Without Memory or Desire

In the mid-twentieth century, the British psychoanalyst Wilfred Bion posited that therapists should approach their patients “without memory or desire.” In his view, therapists’ memories were prone to subjective interpretation, morphing over time, while their desires might run counter to what their patients wanted. Taken together, memories and desires can create biased notions that therapists hold about the treatment (known as formulated ideas). Bion wanted clinicians to enter each session committed to hearing the patient in the present moment (rather than being influenced by memory) and remaining open to various outcomes (rather than being influenced by desire).

Early in my internship, I trained under a Bion enthusiast, and I challenged myself to start each session with “no memory, no desire.” I loved the idea of not getting sidetracked by preconceived notions or agendas. There also seemed to be a Zen flavor to this kind of relinquishment, similar to the Buddhist notion of letting go of attachment. In practice, though, it felt more like trying to emulate the neurologist Oliver Sacks’s famous patient H.M., whose brain injury confined him to live only in the moment, with no ability to remember the immediate past or conceptualize the future. With my frontal lobes intact, I couldn’t will myself into that kind of amnesia.

I know, of course, that Bion’s concept was more nuanced and that there’s value in checking the distracting aspects of memory and desire at the door. But I bring up Bion here because when I drive to my sessions with Wendell, I think about how, from the patient’s side of the room—from my side—“no memory (of Boyfriend), no desire (for Boyfriend)” would be close to grace.

It’s Wednesday morning and I’m on Wendell’s couch, sitting halfway between positions A and B, having just arranged the pillows behind my back.

I fully intend to open with what happened at work the day before when I was in the communal kitchen and spotted a copy of Divorce magazine on top of a pile of reading material that was to be placed in the waiting room. I pictured the people who subscribed to this magazine coming home at the end of the day and finding, among all the bills and store catalogs, this magazine with the word DIVORCE in bright yellow letters on the cover. Then I imagined these people walking into their empty houses, each one turning on the lights, heating up a frozen dinner or ordering takeout for one, sitting down to eat, and flipping through this magazine’s pages, wondering, How did this become my life? I figured the people who had moved on from their divorces were doing something other than reading this magazine and that the majority of subscribers would be people like me, newly smarting and trying to make sense of it all.

Of course, I hadn’t married Boyfriend, so this wasn’t a divorce. But we were supposed to get married, which, according to my thinking at that moment, put me in a similar category. I even felt that this breakup might be worse than a divorce in one particular aspect. In a divorce, things have gone badly already, thus leading to the split. If you’re going to mourn a loss, isn’t it better to have an arsenal of unpleasant memories—stony silences, screaming fights, infidelity, massive disappointment—to temper the good ones? Isn’t it harder to let go of a relationship filled with happy memories?

It seemed to me the answer was yes.

So I was sitting at the table eating a yogurt and scanning the magazine’s headlines (“Healing from Rejection”; “Managing Negative Thoughts”; “Creating the New You!”) when my phone beeped, indicating that an email had come in. It was not, as I still (delusionally) hoped, from Boyfriend. The subject line read Prepare for the best night ever! Spam, I assumed—but if it wasn’t, who was I to turn down the best night ever, given how bad I felt?

I clicked on it and saw that the email was a confirmation for the concert tickets I’d ordered months in advance as a surprise for Boyfriend’s upcoming birthday. We both loved this band, and their music had been like a soundtrack to our relationship. On our first date, we discovered that we had the same all-time-favorite song. I couldn’t imagine going to this concert with anyone but Boyfriend—especially on his birthday. Should I go? With whom? And wouldn’t I be thinking about him on his birthday? Which raised the questions: Would he be thinking about me? And if not, didn’t I mean anything to him? I looked back at the Divorce headline: “Managing Negative Thoughts.”

I was finding it hard to manage my negative thoughts because, outside of Wendell’s office, they didn’t have much of an outlet. Breakups tend to fall into the category of silent losses, less tangible to other people. You have a miscarriage, but you didn’t lose a baby. You have a breakup, but you didn’t lose a spouse. So friends assume that you’ll move on relatively quickly, and things like these concert tickets become an almost welcome external acknowledgment of your loss—not only of the person but of the time and company and daily routines, of the private jokes and references, and of the shared memories that now are yours alone to carry.

I fully intend to say all this to Wendell as I get comfortable on the couch, but instead all that comes out is a torrent of tears.

Through the blur, I see the tissue box soaring toward me. Once again, I miss the catch. (In addition to being dumped, I think, I’ve become uncoordinated.)

