In the case of Carlos, Yalum discusses a patient who is unwilling to accept his reality and therefore has difficulty reaching out to others as he shrouds his existence in creating the character of himself, rather than living in his truth. Betty was a patient who was overweight, manifesting her fear of intimacy and rejection through an eating disorder which ruled her social life. Through cases in his own therapeutic practice history, Dr. Yalum reveals both the issues of patients and the experiences of treating them.
Case Study 1: If Rape Were Legal…
The case begins with an aggressive and negative assessment by a young psychiatric resident, Sarah, who is upset with a member of one of her group therapy members. Another of the members has revealed that she was raped, which inspired the young psychiatric resident to open up to the group about her own experience of being raped. As a response, one of the male members, Carlos, who is the subject of this case study, began to probe about the event and was eventually understood as being inappropriate because his questions were based upon a sexual response to the experiences of the women, leaving them both feeling violated. Both Martha and Sarah had discussed a very painful experience in their lives, but Carlos had taken that experience and used it for his own gratification without any consideration for their pain.
Carlos has his own problems that he is not addressing well. Carlos has cancer which is described as a rare, slow-growing lymphoma (Yalom 76). This illneess had been treated for over ten years, but was now invading his lungs and heart through the size of the tumor, thus giving him a short time of life left (Yalom 76). One of the problems that defined his mental state was that he did not do well in hearing the truth or accepting what was happening to him. His support system was non-existence, with two seventeen year old twins, a boy and a girl, living in Argentina with their mother. Carlos had no significant relationships, remaining isolated because of what seemed like a fear of intimacy in any form. During an epiphany in a therapy session with the narrator of the story, Dr. Irvin Yalom, he comes to realize that in the group sessions he has the opportunity to begin to form relationships with people in a safe place. When he comes back to report to the doctor, he has come to a second epiphany in which he realizes that people all have feeling, something he relates to the idea that people all have hearts. He uses a rather explicit concept of this, relating how he pulls back the skin, the bone, and the physical body to ‘see’ the hearts of all those around him. He shifts from being completely oblivious to the feelings of others to believing that he has realized that others have feelings and that he can be instrumental in helping others to connect to those feelings. The observable problem is that he is completely absorbed by his sense of self, and never fully reaches outside of his own needs when he engages others in his life. His issue is that he is facing something formidable, and has been facing it for ten years. He is isolated and has a very difficult time relating to how others are feeling. More than that, he frames everything in reference to how it makes him into a ‘character’ rather than realistic interactions. Even as he tries to interact, his experience is to create himself at the center of the