LOVE'S. EXECUTIONER. And Other Tales of. Psychotherapy. IRVIN D. YALOM. Basic Books, Inc., Publishers. NEW YORK. Love's Executioner: & Other Tales of Psychotherapy by Irvin D. Yalom Love's Executioner: & Other Tales of Psychotherapy PDF Love's Executioner: & Other. Synopsis book The collection of ten absorbing tales by master psychotherapist Irvin D. Yalom uncovers the mysteries, frustrations, pathos, and humor at the heart of the therapeutic encounter. In recounting his patients dilemmas, Yalom not only gives us a rare and enthralling.
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Editorial Reviews. Review. “Dr. Yalom demonstrates once again that in the right hands, the stuff of therapy has the interest of the richest and most inventive. Love's executioner and other tales of psychotherapy urn:acs6: lovesexecutioner00yalo_0:pdfdd9be-f4cb3ac-d1c5ecae8bb9. Get this from a library! Love's Executioner.. [Irvin D Yalom] -- The collection of ten absorbing tales by master psychotherapist Irvin D. Yalom uncovers the.
And yet, time after time, I have seen this group exercise evoke unexpectedly powerful feelings. Often, within minutes, the room rocks with emotion.
Men and women—and these are by no means desperate or needy but successful, well-functioning, well-dressed people who glitter as they walk—are stirred to their depths. I want to be loved, to be respected. I want my life to mean something.
I want to accomplish something. I want to matter, to be important, to be remembered. So much longing. And so much pain, so close to the surface, only minutes deep. Destiny pain. Existence pain.
Pain that is always there, whirring continuously just beneath the membrane of life. Pain that is all too easily accessible. Many things—a simple group exercise, a few minutes of deep reflection, a work of art, a sermon, a personal crisis, a loss—remind us that our deepest wants can never be fulfilled: our wants for youth, for a halt to aging, for the return of vanished ones, for eternal love, protection, significance, for immortality itself.
It is when these unattainable wants come to dominate our lives that we turn for help to family, to friends, to religion—sometimes to psychotherapists. In this book I tell the stories of ten patients who turned to therapy, and in the course of their work struggled with existence pain.
This was not the reason they came to me for help; on the contrary, all ten were suffering the common problems of everyday life: loneliness, self- contempt, impotence, migraine headaches, sexual compulsivity, obesity, hypertension, grief, a consuming love obsession, mood swings, depression.
I want! I believe that the primal stuff of psychotherapy is always such existence pain—and not, as is often claimed, repressed instinctual strivings or imperfectly buried shards of a tragic personal past.
However grim these givens may seem, they contain the seeds of wisdom and redemption. I hope to demonstrate, in these ten tales of psychotherapy, that it is possible to confront the truths of existence and harness their power in the service of personal change and growth. Of these facts of life, death is the most obvious, most intuitively apparent.
At an early age, far earlier than is often thought, we learn that death will come, and that from it there is no escape. To adapt to the reality of death, we are endlessly ingenious in devising ways to deny or escape it. When we are young, we deny death with the help of parental reassurances and secular and religious myths; later, we personify it by transforming it into an entity, a monster, a sandman, a demon. Later, children experiment with other ways to attenuate death anxiety: they detoxify death by taunting it, challenge it through daredevilry, or desensitize it by exposing themselves, in the reassuring company of peers and warm buttered popcorn, to ghost stories and horror films.
As we grow older, we learn to put death out of mind; we distract ourselves; we transform it into something positive passing on, going home, rejoining God, peace at last ; we deny it with sustaining myths; we strive for immortality through imperishable works, by projecting our seed into the future through our children, or by embracing a religious system that offers spiritual perpetuation.
Many people take issue with this description of death denial. We know that. The facts are obvious. But is there any point to dwelling on it? We know about death, intellectually we know the facts, but we—that is, the unconscious portion of the mind that protects us from overwhelming anxiety—have split off, or dissociated, the terror associated with death.
This dissociative process is unconscious, invisible to us, but we can be convinced of its existence in those rare episodes when the machinery of denial fails and death anxiety breaks through in full force. That may happen only rarely, sometimes only once or twice in a lifetime. Occasionally it happens during waking life, sometimes after a personal brush with death, or when a loved one has died; but more commonly death anxiety surfaces in nightmares.