I’m both surprised by and ashamed of my outburst—we haven’t even greeted each other yet—and every time I try to pull it together, I get in a quick “I’m sorry” before I lose it again. For about five minutes, my session goes like this: Cry. Try to stop. Say, I’m sorry. Cry. Try to stop. Say, I’m sorry. Cry. Try to stop. Say, Oh God, I’m really sorry.

Wendell wants to know what I’m apologizing for.

I point to myself. “Look at me!” I make loud honking noises into a tissue.

Wendell shrugs as if to say, Well, yeah—and so what?

And then I don’t even pause to say “I’m sorry”; it’s just cry. Try to stop. Cry. Try to stop. Cry. Try to stop.

This goes on for another few minutes.

While I’m crying, I think about how the morning after the breakup, after a sleepless night, I got out of bed and went on with my daily life.

I remember how I dropped Zach off at school and said, “Love you,” as he jumped out of the car, and he looked around to make sure nobody could hear and then said, “Love you!” before running off to join his friends.

I think about how on the drive to work, I replayed Jen’s comment over and over in my mind: I don’t know that this is the end of the story.

I think about how, riding up to my office in the elevator, I actually laughed when I remembered the old pun Denial is not a river in Egypt—and how even so, I went right back into denial: Maybe he’ll change his mind, I thought. Maybe this is all a big misunderstanding.

Of course it wasn’t all a big misunderstanding because here I am, crying in front of Wendell and telling him again how lame I am to be doing this, to still be such a wreck.

“Let’s make a deal,” Wendell says. “How about we agree that you’ll be kind to yourself while you’re in here? You can go ahead and beat yourself up all you want as soon as you leave, okay?”

Be kind to myself. This hadn’t occurred to me.

“But it’s just a breakup,” I say, immediately forgetting to be kind to myself.

“Or I could just leave a pair of boxing gloves at the door so you could hit yourself with them all session. Would that be easier?” Wendell smiles, and I feel myself take in some air, let it out, relax into the kindness. I flash on a thought I often have when seeing my own self-flagellating patients: You are not the best person to talk to you about you right now. There is a difference, I point out to them, between self-blame and self-responsibility, which is a corollary to something Jack Kornfield said: “A second quality of mature spirituality is kindness. It is based on a fundamental notion of self-acceptance.” In therapy we aim for self-compassion (Am I human?) versus self-esteem (a judgment: Am I good or bad?).

“Maybe not the boxing gloves,” I say. “It’s just that I was doing better and now I can’t stop crying again. I feel like I’m going backward, like I’m back where I was the week of the breakup.”

Wendell tilts his head. “Let me ask you something,” he says, and, assuming it’s going to be about my relationship, I wipe my eyes and wait expectantly.

“In your work as a therapist,” he begins, “have you ever sat with somebody who’s grieving?”

His question stops me cold.

I have sat with people dealing with all kinds of grief—the loss of a child, the loss of a parent, the loss of a spouse, the loss of a sibling, the loss of a marriage, the loss of a dog, the loss of a job, the loss of an identity, the loss of a dream, the loss of a body part, the loss of youth. I’ve sat with people whose faces close in on themselves, whose eyes become slits, whose open mouths resemble the image in Munch’s The Scream. I’ve sat with patients who describe their grief as “monstrous” and “unbearable”; one patient, quoting something she had heard, said it made her feel “alternately numb and in excruciating pain.”

I’ve also seen grief from afar, like the time in medical school when I was transporting blood samples in the emergency room and heard a sound so startling that I almost dropped the tubes. It was a wail, more animal-like than human, so piercing and primal that it took me a minute to find its source. Out in the hallway was a mother whose three-year-old had drowned after running out the back door and falling in the swimming pool during the two minutes in which the mother had gone upstairs with her infant to change his diaper. As I listened to the wail, I saw her husband arrive and receive the news, heard his shock erupting into shrieks as if in chorus with his wife’s roar-moan. It was my first time hearing this particular music of sorrow and anguish, but I have heard it countless times since.

Grief, not surprisingly, can resemble depression, and for this reason, until a few years ago, there was something termed the bereavement exclusion in our profession’s diagnostic manual. If a person experienced the symptoms of depression in the first two months after a loss, the diagnosis was bereavement. But if those symptoms persisted past two months, the diagnosis became depression. This bereavement exclusion no longer exists, partly because of the timeline: Are people really supposed to be done grieving after two months? Can’t grief last six months or a year or, in some form or another, an entire lifetime?

Then there’s the fact that losses tend to be multilayered. There’s the actual loss (in my case, of Boyfriend), and the underlying loss (what it represents). That’s why for many people the pain of a divorce is only partially about the loss of the other person; often it’s just as much about what the change represents—failure, rejection, betrayal, the unknown, and a different life story than the one they’d expected. If the divorce happens at midlife, the loss might involve coping with the limitations of knowing someone and being known again with the same degree of intimacy. I remember reading a divorced woman’s experience of getting to know a new lover after her decades-long marriage ended: “I will never lock eyes in the delivery room with David,” she wrote. “I’ve never met his mother.”

