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The emotional struggles of a depressed person during therapy sessions. The person shares her feelings of isolation, abandonment, and resentment towards her therapist and the perceived favoritism shown to other patients. The text also touches upon the importance of communication, trust, and the emotional burden of unmet needs.
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Le depressed person was in terrible and unceasing emotional pain, and the impossibili- ty of sharing or articulating this pain was itself a component of the pain and a contributing factor in its essential horror. Despairing, then, of describing the emotional pain itself, the depressed person hoped at least to be able to express something of its context- its shape and texture, as it were-by recounting circumstances related to its etiology. The de- pressed person's parents, for example, who had divorced when she was a child, had used her as a pawn in the sick games they played, as in when the depressed person had required ortho- donture and each parent had claimed-not without some cause, the depressed person al- ways inserted, given the Medicean legal ambi- guities of the divorce settlement-that the oth- er should pay for it. Both parents were well-off, and each had privately expressed to the de- pressed person a willingness, if push came to shove, to bite the bullet and pay, explaining that it was a matter not of money or dentition but of "principle." And the depressed person al- ways took care, when as an adult she attempted to describe to a supportive friend the venomous struggle over the cost of her orthodonture and that struggle's legacy of emotional pain for her, to concede that it may well truly have appeared to each parent to have been, in fact, a matter of "principle," though unfortunately not a "princi- ple" that took into account their daughter's feelings at receiving the emotional message that
scoring petty points off each other was more im- portant to her parents than her own maxillofa- cial health and thus constituted, if considered from a certain perspective, a form of neglect or abandonment or even outright abuse, an abuse clearly connected-here she nearly always in- serted that her therapist concurred with this as- sessment-to the bottomless, chronic adult de- spair she suffered every day and felt hopelessly trapped in. The approximately half-dozen friends whom her therapist-who had earned both a terminal graduate degree and a medical degree-referred to as the depressed person's Support System tended to be either female acquaintances from childhood or else girls she had roomed with at various stages of her school career, nurturing and comparatively undamaged women who now lived in all manner of different cities and whom the depressed person often had not laid eyes on in years and years, and whom she called late in the evening, long-distance, for badly needed sharing and support and just a few well-chosen words to help her get some realistic perspective on the day's despair and get centered and gather together the strength to fight through the emo- tional agony of the next day, and to whom, when she telephoned, the depressed person al- ways apologized for dragging them down or com- ing off as boring or self-pitying or repellent or taking them away from their active, vibrant, largely pain-free long-distance lives. She was, in addition, also always extremely careful to share
David Foster Wallace is a contributing editor of Harper's Magazine. His most recent book, A Supposedly Fun Thing I'll Never Do Again, was published by Little, Brown last February.
STORY 57
with the friends in her Support System her be- lief that it would be whiny and pathetic to play what she derisively called the "Blame Game" and blame her constant and indescribable adult pain on her parents' traumatic divorce or their cynical use of her. Her parents had, after all-as her therapist had helped the depressed person to see---done the very best they could do with the emotional resources they'd had at the time. And she had, the depressed person always inserted, laughing weakly, eventually gotten the ortho-
precedence and required her (i.e., the friend) to get off the telephone. The feelings of shame and inadequacy the depressed person experienced about calling members of her Support System long-distance late at night and burdening them with her clumsy attempts to describe at least the contex- tual texture of her emotional agony were an is- sue on which she and her therapist were cur- rently doing a great deal of work in their time together. The depressed person confessed that when whatever supportive friend she was sharing with finally confessed that she (i.e., the friend) was dreadfully sorry but there was no helping it she
phone, and had verbally detached the depressed person's needy fingers from her pantcuff and returned to the de- mands of her full, vibrant long-dis- tance life, the depressed person always sat there listening to the empty apian drone of the dial tone feeling even more isolated and inadequate and un- empathized-with than she had before she'd called. The depressed person confessed to her therapist that when she reached out long-distance to a member of her Support System she al- most always imagined that she could detect, in the friend's increasingly long silences and/or repetitions of en- couraging cliches, the boredom and abstract guilt people always feel when someone is clinging to them and be- ing a joyless burden. The depressed person confessed that she could well imagine each "friend" wincing now when the telephone rang late at night, or during the conversation looking impatiently at the clock or di- recting silent gestures and facial ex- pressions communicating her boredom and frustration and helpless entrapment to all the other people in the room with her, the expres- sive gestures becoming more desperate and ex- treme as the depressed person went on and on and on. The depressed person's therapist's most noticeable unconscious personal habit or tic consisted of placing the tips of all her fingers together in her lap and manipulating them idly as she listened supportively, so that her mated hands formed various enclosing shapes-e.g., cube, sphere, cone, right cylinder-and then seeming to study or contemplate them. The de- pressed person disliked the habit, though she was quick to admit that this was chiefly be- cause it drew her attention to the therapist's fingers and fingernails and caused her to com- pare them with her own.
