Consideration and Mortality

When my therapist, S. Joseph Nemetz, suddenly died at the end of May in 1994, I felt lonelier than ever in my life. I turned for comfort to the same places I've turned all my life: to people and to books. The first were wholly satisfactory, the second only partly so.

The safety net provided by friends and family was strong, flexible, and reliable. So too was the professional net: Nemetz's colleagues and friends offered themselves immediately and generously, and at every point they proceeded wisely, all in the face of their own confusion and grief.

I can't say the same for the comfort I got from reading. In turning to books, I also had two accustomed directions to take: First, I could go to literature, which has cushioned and buoyed me since I was small; second, I could go to psychoanalytic theory, an interest only nine years old, though an avid one.

In literature I found what I needed. In psychoanalytic theory, not only did I not find what I needed, but what I did find outraged and discomfited me. In the body of papers on the illness and death of the therapist, instead of comfort or insight, I found avoidance, confusion, condescension, self-delusion, and dissimulation. The subject of the therapist's mortality itself seemed to inspire avoidance and disarray. But perhaps most remarkably, nowhere did I find the voice or perspective of the patient.

Joseph Nemetz's professional conduct, in retrospect, serves as an implicit critique of the inadequate professional literature regarding the central matter of the therapist's mortality. When he suddenly died, I had been working with him in an intensive psychotherapy for almost four years. I had asked several weeks earlier, in April, if we could talk about my beginning analysis.

Nemetz was surprised by my request, and I, by his surprise; I thought I had made many less-than-subtle hints about analysis. I told him I thought I had been reasonably clear; he replied that he had not understood me. Possibly, both of us were right. I came to wonder later whether I had in fact been quite clear, but that his usually exquisite capacity to hear me had in this particular matter broken down: Conceivably, he wished not to hear me. I have wondered whether his deafness to my hints came from his intuitive understanding that, if I were to ask, he would have to say, “No”—the answer he would be compelled, as I now understand, to give. With the refusal, I would, if I wanted analysis enough, move to another therapist. I believe that he cared very much about me, enjoyed his work with me, and preferred that I not leave him.

In the body of papers on the illness and death of the therapist, instead of comfort or insight, I found avoidance, confusion, condescension, self-delusion, and dissimulation.

He did not answer my request right away. He told me that, because of his age, he was cautious about beginning new analyses. When I asked if our nearly four years of work together made no difference, he answered that of course it did, and that he would need some time to think about it. Over the next 10 days I argued my case, growing more excited and hopeful as the days passed and he did not refuse.

Several minutes into our fifth meeting after I had first asked to begin analysis, I was speaking with an animation every minute moving closer to pleased assumption: I would have my wish. I remember that he lifted his hand lightly, several inches off his knee, in a gesture that stopped me dead—a “Whoa!” to a racing horse. The very long silence lasted perhaps five seconds, and then he spoke quietly: “There's more than one person in this room to be considered.”

I was speechless. At that moment and in that pause, I caught a clear glimpse of him, perhaps for the first time in 10 days, so hard had I been working to obliterate him in order to have what I wanted. I saw something then about what he might feel, what he might wish, and what this decision might mean for him. I was able then to say, calmly and with tremendous sadness, “This must be hard for you, too.” He nodded very slightly and said, “In many ways.”

Although he didn't give me his answer until the next time we met, I knew then what he would likely say and began to prepare myself for it. I think I had really known the answer from the beginning, maybe even before he did, and my wish not to hear what I already knew explained my impetuous rush to fill with words any space for an honest exchange with him. My unconscious hope was to keep both of us from reflecting; but he didn't give up that responsibility.

Near the start of our next meeting, he said that given the nature of my own losses and the power of analysis, and given the good possibility that he might die before the work was done, analysis with him was not a good idea. He said, if I wanted analysis, he would help me arrange it. I knew that given his love for the work, and especially for that work from behind the couch, his decision was not easy But I also knew in a hazy way that it was his commitment to the work, and to me, that led to the decision.

I asked him if he had ever changed his mind about anything, and he replied, quickly and very gently, “I once decided not to be a cowboy.” As was often true in my time with him, my laughter was part of the power of the moment: Few people have ever looked less like a cowboy. My tears and rage followed.

But I didn't fully understand his words for a long time. Many months after his death, I did understand that Nemetz was telling me far more than, “No, I can't be your analyst.” He was telling me that, however much he might wish to give me what I wanted, he could not change his mind because any other decision would be wild and incautious. His refusal was clearly dictated from the start—although it was not easy for him to accept it—by his understanding of and respect for the power of the analytic process, for his own human limitations, and for me. With that decision he looked squarely at the ending of his

lifework, and of his life. Holding to the highest ideals of his profession, he was guarding my safety. He had the capacity to bear the responsibility of “No,” and with it, to bear responsibility for the pain he caused me and, I believe, caused himself. At the moment he spoke, it was to remind me that there are always two individual, mortal people in the consulting room, and in that quiet reminder is located the most essential principle guarding the patient's safety.

A few weeks later, on a Wednesday in mid-May, the hour came to a close. I remained angry at him. He was going away for the weekend to a conference in Philadelphia. He often ended an hour with something intended to leave me thinking. This time it was a question; his last words to me were, “What have I done to make you think I don't understand how disappointed you are?”

I paused and said, “I'll think about it, and I'll let you know Monday morning.” I stood up and left him with my usual tagline when he went away to meetings: “Have a good time, learn something, and cross the street very carefully.” He collapsed without warning on Sunday in the airport in Philadelphia, and he died six days later, apparently never regaining consciousness.

(This article originally appeared in the Winter 2004 issue of Threepenny Review.)