A Welcome Diversion

Similarly, if, when I return the call, a person begins to tell me her life story seconds after she asks for an appointment, I know this is someone whose need is great and who has, what we call in the trade, boundary problems. If someone asks what kind of therapy I do and no matter how many questions I answer still has one more, I expect to meet a patient who’s untrusting and controlling.

Bruce Marins’s richly timbred voice on my answering machine caught and held my attention immediately, but it took several rounds of phone tag before we spoke one evening. Meanwhile, the messages he left, his wit, when on the third try we still hadn’t connected, suggested to me a man of considerable humor and intellect, one who was confident of his ability to charm and knew how to use his beautiful voice as an instrument of seduction.

I was intrigued. At the time I had what felt like more than my fair share of patients who came each week to do what I think of as storytelling, a repetitive recitation of their frustrations, sometimes a new story, sometimes an old one, but always the same themes and conflicts, which they seemed incapable of resolving. Everyone has such patients, and each of us finds her own way to deal with them, some more easily than others. But I’ve never met a therapist who doesn’t know what it’s like to look at the clock thinking surely this hour will soon be over, only to find that there are still forty minutes left. One colleague recently confided, “In my mind I split the hour up into ten-minute segments and try not to look at the clock until I’m pretty sure ten minutes have gone by.”

“Does it work?”

She replied with a laugh, “Only if the purpose is to find out just how long ten minutes can be.”

It’s in this context that Bruce Marins presented himself as a welcome diversion. From our telephone contacts, I assumed that I’d find myself in the presence of a man with a fairly heavy dose of narcissism, but I’d worked well with such men and looked forward to the challenge. I also knew that I’d have to watch my countertransference, which already was evident in the way he’d insinuated himself into my thoughts. My warning to myself notwithstanding, I found myself with images of a tall, dark, handsome man, someone whose appearance would match his marvelous voice, as I waited with a frisson of pleasant anticipation for the bell to signal his arrival for his first appointment.

When I opened the door that connects my office to the waiting room, I wasn’t conscious of the habitual welcoming smile on my face. I only realized it was there after I felt it slip away when I beheld the man before me and heard the same melodious voice say, “I wiped that smile off your face pretty fast, didn’t I?” Only this time the seduction was gone, replaced by an edge of mockery.

Me About Yourself

He laughed, an angry challenging sound, and said, “I see this is going to be fun.”

“Why don’t we go in and get started, then,” I said.

“Seems to me we already have,” he replied.

Another point for you, I thought, but I just smiled and said, “Yes, you’re right, so let’s sit down and be comfortable.”

With a nod he moved toward the door, his head bent, his shoulders hunched over the crutches with which he pulled his body along, each step of his withered legs seeming to be an exercise in will. As I watched his slow progress, I was struck by the sharp contrast between the breadth of his well-muscled upper torso and the puny look of the lower half of his body. Finally, his crutches laid carefully on the floor beside him, he sank into the chair I indicated and scanned my face intently as if to see what he could read there.

We sat quietly taking each other’s measure. He held my gaze with an enigmatic smile, and I knew that if I didn’t speak first we would end up in a power struggle that was a lose-lose proposition for the both of us. So I plunged in. “I’m sure you remember the question I asked when we were in the waiting room, and I wonder if you’d care to answer it now?”

“Don’t you want to know something about me first? Every other shrink I’ve ever seen started with some mealymouthed ‘Tell me about yourself.’”

I said I certainly did need to know a lot about him if we were to work together, but that he was right when he said we’d already started something, and it might be best if we tried to finish that first.

“So what do you think we started?” he asked belligerently.

“Well, as I said, I think you set me up to be surprised by your handicap…”

He interrupted sharply, “Dammit, don’t use euphemisms with me. I’m a cripple. Do you think you can say the word, or are we going to have to dance around it so you don’t have to be uncomfortable? Anyway, what would you have wanted me to do, announce on the phone that I’m a fucking cripple so you could get used to it? That’s your problem, not mine.”

He’s right, I thought; what could he have done? One answer, of course, was that he didn’t have to set out deliberately to seduce me. But then that, too, is a part of him, just as his crippled body, and there’s no reason why that part should have gone into hiding. The reality I wasn’t eager to look at, however, is that his refusal to hide his infirmity behind the usual polite civilities forced me into a confrontation with my discomfort in his presence, which until then I’d been able to displace into anger at his behavior.