Though nightmares differ in manifest content, the underlying process of every nightmare is the same: raw death anxiety has escaped its keepers and exploded into consciousness. In my many years of work with cancer patients facing imminent death, I have noted two particularly powerful and common methods of allaying fears about death, two beliefs, or delusions, that afford a sense of safety.
One is the belief in personal specialness; the other, the belief in an ultimate rescuer. Specialness is the belief that one is invulnerable, inviolable—beyond the ordinary laws of human biology and destiny. While the belief in personal specialness provides a sense of safety from within, the other major mechanism of death denial—belief in an ultimate rescuer—permits us to feel forever watched and protected by an outside force.
Though we may falter, grow ill, though we may arrive at the very edge of life, there is, we are convinced, a looming, omnipotent servant who will always bring us back. Together these two belief systems constitute a dialectic—two diametrically opposed responses to the human situation. The human being either asserts autonomy by heroic self-assertion or seeks safety through fusing with a superior force: that is, one either emerges or merges, separates or embeds.
Freedom, another given of existence, presents a dilemma for several of these ten patients. When Betty, an obese patient, announced that she had binged just before coming to see me and was planning to binge again as soon as she left my office, she was attempting to give up her freedom by persuading me to assume control of her. Freedom as a given seems the very antithesis of death. While we dread death, we generally consider freedom to be unequivocally positive. Has not the history of Western civilization been punctuated with yearnings for freedom, even driven by it?
Yet freedom from an existential perspective is bonded to anxiety in asserting that, contrary to everyday experience, we do not enter into, and ultimately leave, a well-structured universe with an eternal grand design. We are free to be anything but unfree: we are, Sartre would say, condemned to freedom. Indeed, some philosophers claim much more: that the architecture of the human mind makes each of us even responsible for the structure of external reality, for the very form of space and time.
It is here, in the idea of self-construction, where anxiety dwells: we are creatures who desire structure, and we are frightened by a concept of freedom which implies that beneath us there is nothing, sheer groundlessness.
If, after all, the problem lies out there, then why should one change oneself? It is the outside world friends, job, spouse that must be changed—or exchanged.
Since patients tend to resist assuming responsibility, therapists must develop techniques to make patients aware of how they themselves create their own problems. A powerful technique, which I use in many of these cases, is the here-and-now focus.
Since patients tend to re-create in the therapy setting the same interpersonal problems that bedevil them in their lives outside, I focus on what is going on at the moment between a patient and me rather than on the events of his or her past or current life. By examining the details of the therapy relationship or, in a therapy group, the relationships among the group members , I can point out on the spot how a patient influences the responses of other people.
Thus, though Dave could resist assuming responsibility for his marital problems, he could not resist the immediate data he himself was generating in group therapy: that is, his secretive, teasing, and elusive behavior was activating the other group members to respond to him much as his wife did at home.
It was only when I demonstrated how, in our hours together, her impersonal, shy, distancing manner re-created the same impersonal environment in therapy, that she could begin to explore her responsibility for creating her own isolation.
While the assumption of responsibility brings the patient into the vestibule of change, it is not synonymous with change.
And it is change that is always the true quarry, however much a therapist may court insight, responsibility assumption, and self-actualization. Freedom not only requires us to bear responsibility for our life choices but also posits that change requires an act of will.
We endlessly clarify and interpret, assuming and it is a secular leap of faith, lacking convincing empirical support that understanding will invariably beget change. You have to try, you know. It is through willing, the mainspring of action, that our freedom is enacted.
I see willing as having two stages: a person initiates through wishing and then enacts through deciding. Some people are wish-blocked, knowing neither what they feel nor what they want.
Without opinions, without impulses, without inclinations, they become parasites on the desires of others. Such people tend to be tiresome. Betty was boring precisely because she stifled her wishes, and others grew weary of supplying wish and imagination for her.
Other patients cannot decide. Though they know exactly what they want and what they must do, they cannot act and, instead, pace tormentedly before the door of decision. She knew that she was, as she put it, living her life eight years ago, and that, to regain it, she would have to give up her infatuation. But that she could not, or would not, do and fiercely resisted all my attempts to energize her will.
Decisions are difficult for many reasons, some reaching down into the very socket of being. Thus, Thelma clung to the infinitesimal chance that she might once again revive her relationship with her lover, renunciation of that possibility signifying diminishment and death.
