Jarod entered my office and trudged straight to his chair without greeting me. I braced myself.
While staring out the window at strands of fleecy wisteria, he said, 鈥業rv, I have a confession to make.鈥� He hesitated and then suddenly turned to face me directly to say, 鈥楾his woman, Alicia... you remember my talking about her?鈥�
鈥楢licia? We鈥檝e spoken a great deal about Marie, of course, but no, I don鈥檛 remember Alicia. Refresh my memory.鈥�
鈥榃ell, there is this other woman, Alicia, and the thing is... uh... Alicia also thinks I鈥檓 going to marry her.鈥�
鈥榃hoa, I鈥檓 lost. Jarod, back up, and fill me in.鈥�
鈥榃ell, yesterday afternoon, when Marie and I met for our couples therapy session with your Patricia, the shit hit the fan. Marie began by opening her bag, pulling out a sheaf 鈥� a very large sheaf 鈥� of emails, highly incriminating emails, in which Alicia and I discussed marriage. So I decided I鈥檇 better fess up here today. I鈥檇 rather you hear this from me than from Patricia. Unless you鈥檝e already talked to her.鈥�
I was stunned. In the year I had been meeting with Jarod, a 32-year-old dermatologist, we had been focusing heavily on his relationship with Marie, his live-in partner for the last nine months. Though he claimed to love Marie, he balked at commitment. 鈥榃hy should I,鈥� he said more than once, 鈥榦ffer up my one and only life?鈥�
Up to now I had been under the impression that therapy was proceeding slowly but steadily. Jarod had been a philosophy major in college and had originally sought me out because he had read some of my philosophical novels and felt certain I would be the right therapist for him. In the first months of our work together he often resisted therapy through attempts to engage me in abstract philosophical discussions. However, in recent weeks, I saw less of that, and he seemed to have grown more serious and shared more and more of his inner self. Even so, Jarod鈥檚 most pressing issue, his problematic relationship with Marie, remained unchanged. Knowing that it was futile to attempt couples work in an individual therapy setting, I had suggested a few weeks earlier that he and Marie see an excellent couples therapist, Dr Patricia Johnson, whom today, out of the blue, he referred to as 鈥榤y Patricia鈥�.
How to respond to Jarod鈥檚 confession? Several directions beckoned: his crisis with Marie, his having led two women to believe he would marry them, his reaction to Marie鈥檚 breaking into his email account, or his comment about 鈥榤y Patricia鈥� and the fantasies that underlay that. But all these things would have to wait a bit. I considered that my primary task just then was to attend to our therapeutic relationship. That always takes precedence.
鈥楯arod, let鈥檚 go back and explore your very first comment: your statement about needing to make a confession. Obviously you鈥檝e withheld some important things from our work, things that you speak of today only because you believe I鈥檒l hear about them from Patricia. From 鈥渕y Patricia鈥�.鈥�
Dammit, I shouldn鈥檛 have added that last bit. I knew it would divert us, but it just popped out.