donture she'd needed. The former acquain- tances and classmates who composed her Sup- port System often told the depressed person that they just wished she could be a little less hard on herself, to which the depressed person responded by bursting involuntarily into tears and telling them that she knew all too well that she was one of those dreaded types of everyone's grim acquaintance who call at in- convenient times and just go on and on about themselves. The depressed person said that she was all too excruciatingly aware of what a joy- less burden she was, and during the calls she al- ways made it a point to express the enormous gratitude she felt at having a friend she could call and get nurturing and support from, how- ever briefly, before the demands of that friend's full, joyful, active life took understandable
58 HARPER'S MAGAZINE / JANUARY 1998 Illustrations by Mark Ulriksen
even remotely accepted her at all and around whom the depressed person hadn't felt so to- tally pig-nosed and brace-faced and inferior that it had been a daily act of enormous per- sonal courage and will just to leave her room and go eat dinner in the dining hall. The professional arbitrator her parents' lawyers had agreed on for help in structuring their compromises had been a highly respected conflict-resolution specialist named Walter D. ("Walt") Ghent Jr. The depressed person had never even laid eyes on Walter D. ("Walt") Ghent [r., though she had been shown his business card-complete with its parenthe- sized invitation to informality-and his name had been invoked bitterly in her hearing on countless occasions, along with the fact that he billed at a staggering $130 an hour plus ex- penses. Despite overwhelming feelings of re- luctance on the part of the depressed person, the therapist had strongly supported her in taking the risk of sharing with members of her Support System an important emotional real- ization she (i.e., the depressed person) had achieved during an Inner-Child-Focused Ex- periential Therapy Retreat Weekend which the therapist had supported her in taking the risk of enrolling in and giving herself open-
e.-F.E.T. Retreat Weekend's Small-Group Drama- Therapy Room, other members of her small group had role-played the depressed per- son's parents and the parents' significant oth- ers and attorneys and myriad other emotional- ly painful figures from her childhood, and had slowly encircled the depressed person, moving in steadily together so that she could not es- cape, and had (i.e., the small group had) dra- matically recited specially prepared lines de- signed to evoke and reawaken trauma, which had almost immediately evoked in the de- pressed person a surge of agonizing emotional memories and had resulted in the emergence of the depressed person's Inner Child and a cathartic tantrum in which she had struck re- peatedly at a stack of velour cushions with a bat of polystyrene foam and had shrieked ob- scenities and had reexperienced long-pent-up wounds and repressed feelings, the most im- portant of which being a deep vestigial rage over the fact that Walter D. ("Walt") Ghent Jr. had been able to bill her parents $130 an hour plus expenses for playing the role of me- diator and absorber of shit while she had had to perform essentially the same coprophagous services on a more or less daily basis for free, for nothing, services which were not only gross- ly unfair and inappropriate for a child to feel required to perform but which her parents had then turned around and tried to make her, the
60 HARPER'S MAGAZINE/jANUARY 1998
depressed person herself, as a child, feel guilty about the staggering cost of Walter D. Ghent [r., as if the cost and hassle were her fault and undertaken only on her spoiled little fat-thighed pig-nosed shiteating behalf instead of simply because of her fucking parents' utterly fucking sick inability to communicate directly and share honestly and work through their own sick issues with each other. This exercise had allowed the depressed person to get in touch with some really core resentment-issues, the small-group facilitator at the Inner-Child- Focused Experiential Therapy Retreat Week- end had said, and could have represented a real turning point in the depressed person's journey toward healing, had the public shrieking and velour-cushion-pummeling not left the de- pressed person so emotionally shattered and drained and traumatized and embarrassed that she'd felt she had no choice but to fly back home that night and miss the rest of the Weekend. The eventual compromise which she and her therapist worked out together afterward was that the depressed person would share the shat- tering emotional realizations of the I.-e.-F. E.T.R. Weekend with only the two or three very most trusted and unjudgingly supportive members of her Support System, and that she would be permitted to reveal to them her re- luctance about sharing these realizations and to inform them that she knew all too well how pathetic and blaming they (i.e., the realiza-