Existential isolation, a third given, refers to the unbridgeable gap between self and others, a gap that exists even in the presence of deeply gratifying interpersonal relationships. Such isolation is to be distinguished from two other types of isolation: interpersonal and intrapersonal isolation.
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One experiences interpersonal isolation, or loneliness, if one lacks the social skills or personality style that permit intimate social interactions. Intrapersonal isolation occurs when parts of the self are split off, as when one splits off emotion from the memory of an event. While there is no solution to existential isolation, therapists must discourage false solutions.
Many a friendship or marriage has failed because, instead of relating to, and caring for, one another, one person uses another as a shield against isolation. One of the great paradoxes of life is that self-awareness breeds anxiety. Fusion eradicates anxiety in a radical fashion—by eliminating self-awareness. The person who has fallen in love, and entered a blissful state of merger, is not self-reflective because the questioning lonely I and the attendant anxiety of isolation dissolve into the we.
Thus one sheds anxiety but loses oneself. This is precisely why therapists do not like to treat a patient who has fallen in love. Therapy and a state of love-merger are incompatible because therapeutic work requires a questioning self-awareness and an anxiety that will ultimately serve as guide to internal conflicts.
Furthermore, it is difficult for me, as for most therapists, to form a relationship with a patient who has fallen in love. Beware the powerful exclusive attachment to another; it is not, as people sometimes think, evidence of the purity of the love. Such encapsulated, exclusive love—feeding on itself, neither giving to nor caring about others—is destined to cave in on itself.
Love is not just a passion spark between two people; there is infinite difference between falling in love and standing in love.
Though we try hard to go through life two by two or in groups, there are times, especially when death approaches, that the truth—that we are born alone and must die alone—breaks through with chilling clarity. I have heard many dying patients remark that the most awful thing about dying is that it must be done alone. Yet, even at the point of death, the willingness of another to be fully present may penetrate the isolation.
This question plagues contemporary men and women, and many seek therapy because they feel their lives to be senseless and aimless. We are meaning-seeking creatures. Biologically, our nervous systems are organized in such a way that the brain automatically clusters incoming stimuli into configurations. Meaning also provides a sense of mastery: feeling helpless and confused in the face of random, unpatterned events, we seek to order them and, in so doing, gain a sense of control over them.
Even more important, meaning gives birth to values and, hence, to a code of behavior: thus the answer to why questions Why do I live? There are, in these ten tales of psychotherapy, few explicit discussions of meaning in life.
The search for meaning, much like the search for pleasure, must be conducted obliquely. Meaning ensues from meaningful activity: the more we deliberately pursue it, the less likely are we to find it; the rational questions one can pose about meaning will always outlast the answers.
In therapy, as in life, meaningfulness is a by-product of engagement and commitment, and that is where therapists must direct their efforts—not that engagement provides the rational answer to questions of meaning, but it causes these questions not to matter.
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This existential dilemma—a being who searches for meaning and certainty in a universe that has neither—has tremendous relevance for the profession of psychotherapist. In their everyday work, therapists, if they are to relate to their patients in an authentic fashion, experience considerable uncertainty. Indeed, the capacity to tolerate uncertainty is a prerequisite for the profession. Though the public may believe that therapists guide patients systematically and sure-handedly through predictable stages of therapy to a foreknown goal, such is rarely the case: instead, as these stories bear witness, therapists frequently wobble, improvise, and grope for direction.
The powerful temptation to achieve certainty through embracing an ideological school and a tight therapeutic system is treacherous: such belief may block the uncertain and spontaneous encounter necessary for effective therapy. This encounter, the very heart of psychotherapy, is a caring, deeply human meeting between two people, one generally, but not always, the patient more troubled than the other.
Therapists have a dual role: they must both observe and participate in the lives of their patients. As observer, one must be sufficiently objective to provide necessary rudimentary guidance to the patient. As participant, one enters into the life of the patient and is affected and sometimes changed by the encounter.
I must assume that knowing is better than not knowing, venturing than not venturing; and that magic and illusion, however rich, however alluring, ultimately weaken the human spirit. Should I, for example, expect a patient, who asked me to be the keeper of his love letters, to deal with the very problems that I, in my own life, have avoided?