I’d never had such close contact with a person who was so severely disabled. I was afraid I wouldn’t have the right words, or maybe even the right thoughts. But even as I explained my discomfort to myself, I knew it was more than that. In truth, my feelings were something akin to those I’ve had when seeing a homeless person on the street, a kind of fascination and revulsion at the same time—a sense of outrage that, in the wealthiest nation in the world, people are forced to live on the street, coupled with a wish to turn away, to block it all out of consciousness so as not to have to deal with the morass of guilt, anger, and helplessness the sight stirs.

Talk about countertransference issues to try a therapist’s soul. “As I looked into Bruce’s eyes, I knew that this therapy would be an ongoing confrontation with myself—yet another moment when I was reminded that the therapeutic enterprise can be as much a learning experience for the therapist as for the patient.”

The Ongoing Confrontation

I wasn’t without sympathy for the man who sat before me. But, angry as it made me then, I would learn that Bruce was right in rejecting that sympathy as patronizing, a way of dealing with my own guilt and discomfort and a way of categorizing him, a disabled person, someone to feel sorry for because he isn’t like the rest of us, a man but not quite a man.

Examining these feelings, however, was for another time. In the moment I had to respond. So after wrestling with myself for a few seconds, I replied, “You’re right, that is my problem, and I’ll deal with it. But how we handle this fact of your life and whether we allow it to dominate our relationship and disable our work is our problem.”

His body language softened and some of the tension seeped out of the room. “At least you didn’t throw it all back into my lap.”

I laughed. “I guess that means you have some hope for me.”

He relented, grudgingly allowed as how I deserved an answer to my question, and acknowledged that he had set me up. “It was important to me to see how you’d react because I get so damn much phoniness coming my way, people pretending they don’t see what they see. I didn’t want to have to go through that with another shrink who’s always tiptoeing around. But if you don’t mind, right now I’d like to talk about something else.”

I thanked him for his honesty and asked what was on his mind, assuming that some immediately pressing problem had brought him into therapy. But in fact there was no “something else.” “I don’t mean that he didn’t have problems and conflicts that needed resolution, but so many of them stemmed from his being crippled that this became the central fact of his life and of the therapy we would do together.”

Bruce Marins had the misfortune of lying in his mother’s womb at the time when doctors discovered that Thalidomide, a relatively new drug in this country then, would cure the morning sickness that plagues so many women, his mother included, in the early months of their pregnancy. Eight months after his mother swallowed the pills her doctor prescribed, Bruce was born with both legs deformed, one of the many thousands of children who would become known collectively as Thalidomide babies, some whose bodies were disfigured so grotesquely that any semblance of a normal life was forever closed to them.

Every parent experiences some measure of irrational guilt (What did I do wrong?) when a child is born with even a small defect. But the parents of Thalidomide babies, especially their mothers, bear a special burden of guilt and blame because they know what went wrong and are stuck with the should have, would have, could have scenario that nearly inevitably follows such a tragedy. No matter how often a woman may tell herself that she was following doctor’s orders, she’ll probably never fully escape the fact that she put the pills in her mouth.

Over the years I’ve treated some families of these children and have seen firsthand the psychological devastation the tragedy wrought. Fathers blaming mothers, mothers blaming themselves; couples unable to get past the guilt, blame, shame, and rage. I’ve seen a father turn away from a child because “looking at her hurts too much”; another whose rage at his wife for taking the pills, and at God for allowing his son to live, split the family asunder. I’ve worked with mothers who were so oppressed by guilt they contemplated suicide, and others so depressed that all light had seeped from their world. But Bruce was my first personal contact with an adult who was the victim of that notorious pill.

When I was able to get past my initial response, I saw a man whose dark curly hair, worn fashionably long and well coiffed, made an appealing frame for his strong, square, olive-complexioned face. Intelligence radiated from his blue-green eyes, which were so startlingly bright that I thought they must be the product of colored contact lenses. Not the beautiful prince of my imagination, but a man who could have been very attractive if anger didn’t mark every line of his face. He was impeccably dressed in an expensive charcoal-colored suit, light blue shirt, its sleeves fastened by silver cuff links, and a lightly patterned deep red tie that matched the gemstone adorning the links. “Everything about his appearance bespoke success, yet he oozed an air of anger that made me wonder how he got there.”

From the time he was a small child, he reported, he had been good with both words and images and spent many hours making up stories and drawing pictures to illustrate them. In adulthood, he got started in the advertising business because it was the best job offered to him after college. Now, fourteen years later, he was the West Coast creative director of a well-known ad agency. He still occasionally tried his hand at writing something more serious than advertising copy, but mostly he spent his very limited spare time painting, usually portraits. I listened carefully and admiringly as he laid out both his talents and his successes, and finally remarked in what I thought was a warmly supportive way, “That’s quite a list of accomplishments.”