mise, the therapist, who by this time had less than a year to live, said that she felt she could support the depressed person's use of the word "vulnerable" more wholeheartedly than she could support the use of the word "pathetic," which word (i.e., "pathetic") struck the thera- pist as toxically self-hating and also somewhat manipulative, an attempt to protect oneself against the possibility of a negative judgment by making it clear that one was already judging oneself far more negatively than any listener could have the heart to. The therapist-who during the year's cold months, when the abun- dant fenestration of her home office kept the room chilly, wore a pelisse of hand-tanned Na- tive American buckskin that formed a some- what ghastlil y moist-looking flesh-colored background for the enclosing shapes her hands formed in her lap-said that she felt comfort- able enough in the validity of their therapeutic connection together to point out that a chron- ic mood disorder could itself be seen as consti- tuting an emotionally manipulative defense mechanism: i.e., as long as the depressed per- son had the depression's affective discomfort to preoccupy her, she could avoid feeling the
deep vestigial childhood wounds which she was apparently determined to
keep repressed at all costs)
everal months later, when the depressed person's therapist suddenly died-as the result of what was determined to be an "accidentally" toxic combination of caffeine and homeopathic appetite suppressant but which, given the ther- apist's extensive medical background, only a person in very deep denial indeed could fail to see must have been, on some level, intention- al-without leaving any sort of note or cassette or encouraging last words for any of the patients who had come to connect emotionally with the therapist and establish some degree of intimacy even though it meant making themselves vul- nerable to the possibility of adult loss- and abandonment-traumas, the depressed person found this fresh loss so shattering, its resultant hopelessness and despair so unbearable, that she was forced now to reach frantically and repeat- edly out to her Support System, calling three or even four different supportive friends in an evening, sometimes calling the same friends twice in one night, sometimes at a very late hour, and sometimes, even, the depressed per- son felt sickeningly sure, either waking them up or maybe interrupting them in the midst of healthy and joyful sexual intimacy with their partner. In other words, sheer emotional sur- vival now compelled the depressed person to put aside her innate feelings of shame at being a pathetic burden and to lean with all her might on the empathy and nurture of her Support Sys- tem, despite the fact that this, ironically, had been one of the two issues about which she had most vigorously resisted the therapist's counsel. The therapist's death could not have oc- curred at a worse time, coming as it did just as the depressed person was beginning to process and work through some of her core shame- and resentment-issues concerning the therapeutic process itself, the depressed person shared with her Support System. For example, the depressed person had shared with the therapist the fact
2 The depressed person's therapist was always ex- tremely careful to avoid appearing to suggest that she (i.e., the depressed person) had in any con- scious way chosen or chosen to cling to her endoge- nous depression. Defenses against intimacy, the therapist held, were almost always arrested or vesti- gial survival mechanisms: they had, at one time, been environmentally appropriate and had served to shield an otherwise defenseless childhood psyche against unbearable trauma, but in nearly all cases these mechanisms became inappropriately imprint- ed and outlived their purpose, and now "in adult- hood," ironically, caused a great deal more rrauma and pain than they prevented.
