My own words insisted that I listen to them. There wasn’t much else for me to do. The silence in the room reminded me of what I’d just said: I really felt bad that I had to reschedule our next session. I knew that wasn’t true. I didn’t feel bad at all. There was something else I had to do that day. The word “really” demanded my attention. Listening to these sentences in my head, I felt that I was overconfident about what was happening in my mind. How could I know if the words in my head were insisting on something? My spoken words ended the silence, and I heard myself say that I wanted to postpone our next session. I corrected myself. I wanted to reschedule it, which I’d said a minute or two earlier. But it was too late. My words had spoken. Were my words separate from me? They were expressing things against my will. Suddenly, my will, whatever it was, didn’t seem important. Our next session would be important, and I realized that I didn’t want to reschedule it. I wanted to be here on that day. She would be away for a week after that. The word “separate” returned to me. I felt more than thought that I didn’t want to be separate from her. It would only be a week. She wasn’t my mother. The words in my head were overwhelming me. I needed inner silence. I also needed a name for what I was experiencing.
There was no time for me to do what I wanted. I wished I knew what that was. Time was running out. I glanced at the clock across the small room, and I realized I was anxious. The couch was between me and the clock on the window sill. My sense of time in this room would soon change. The couch’s lone occupant would arrive, I hoped, in fourteen minutes. Time was on my mind. Or maybe my mind was lost in a mysterious sort of time in which seconds and minutes weren’t part of the equation. Or maybe they were, but I would never know for sure. Was something trying to figure itself out in my head? A long moment seemed to refuse to end. Then I turned my chair back toward the desk and checked my email on my laptop. There was a new mail that must have arrived in the last few minutes. A colleague commented on the book our study group was reading. It was difficult reading for me. The book was antiquated somehow, as if I weren’t satisfied with it. Maybe it wasn’t satisfied with me or my work with patients. Or maybe I was antiquated. Perhaps I needed to change how I worked. This was too much irrationality and uncertainty twelve minutes before a session. What work was I referring to? My own inner work was the most important, and doing it was the only way I could help anyone else. Time always seemed to be running out. Maybe I had to forget about time and numbers, for a minute.
I realized I had no idea what would find me in the psychology section of the bookstore where I would meet a friend in half an hour. Thirty minutes was enough time for me to walk there, but I wasn’t on the sidewalk yet. I hoped to have time to glance at some titles before meeting him in the coffee shop that was connected to the bookstore. My shoes were on and I was about to open the door when it came to me that maybe something surprising would happen to me in front of the shelves. I was excited about walking. As a psychotherapist, I spent much of the week seated in a chair. I realized I was less excited to meet my childhood friend for coffee. Why did the words “childhood friend” come to me? In reality, we had met at university. He was in Seattle for a few days, and I’d thought I was looking forward to seeing him again. His life seemed to have creative purpose. And mine didn’t? I’d been a confused and unhappy child. My dream had always been to spend my life doing something meaningful, meaningful to me first and foremost. The last few sentences came to me as I was about to enter the bookstore. I decided to spend a few moments in the psychology section before facing another reminder of my past in the coffee shop. The twenty-five or thirty minutes of walking had helped. I no longer felt confused or lost. A few minutes later, in front of my favorite books, I felt as if I were dreaming on my feet. The hardcover on the history of the psychoanalytic couch might as well have appeared to me in a dream. I’d imagined finding a book like this. Now I held it in my hands. I was a therapist. I was training to be a psychoanalyst. My own dreams were finding me.
I thought I heard him say he was sick in mind. It didn’t sound like something he would say. How could I know what he would say next? He was supposed to attempt to say whatever came to mind. Sick in bed came to my mind. Why was I questioning his associations on the couch? My job was to listen. Perhaps he was judging himself for something he’d done either in reality or in his imagination or in both. Fantasy was important in this room. He’d stopped speaking. For how long had he been silent? His words, sick in mind, returned to me. I heard myself say aloud: “You sound sad, as if you believe that you are sick in mind and that you can’t recover from it.” “I feel as if I were in bed and I don’t want to get up.” Maybe he felt trapped, in his mind, in his body, and he experienced himself as helpless. Perhaps I felt trapped. Trapped and helpless reminded me of his words, sick in mind. Now I remembered more of what he’d said along with those words. The words had come to him in a dream, in which a man, who stood nearby in the darkness, said that he was sick in mind. Awake, on the couch, my patient seemed to believe the dream figure’s words. Was I somehow this figure in the darkness? I imagined myself lying down. Maybe the middle-aged man before me on the couch was ready to get to his feet and walk out the door. I would become the one sick in mind and unable to recover. Time was running out. In a few minutes we would separate until next time. Until then our focus would be his mind.