“Why,” he snapped back instantly, “because I’m a cripple?”

I sighed. “Is there anything I might have said that wouldn’t have generated that response?”

“Not until I’m certain that’s not the unspoken message.”

Was it? My immediate impulse was to say, “No, that’s not it; I’m genuinely impressed.”

Which may have been true. But when I recalled my internal response when I first saw him, I knew it wasn’t the only truth.

I didn’t have to figure it out right then because we were close to the end of the hour and, as is my wont in a first session, I suggested that we stop and talk about how he felt about what went on and whether he wanted to come back. He wasn’t sure, he said; he thought I was “smart enough” but was uncertain whether I had “the stomach” for dealing with him.

“Why, because you’re crippled?”

“Okay, so you proved you can say the word, but it doesn’t tell me a damn thing about whether I can trust you. So the answer is yes, because I’m a cripple and also because I’m a hard-ass son of a bitch.”

I sighed, thinking how attractive his quick wit and keen intelligence could have made him if he didn’t use them like a sword. And I wondered for a moment whether I really wanted to take up the challenge he presented. I already had a couple of patients who were expert at denigrating everything I said and finding inventive ways to defeat our work. Did I really need another one? But in spite of his truculence, something about him caught and held me.

Who knows what mix of emotion and chemistry went into my response to him? Maybe it was, as he feared, pity; maybe it was respect for his struggle; maybe he touched the place inside me that had been a lonely child; maybe I identified with his anger and understood, as I had learned in my own life, that it was partly motivated by fear that a disabling depression lurked underneath it; maybe I sensed that below the surface lived a man I could really like; maybe I knew he had something to teach me about myself; maybe all of the above and more I couldn’t know then. I knew only that I didn’t want him to walk away. “I said as gently as I knew how, “That’s certainly the side you’ve shown me today, but I also see a man who’s dug himself into a hole and covered it up with rage so neither he nor anyone else would have to face his vulnerabilities.””

At this his arm flung out in a gesture as if to wave me away, then he leaned down, grabbed his crutches, pulled himself upright, and made his painful way out of the room, calling back over his shoulder, “I’ll call you.”

I watched him leave, feeling let down and angry with myself. I wasn’t surprised that he was upset, but I had bet that he was strong enough so that whatever anxiety my observation raised would be offset by the reassurance I offered that he was seen and understood. Clearly I’d lost the bet.

Was it too much, too soon? So much of therapy is in the timing, and I know I have a tendency sometimes to move too fast. The same comment or interpretation that’s helpful when a patient is ready can be met with resistance when he’s not. A psychiatrist I saw as a patient a few years ago remarked, when we were ending his therapy, that he had learned a lot about psychotherapy from our work together and that he was much more likely to respond openly to a patient than he had been before. But there were times, he said, when he thought I “shoot from the hip,” and although he could see that it worked most of the time, he wondered about the times when it must have been “disastrous.”

I thought about his words after Bruce left and wondered if this was one of those disasters he foresaw. I hated the thought. It wasn’t just my ego at stake, although I certainly didn’t feel good to think I’d blundered. I was hooked by the challenge Bruce presented, by what I could learn from him, and by my long-standing interest in resilience. I was, at the time, in the middle of a research project in which I was interviewing adults who had transcended seriously difficult childhoods. I had by then learned a good deal about what enables some people to surmount early traumatic experiences while others are felled by them. I was impressed with how Bruce had managed to overcome his infirmity in the professional world, and my clinical intuition told me he was ready to take the next step into his internal world. All I had to do was find the key. But first he had to decide to come back, and there was nothing to do now but wait.

Three days later the wait was over. Bruce left a message saying he wanted another appointment but would prefer not to wait a week. Fortunately I had a cancellation the next day and called back to offer him the hour.

Behind the Not-so-quiet Rage

I laughed, pleased with this indication of self-awareness, but before I could say anything, he leaned forward, his eyes holding mine, and explained that he’d seen three or four therapists before, never for more than a few visits, because none of them was “much of a brain” and “even when they talked, they never had anything interesting to say.” After checking me out he decided I was “smart enough to be worth a try.” Nothing about our first hour, nothing about his feelings when he fled from the room. All in all, not a ringing endorsement, but a beginning.

