The Case of Harold Payne
Within the network of psychotherapists for whom I have been privileged to serve as therapist and preceptor for three decades, Harold's name had been bandied about for a couple of years before he actually appeared in my office. A successful clinician and administrator known for the endless hours he worked as well as his refusal to give up on anybody no matter what their situation, he was known (more behind his back than to his face) as "Harried Pained." Everybody but his wife, it seemed, knew that he was deeply in love with Meg, the warmly affectionate and much loved office manager who helped him run his always growing empire, and trapped in a marriage to the beautiful and austere woman he had inseminated on a blind date while in graduate school some 15 years earlier.
Scant days into the beginning of 1983, Harold appeared in my office for a consultation. After exchanging the routine statements through which we established our long-time awareness of each other's reputation and network of colleagues, I asked him the formal question that allowed us to shift into a therapeutic relationship: "What is the trouble that has brought you here today?" Speaking slowly, as if the words might change their meaning once expressed, he said "I left home recently." Harold continued: "It was 9 days ago. I thought about it for 5 years, seriously for the last 2 years. It's not the bed of roses I thought it would be. My children are 13, 11, and 6. . . Boys . . . I have a minor degree of guilt about leaving Martie, but enough built-up justification."
A decade earlier, said Harold, "I thought I was dying of every disease known to man. I had 900 tests by 6 different doctors---cardiologists, GI, x-rays. At any time, day or night, I could suddenly get short of breath or feel my stomach contracting. A year-and-a-half into a new house!" A year later, he saw a psychologist for one session but complained that the doctor just sat there waiting for him to discuss what was on his mind. "After all the years I have done this with my own patients, suddenly I was immersed in the same process. His style of indirection was so frustrating that I left after one session. It's a good way to take control of an interaction, but really makes you feel stupid when you don't know how to express or explain why you feel terrible." A year later, he found himself going to dinner with Meg after work "in order to go over office matters. One night she made dinner for me at her apartment, and we have been lovers since then. In my entire life I have never met someone so unselfish. Peculiar, though. She had been married then, to a man who stopped having sex with her the evening of the wedding. She left her husband 5 years ago, and it would seem that I have the best of both worlds. Martie runs my home and the day-to-day world of the boys, while Meg runs my office and gives me more love than I ever knew existed. A couple of years ago something began to change for me because I began to love her so much that I wanted to go out with her in public, kind of to expose my happiness to the world, but we couldn't because we would be seen and that would get back to my wife. Now I have left, I guess, but I am so torn up about what I am doing to the boys that every time they look at me I have to turn away and they are really mad at me."
We were almost done with that first session, and I ended it with the following instruction: "Look at you. With all your skill at taking care of everybody in the world, from patients to staff, here you are overwhelmed with feeling for your children and acutely concerned about a wife you claim not to love. I want you to tell them, Martie and the 3 boys, that for the first time in your life you need to do something for yourself, to recover from what you are feeling, and that they must support you. If she is to have any kind of a husband, and the boys any kind of real father, everybody must leave you alone for a while so you can figure yourself out." Harold chuckled for a moment and said "Funny. Just by telling me to tell them that, you are taking care of me more than I take care of me. So, next week we take a history, right?"