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For years, I saw a client who lived by himself.* He was isolated in
many other ways in addition to his living situation. He had extremely
limited family ties. Both of his daughters had moved out of the
country, and did not maintain much contact, and he had no other
relatives except a father and sister from whom he was estranged. His
wife and the mother of his children had passed away years ago, and
the sole relationship he endeavored to establish while he saw me over
the course of more than a decade and a half terminated tragically
when his new partner was killed in an automobile accident.
When we began to work together, our conversations were decidedly
awkward. He was not accustomed to the subtleties of social
interaction, so his behaviors, verbal and nonverbal, lacked the dance-
like rhythm and harmony that characterize the socially fluent. As a
child, he had been thoroughly ignored as well as actively discouraged
by both parents. His father—mostly absent—was neglectful and
sadistic in his inclinations, while his mother was chronically alcoholic.
He had also been consistently tormented and harassed at school, and
had not chanced upon a teacher in all his years of education who paid
him any genuine attention. These experiences left my client with a
proclivity toward depression, or at least worsened what might have
been a biological tendency in that direction. He was, in consequence,
abrupt, irritable, and somewhat volatile if he felt misunderstood or
was unexpectedly interrupted during a conversation. Such reactions
helped ensure that his targeting by bullies continued into his adult life,
particularly in his place of work.
I soon noticed, however, that things worked out quite well during
our sessions if I kept mostly quiet. He would drop in, weekly or
biweekly, and talk about what had befallen and preoccupied him
during the previous seven to fourteen days. If I maintained silence for
the first fifty minutes of our one-hour sessions, listening intently, then
we could converse, in a relatively normal, reciprocal manner, for the
remaining ten minutes. This pattern continued for more than a
decade, as I learned, increasingly, to hold my tongue (something that
does not come easily to me). As the years passed, however, I noticed
that the proportion of time he spent discussing negative issues with
me decreased. Our conversation—his monologue, really—had always
started with what was bothering him, and rarely progressed past that.
But he worked hard outside our sessions, cultivating friends, attending
artistic gatherings and music festivals, and resurrecting a longdormant
talent for composing songs and playing the guitar. As he
became more social, he began to generate solutions to the problems he
communicated to me, and to discuss, in the latter portion of the hours
we shared, some of the more positive aspects of his existence. It was
slow going, but he made continual incremental progress. When he first
came to see me, we could not sit together at a table in a coffee shop—
or, indeed, in any public space—and practice anything resembling a
real-world conversation without his being paralyzed into absolute
silence. By the time we finished, he was reading his original poetry in
front of small groups, and had even tried his hand at stand-up
comedy.
He was the best personal and practical exemplar of something I had
come to realize over my more than twenty years of psychological
practice: people depend on constant communication with others to
keep their minds organized. We all need to think to keep things
straight, but we mostly think by talking. We need to talk about the
past, so we can distinguish the trivial, overblown concerns that
otherwise plague our thoughts from the experiences that are truly
important. We need to talk about the nature of the present and our
plans for the future, so we know where we are, where we are going,
and why we are going there. We must submit the strategies and tactics
we formulate to the judgments of others, to ensure their efficiency and
resilience. We need to listen to ourselves as we talk, as well, so that we
may organize our otherwise inchoate bodily reactions, motivations,
and emotions into something articulate and organized, and dispense
with those concerns that are exaggerated and irrational. We need to
talk—both to remember and to forget.
My client desperately needed someone to listen to him. He also
needed to be fully part of additional, larger, and more complex social
groups—something he planned in our sessions together, and then
carried out on his own. Had he fallen prey to the temptation to
denigrate the value of interpersonal interactions and relationships
because of his history of isolation and harsh treatment, he would have
had very little chance of regaining his health and well-being. Instead,
he learned the ropes and joined the world.