In the weeks and months that followed we examined his nighttime dreams, his daytime fantasies, his life in the present, and his past experiences in the family and the world outside. His was a middle-class family, financially comfortable enough to, as he said bitterly, “give their kids everything they needed and more, I mean, everything but what a kid really needs.” He had one brother, Pete, three years younger than he, a child who was conceived “to make up for them having me. How the hell can anybody expect a little kid to do that?” he asked, his voice dripping with rancor, as he reflected on Pete’s lifetime of failure.

His father, he recalled, “could never really look at me,” and he was convinced that he wished Bruce had died so he wouldn’t have to deal with having a crippled son. “Of his mother, he said, “As far back as I can remember, she’d look at me with blank eyes, like she couldn’t stand to really see me."”

As angry as he was with his father, it was easier than with his mother because “at least I knew what he wanted: a son who would be the athlete he could be proud of. But my mother just walked around like in a fog. You never knew what the hell would make it okay for her, and believe me, I tried. For years I tried.” He told of the time when he was twelve and spent days writing and illustrating a story, which he made into a book to give to his mother on Mother’s Day. “I thought for sure it would make her happy for a minute, but all she did was look at it and cry.”

Despite his efforts to speak calmly, his pain and sadness enveloped both of us, and I had to struggle to keep my feelings in check and hold back tears. Not that I think there’s anything wrong with allowing a patient to see me as human in that way, but because I knew that Bruce would see any display of feeling as born in pity rather than in empathy and identity, and it would bring down his wrath. So I made what I thought was an obvious comment. “You spent so much of your life trying to make it okay for your mother, it’s no wonder you were worried about having to take care of me.”

He looked startled, his face reddening as he fought to contain the feelings that rose up in him. He wasn’t ready yet to let me see the hurt too clearly, nor could he risk a confrontation with the needy child inside him. What if he let the guard down and found out I was no different from the rest? So he threw me a sidewise glance and said gruffly, “Yeah, I said you were smart.”

I noted, not for the first time, how much being smart meant to Bruce, how important it was to him to believe I was not just smart but smarter than others. It’s not unusual for patients, especially those who lean toward narcissism, to need to believe their therapist is the smartest of all. But it was something deeper for Bruce who, it was clear from the outset, was saved from disaster by the gifts with which he was born. And being smart was high among them. Like other children who transcend early difficulties, he made the most of what he had, using his artistic talent and intelligence to gain success and admiration, first in school then on the job where, unlike in his family, some people at least could see beyond his crippled body.

But none of his successes cooled his angry distrust of the people around him. When a child grows up, as Bruce did, with parents who see him as a cross to bear, he has two options. The most dysfunctional one is to keep knocking on the door that’s closed to him, to make winning their love and approval the cornerstone of his childhood. The other is to make an emotional separation from them long before any child should have to do so and try to compensate with whatever positive experiences and relationships he can find. It’s Bruce’s strength that he did the latter. But to accomplish this difficult psychological task, he bottled up his need for companionship, love, warmth, another’s touch, and corked it with his anger.

I had myself felt the heat of his anger, and I knew how hard it was to deal with his relentless testing. “Time and again, I came up against the barriers he erected to frustrate any approach I made, and I often marveled at how skillful he was at keeping me at bay.” I was certain, therefore, that, consciously or not, he had engineered the failure of at least some of his relationships. His rageful, distrusting behavior, designed to protect himself from the pain of rejection, practically assured the very outcome he feared.

His wariness reached its height around women, with whom he had no relationships at all, neither friendship nor sex. Twice, once in college and once soon after he got his first job, he met a woman who “seemed different.” But he saw deceit, pity, and rejection wherever he turned and the budding friendships ended “in disaster.” In his thirty-six years his only non-commercial sexual encounter was with a high school classmate who, he said, “came on to me so she could brag about doing it with the crip.” Since then, when he needed sexual release and masturbation didn’t satisfy, he sought out a prostitute who did what he wanted “with no pity and no questions asked.”

His relationships weren’t much better with men than with women. He became friendly with a couple of men at college with whom he studied occasionally, but soon bowed out of any social activities because he “felt like a drag on them.” On the job he did somewhat better than in his personal life, largely because he had no choice but to find some way to relate amicably, or at least not disruptively. He managed dealing with workmates by keeping a cool distance and by, he said with a caustic jab at himself, “my rapier wit.” He liked his boss, an older man who recognized and nourished his talent and whom he described as “the closest thing to a father I’ll ever have.” But despite the obvious attachment, except for the social events required by the business, he never allowed the relationship to go beyond the office door. When I asked why, he replied sourly, “Work’s one thing, but nobody wants a cripple hanging around and spoiling the party.”

