Mrs B

Mrs. B

Mrs. B had moved to our area with her husband after having spent the previous 58 years in Manhattan.  She had made regular visits to her analyst during most of her adult life there and had decided she should find another psychiatrist to talk to. Upon discovering there were no psychoanalysts within 100 miles she decided to try me out. 

Mrs. B was a very sophisticated appearing and sounding lady.  She had attended a prestigious women’s college in the East.  Her husband had been a successful businessman and had pretty much catered to her every material wish.  They had not had children and it was not clear whether this had been by chance or choice. 

In our initial interview she recounted facts rather than concerns about her family, education, marriage and herself. She did not have a chief complaint and did not describe the course of any particular mental disorder.  It was my impression that what she was now seeking was the continuation of a ritual that she had found in some way or ways useful in the past.

Apparently I had met her expectations in my first trial session because she requested a follow up appointment.  On her return she voiced both a complaint and a request.  She noted that her husband who was 20 years her senior was impotent.  She went on to say that her analyst had told her that this represented passive-aggressive behavior on his part aimed at denying her the pleasure she deserved.  According to her report, her analyst had seen him in order to confront him about this just prior to their move.  Unfortunately, his impotence had continued in spite of the reprimand and she requested that I give him a boost by asking him to come in to see me for a similar session in which I would give him the same message. 

I said I did not think it would be appropriate for me to do so.  I explained that although some cases of impotence resulted from psychological problems it had been my experience that most men in his age group experienced this difficulty because of physical conditions that decreased the blood supply to the penis. (I thought to myself that if she related to her husband in the demanding and hostile manner she did with me it would not take a stretch of imagination to imagine why he was unable to get an erection in her presence on a psychological basis as well). I offered to see them together to discuss not only their feelings but how their problem might be better assessed and treated.  She was not happy with my response and said she thought it would probably be a good idea to find another psychiatrist who might be more supportive and responsive to her needs.

A couple of months later she called back to say she had decided against seeing a different doctor and would like to continue seeing me.  I must admit that her decision was not the one I would by now have hoped for. 

On the occasions that she saw me during the ensuing year she often made the same complaint and request regarding her husband that I responded to in the same way.  She continued to fire and rehire me. She spent most of the time during our sessions pointing out what she had observed in terms of my faults when compared to her analyst in NYC.  When she finally made a permanent decision to discontinue her visits she did so with the comment,  “If you think you’re such hot stuff, what are you doing in Oshkosh?”

2006