that it felt ironic and demeaning, given her par- ents' dysfunctional preoccupation with money and all that that preoccupation had cost her, that she was now in a position where she had to pay a professional therapist $90 an hour to lis- ten patiently and respond empathetically. It felt demeaning to have to purchase patience and empathy, the depressed person had confessed to her therapist, and was an agonizing echo of the childhood pain she was so anxious to put be- hind her. The therapist, after attending very closely and patiently to what the depressed per- son later acknowledged to her Support System could all too easily have been interpreted as just a lot of ungrateful whining, and after a long pause during which both of them had gazed at the digiform ovoid cage which the therapist's mated hands at that moment composed.I had responded that, while she might sometimes dis- agree with the substance of what the depressed person said, she nevertheless wholeheartedly supported the depressed person in sharing what-
3 The therapist-who was substantially older than the depressed person but still younger than the de- pressed person's mother, and who resembled that mother in almost no respects-sometimes annoyed the depressed person with her habit of from time to time glancing very quickly at the large bronze sun- burst-design clock on the wall behind the recliner in which the depressed person customarily sat, glancing so quickly and almost furtively at the clock that what bothered the depressed person more and more over time was not the act itself but the therapist's apparent effort to hide or disguise it. One of the ther- apeutic relationship's most significant break- throughs, the depressed person told members of her Support System, had come when she had finally been able to share that she would prefer it if the therapist would simply look openly up at the bronze helioform clock instead of apparently believing-or at least behaving, from the depressed person's admit- tedly hypersensitive perspective, as if she believed- that the hypersensitive depressed person could be fooled by the therapist's dishonestly sneaking an ob- servation of the time into something designed to look like a routine motion of the head or eyes. And that while they were on the whole subject, the de- pressed person had to confess that she sometimes felt demeaned and enraged when the therapist's face as- sumed its customary expression of boundless pa- tience, an expression which the depressed person said she knew very well was intended to communi- cate attention and unconditional support but which sometimes felt to the depressed person like emotion- al detachment, like professional courtesy she was paying for instead of the intensely personal compas- sion and empathy she sometimes felt she had spent her whole life starved for. She was sometimes resent- ful, she shared, at being nothing but the object of the therapist's professional courtesy or of the so- called "friends" in her pathetic "Support System"'s charity and abstract guilt.
STORY 61
pressed person assured her Support System, whose members she was by this time calling al- most constantly, sometimes even during the day, from her workplace, swallowing her pride and dialing their work numbers and asking them to take time away from their own vibrant, stimulat- ing careers to listen supportively and share and help the depressed person find some way to process this grief and loss and find some way to survive. Her apologies for burdening these friends during daylight hours at their workplaces were elaborate, vociferous, and very nearly con- stant, as were her expressions of gratitude to the Support System for just Being There for her, be- cause she was discovering again, with shattering new clarity in the wake of the therapist's word- less abandonment, just how agonizingly few and far between were the people with whom she could ever hope to really communicate and forge intimate, mutually nurturing relationships to lean on. The depressed person's work envi- ronment, for example, was totally toxic and dys- functional, making the idea of trying to bond in any mutually supportive way with coworkers lu- dicrous. And her attempts to reach out in her isolation and develop caring relationships through church groups or nutrition or holistic stretching classes or community woodwind en- sembles had proved so excruciating, she shared, that she had been reduced to begging the thera- pist to withdraw her gentle suggestion that the depressed person try her best to do so. And as for the idea of girding herself and venturing out once again into the emotionally Hobbesian meat market of the dating scene ... at this junc- ture the depressed person usually laughed hol- lowly into the speaker of the headset telephone she wore at the terminal inside her cubicle and asked whether it was even necessary to go into why her intractable' depression and highly charged trust-issues rendered this idea a sheer
niscence that the therapist's display of attention dur- ing this seminal but ugly and humiliating break- through session had been so intense and professional- ly uncompromising that she had blinked far less often than any listener the depressed person had ever opened up to face-to-face had ever blinked. The two most special and trusted current members of her Sup- port System had responded, almost verbatim, that it sounded as though the therapist had been very spe- cial and the depressed person obviously missed her very much; and the one particularly trusted and valu- able, physically ill long-distance friend whom the de- pressed person leaned on more heavily than on any other friend during the grieving process suggested that the most loving and appropriate way to honor both the therapist's memory and the grief over her loss might be for the depressed person to try to be- come as special and caring and nurturing a friend to herself as the late therapist had been.