By then, we had been working together for well over a year. I can’t say we’d established a close rapport, but he wasn’t always angry, he no longer denigrated everything I said, and we could occasionally engage in the kind of wordless communication that can happen when therapist and patient have developed a working alliance. So I said nothing, letting him listen to the echoes of his own words, hoping he’d hear them as I had.

A Turning Point

I shrugged, wordlessly. Finally, he shouted, “You still don’t get it, do you? You’re sitting there with that smug look thinking it’s my problem, but dammit, it’s not that way. You can be sure he wouldn’t want me marrying his daughter.”

It was hard to stay cool, hard not to respond with something like “How can you be so sure when you never gave him a chance?” But a voice inside stepped in with a warning that kept me silent.

“What?” he shouted.

I shrugged again, eyebrows raised, palms turned up.

“Christ, you know I hate it when you do that shrink number. What the hell do you want from me?” His hands raked his hair, his face a mask of the most profound weary pain I’d ever seen.

Inside I was in turmoil. I wanted to move to his side, to take his hand, hold his head to my breast, offer him the comfort and love I knew he needed. Outside I sat quietly, cautioning myself to wait to see where he would go. Finally, his eyes brimming with unshed tears, he spoke in a voice quieter and gentler than I’d ever before heard from him. “I know what you want; I don’t need you to say the words. But it’s so damn hard to give people that chance you’re always talking about. I did that with them [referring to his parents] over and over, and look what it got me. How do I know who to trust?”

It was a critical moment in his therapy, and I had a decision to make. It seemed to me that the time was right, that he wouldn’t retreat from a move, that he was ready for a deeper, more intimate relationship with me than he’d ever had with anyone in his life. But I couldn’t be sure whether it was intuition speaking to me or wishful thinking. I wanted to reach out to him as I would to anyone in such pain, to let him know I was moved by the emotional depth of his response. But what if I was wrong? What if it was too much, too soon? What if I awakened his fear and drove him back into his cave?

I can’t say I made a reasoned choice, but then I don’t think reason is what counts at a time like that. It’s that indefinable something we call clinical intuition that guides every good therapist in these decisive junctures in a therapy. And mine told me to do what felt right and hope it wasn’t one of those shoot-from-the-hip moments.

I can’t say I made a reasoned choice, but then I don’t think reason is what counts at a time like that. It’s that indefinable something we call clinical intuition that guides every good therapist in these decisive junctures in a therapy. And mine told me to do what felt right and hope it wasn’t one of those shoot-from-the-hip moments.I moved to the hassock that separated our two chairs, reached over, took his hand in both of mine, and said softly, “You knew enough to trust me. Why wouldn’t you be able to do that again?”

He looked away but left his hand in place, then, struggling to keep his voice steady, replied, “You’re paid to be trustworthy.”

“Really?” I asked, holding up our joined hands to his view. “Am I paid to do this, too?”

He squeezed my hand and said, “Sorry,” a word I wasn’t sure I’d ever hear him speak.

This was the beginning. Until now we had nibbled around the edges of his psyche. I saw some change in him, largely in the easier way he could relate to me. On the outside, however, his world remained as closed and isolated as ever. But this hour was a turning point. For the first time in his adult life he moved from emotional isolation to intimacy from which he wasn’t impelled to flee. For the first time he believed that someone could see his need and meet it.

Early in our work I had asked to see Bruce’s paintings, partly because I’ve always been interested in art and artists, partly because I thought it might help form a bond between us, and partly because I thought I’d learn something about him that wouldn’t be so easily accessible with words. But he was steadfast in his refusal. “I don’t show them to anyone; I paint them for myself.”

A few weeks after the session in which I’d held his hand and some of his defenses had crumbled, he arrived with a canvas, which he carried pinned against his body as he maneuvered it and himself into the room. “You wanted to see one of my paintings,” he said with no further explanation.

I took it somewhat apprehensively, knowing that this was a gift of trust and that much hung on how I received it. I turned the canvas to me carefully and stood awestruck by its power. It was a portrait of a woman, every line of her body speaking to an agonizingly profound dejection. When I could finally speak, I said exactly what I thought and hoped it was the right thing. “I can’t say it’s easy to look at, but it’s one of the most powerful portraits I’ve ever seen and an absolutely marvelous painting.”