Was it possible to help him go further than I have gone? Should I ask harsh existential questions of a dying man, a widow, a bereaved mother, and an anxious retiree with transcendent dreams—questions for which I have no answers? Should I reveal my weakness and my limitations to a patient whose other, alternative personality I found so seductive? Could I possibly form an honest and a caring relationship with a fat lady whose physical appearance repelled me?
Or forcibly impose my will on a man who, incapable of acting in his best interests, allowed himself to be terrorized by three unopened letters?
Though these tales of psychotherapy abound with the words patient and therapist, do not be misled by such terms: these are everyman, everywoman stories. Patienthood is ubiquitous; the assumption of the label is largely arbitrary and often dependent more on cultural, educational, and economic factors than on the severity of pathology. Since therapists, no less than patients, must confront these givens of existence, the professional posture of disinterested objectivity, so necessary to scientific method, is inappropriate.
We psychotherapists simply cannot cluck with sympathy and exhort patients to struggle resolutely with their problems. We cannot say to them you and your problems. Instead, we must speak of us and our problems, because our life, our existence, will always be riveted to death, love to loss, freedom to fear, and growth to separation.
We are, all of us, in this together.
Perhaps it is because of envy—I, too, crave enchantment. Perhaps it is because love and psychotherapy are fundamentally incompatible.
The good therapist fights darkness and seeks illumination, while romantic love is sustained by mystery and crumbles upon inspection. Yet Thelma, in the opening minutes of our first interview, told me that she was hopelessly, tragically in love, and I never hesitated, not for one moment, to accept her for treatment. Everything I saw in my first glance—her wrinkled seventy-year-old face with that senile chin tremor, her thinning, bleached, unkempt yellow hair, her emaciated blue-veined hands—told me she had to be mistaken, that she could not be in love.
How could love ever choose to ravage that frail, tottering old body, or house itself in that shapeless polyester jogging suit? Moreover, where was the aura of love bliss? So I agreed to treat her because I was certain she was suffering, not from love, but from some rare variant which she mistook for love. Not only did I believe that I could help Thelma but I was intrigued by the idea that this counterfeit love could be a beacon that might illuminate some of the deep mystery of love.
Thelma was remote and stiff in our first meeting. She had not returned my smile when I greeted her in the waiting room, and followed a step or two behind me as I escorted her down the hall. Once we entered my office, she did not inspect her surroundings but immediately sat down. Since then he has never left my mind. I almost killed myself once and I believe I will succeed the next time. You are my last hope. They are often preternaturally revealing and foreshadow the type of relationship I will be able to establish with a patient.
The first was of a young beautiful dancer wearing a sleek black leotard. In fact, I had said nothing at all. I had tried to maintain complete objectivity but she must have noticed some evidence of disbelief, some small cue, perhaps a minuscule widening of my eyes.
I decided not to protest her accusation that I did not believe her. This was no time for gallantry and there was something incongruous in the idea of a disheveled seventy-year-old infatuated, lovesick woman. She knew that, I knew it, and she knew I knew it. I soon learned that over the last twenty years she had been chronically depressed and in psychiatric treatment almost continuously. Much of her therapy had been obtained at the local county mental health clinic, where she had been treated by a series of trainees.
About eleven years before, she began treatment with Matthew, a young, handsome psychology intern, and met weekly with him for eight months at the clinic and continued to see him in his private practice for another year.
The following year, when Matthew took a full-time position at a state hospital, he had to terminate therapy with all his private patients. It was with much sadness that Thelma said goodbye to him.
He was, by far, the best therapist she had ever had, and she had grown fond of him, very fond, and for those twenty months looked forward all week to her therapy hour. Never before had she been as totally open with anyone. Never before had a therapist been so scrupulously honest, direct, and gentle with her. Thelma rhapsodized about Matthew for several minutes. He really cared, he really accepted me. He helped me in the way therapists usually do, but he did a lot more. He taught me to care for all living things.
He taught me to think about the reasons I was put here on earth. He was right in there with me. I could see she liked talking about Matthew. He always called me on my shitty habits. My negative feelings toward him were rapidly growing, but I kept them to myself. After Matthew, Thelma started therapy with other therapists, but none ever reached her or helped her value her life the way he had. Imagine, then, how pleased she was, a year after their last meeting, to run into him late one Saturday afternoon at Union Square in San Francisco.
