Last Analysis in Marienbad - II.

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FICTION

II.

Liselotte S. sat in the plush, leather-upholstered chair, directly across from Kessler, her lips pursed in what he first perceived as sardonic amusement. But the young woman’s eyes, though of the same azure blue as Hannah’s, had been dulled by some festering, enervating sorrow. And there was no doubt about it: Liselotte could have passed for Hannah Kessler herself, aged 20 or 21.

Kessler sat behind a large mahogany desk, nervously tapping his pencil, wondering how on earth he could possibly work with this young woman, whose face and voice could have been transported to this office from 1938. The “Leading Authority on Countertransference” chuckled inwardly at this inversion of the natural order and the endless perversity of the Cosmos, with or without a supervising Deity. And yet, and yet, he thought, the work must be done. He drew himself up in his chair; summoned his 60 years of clinical experience; and at last, found his voice.

“So, Fräulein,” Kessler began. “This first meeting, as I explained to you by telephone, is a consultation—not necessarily the beginning of treatment. It is a kind of, well, an introduction to one another—to see, so to speak, if the treatment should proceed; and if so, by what mutual arrangements. But then, I assume my colleague, Professor Linzner, told you a bit about psychoanalysis? What it involves, how long it…”

“Yes, yes, Herr Doktor,” she interrupted with a look of irritation. “I am quite well informed on that matter, thank you. Uncle Otto—well, he is not actually my uncle, but he is so close to my family—discussed the process with me in some detail.”

“I see. Of course. May I say, Fräulein, you sound a little annoyed.”

Her face flushed, and for a moment, the light that had vanished from her eyes returned.

“Well, Herr Doktor, I am not some idiot! After all, most educated people—I have been to university, you know!—most educated people know something about whatever this process is called these days. Freud, Adler, blah, blah, whoever.”

Kessler saw an opening. “I see. Of course. And may I ask, Fräulein, do you worry quite a bit that people will think you are an idiot?”

At this, the young woman’s countenance changed almost imperceptibly, but enough for Kessler to see that a nerve had been touched and a tiny portal opened. The flash of anger gave way to a kind of subterranean sorrow that overspread her features. Now, Kessler thought, now is the time to hear her story.

And so, the session went on for the well-known and often satirized “50-minute hour.” Fräulein S., who liked to be called Lotte,slowly unspooled the history of her depression.

“It started when I was 18,” she said matter-of-factly, as if narrating a tale she had told many times. (And, to be sure, she had already been evaluated by 4 therapists.) “I was living at home with my parents and my ailing grandfather. Life was normal; life was good. I had just entered a training program in physical therapy—for which I am now fully qualified—and was also taking some psychology courses at Univerzita Karlova in Prague.”

“And you have no brothers or sisters, Fräulein?”

“I am an only child, Herr Doktor. I was expected to take care of my grandfather when my parents were away, but otherwise, I lived the life of a normal teenager. Life was wonderful, in fact! I had friends—even a boyfriend for a while!” At this, a forlorn light flickered in her eyes, and she made a faint attempt to smile.

“The depression—die Dunkelheit (the dark), I call it—it seemed to come out of nowhere, Herr Doktor. Like a curtain falling over my brain, over my soul...but...but...”

At this point, the young woman looked puzzled.“Are you quite alright, Herr Doktor? Your face…you look as if you are in pain.”

Kessler flinched, as if a needle had suddenly pricked his cheek. “I am fine, Fräulein, thank you.Please continue.”

“But…Herr Doktor, with respect, I notice you rubbing and rubbing your finger, as if…”

Kessler’s voice rose and betrayed his consternation. “As I said, Fräulein, I am fine!Now, may we please continue? You were saying…?”

But although the session continued for its appointed hour, Kessler was convinced at this point that proceeding with an analysis of this young woman would be impossible—even a bit mishugah (crazy)! Still, he felt he owed his friend—Lotte’s “uncle”—a frank explanation.

“Fräulein,” Kessler said, looking visibly shaken, “I would like your permission to discuss your situation with Professor Linzner before making any decisions about treatment. Then, if you would be willing, we will meet again to discuss how best to be of help to you.”

________

Otto Linzner looked flummoxed. “What on earth do you mean you can’t possibly treat Lotte?”

“Otto, my dear friend, you know very well that an analysis is likely to fail when the analyst begins with a strong, erotic countertransference to the analysand! And this Lotte, who could pass as my dear Hannah when she was the same age…”

“Wait, you are saying what? That Lotte looks just like Hannah at that age? Heinz, have you had your vision checked recently? Oh, natürlich, there is a passing resemblance. I remember Hannah at that age very well. She was a very lovely and beautiful young woman, and, yes, so is Lotte. But beyond that, I don’t see…”

“That is your problem, my old friend, you don’t see! The 2 women could be sisters, if not twins! And beyond that, there is a certain brazenness—a tendency to interrupt with superfluous questions…”

“Ah, now the truth comes out, Heinz—our Lotte was a little too much for you to handle! You, the Dean of Countertransference!” At this, he let out a little cackle.

“Very well, mock me if you must, Otto. Have a little fun at the expense of an old friend! But I cannot see how the analysis can go forward. I will meet with the girl, this impertinent young woman who thinks she is your niece, for a final session and explain my decision. Surely there are other analysts…”

“Heinz, please hear me out. I understand your concern. But I remain convinced you can do this, and that Lotte will benefit from your work with her. I understand how hard it must be to see Hannah’s face when you look at her. And yes, of course there will be some, well, passionate feelings that are stirred up. But you of all people know we can surmount these issues with sufficient self-awareness. That is what we do for a living, Um Gottes willen! [For heaven’s sake]. And if the analysis goes forth,Greta and I will be happy to have you stay with us for the duration!”

Read the next installment here: Last Analysis in Marienbad - III.

Dr Pies is professor emeritus of psychiatry and lecturer on bioethics and humanities, SUNY Upstate Medical University; clinical professor of psychiatry, Tufts University School of Medicine; and editor in chief emeritus of Psychiatric Times™ (2007-2010). Dr Pies is the author of several books. A collection of his works can be found on Amazon.