A Requiem for Eleanor Rigby

Elanor Rigby
Picks up the rich in the church
Where her wedding has been
Lives in a dream
Waits at the window
Wearing the face
That she keeps in a jar by the door
Who is it for?

All the lonely people
Where do they all come from?
All the lonely people
Where do they all belong?

John Lennon & Paul McCartney


Perhaps more than any case I’ve ever had, Sarah made me truly examine what it is I hoped to accomplish by being a therapist, and what this title really means. I met her during a period of my life when I had just come out a difficult relationship, and was in one of those interpersonal vortexes where I just couldn’t seem to connect with another person. This became particularly clear to me on a drive back to Chicago on a long, rainy night, where there was not another car in site for miles. I turned on the radio and heard,

“Never gonna fall in love again
I don't wanna start with someone new
Cause I couldn't bear to see it end
Just like me and you
No I never wanna feel the pain
Of rememberin' how it used to be
Never gonna fall in love again
Just like you and me”


It was a song by a man named Erik Carmen that I remembered from my youth. It was one of those songs that had the double bonus of being both grating as well as terribly depressing. I pulled over to the side of the road and looked into the mirror. I needed to gather myself for a minute. How had I gotten here, on the side of the road next to an Indiana wheat field with rain pounding down and not another person in site. Where had I gone wrong?

I eventually came out of this funk and made it back to Chicago, determined to commit myself to my work as a therapist, where I could focus on other people, something that had always been a wonderful recipe for alleviating my own feelings of loneliness.


An interesting thing that happens when you work as a therapist is that whatever your own personal issues are at the time, you can almost guarantee that one of your clients will have a problem that will pull these feelings out of you even more. This is the strange, synchronistic, dance of energy that takes place between two people in a therapeutic relationship. This dynamic was especially apparent in my work with Sarah, a 35 year-old woman who had found our office in the phone book and innocently scheduled an appointment with me on the Monday following the ride home I just described.


Sarah showed up to her appointment dressed very nicely and laughing and joking in a way that made me wonder what exactly I could help her with. We spent the whole first session engaging in this good-natured repartee, and when she left I couldn’t help but think I had just been on a first date rather than a therapy session.


Careful here, I thought to myself, this woman clearly has some of the exact issues that you do in your life, and this could be a tricky road to walk down. I thought about this a bit when I got home. One technique that is often pretty effective in therapy is to ask a person what advice they would give someone close to them if they described a similar issue that the person has presented. They are often able to come up with effective and creative solutions to this problem, which they are inexplicably unable to apply to themselves. This then can create a kind of cognitive dissonance, where a person becomes uncomfortable with their own illogical thinking, and slowly begin to incorporate changes into their lives.


From a psychological standpoint, I wanted to keep in mind Jung’s idea that “The meeting of two personalities is like the contact of two chemical substances; if there is any reaction, both are transformed.” My own hope for transformation was secondary in this case, as it was my first priority to see Sarah through her difficulties, and help her feel understood and perhaps even reach a new understanding about how she could create more intimate interpersonal relationships.


Sarah came in complaining about exactly that. She was, in her own words, “too picky” about the men she dated, and would often look for the slightest abnormality in a man and then use it as an excuse to cut her ties with them. For ten years she had been going on like this, and now, as she got into her mid-thirties, she had come to believe that she would never find a husband and be a mother, which had created significant feelings of sadness and loss.


All of this took weeks to get to however, as she masked this sadness by making jokes, laughing at herself, and generally changing the subject whenever the conversation would get uncomfortable or hit too close to home. It was a difficult dance, as these were all of my own compensatory patterns, and I had personally used all of them to change the subject when someone asked me about my own single lifestyle.


But this was my job, and, despite any personal shortcomings, I knew I could not allow her to continue to distract me from the issue she had come in seeking help for. I learned to stop laughing at all of her jokes and playing along with the witty banter, as it was a trap we had fallen into too often. I acknowledged that had we met under different circumstances, I would love to sit and talk with her like this, but she had come in with a problem, and that kind of conversation wasn’t helping us solve the problem.


So over time we began to talk more seriously. She attributed many of her problems with intimacy back to her parent’s divorce when she was 16, which had “blindsided” her and made her distrust the outward appearances of happy couples. Her parent’s relationship had seemed perfect to her, and when they hadn’t made it she had begun to question who could. It wasn’t an altogether uncommon response to divorce, and in particular a divorce that occurred at the age of 16, which is an important time in a woman’s life to begin to make sense of dating, relationships, and romance. Our parents are our templates for these relationships, and when their relationship dissolves, it is natural to wonder how one should proceed when their own model has been destroyed.