Francis Hotel. Somehow it all seemed so natural, as if they had shared meals like this countless times before. In reality, they had had a strictly professional relationship which had in no way splashed over the formal patient-therapist boundary.
They had learned to know each other in weekly segments of precisely fifty minutes, no more, no less. But that evening, for reasons Thelma, even now, cannot comprehend, she and Matthew slipped outside everyday reality. Neither looked at the time; they silently colluded in pretending that there was nothing unusual about talking personally or sharing coffee or dinner. It seemed natural for her to adjust the crumpled collar of his shirt, to brush the lint from his jacket, to take his arm as they climbed Nob Hill.
They had chuckled when Thelma said that her husband was out of town: Harry, a member of the advisory board of the Boy Scouts of America, spoke at Boy Scout functions somewhere in America almost every night of the week. Matthew was amused that nothing had changed; there was no need to explain anything to him—after all, he knew everything about her. We spoke on the phone several times a day and saw one another fourteen times. I floated, I glided, I danced.
Her eyes were almost closed, sorely trying my patience. I have never before or since been so happy.
Whatever has happened since then can never erase what he gave me then. He was eating a sandwich and had about twenty minutes before he had to lead a therapy group.
Would you see me? Could we take another walk across the Golden Gate Bridge? Would I be allowed to hug you? At first he returned some of my calls, but then I stopped hearing from him at all.
He cut me off. Complete silence. The lilt was gone from her voice. She was speaking more deliberately, in a bitter, forlorn tone, but there were no more tears. I thought that now she was closer to ripping or gouging than to crying. In one of our last talks he said that we have to return to our real lives, and then added that he was involved with a new person.
This possibility occurred to her a couple of years later when, while taking an out-of-town guest sightseeing, she warily entered a gay bar on Castro Street and was astounded to see fifteen Matthews sitting at the bar—fifteen slim, attractive, neatly mustached young men.
To be suddenly cut off from Matthew was devastating; and not to know why, unbearable. Thelma thought about him continuously, not an hour passing without some prolonged fantasy about him. She became obsessed with why? Why had he rejected her and cast her out? Why then? Why would he not see her or even speak to her on the phone? Thelma grew deeply despondent after all attempts to contact Matthew failed. She stayed home all day staring out the window; she could not sleep; her movements and speech slowed down; she lost her enthusiasm for any activities.
She stopped eating, and soon her depression had passed beyond the reach of psychotherapy or antidepressive medication. By consulting three different doctors for her insomnia and obtaining from each a prescription for sleeping medication, she soon collected a lethal amount. Precisely six months after her chance meeting with Matthew in Union Square, she left a goodbye note to her husband, Harry, who was out of town for the week, waited until his goodnight phone call from the East Coast, took the phone off the hook, swallowed all the tablets, and went to bed.
Harry, unable to sleep that night, phoned Thelma back and grew alarmed at the continual busy signal. Soon they called the police, who stormed into the house to find her close to death.
She assured him she would keep their secret and pleaded with him to visit her in the hospital. Matthew came to visit but stayed only fifteen minutes and his presence, Thelma said, was worse than his silence: he evaded any allusions she made to their twenty-seven days of love and insisted on remaining formal and professional.
Every time I switch therapists, I call to let him know. He never calls back. I keep looking for him when I walk down the street.
I often mistakenly think I see him, and rush up to greet some stranger. I dream about him. I replay in my mind each of our meetings together during those twenty-seven days. My life is being lived eight years ago. I stored it for future use. Not much other therapy has gone on. Talking treatments have never helped. I, of course, kept my reverie to myself. Tell me about that decision. I called five former therapists and told them I was going to give therapy one last chance and asked them who I should see.
So that was one thing in your favor. But I also knew they were your former students, so I checked you out some more. I went to the library and checked out one of your books. I was impressed by two things: you were clear—I could understand your writing—and you were willing to speak openly about death. After this session I had much to think about. First, there was Matthew. He infuriated me. While plenty of patients may need sexual affirmation—those who are markedly unattractive, extremely obese, surgically disfigured—I have yet to hear of a therapist affirming one of them sexually.