鈥楻ight, sorry about that Patricia crack. I don鈥檛 know where it came from.鈥�
鈥楢ny hunches?鈥�
鈥楴ot sure. I think it鈥檚 just that you seemed so keen on her and so effusive in your praise of her ability. Plus she is drop-dead gorgeous.鈥�
鈥楢nd so you thought there was something going on between Patricia and me?鈥�
鈥榃ell, not really. I mean, for one thing, there is a big age difference. You said she was a student of yours about 30 years ago. I did some internet research and learned she鈥檚 married to a psychiatrist, another ex-student of yours... so... I mean... uh... tell you the truth, Irv, I don鈥檛 know why I said that.鈥�
鈥楶erhaps you may have wished it, wished that you and I were in collusion, that I, like you, was engaged in a problematic affair?鈥�
鈥楶谤别辫辞蝉迟别谤辞耻蝉.鈥�
鈥楶谤别辫辞蝉迟别谤辞耻蝉?鈥�
鈥楶reposterous but...鈥� Jarod nodded to himself a few times. 鈥楶reposterous, but probably true. I admit that when I walked in today, I felt exposed and alone, flapping in the breeze.鈥�
鈥楽o you wanted company? Wanted us to be co-conspirators?鈥�
鈥業 guess so. Makes sense. That is, it makes sense if you鈥檙e psychotic. God, this is embarrassing. I feel like I鈥檓 about 10 years old.鈥�
鈥業 know this is uncomfortable, Jarod, but try to stay with it. I鈥檓 struck by your word 鈥渃onfession鈥�. What does it say about you and me?鈥�
鈥榃ell, it says something about guilt. About something I鈥檝e done that I hate to admit. I avoid telling you anything that would tarnish your view of me. I have a lot of respect for you... you know that... and I very much want you to continue to have a certain... uh... a certain image of me.鈥�
鈥榃hat kind of image? What do you want Irv Yalom to think about Jarod Halsey? Take a moment and conjure up a scene in which I am attentive to your image.鈥�
鈥榃hat? I can鈥檛.鈥� Jarod grimaced and shook his head as though to rid himself of a bad taste. 鈥楢nd anyway what are we doing now? This all seems off the mark. Why aren鈥檛 we talking about the important stuff 鈥� my tight spot with Alicia and Marie?鈥�
鈥楾hat, too. Shortly. But humor me for a moment. Continue with our discussion of my image of you.鈥�
鈥楤oy, I can really feel my unwillingness. This what you call 鈥渞esistance鈥�?鈥�
鈥業n spades. I know this feels risky, but do you remember my telling you at our first meeting that it was important to take a risk each session? Now鈥檚 the time! Try to risk it.鈥�
Jarod closed his eyes and turned his face toward the ceiling. 鈥極kay, here goes... I see you in this office sitting there,鈥� he turned and, with eyes still shut, pointed in the direction of my desk at the opposite end of my office. 鈥榊ou鈥檙e busy writing, and for some reason my image drifts into your mind. This what you mean?鈥�
鈥楨xactly. Don鈥檛 stop.鈥�
鈥榊ou close your eyes; you see my face in your mind and take a good long look at it.鈥�
鈥楪ood. Keep going. And now imagine my thoughts as I look at your face.鈥�
鈥榊ou think, Ah, there鈥檚 Jarod. I see him...鈥� He seemed more relaxed as he sank into the fantasy task. 鈥榊es, that Jarod, what a fine fellow. So smart, so knowledgeable. A young man of unlimited promise. And so deep, so philosophically inclined.鈥�
鈥楰eep going. What else am I thinking?鈥�
鈥榊ou鈥檙e thinking, What character he has, what integrity... One of the best and brightest men I鈥檝e ever seen... a man to be remembered. That kind of stuff.鈥�
鈥楽ay more about how important it is that I have this image of you.鈥�
鈥極f paramount importance.鈥�
鈥業t seems like it鈥檚 more important for me to have this image of you than for me to help you change, which, after all, is the purpose of your consulting with me.鈥�
Jarod shook his head, resigned. 鈥楢fter what鈥檚 gone down today, it鈥檚 damned hard to refute that.鈥�
鈥榊es, if you withhold crucial information from me, like your relationship to Alicia, it must be so.鈥�
鈥楶oint taken. Believe me, the absurdity of my position is all too evident.鈥�
Jarod slumped in his chair, and we sat briefly in silence.
鈥楽hare what鈥檚 passing through your mind.鈥�
鈥楽hame. Mainly shame. I was ashamed to admit to you that I might not marry Marie when you... we... put in all that hard work together after Marie鈥檚 cancer diagnosis and mastectomy.鈥�
鈥楰eep going.鈥�
鈥業 mean, what kind of a prick leaves a woman who has cancer? What kind of man betrays and abandons a woman because she has lost one of her tits? Shame. A lot of shame. And to make it worse, I鈥檓 a doctor: I鈥檓 supposed to care about people.鈥�
I began to feel some real sorrow for Jarod and spotted an impulse bubbling up in me to protect him from the wrath of his self-accusations. I wanted to remind him that his relationship to Marie was troubled long before she was diagnosed with cancer, but he was now in such decisional crisis that I feared saying anything he might interpret as advice. I have known too many patients in such a state who provoke others, including their therapist, to make their decision for them. In fact, it seemed likely to me that Jarod was covertly prodding Marie to make the decision to break off their relationship. After all, how did she discover those email messages? He must have unconsciously colluded with her; otherwise why hadn鈥檛 he trashed and deleted that correspondence?