And that’s also why Wendell’s question is so important. In asking me to remember what it’s like to sit with people who are grieving, he’s showing me what he can do for me right now. He can’t fix my broken relationship. He can’t change the facts. But he can help because he knows this: We all have a deep yearning to understand ourselves and be understood. When I see couples in therapy, often one or the other will complain, not “You don’t love me” but “You don’t understand me.” (One woman said to her husband, “You know what three words are even more romantic to me than ‘I love you’?” “You look beautiful?” he tried. “No,” his wife said. “I understand you.”)

My tears start again, and I’m thinking about what it might be like for Wendell to sit here with me. Everything we therapists do or say or feel as we sit with our patients is mediated by our histories; everything I’ve experienced will influence how I am in any given session at any given hour. The text I just received, the conversation I had with a friend, the interaction I had with customer service while trying to resolve a mistake on my bill, the weather, how much sleep I’ve gotten, what I dreamed of before my first session of the day, a memory inspired by a patient’s story, will all influence my behavior with my patient. Who I was before Boyfriend is different from who I am now. Who I was when my son was an infant is different from who I am in sessions now, including in this one with Wendell. And he is different in this session with me because of whatever has happened in his life up to this point. Maybe my tears are bringing up whatever grief he’s experienced and it’s painful for him to sit through this too. He’s as mysterious to me as I am to him, and yet here we are, joining forces to unravel the story of how I ended up here.

It’s Wendell’s job to help me edit my story. All therapists do this: What material is extraneous? Are the supporting characters important or a distraction? Is the story advancing or is the protagonist going in circles? Do the plot points reveal a theme?

The techniques we use are a bit like the type of brain surgery in which the patient remains awake throughout the procedure; as the surgeons operate, they keep checking in with the patient: Can you feel this? Can you say these words? Can you repeat this sentence? They’re constantly calibrating how close they are to sensitive regions of the brain, and if they hit one, they back off so as not to damage it. Therapists delve into a mind rather than a brain, and we can see from the subtlest gesture or expression if we’ve hit a nerve. But unlike neurosurgeons, we gravitate toward the sensitive area, pressing delicately on it, even if it makes the patient feel uncomfortable.

That’s how we get to the deeper meaning of the story, and often at the core is some form of grief. But a lot of plot stands in between.

A patient named Samantha came to therapy in her twenties to understand the story of her beloved father’s death. She’d been told as a child that he had died in a boating accident, but as an adult, she began to suspect that he had killed himself. Suicide often leaves the survivors with an unsolved mystery: Why? What could have been done to prevent this?

Meanwhile, Samantha was always looking for problems in her relationships, searching for issues that would inevitably provide her with a reason to leave. In not wanting her boyfriends to be the enigma that her father was, she’d unwittingly re-create a story of abandonment—only in this version, she was the one doing the abandoning. She had control, but ended up alone. In therapy, she learned that the mystery she was trying to solve was larger than whether or not her father committed suicide. It was also the mystery of who her father was when he was alive—and who she became as a result of that.

People want to be understood and to understand, but for most of us, our biggest problem is that we don’t know what our problem is. We keep stepping in the same puddle. Why do I do the very thing that will guarantee my own unhappiness over and over again?

I cry and cry, wondering how it’s possible that I can cry so long. I wonder if I’ve become massively dehydrated. And still more tears appear. Before I know it, Wendell is patting his legs to indicate that our session is over. I take a breath and notice that I feel strangely calm now. Sobbing freely in Wendell’s office was like being wrapped in a blanket, warm and safe and separate from everything happening out there. I think about the Jack Kornfield quote again, the part about self-acceptance, but still I start to judge: Did I just pay somebody to watch me cry for forty-five minutes straight?

Yes and no.

Wendell and I had a conversation, even if no words were exchanged. He watched me grieve, and he didn’t try to make things more comfortable by interrupting or analyzing the issue. He let me tell my story in whatever way I needed to today.

As I dry my tears and stand to leave, I think about how whenever Wendell has asked about other aspects of my life—what else was happening while Boyfriend and I were dating, what my life was like before I met Boyfriend—I’ve given a pat response (family, work, friends; nothing to see here, folks!), always returning the topic to Boyfriend. But now, tossing my tissues in the trash can, I realize that what I’ve told Wendell isn’t really complete.

I haven’t lied, exactly. But I haven’t told the whole story either.