her how important Gina is and says he saw her first for supervision then she became his analyst. And that she had also seen his ex-wife. All of this feels like jousting. She asks if he is an analyst and he says yes.

Adele returns to his sleep. He said the problem started as trouble falling asleep and he would take a pill and sleep. But now he wakes up. She asks what that wake time is like. He says he has always had trouble sleeping. She wants to know more — does he dream, have nightmares. Paul says for a while he has been waking up with a recurring dream but he knows what it is about. She reflects that he does not want to tell her and he says no he doesn’t. She asks what he thinks the dream is trying to tell him. Paul refers to Frances coming at the beginning of the week. He goes on talking about her. And that he reacted to her talk about the breast cancer gene. Paul looks at his hand and Adele sees he is afraid he has Parkinson’s, like his father. Adele asks about the fear which Paul says is not a fear, but a fact. He believes his unconscious has been trying to get him to stop ignoring the symptom. Paul angrily resists talking about any of this, saying he has already been over all of it with the best analyst. Adele says — Gina was your teacher, then your supervisor, then your analyst and saw your ex-wife? Paul asks why she asks and she says she just wanted to know more about how “the best analyst on the east coast practices”. Paul again angrily attacks her age. She observes he looks distressed — he says of course he is — he is divorced, estranged from his children, facing confinement to his chair. She gets more medical info and then Paul defends Gina, that what she did was good. Adele again apologizes.

She asks what it feels like to be reading his analyst’s novel. He waxes rhapsodic about Gina. He says he can imagine what Adele sees — that his bringing in the book was a security blanket. Adele asks how it feels to read the high praise of the blurbs he shares with her. He says he is pleased for Gina. Adele asks what he is jealous of. That she has escaped patients like me, he says. Adele asks why she would feel that and he says Adele likely feels that way already. Paul admits he sometimes feels that way, and that Gina was disgusted to hear that when he told her. Paul says patients become oppressive, the work becomes oppressive. He talks a bit about Jesse. He shares with her that Jesse told him about the message from his mother, that sometimes they make real contact and then Jesse goes into the world and it all implodes. Adele asks if he doesn’t think the listening matters. Then Paul talks about Sunil — saying he has the loneliest face he has ever seen because all he wants is for his wife to come back.

Adele asks if outside his office he has anyone to talk to. She observes that all of his significant attachments have ended. Paul says he does have Wendy. Adele asks if that was who he was talking to on the phone and why he told her he was in the grocery store. Paul says Wendy is 35 and he is 55 and he  doesn’t want to tell her yet about Parkinson’s. Adele says he isn’t seeing her for that and he says it is all related. Parkinson’s, the dream and not being able to sleep.

Adele ends observing that he used the same language of escape and entrapment about Sunil, about Gina and she wonders if the dream does also. He denies this, takes the prescription and goes.

At the very end, Adele reflects that  he had the dream again last night  but said he had figured out what it means  — so why he would have it again. She says if he decides he would like to talk again, the door is always open. He arrives home to find Max sitting on the stoop. He asks what he is doing there and Max says he came to live with him.

Any thought we had that Paul’s prickliness with Gina was just due to their complicated history flies out the window as we see him fence with Adele. He is angry and defensive. It seems that Gina’s importance in the field satisfied his need to be special and now to see a woman who is younger and less experienced appears to be a blow to his narcissism, his need to be important. After all, Adele doesn’t even know who Gina is.

It is curious that Paul chose to find a psychiatrist to get a new prescription for Ambien rather than finding a new primary care doctor, who could easily prescribe it for him without expecting him to discuss his therapy history. In fact, I wonder why he has not found a new physician in New York given that he has been there for two years now, unless he keeps the ties to Baltimore as a way to remain attached to his life there. My guess is that he knows he needs help and so selected someone who would ask questions. And Paul has a need to fence with her, likely to determine if she can withstand his attacks without rejecting or abandoning him. Adele looks to me to have passed that test with flying colors.

Note that Paul mentioned all three of the patients we met this week. He knows Sunil’s loneliness and it may well be that he misses Kate in a way he never expected to. He shares with Frances her fear of aging and death and that he, like she, may meet the same fate as his parent. And Jesse who is 16, very close to the age when Paul’s mother committed suicide, abandoning him.  He has the patients he needs to surface his own complexes and problems.

With Adele, who is skeptical about the way Gina and Paul complicated and re-complicated their relationship and may well already see that though Paul believes that he has worked through all of his issues, they actually have barely been touched, we will see Paul having to contend with an actual therapeutic relationship. This promises to be very interesting. Among other things, Paul must deal with his weariness about his work. I hope this is one of the things Adele helps him to explore.

I am also interested to see what else we learn about what Gina wrote and how Paul feels about it. It is not at all unusual for patients of an analyst who publishes to want to read what they write and I am certain Paul is curious.

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