“It’s a story about avoidance, isn’t it?” I say.
“Well, in some ways, yes,” Wendell replies. “Though I was going to say uncertainty. It’s also a story about uncertainty.”
Of course, I think. Uncertainty.
I’ve always thought about uncertainty in terms of my patients. Will John and Margo stay together? Will Charlotte stop drinking? But now so much seems uncertain in my own life. Will I be healthy again? Will I find the right partner? Will my writing career go up in flames? What will the next half of my life—if I even have that long—look like? I’d once told Wendell that it was hard to walk around those prison bars when I didn’t know where I was headed. I might be free, but which way should I go?
I remember a patient who had pulled into her garage at the end of an ordinary workday and was greeted by an intruder with a gun. The intruder’s accomplice, she would soon learn, was in the house with her children and their babysitter. After a horrific ordeal, they were saved when a neighbor called the police. My patient told me that the worst thing about this incident was that it had shattered her smug sense of safety, however illusory it might have been.
And yet, whether she realized it or not, she still held on to that illusion.
“Do you worry about pulling into your new garage?” I asked when the family, too traumatized to live at the scene of the crime, had moved into a new home.
“Of course not,” she said, as if it were an absurd question. “Like this would happen twice? What are the chances of that?”
I tell Wendell this story and he nods. “How do you make sense of her response?” he asks.
Wendell and I rarely talk about my work as a therapist, and now I feel self-conscious. Sometimes I wonder how Wendell would be with my patients, what he would say to Rita or John. Therapy is a completely different experience with a different therapist; no two are exactly the same. And because Wendell has been doing this much longer than I have, I feel like the student to his teacher, Luke Skywalker to his Yoda.
“I think we want the world to be rational, and it was her way of having control over how uncertain life is,” I say. “Once you know a truth, you can’t unknow it, but at the same time, to protect herself from that knowledge, she convinces herself she could never be assaulted again.” I pause. “Did I pass the test?”
Wendell starts to open his mouth but I know what he’s about to say: This isn’t a test.
“Well,” I say, “was that what you were thinking? How would you make sense of her certainty in the face of uncertainty?”
“The way you did with her,” he says. “The same way I’d make sense of it with you.”
Wendell goes through the concerns I’ve brought to him: my breakup, my book, my health, my father’s health, my son’s rapid ascent through childhood. The seemingly offhand observations I’d pepper our conversations with, like “I heard on the radio that about half of today’s Americans weren’t alive in the 1970s!” Everything I talk about is shaded with uncertainty. How much longer will I live, and what will happen in that time before I die? How much control will I have over any of it? But, Wendell says, like my patient, I’ve come up with my own way to cope. If I screw up my life, I can engineer my own death rather than have it happen to me. It may not be what I want, but at least I’ll choose it. Like cutting off my nose to spite my face, this is a way to say, Take that, uncertainty.
I try to wrap my mind around this paradox: self-sabotage as a form of control. If I screw up my life, I can engineer my own death rather than have it happen to me. If I stay in a doomed relationship, if I mess up my career, if I hide in fear instead of facing what’s wrong with my body, I can create a living death—but one where I call the shots.
Irvin Yalom, the scholar and psychiatrist, often talked about therapy as an existential experience of self-understanding, which is why therapists tailor the treatment to the individual rather than to the problem. Two patients might have the same problem—say, they have trouble being vulnerable in relationships—but the approach I take with them will vary. The process is highly idiosyncratic because there’s no cookie-cutter way to help people through what are at the deepest level existential fears—or what Yalom called “ultimate concerns.”
The four ultimate concerns are death, isolation, freedom, and meaninglessness. Death, of course, is an instinctive fear that we often repress but that tends to increase as we get older. What we fear isn’t just dying in the literal sense but in the sense of being extinguished, the loss of our very identities, of our younger and more vibrant selves. How do we defend against this fear? Sometimes we refuse to grow up. Sometimes we self-sabotage. And sometimes we flat-out deny our impending deaths. But as Yalom wrote in Existential Psychotherapy, our awareness of death helps us live more fully—and with less, not more, anxiety.
Julie, with the “wacky” risks she’s been taking, is a perfect example of this. I never paid attention to my own death until I embarked on the Medical Mystery Tour—and even then, Boyfriend allowed me to distract myself from my fears of extinction, both professional and actual. But he also offered me an antidote to my fear of isolation, another ultimate concern. There’s a reason that solitary confinement makes prisoners literally go crazy; they experience hallucinations, panic attacks, obsessional behavior, paranoia, despair, difficulty with focus, and suicidal ideation. When released, these people often struggle with social atrophy, which renders them unable to interact with others. (Perhaps this is simply a more intense version of what happens with our increasing want, our loneliness, created by our speedy lifestyles.)
And then there’s the third ultimate concern: freedom, and all the existential difficulties that freedom poses for us. On the surface, it’s almost laughable how much freedom I have—if, as Wendell pointed out, I’m willing to walk around those bars. But there’s also the reality that as people get older, they face more limitations. It becomes harder to change careers or move to a different city or marry a different person. Their lives are more defined, and sometimes they crave the freedom of youth. But children, bound by parental rules, are really free only in one respect—emotionally. For a while, at least, they can cry or laugh or have tantrums unselfconsciously; they can have big dreams and unedited desires. Like many people my age, I don’t feel free because I’ve lost touch with that emotional freedom. And that’s what I’m doing here in therapy—trying to free myself emotionally again.
In a way, this midlife crisis may be more about opening up than shutting down, an expansion rather than a constriction, a rebirth rather than a death. I remember when Wendell said that I wanted to be saved. But Wendell isn’t here to save me or solve my problems as much as to guide me through my life as it is so that I can manage the certainty of uncertainty without sabotaging myself along the way.
Uncertainty, I’m starting to realize, doesn’t mean the loss of hope—it means there’s possibility. I don’t know what will happen next—how potentially exciting! I’m going to have to figure out how to make the most of the life I have, illness or not, partner or not, the march of time notwithstanding.
Which is to say, I’m going to have to look more closely at the fourth ultimate concern: meaninglessness.