鈥楢nd Alicia?鈥� I asked. 鈥楥an you fill me in about you and her?鈥�
鈥業鈥檝e known her a few months. Met her at the gym.鈥�
鈥楢苍诲?鈥�
鈥楤een seeing her a couple of times a week in the daytime.鈥�
鈥極h, can you give me a little less information?鈥�
Perplexed, Jarod looked up at me, noted my grin, and smiled. 鈥業 know, I know...鈥�
鈥榊ou must feel jammed up. This is an awkward and painful predicament. You come to me for help, but you鈥檙e reluctant to speak openly.鈥�
鈥樷�淩eluctant鈥� is putting it delicately. I absolutely hate talking about this.鈥�
鈥楤ecause of influencing the image I鈥檒l have of you in my mind?鈥�
鈥榊es, because of that image.鈥�
I pondered Jarod鈥檚 words for a few moments and then decided on an unorthodox strategy 鈥� one that I had rarely ever used in a course of therapy.
鈥楯arod, I happen to have been reading Marcus Aurelius recently, and I鈥檇 like to read you a few of his passages that seem pertinent to our discussion. Do you know his work?鈥�
Jarod鈥檚 eyes immediately filled with interest. He welcomed this respite. 鈥楿sed to. I read his Meditations in a college course. I was a classics major for a while. But I haven鈥檛 read him since.鈥�
I walked over to my desk to fetch my copy of The Meditations of Marcus Aurelius and started flipping through the pages. For the past few days I had been reading and highlighting passages because of an unusual interaction with another patient, Andrew. At our session the previous week Andrew had expressed, as he had done so many times before, his anguish at spending his life in a meaningless vocation. He worked as a high-salaried advertising executive and hated such meaningless goals as selling Rolls Royce sedans to women wearing Galliano evening gowns. But he felt he had no choice: with advanced emphysema likely to shorten his productive work years, he needed the income to pay for his four children鈥檚 college tuition and to care for his ailing parents.
I surprised myself when I suggested to Andrew that he read The Meditations of Marcus Aurelius. I hadn鈥檛 read Marcus Aurelius for many years, but I did recall that he and Andrew had something in common: Marcus Aurelius, too, had been forced into a vocation not of his own choosing. He would have preferred to be a philosopher, but he was the adopted son of a Roman emperor and was ultimately chosen to succeed his father. So, instead of a life of thought and learning, he spent most of his adult years as an emperor fighting wars to protect the Roman empire鈥檚 borders. However, in order to maintain his own equanimity, he dictated, in Greek, his philosophical meditations to a Greek slave, who entered them into a daily journal meant only for the emperor鈥檚 eyes.
After that session, it occurred to me that Andrew was so diligent he would, without doubt, do a close reading of Marcus Aurelius. Hence, I had to reacquaint myself immediately with The Meditations, and I spent much of my spare time in the previous week savouring that second-century Roman emperor鈥檚 powerful, poignant words and preparing myself for the next session with Andrew, whom I was to see shortly after Jarod.
This was all in the back of my mind when I met with Jarod and, as he spoke of longing for his image to flicker forever in my brain, I grew persuaded that he, too, might be transformed by some of the ideas of Marcus Aurelius. At the same time I doubted my own inclinations: I had on many occasions observed that, whenever I read any of the great life philosophers, I invariably sensed their relevance to many of the patients I was currently seeing and couldn鈥檛 help citing some ideas or passages I had just stumbled on. Sometimes it was useful, but often not.