From them on, his paintings became an integral part of the therapy. Every few weeks he brought another one in. Finally, after watching his struggle to get himself and the painting into the office, I asked if he’d like me to drive by his house and pick up a few at a time.

“You’d do that? Isn’t it against the rules?”

I laughed. “If you don’t tell, I won’t.”

It was another defining moment for him, a statement that I cared enough about him and what was clearly his heart’s work to go out of my way to see it. For the next several months we examined the portraits together, appreciated them, criticized them, analyzed them for what they could tell him about himself, his fears, his desires. Far more than his dreams, they held up a mirror to his internal life. His palette was somber, the occasional flash of red or orange serving only to highlight the darkness of the canvas.

Every one of the portraits was stunning, his enormous talent apparent in each stroke of his brush; all were frightening in his vision of his subjects. Over and over he painted his parents, looking, it seemed, for something he could never find. The women were all in some painfully depressive posture; the men cold, hard, often turned away as if to avert their eyes from what they didn’t want to see. But it was his self-portraits that were the most striking: gnarled, bent, crippled images of an ugly man whose eyes were filled with angry self-loathing.

It was chilling to see his vision of himself, to realize that this was not far off from what I had seen when we first met. Now, two-plus years later, these portraits no longer looked like the man I knew. Was it I who had changed? Or did he really look different? We hadn’t talked about his being crippled for a long time, and I was somewhat anxious about raising the issue now, fearful perhaps that I’d find out that I still hadn’t passed the test. Finally, I gulped one day and took the plunge. “These don’t look like you anymore, and I wonder whether you think it’s because I’ve changed, you have, or we both have?”

It was chilling to see his vision of himself, to realize that this was not far off from what I had seen when we first met. Now, two-plus years later, these portraits no longer looked like the man I knew. Was it I who had changed? Or did he really look different?He thought about that for a minute, then in a voice so tender it overwhelmed me, “I don’t know about me, but I know you have.” Then, returning to the more bantering style that marked our relationship, “Not a cringe in sight, not even one you thought I wouldn’t notice.”

“Thank you,” I replied, not trying to hide how deeply his words moved me. “But you haven’t looked very hard, either inside yourself or in the mirror, if you think you haven’t changed, too.”

A few months later he brought in a new piece, a self-portrait of a man who was crippled but not ugly, the first painting that actually resembled him. Even the colors were different, the same tones but lighter hues, reflecting a brighter, more hopeful view of the world.

We stood looking at it together, tears streaking both our faces. I turned and hugged him; he wrapped his arms, still holding his crutches, around me and held on tight. We didn’t need to say it; we knew our work was done. We continued to see each other for several more months while we processed where we had come from and where we were now. But except for saying goodbye, the active work of therapy was over.

I don’t mean he became a different person. “Despite the public press and our wish that we could do it, therapy doesn’t transform anyone. We leave therapy changed only in that we have a better understanding of who we are and how to deal with the troubled and troubling parts of ourselves.” But knowing, itself, important though it may be, is not enough to enable us to live life more productively. It’s what we do with the knowledge, how we manage to live with the scars life inevitably leaves, that counts. For no matter how long we’re in therapy, no matter how much we learn there, old scars will bleed when picked and new issues will arise to push us back into old responses. A successful therapy leaves us enabled to deal with both in a new and more fruitful way.

So it was with Bruce Marins, who left therapy as physically crippled as he was on the day he walked in. He still faced a world that turned away; his parents still couldn’t look at him without pain and guilt; the wounds of a lifetime, although scarred over, could still bleed when scratched. But he no longer allowed those realities to define him and control his life. With a new ability to trust, he could let go of some of the anger and let some people come close.

Three years after our last session, Bruce called to tell me there would be a showing of his work at a San Francisco gallery. A year after that I was invited to his wedding.

“Sure, I love my family, but nothing will ever take the place of my job!”

This was our first meeting and "Patti" was sitting in my psychotherapy office explaining to me that her life was over. She felt her boss had betrayed her; she had left work on disability; she no longer had an identity.

I wasn't surprised. Over the course of the past seven years I have met with dozens of women and men who seek out psychotherapy after feeling betrayed at the workplace. For them, work isn't what they do for money; nor is it an important part of their lives which provides them with a sense of purpose. Work is their life. And when it ends, they are devastated, feeling as though they are aliens or exiles from a society that increasingly values commitment to and identification with work over all else.

