Harold's preference for a "medical diagnosis" may reveal his insecurities about the field of psychology and the impact of feelings in his life. He could be avoiding an area of functioning where he does not feel competent or superior, instead of seeking to correct that deficiency. If he is out of touch with his own feelings, how can he recognize, empathize with, and deal with the feelings of his clients? Does he try to compensate for this lack of empathy by giving an excessive amount of time? His homey, easygoing style may initially make some clients comfortable, but does he eventually help people correct the mistaken ideas and attitudes that cause much of their distress? I get an impression of him wanting to keep encounters safely “on the surface.”
Harold’s weekly use of Valium to prevent losing control and his occasional use of Librax to calm his stomach, could represent emotional and physical signals of unconscious inferiority feelings that are pestering him. It would not be surprising if Harold also used alcohol to help keep his feelings out of conscious awareness. His discomfort with the past, but his willingness to let Don understand him, suggests that he probably has tried to put his uncomfortable past into place intellectually, but has never digested or let go of it emotionally. His explosive anger, and feeling out of control could be interpreted as an unadmitted desire to dominate and hurt, yet not feel responsible for his outbursts.
The earliest memory of illness is not unusual for people in the medical field. Adler claimed that most of the doctors he talked to had early memories of personal or family illness (or death). The image of his childhood living space as an extension of the hardware store, with no place sacred, gives the impression of living in a cold machine instead of a warm “home,” emphasized by his father’s refusal to permit his mother to decorate the house. (Does Harold compensate for this today by living in beautiful or lavish surroundings--or does he imitate his father and demand austerity?) His parents’ lack of closeness, and his father’s inconsiderate attitude towards his mother, could have provided a negative imprint of a marriage, wherein a dominant, punitive man exploits a self-sacrificing woman. His mother’s hitting, followed by her subsequent feelings of guilt, probably permitted her to take out her frustrations repeatedly on a helpless child, rather than on the man she feared to confront.
Being quick-witted, he apparently breezed through his early schooling. However, when the work became more difficult, he was not prepared, and it took a bad report card in high school to temporarily wake him up to the reality of his lack of effort. His life style movements may reflect a desire to take an easy road, until he experiences a failure--then he may be willing to correct the problem. He omits the perspective of prevention. Goofing off for the first two years at the university, is a repeat of the pattern of trying to get away with minimal effort. Did he think that he was superior to his peers intellectually, and consequently didn’t have to work as hard as the others?
Harold’s eclectic orientation could reflect a hesitancy to adopt one theoretical approach, commit himself to it fully, and study it comprehensively. If he is bright and quick, he can probably learn a lot of techniques and strategies easily. Indeed, putting in countless calls at night may be his compensation for not dealing with any cases in great depth. If he is that busy on the phone at night, when does he spend time with his family? Does he use work to avoid regular and sustained contact with them?
As the youngest of five brothers, it would not be unusual to find a burning ambition to outdo them all. The image of being in a race, having started very far behind the others, suggests someone with a lot of ground to cover, and a passion for winning. This is not inconsistent with his periodic slacking off attitude. It reflects the “all or nothing” private logic that Adler described in his great clinical work The Neurotic Constitution. When the individual’s fictional goal seems possible to attain, there is great effort--when achieving that goal seems unlikely, there is little no effort. This hypnotic effect of a fictional final goal, usually cancels out any consideration of consequences, or any awareness of the impact of this attitude on others. Symptoms then provide impressive excuses for avoiding tasks and activities that do not serve that goal. I would expect him to work excessively hard or not at all (“never too busy to see anyone” or “refusing to do any work around the house”).
Martie, a beautiful, intelligent, austere, compulsively neat woman gives the impression of being a “beautiful fixture-housekeeper,” not an intimate partner. Choosing a woman who is the opposite of himself, and then complaining about those qualities, provides a convenient opportunity to depreciate her, and feel constantly superior to her. They never got a chance to know each other, not just because she got pregnant right away, but because he probably has never seen her as a whole person--he has only seen those parts of her that enhance his unconscious, fictional final goal.
Harold wants to be told that "everything will be all right." Does he also want an affirmation from another "authority" that his attitudes and desires are not causing the problems--that other people are to blame. Feeling more comfortable when “taking care of people” and less comfortable “being taken care of” may indicate a preference for what he believes to be a superior role. Good psychotherapy is neither--it is an experience of cooperation between two equals. Harold’s “embarrassment at having to go to someone” for psychological help, and his desire to have people think that he is actually coming to a well known therapist for “training,” express a depreciation of the therapeutic process. (What does he think of his clients who come to him for therapy?) He likes to make great impressions, perhaps, even if it means deceiving others. He could benefit from learning to face himself and his situation more honestly and modestly.
Since Harold wanted people to think that he was coming to Don for training, I would be tempted to suggest to him that it might be a good idea if he actually came for that purpose, as well as his personal difficulties. A study/analysis could combine a personal therapeutic experience with a comprehensive study of theory and practice. Harold has many positive qualities that could be built on: he appears to be active, friendly, bright, and encouraging. But he needs a deep intellectual and emotional connection to a therapist, that will guide him to the insight of what he is omitting in his personal and professional life. If he would accept this challenge, Harold could be a happier, more secure man in his family, and a more confident and effective psychotherapist in his practice.