While Jarod waited, somewhat impatiently, I scanned the passages I had highlighted. 鈥楾his will take just a few minutes, Jarod. I鈥檓 certain there are passages here that will be of value to you. Ah, here鈥檚 one: 鈥淪oon you will have forgotten all things: soon all things will have forgotten you.鈥�
鈥楢nd here鈥檚 the one I was thinking of.鈥� I read aloud while Jarod closed his eyes, apparently in deep concentration. 鈥楢ll of us are creatures of a day; the rememberer and the remembered alike. All is ephemeral 鈥� both memory and the object of memory. The time is at hand when you will have forgotten everything; and the time is at hand when all will have forgotten you. Always reflect that soon you will be no one, and nowhere.鈥�
鈥楢nd this one too: 鈥淪wiftly the remembrance of all things is buried in the gulf of eternity.鈥濃��
I put down the book. 鈥楢ny of these hit home?鈥�
鈥榃hat鈥檚 the one starting with 鈥淎ll of us are creatures of a day鈥�?鈥�
I reopened the book and read again:
鈥楢ll of us are creatures of a day; the rememberer and the remembered alike. All is ephemeral 鈥� both memory and the object of memory. The time is at hand when you will have forgotten everything; and the time is at hand when all will have forgotten you. Always reflect that soon you will be no one, and nowhere.鈥�
鈥楴ot sure why, but that one sent some shivers down my back,鈥� Jarod said.
BINGO! I was delighted. Just what I had hoped for. Maybe this was an inspired intervention after all. 鈥楯arod, put other thoughts aside, and focus on that shiver. Give it a voice.鈥�
Jarod closed his eyes and appeared to sink into a reverie. After a few moments of silence, I again prodded him.
鈥楻eflect on this thought: All of us are creatures of a day: the rememberer and the remembered alike.鈥�
Slowly Jarod, eyes still closed, responded. 鈥楻ight now I have a crystal-clear memory of my first contact with Marcus Aurelius... I was in Professor Jonathan Hall鈥檚 class in my sophomore year at Dartmouth. He asked me for my reactions to Part 1 of The Meditations, and I posed a question that surprised and interested him. I asked, 鈥淲ho was the intended audience of Marcus Aurelius?鈥� It is said that he never intended for others to read his words and that his words expressed things he knew already, so to whom exactly was he writing? I recall my question launching a long, interesting class discussion.鈥�
How annoying. How very annoying. How typical of Jarod to attempt to involve me in an interesting but distracting discussion. He was still trying to embellish my image of him. But over my year of work with him I had learned that it was best not to challenge him at times like this but, instead, to address his question directly and then gently guide him back to the issue.
鈥楢s far as I know, the scholars have felt that Marcus Aurelius was repeating these phrases to himself primarily as a daily exercise to bolster his resolve and to exhort himself to live a good life.鈥�
Jarod nodded. His body language signified satisfaction, and I continued, 鈥楤ut let鈥檚 return to the particular passages I cited. You said you were moved by the one that began: 鈥淎ll of us are creatures of a day; the rememberer and the remembered alike.鈥濃��
鈥楧id I say I was moved? Perhaps I did, but for some reason it leaves me cold now. Honestly, right now, tell you the truth, I don鈥檛 know how it applies to me.鈥�
鈥楳aybe I can help by recalling the context for you. Let鈥檚 see, 10, 15 minutes ago, when you described the importance of my having a certain image of you, it occurred to me that certain Marcus Aurelius statements might be illuminating for you.鈥�
鈥楤ut how?鈥�
How irritating! Jarod seemed oddly obtuse today 鈥� ordinarily he had such a nimble mind. I considered commenting on his resistance but ruled that out because I had no doubt he would have a clever rebuttal and it would slow us down even more. I continued to plod along. 鈥榊ou place great importance on my image of you, so let me read the beginning of this one again: 鈥淎ll of us are creatures of a day: the rememberer and the remembered alike.鈥濃��
Jarod shook his head. 鈥業 know you鈥檙e trying to be helpful, but these stately pronouncements seem so off the mark. And so bleak and nihilistic. Yes, of course we are but creatures of a day. Of course everything passes in an instant. Of course we vanish without a trace. That鈥檚 all pretty obvious. Who can deny it? But where鈥檚 the help in that?鈥�
鈥楾ry this, Jarod: keep in mind that phrase 鈥淭he time is at hand when all will have forgotten you,鈥� and juxtapose that to the vast importance you place upon the persistence of your image in my mind, my very mortal, evanescent, 81-year-old mind.鈥�
鈥楤ut Irv, with all respect, you鈥檙e not offering a coherent argument...鈥�
I could see Jarod鈥檚 eyes sparkling with the prospect of an intellectual debate. He was in his element as he continued, 鈥楲ook, I鈥檓 not arguing with you: I accept all is ephemeral. I have no pretence of being special or immortal. I know, like Marcus Aurelius, that eons of time have passed before I existed and that eons will go on after I cease to be. But how does that possibly bear on my wish for someone I respect, in other words, you, to think well of me during my brief time in the sun?鈥�
Yikes! What a blunder to have tried this. I could hear the minutes clicking by. This discussion was eating up the whole session, and I felt pressed to salvage some part of our hour together. I always teach my students that, when you鈥檙e in trouble in a session, you can always bail yourself out by calling on your ever-reliable tool, the 鈥榩rocess check鈥� 鈥� you halt the action and explore the relationship between you and the patient. I heeded my own advice.