pie-in-the-sky flight of pathetic and denial- ridden fancy, at best. By this stage in the grieving process, the de- pressed person's emotional agony had so com- pletely overwhelmed her vestigial defense mech- anisms that whenever a member of her Support System finally said that she was dreadfully sorry but she absolutely Iuul to get off the telephone, the primal instinct for sheer emotional survival now drove the depressed person to swallow every last tattered remnant of pride and to beg shamelessly for two or even just one more minute of the friend's time and attention, and- if the "supportive friend" held firm and termi- nated the conversation-to spend now hardly any time listening dully to the dial tone or gnawing the ragged cuticle of her index finger or grinding the heel of her hand savagely into her forehead or feeling anything other than sheer primal desperation as she hurriedly dialed the next ten-digit number on her Support System Telephone List, which by this time had been photocopied several times and placed in the de- pressed person's address book, workstation ter- minal's PHONE.VIP file, billfold, minilocker at the Holistic Stretching and Nutrition Center, and in a special pocket inside the back cover of the leatherbound Feelings Journal which the de- pressed person-at her late therapist's suggestion'i-e-carried with her at all times. It was at this same point, driven by despera- tion to abandon all defenses and to share her deepest feelings with what was possibly the sin- gle most trusted and indispensable member of
5 As a natural part of the grieving process, sensuous de- tails and affective memories flooded the depressed per- son's agonized psyche at random and unpredictable moments, pressing in on her and clamoring for ex- pression and processing. The buckskin pelisse, for ex- ample, though the therapist had seemed almost fetishis- tically attached to the Native American garment and during cool weather had worn it, seemingly, on a near- daily basis, was always immaculately clean and always presented an immaculately raw- and moist-looking flesh-toned backdrop to the varioform cages the ther- apist's unconscious hands composed. It had never been clear how or by what process the therapist's authentic pelisse's buckskin was able to stay so perfectly clean- unless, the depressed person confessed to imagining, the therapist had woru it only for their particular appoint- ments. The therapist's chilly home office also con- tained, on the wall opposite the bronze clock and be- hind the therapist's recliner, a stunning molybdenum desk-and-personal-computer-hutch ensemble, one shelf of which was lined, on either side of the deluxe Braun coffee maker, with small framed photographs of the therapist's husband and sisters and son; and the de- pressed person often broke into fresh sobs of grief and self-excoriation on her workstation's headset telephone as she confessed to her Support System that she had nev- er even asked the therapist's intimate loved ones' names.