The new work order—spearheaded by the high-tech companies of Silicon Valley—is creating total company cultures that offer engagement, a shared sense of purpose, exhilaration, and interpersonal connection that is increasingly absent in people's families and communities outside the workplace. As divorce, geographic mobility, social fragmentation and the decline of neighborhood, community and civic participation grow, more and more of us are turning to the workplace for the satisfaction of needs formerly filled by family, friends and neighbors.

We Are Family

This trend is hard to resist. As workplaces become campuses offering gyms, free food, parties, sports leagues, chess clubs, and massage therapy, it is not surprising that more of us like spending long hours at work. In the absence of countervailing institutions that sustain and protect us, or that provide a vision of how life should be led and for what purpose, corporations offer a sense of belonging and personal identity. Company logos and slogans that surround employees and pervade our culture often are all people can identity with, claim as their own. Supervisors become parental figures to dote on and please; coworkers become one's community, and the corporation feeds our unmet longings with countless exhortations that "We Are A Team!"; "We're Number One!"; "We Are Fam-i-ly!"

The catch in all of this, of course, is that the people who control "the family" can lay us off, change our jobs, fire our supervisors, or make things so unpleasant that "divorce" feels preferable to the ongoing emotional abuse we often feel at our workplaces. And if we invest all of our energies, time and emotional needs in our jobs, there is often little to fall back on when work ends.

"Patti" knows this all too well. As a 39-year-old black mother of two who lives with her boyfriend, a high school math teacher, Patti spent much of her early life on welfare. But in spite of her modest beginnings, she has been able to complete college, buy a home, and work as a bookkeeper in a growing biotechnology firm. This position has been her favorite. The company emphasizes "team spirit," and her boss, a vice president, repeatedly talks about the company being "one big family." “The company's unofficial anthem is “We Are Family” by Sister Sledge, a song that is played at company picnics and parties.”

Patti's boss, Bill, always struck her as an extremely ethical, fair-minded man whom she often turned to for advice about problems at work. Although she did not believe Bill favored her, she did think he respected her and always was extremely laudatory in his evaluations of her work. Because she admired Bill and trusted his judgment so completely, Patti made him the executor of her will. "He sort of reminded me of Marcus Welby. When he was around, you knew things were gonna be okay."

After three years working at this company, a new computer system to handle accounts receivable and accounts payable was introduced. Patti found the new system difficult to work with and believed it was much worse than the previous system. She voiced her concerns to Bill and was surprised that rather than welcoming the feedback, he seemed annoyed. Gradually her boss's calm, benevolent mien changed. He became more critical and sharp. As Bill's impatience with Patti grew, her ability to work with the new computer system floundered. She often stayed after work trying to make up for how long it took her to process accounts on the new system during working hours. She increasingly got headaches and began seeing her doctor for what was later diagnosed as irritable bowel syndrome. When Bill asked her for a report she had not completed, she states that she felt herself "sinking. It was like my identity was being taken away. I could tell he thought I was a fuck-up."

Finally, Bill came into Patti's office one day clutching a handful of her billing statements, his face red with rage. "Are you the person for this job? Are you the person for this job?" she reports his shouting at her. He threw the papers at her and stormed out the door. ““That was it; I knew that was it. It was over.”” Patti has some amnesia for what happened next, but is able to recount that she found herself at a hospital emergency room that evening complaining of numbness and tingling in her arm.

Patti's doctor immediately took her off work and referred her to me for psychological assessment. When I met with her, Patti was clinically depressed, with slow mentation, dulled to the activity around her. "I have no identity. My work was everything and I blew it. It's over." During the next few months, Patti grew distant from both her boyfriend and children. Although she repeatedly acknowledged that her family was worried about her and she felt some guilt in connection to this, she insisted her "other family, my work family is gone." Bill had been her main conduit to that "other family," and his unhappiness with her seemed to sever the tie that bound her to the larger community of the company family. Patti recounted that her anxiety about learning the new computer system had been fueled by her belief that if she were unable to master it, her employment with the company would end. "And that would be it. No more having a reason to get up in the morning." Curiously in this equation Patti's children, boyfriend, or recent purchase of a home did not seem to beckon her out of bed.

“They Made Me What I Am!”

On the surface, my new patient, "Lionel," appears quite different from Patti. A tall, lean man of Irish descent with a wife of 20 years, a step-son and a home in the suburbs, Lionel has worked for one of the oldest Silicon Valley corporations for 27 years. His is a true American success story: rising from mailroom worker to manager in marketing, Lionel has ridden the wave of the high tech revolution. Because he has never worked for any other employer, his emotional dependence on his job transcends any feeling he has had for another person. "They made me what I am. Without their faith in me I'd probably still be working minimum wage. “I love my wife, but I owe my company everything.”"