鈥楯arod, can we stop for a moment and turn our attention to what鈥檚 going on between you and me? How do you feel about the last 15 minutes?鈥�
鈥業 think we鈥檙e doing great. This is the most interesting session we鈥檝e had for ages.鈥�
鈥榊ou and I do share a delight in intellectual debate, but I have grave doubts that I鈥檓 being helpful to you today. I had hoped that some of these meditations would shed light on the importance of your desire for me to have a positive image of you in my mind, but I now agree with you that this was a hare-brained notion. I suggest we just drop it and use what little time remains today to address the crisis you鈥檙e facing with Marie and Alicia.鈥�
鈥業 don鈥檛 agree it was hare-brained. I think you were right on. I鈥檓 just too rattled now to think straight.鈥�
鈥楨ven so, let鈥檚 go back to how things stand right now with you and Marie.鈥�
鈥業鈥檓 not sure what Marie is going to do. All this just happened this morning, and right after the session she had to get back to a research meeting in her lab. Or at least that鈥檚 what she claims. Sometimes I think she fabricates excuses not to talk.鈥�
鈥楤ut tell me this: What do you want to happen between the two of you?鈥�
鈥業 don鈥檛 think it鈥檚 up to me. After what鈥檚 just happened, it鈥檚 her call right now.鈥�
鈥楶erhaps you don鈥檛 want it to be your call. Here鈥檚 a thought experiment: tell me, if it were up to you, what would you want to happen?鈥�
鈥楾hat鈥檚 just it. I don鈥檛 know.鈥�
Jarod shook his head slowly, and we sat in silence for the last minutes of the hour.
As we prepared to end, I commented, 鈥業 want to underscore these last few moments. Keep them in mind. My question is: What does it mean that you don鈥檛 know what you want for yourself? Let鈥檚 start from that question next session. And, Jarod, here鈥檚 one more thought to ponder during the week: I鈥檝e got a hunch there鈥檚 a connection, maybe a powerful connection, between your not knowing what you want and your powerful craving for your image to persist in my mind.鈥�
As Jarod stood to leave, I added, 鈥榊ou have a lot going on now, Jarod, and I鈥檓 not sure I鈥檝e been helpful. If you鈥檙e feeling pressed, call me, and we鈥檒l find a time to meet again this week.鈥�
I was not pleased with myself. In a sense, Jarod鈥檚 confusion was understandable. He came to see me in extremis, and I responded by becoming professorial and pompous and reading him arcane passages from a second-century philosopher. What an amateurish error! What was I expecting? That simply reading Marcus Aurelius鈥� words would, presto, magically enlighten and change him? That he would immediately realize that it was his own image of himself, his own self-love, that mattered, not my image of him? What was I thinking? I was embarrassed for myself and certain he left my office far more confused than when he had entered.
Irvin D Yalom is an emeritus professor of psychiatry at Stanford University and a psychiatrist in private practice in San Francisco. He is the author of many books, including Love鈥檚 Executioner, The Gift of Therapy and Staring at the Sun.
Copyright 漏 2015 by Irvin D Yalom. Extracted from Creatures of a Day: and other tales of psychotherapy by Irvin D Yalom, published by Piatkus