STORY 63
her Support System, that the depressed person shared that she felt she had found, somehow, fi- nally, the willingness to risk trying to follow the second of the late overdosed therapist's two sug- gestions which she (i.e., the depressed person) had most vehemently resisted over the course of their work together. The depressed person proposed now to take an unprecedented emo- tional risk and to begin asking certain impor- tant persons in her life to tell her straight out whether they had ever secretly felt contempt, derision, judgment, or repulsion for her, and was choosing to begin this vulnerable inter- rogative process with the one particularly nur- turing and dependable and trustworthy Sup- port System member with whom she was sharing via her workstation's telephone right this rnorne n t.v She had resolved, the de- pressed person shared, to ask these potentially deeply traumatizing questions without pream- ble or apology or interpolated self-criticism. She wished to hear, with no holds barred, her very most valuable friend's honest opinion of her, the potentially negative and judging and traumatic and hurtful parts as well as the posi- tive and affirming and supportive and nurtur- ing parts. The depressed person stressed that she was serious about this: the honest assess- ment of her by an objective but deeply caring confidante felt, at this point in time, like a lit- eral matter of life and death. For she was frightened, the depressed person confessed to the trusted and convalescing friend, profoundly frightened by what she felt she was learning about herself following the sudden death of a therapist who for nearly four years had been her single most valuable re- source and trusted support and-with no of- fense intended to any of the members of her Support System-her very best friend in the world. For she had discovered, the depressed person confessed, that when she took her daily Quiet Time now, during the grieving process, and got quiet and centered and looked deep within, she could neither feel nor identify any feelings for the therapist as a person, as a per- son who had died, a person who only somebody
6 The singularly valuable and supportive friend on the telephone wasan alumna of one of the depressed person's boarding schools, a generous, nurturing di- vorced mother of two in BloomfieldHills, Michigan, who had recently undergone her second course of chemotherapy for a virulent neuroblastoma, which greatly reduced the number of activities and respon- sibilities in her full, vibrant, undepressed life, and who thus wasnot only almost alwaysat home but al- so enjoyed nearly unlimited conflict-freeavailability and time to share on the telephone, for which the depressed person was now careful to enter a daily prayer of gratitude in her FeelingsJournal.
64 HARPER'S MAGAZINE/JANUARY 1998
in truly stupefying denial could fail to see had probably taken her own life, and thus a person who, the depressed person posited, had possibly suffered levels of emotional pain and isolation and despair which were comparable to or maybe even exceeded the depressed person's own. And thus that although the depressed person had had agonizing feelings aplenty since the therapist's suicide, these feelings appeared
pain and primal affective survival. And that this terrifying set of realizations, instead of awakening in her any feelings of compassion, empathy, or Other-directed grief for the thera- pist-and here the depressed person waited pa- tiently for an episode of retching in the espe- cially available trusted friend to pass so that she could take the emotional risk of sharing this with her-these realizations seemed mere- ly to have brought up in the depressed person
sharing, the depressed person paused to swear up and down to her long-distance, gravely ill, frequently retching, but still caring and inti- mate friend that there was no toxic or manipu- lative self-hatred in this confession, only pro- found fear: the depressed person was frightened
"spirit" or "soul," her capacity for basic human empathy and compassion-she told the sup- portive friend with the neuroblastoma. She was asking sincerely, the depressed person said, honestly, desperately: what kind of person could seem to feel nothing-"nothing," she em- phasized-for anyone but herself? She wept in- to the headset telephone and said she was shamelessly begging her now single most valu- able friend and confidante in the world to share her (i.e., the friend with the virulent ma- lignancy in her adrenal medulla's) brutally can- did assessment, to pull no punches, to say nothing reassuring or supportive or exculpatory which she did not honestly believe to be true. She trusted her, she assured her. She had de- cided, she shared, that her very life itself, how- ever fraught with agony and despair and inde- scribable loneliness, depended, at this point in her journey toward healing, on inviting-even, if necessary, begging shamelessly for-honest feedback, even if that feedback was traumatic or hurtful. The depressed person therefore urged her terminally ill friend to go on, to not hold back, to let her have it: What terms might be used to describe and assess such a solipsistic, self-consumed, bottomless emotional vacuum and sponge as she now appeared to herself to be? How was she to decide and describe-even to herself, facing herself-what all she had learned said about her? •