It is, of course, the offending therapists who are in need of sexual affirmation and lack the resources or resourcefulness to obtain it in their own personal lives. But Matthew presented somewhat of an enigma. When he seduced Thelma or permitted himself to be seduced—same thing , he had just finished graduate school and thus must have been in his late twenties or early thirties.
So why? Why does an attractive, presumably accomplished young man select a sixty-two-year-old woman who has been lifeless and depressed for many years?
Perhaps the most reasonable hypothesis was that Matthew was working on or acting out some personal psychosexual issues—and using his patient s to do it. I feel little charity for the irresponsible professionals and have urged many patients to report sexually offending therapists to professional ethics boards. I considered, momentarily, what recourse I had with Matthew, but supposed he was beyond the statute of limitations. Still, I wanted him to know about the damage he had done.
I was struck by the tenacity of her love obsession, which had possessed her for eight years with no external reinforcement.
The obsession filled her entire life space. She was right: she was living her life eight years ago. The obsession must draw part of its strength from the impoverishment of the rest of her existence. I doubted whether it would be possible to separate her from her obsession without first helping her to enrich other realms of her life.
I wondered about the amount of intimacy in her daily life. From what she had so far told me of her marriage, there was apparently little closeness between her and her husband. Perhaps the function of the obsession was simply to provide intimacy: it bonded her to another—but not to a real person, to a fantasy.
My best hope might be to establish a close, meaningful relationship between the two of us and then use that relationship as a solvent in which to dissolve her obsession.
But that would not be easy. Her account of therapy was chilling. Imagine being in therapy for eight years and not talking about the real problem!
That takes a special type of person, someone who can tolerate considerable duplicity, someone who embraces intimacy in fantasy but may avoid it in life. Thelma began the next session by telling me that it had been an awful week.
Therapy always presented a paradox for her. Therapy sessions always just stir the pot. They never resolve anything—they always make things worse.
Were these previews of coming attractions? Was Thelma telling me why she would ultimately leave therapy? Years ago I told him that I briefly saw Matthew once by chance. I must have talked too much because later Harry stated that he believed that Matthew was in some way responsible for my suicide attempt. If he ever were to know the truth, I honestly believe he would kill Matthew. He was a British commando officer during the Second World War and specialized in teaching methods of hand-to- hand killing.
I refused to stop dancing to have children, but I was forced to stop thirty-one years ago because I got gout in my large toe—not a good disease for a ballerina. As for love, when I was younger I had many, many lovers. You saw that picture of me—be honest, tell the truth, was I not beautiful? Very few men though there were some were brave enough to love me—everyone was terrified of Harry. Basically your existence is impervious to the fleeting thoughts, to the electromagnetic ripples occurring in some unknown mind.
Try to see that. It offered an introspective look into moments not many of us get to see represented. So I, as a child, am dead. Some day soon, perhaps in forty years, there will be no one alive who has ever known me.
I thought a lot about how someone very old is the last living individual to have known some person or cluster of people. When that old person dies, the whole cluster dies, too, vanishes from living memory.
I wonder who that person will be for me. Whose death will make me truly dead? And though I did not agree with the tactics used in certain tales, I read on in fascination of the differing views of reality presented. Her image took up housekeeping in my mind and defied all my efforts to dislodge it. But, for a time, that was all right: I liked the obsession and savored it afresh again and again. It was only after several days that I realized I was missing everything on the trip—the beauty of the beach, the lush and exotic vegetation, even the thrill of snorkeling and entering the underwater world.And then an event occurred which I chose not to tell you about and which caused me to change my mind.
Her life was being stifled in an airless, windowless chamber ventilated only by those long-gone twenty-seven days. So much longing. Even though she gave no evidence of it, I believe she was relieved.
Love's Executioner : & Other Tales of Psychotherapy
He wants to build a new room for his exercise equipment—O. Throughout, Dr Jalom remains refreshingly frank about his own errors and prejudices; his book provides a rare glimpse into the consulting room of a master therapist. No therapy has a chance if the patient conceals the main issues. I thought a lot about how someone very old is the last living individual to have known some person or cluster of people.
In addition to bringing the reader up close to his patients, and to a process often necessarily cloaked in secrecy, he gives the reader an un-airbrushed picture of the therapist, warts and all. Very few men though there were some were brave enough to love me—everyone was terrified of Harry.
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