Сэмуэль Шэм - Mount Misery

Heiler got up, turned to the blackboard and wrote in big capital letters THE THEORY. Then for several minutes he outlined the Borderline Theory, listing the Krotkey Factors for diagnosis and then, with the aid of circles and flowcharts and line diagrams between stick figures that crisscrossed and darted into their stick brains and through their stick armpits like sword thrusts faked onstage, and even into their tiny stick crotches, focused particularly on Factor Number 3, "Projec-tive Identification." This, spelled out with the kind of certainty you get from accountants and surgeons, showed borderline rage as so horrible that it couldn't be contained in the borderline's stick body, and so was projected onto the therapist's stick body, which then, in a kind of carom shot back, made the therapist, to the borderline, seem enraged at the borderline, which then made the borderline afraid of the therapist, and hence depressed.

I didn't understand much of this, but I had to admit that it did seem kind of brilliant, as if, if you could understand it, it would explain, brilliantly, a lot of the things you didn't understand.

"Which is what we call empathy." Blair Heiler wrote, in big

caps in the nexus of lines and circles that looked remarkably like a child's try at a house, or perhaps a cat: EMPATHY. Turning to us, he said: "What you saw with Zoe was her and my projective identifications overlapping, which is called-" Here he underlined the word. "-EMPATHY."

"But isn't empathy putting yourself in another person's shoes, in a feeling way?" Hannah asked tentatively. "Isn't empathy subjective?"

"Exactly," he said, "which is why we're going to be completely objective about it." Heiler turned to the blackboard and wrote SELF, and then OBJECT. Solini crunched my knee. I crunched Hannah's. "The world is divided into the SELF," Heiler said, "and every other person, or, the OBJECT." He drew a vertical line between SELF and OBJECT. "There is a wall between them, a kind of movie screen for projective identification, or EMPATHY, which is key in working with these gals. Freud didn't know shit about borderlines- there weren't any in Vienna in 1890. Hell, Freud didn't even charge his patients. My teacher, the great American pioneer in"-tapping the blackboard-"SELF-psychology, and OBJECT-relations, is Dr. Renaldo Krotkey, a true genius." Reverentially he repeated this while writing the equation, "RENALDO KROTKEY = TRUE GENIUS. I am a Krotkeyan. Questions?"

Silence, one of "How Could We Nongeniuses Even Think of Asking Questions of Even a Proteg6 of the Great Renaldo Krotkey?"

"But Roy and I have been thinking," Hannah said bravely, "that Zoe fits the criteria for depression?" In a shaky, hesitant voice, Hannah retraced the genetic and personal history, along with the vegetative signs-loss of appetite, bulimia, change in sleep pattern, etc.-and the suicidal ideation. "And besides, she's really responded. She's incredibly better."

"Ah yes," Heiler said, nodding, "so all you new residents are being quote 'nice' to her and she's getting quote 'better'?'

"We're not just being 'nice,' " I said, "we're trying to be human."

"Being human is being totally human, which, for your information, isn't very 'nice,' and isn't even all that human. Christ, when I walked in here I thought I'd wandered into

some kind of, I don't know, some kind of love nest or something. It's phony. It's Leonard Malik's New Agey-Wagey sentimentality, and with borderlines it does not work." "But ever since Ike White's suicide," I said, "we've-" "Dee White's death. Believe me, Ike was one angry mother. Never got his anger out. If I'd been here to drill out your LNT, your rage at his death, you'd've been over it a lot sooner. What's Malik's theory? Having a buddy? What's his technique? Holding hands? The Borderline Theory and Technique have been proven scientifically, accepted by the toughest referees in the toughest journals in the world." His voice softened, and he went on, "Look. I know that the first time you see it, this theory seems strange-it's counterintuitive. If just being nice to borderlines worked, don't you think I would do it? Of course I would! In fact, I tried, way back, at first. But it's like dealing with difficult children: you've got to be firm. Everybody knows that if you don't dig up the Latent Negative Transference in these gals, next thing you know you've got people killing themselves, or killing other people. For fifty years people have been trying to cure borderlines by being 'nice and human' to them. Everybody felt better, nobody got better. It's easy to act nice, it's hard as hell to stand firm and confront the rage locked up in borderlines. Borderlines are hell. There aren't too many of us left who have the guts to treat 'em. I've specialized in borderlines for years and years, and I've seen what works: You go through that rage to the truth, to their miserable pain and suffering, and, believe me, they get better."

"But," Solini said, rolling his hands and squinching his face, "I mean, but everybody agrees that the lady is better?"

"In this case," Blair said, "better is worse. She'll have to get worse-which is in fact better-in order to get better, which will still be worse. If she gets a little worse, she won't get a lot better, but if she gets a lot worse, she may get a little better. Not smarmy-'nice' better, really better. Borderline better." He looked at his watch. "Daily report."

"Blair?" I said. He looked at me. "Isn't it about time for your vacation?"

Everybody cracked up. Blair too laughed. From his great height he stared down at us. "I'll be filling Ike White's slot

down on Emerson One, and Dr. von Nott has converted Emerson Three to a borderline ward too. I'll be supervising all three of you residents. Dr. Errol Cabot and I have just gotten a two-million-dollar Department of Defense grant to study the use of medication on borderlines. Most Emerson patients will be on randomized double-blind trials of Placedon or Zephyrill or placebo." He smiled. "Don't worry, Roy, your overinvolvement with her is normal. Sick, but normal. Gals like her are experts at getting guys like you entangled. Read my paper: 'Rescue Fantasies in the-' " He opened the door. People were screaming out there. " '-in the Naive Resident.' " He left.

Solini, Hannah, and I walked onto the ward. Henry reached for his key to open the door out of Emerson 2. Suddenly Zoe was in my face, eyes wild, arms raised and fists clenched, screaming, "How could you? I'll never talk to you again!"

My arms went up, for protection. "I'm sorry, I didn't know."

"You're incompetent! I hate you! Hate hate hate you- Primo Jones materialized and started standing around between us, shifting his weight bulkily to counter Zoe's moves, rolling his eyes. I left. Shaken, I followed Hannah and Solini down through the woodwork forest of the stairwell and out onto the lawn, heading toward the lake. The day was clear and hot, with that perfection of summer that reminds you of picnics and swimming holes set amidst protective rock and straight, tall pines. From the rows of locked, screened windows of the second floor of Emerson came screams, shouts, and other desperate sounds of the first liberation of our patients from their getting better, which, according to Heiler, was their getting worse. "That was insane," I said.

"Maybe not," Hannah said. "Dr. Renaldo Krotkey is the world expert in SELF-psychology and OBJECT-relations. 'Confrontation' is an accepted interview technique with borderlines. It really helps them get clearer. It did make some sense.'*

"Leveling her? And then saying it was my problem, being too sensitive?"

"Maybe you are-maybe we all are-like the first time you see real blood in surgery."

"You're defending that jerk?'

"Shhh," she said, grabbing my arm, nodding toward Emerson. "Here he comes."