At his workplace, every employee, including the CEO, occupies a certain level on a scale of 1 to 100. Within each level, an employee is ranked on a 1-to-5 scale according to job performance. Lionel became obsessed with levels and rankings. He was a "59"; his supervisor was a "63," and Lionel hadn't seen any advancement in three years. Therefore he continually ruminated about how to advance his career "to leave the fifties." When a new job within another division became available, Lionel applied. Although he admits he wasn't truly qualified for the job, he pressured the division that was hiring to give him the position. "It was my ticket. I'd automatically be a 63."

Once in his new job, Lionel was overwhelmed. He didn't understand the operating system and was too afraid to ask questions, fearing that those who had hired him would immediately see him as what he thought himself to be, a fraud. He struggled, developed chronic neck and shoulder pain, and found himself increasingly irritable with his family. For the first time in his life he exhibited "road rage" as he sat in his car, commuting two hours each way to the corporation that "made him who he was." Three months into his agony, Lionel was sitting in a team meeting with his new supervisor, a man 15 years his junior with an MBA from a prestigious business school. The supervisor stared at Lionel for what seemed to be an eternity and then, according to Lionel, asked him for a report in a voice dripping with sarcasm. Lionel began to hyperventilate, had to leave the room, and rushed to the company nursing station in a full-blown panic attack.

Lionel is now off work on short-term disability. He feels he cannot return to his workplace because he is humiliated. Lionel believes there is no other job for him despite having an outstanding resume. The rage at his new supervisor whom Lionel feels shamed by is palpable. Lionel states that he can identify with men who go to the workplace and kill supervisors and coworkers out of feelings of betrayal: "I know I'd never do anything like that so you don't have to worry that you have some loon on your hands, but I get it. I never could understand that kind of thing before this happened to me. . . . What? You're just suppose to sit there and take it?"

Despite significant differences in gender and race, Patti and Lionel share the feeling that severance from the world of work is exile from life itself. “They both looked to their workplaces for feelings of emotional security, self-esteem, and belonging.” In return for providing what these employees experienced as self-sustaining environments, Patti's and Lionel's employers benefited enormously from having workers who worshipped their companies, worked long hours, and would do virtually any task in order to elicit their supervisors' approval.

A Radical Notion: Work is Not Life

Emotional recovery for Patti, Lionel and others like them is not easy. While Americans are devoting increasing amounts of time and energy to their work, no social institutions, frameworks of meaning, or even words exist for a "divorce" from a highly valued job. The empathy that is commonly available and considered socially acceptable when a romantic relationship fails is considered inappropriate if not absurd when applied to a work relationship. “The “divorced” employee often has little more than the advice columns in newspaper business sections to turn to, and these routinely tout the virtues of “flexibility,” “marketability,” and treating oneself “as a business.”” The overriding sentiment is simply "get on with it; send out those resumes; only the weak or psychologically impaired could remain emotionally attached to a job."

To counter this disregard I began running a group therapy program seven years ago for clients who feel they have been betrayed at work. The groups function to support and normalize people's experiences, underscore how jobs alone cannot provide identity, and demonstrate how boundaries and limits must be set so that employers do not become pseudo-parents to be pleased.

Ultimately the task for any participant in group is to find connection, esteem, identity and a feeling of aliveness outside of work even while satisfying some of these needs on the job. "Putting all of one's eggs in one basket"—investing in one sphere of life to the exclusion of all others—diminishes what a human being can be and portends emotional devastation if that one sphere fails. Admittedly this task is an arduous one given the sorry state of family and community life for many Americans. But to cede our emotional lives to corporations whose ultimate goal is always profit and power is an act with unparalled political and psychological consequences.

The betrayed workers I have listened to for the past seven years have tried to do what so many of us in this country seem to be attempting to achieve on a daily basis, that is, satisfy unmet emotional needs through our jobs. Perhaps these women and men tried a little too hard, had a surfeit of needs, too few internal resources to begin with, untempered naivete, too great a belief in the American dream of success and salvation through work. But they are on a continuum with most of us who choose longer hours, take fewer vacations, and wake up and go to sleep at night thinking about our jobs. If under the rubric of "group therapy" these exiles from the labor force can learn that there are other ways of connecting with people who are not coworkers or supervisors, I believe I will have accomplished something. “I will have helped them see that work is not life—surprisingly an increasingly radical notion at the beginning of the new millennium.”