There was no doubt in his mind that I was wrong. Was there no doubt in his mind? He had a good reason for wanting some certainty in those initial minutes in my office, on the couch, with me seated out of sight, surrounded by uncertainty. What was I wrong about in his mind? I couldn’t remember what he’d been speaking about. I might have been seeking my own certainty. Experience had taught me that it didn’t help to try to remember anything during a session. Anything or everything would come to me on its own. It was unclear what he thought I was wrong about. I realized that I was confused in part because I’d yet to speak since he’d walked through the door five or six minutes ago. Was he referring to something from our last session? It was unusual for me to remain quiet this long. My own silence might have created too much uncertainty in myself. I wasn’t the only silent person in the room. “I was wrong” were the last words he’d spoken. Or maybe I was wrong about that. The few sentences he’d uttered had seemed to disappear. I wanted some certainty, a fact, something I could be sure of, during this silence. Suddenly, the opening minutes of the session returned to me: he’s spoken in a low voice and said that he was frustrated with himself because he wanted me to tell him that he was wrong and I was right (about what was unclear). There were no facts in my head. I wanted no doubts in my mind. Both of us were afraid of being wrong.
It was a question of time, he said. My mind was both with his words and somewhere else. For a long moment, I was uncertain what he was referring to, and then, without warning, his previous words returned to me. He was here, on this couch, several times a week, because, in his words, he couldn’t seem to accept that loss in life was inevitable. Reality appeared to tell him it was so. His mother had died a year earlier. Yet both this loss and that of others close to him who had died never seemed real enough to him. Perhaps death had become an overwhelming presence inside of him. New beginnings, such as this treatment or his recent decision to train to become a psychotherapist in his mid forties, didn’t seem any easier for him. It occurred to me that he was experiencing another kind of loss during this session, related to speech. His sentences seemed without freedom of movement, as if they lacked action and stopped before they’d started. Then I became aware of my own body: I seemed filled with anxiety and sadness, which seemed connected to what my patient was experiencing on the couch. Overwhelming anxiety and sadness might have been making it hard for him to construct sentences. “It was a question of time.” This was the same sentence that had surprised me minutes earlier. He continued: “I wanted and needed to experience this form of intensive psychotherapy a long time ago. But I didn’t think I could afford it or make such a time commitment.” Without thinking about the words that came to me, I reminded myself what I was listening to: my patient’s inner world. Then my own inner world reminded me that it too was involved: where were my own words in the room? I realized that part of me felt I should speak. Seconds later, the word “should” appeared in one of his sentences: “I should be happy about what I’m doing in my life, but right now I’m not.” Time, loss, sadness, determination, and hope all came to me simultaneously. I waited for them, or for other words, to appear together in a sentence or sentences that felt right to me. Then I might speak.
I heard the word patience and thought of impatience. Was he impatient with me? He said that he hadn’t lost patience with me. The word lost seemed important. He’d recently lost his job. Losing came to mind. A week or two earlier he’d told me that he was afraid of losing his mind, which I associated with total destruction. Seconds after the word destruction came to me, I realized that he was silent on the couch. His silence seemed partly responsible for the following thought: the room belonged to his silence. A few minutes later his words seemed to become the room. He said that I should listen carefully to his words about patience, because they were based on his own experiences. Was he frustrated or envious that I was younger than him? I was becoming frustrated. Frustration became the room. He was silent again. It was unlike him not to be speaking on the couch. I was anxious. He said that he was frustrated with me for being silent all of the time. I wasn’t doing my job well enough. The phrase “all of the time” seemed important. Did he want something from me all of the time? What might he want or not want from himself all of the time? He didn’t seem patient with himself. The word “unlike” returned. It was my word, not his. Maybe he was struggling to make contact with a part of himself that was unlike the him that he thought he was. He seemed to be waiting for me to say something. I seemed to be waiting, too. For what, I wondered.