Over time our therapeutic relationship deepened, and we were in uncharted waters for me in terms of therapeutic intimacy. A companion to me while I thought about Sarah’s case was Irv Yalom’s book The Gift of Therapy, where he made the point over and over again that it was “the relationship that heals” in therapy. I knew that if she could continue to disclose the deepest and most vulnerable parts of herself in the sessions, that it was likely she could learn to develop this same kind of trust outside of the therapeutic office.


So on we went. Her talking all the time about the doubts she felt about herself and whether she would be any good to someone in a relationship given the insecurities she worked so hard to cover up. She made a number of important insights throughout our work together, and as the weeks turned into months, I was pleased at the progress we had made, and patted myself on the back about how neutral I had been able to stay as a therapist, despite struggling with a number of the same problems that Sarah had.

But I was in for a rude awakening. One Saturday about 6 months into our work together, I was out with some friends at an Irish bar, listening to music and having a beer with at least some notion of improving my own social situation. I felt a buzzing in my pocket and looked down. It was Sarah. What was she doing calling me now? I wondered if she had dialed me by mistake, or sat on her phone, or if there was some other such explanation, but when I listened to her message I knew this wasn’t the case.


She had called me sobbing and sounded very desperate, and I knew that I immediately had to snap back into therapist mode for a moment, despite the fact that it was a Saturday night and I was on my own time. I called her back and she explained that she was feeling suicidal and didn’t know if she could make it through the night. I asked her if she had a plan or the means to commit suicide, and she said she did not, but that she was also very desperate and wondered if it was possible if I could come out and talk to her.

This proved to be a serious test of my clinical judgment. I had had a couple of drinks, and knew that driving was not an option. I could call 911, but that didn’t seem to be a great solution either. She seemed to just need to talk to me at this moment, and I began the long and arduous trip on Chicago’s public transportation to go and see her.

When I got there it was midnight and she was sitting in her car. I unlocked the door and we went inside. Her eyes were red from crying and when we got to my office she let it all out.

“I needed you to know.. That for months I have been lying to you.. I have come in here, pretended to be Ok, and that I was making progress. But I’m not” I never told you about Elanor Rigby. You know the song? The song about the woman who dies alone? It has been in my head for months, and it just keeps getting louder. Tonight it got so loud I couldn’t get it to stop. And you know what the funny part is? The only thing that makes it quiet down is coming here. Coming to talk to you. So I guess I wanted to say fuck you.. Fuck you for making me care so much about you and not being available to me. That’s what I wanted to say to you.”

I took a deep breath and thought very carefully about what I was going to say next. Should I tell her about the songs that played in MY head? Tell her about my own dark night of the soul next to an Indiana farm? We were at a very important crossroads here and I wanted to show her how much she meant to me without making it appear like a romantic overture. What I did say is this;

“I care very much about you Sarah. The things you describe are things I have felt myself. A number of times. I became a therapist because I hate to see people in pain. I will give you everything I have as therapist to help you figure out how to get past your own loneliness. That’s how I think we get through pain, by giving what we have to give to others. From what I know you are an amazing, exceptional woman with an incredible amount of this to give to the rest of the world. Maybe we can keep trying to figure this out together.”

She took this all in with a kind of wonder, and slowly but surely stopped crying and began to think. I wasn’t quite sure if I was being tested in that moment, but what I did know is that for that moment at least, the crisis had been averted. We talked a little more and I hopped back onto the train on another rainy Chicago night to go back home. The soundtrack in my own head was playing “Eleanor Rigby”, but I knew it wouldn’t last forever. I had found a way to deal with my own loneliness, and this night had proved to me that I had made the right choice in becoming a therapist.

So Sarah and I continued our sessions, but after that night there seemed to be a whole new level of honesty between us that allowed for some real progress as we worked on the things that Sarah felt were holding her back. The idea of giving love to get love intrigued her, and, to my great surprise and pleasure, one day she marched into my office and told me how she had decided to become a therapist. That was over a year ago now, and I am happy to report that Sarah has now been in grad school for a year, and has also begun dating again.

I include this story because no other therapy case has truly made me think to this extent about why it is I am a therapist, and what it really means to create a healing relationship with someone in this context. When I began my work with Sarah I often felt like an impostor, as the insecurities, doubts, and failures she had experienced were no different than my own. One of my favorite Psychologists, Rudolph Dreikurs, talked about having “the courage to be imperfect” and in this case I found this courage, despite my own substitute feelings that threatened to undermine my confidence and render me ineffective as a therapist. It was a tremendous learning experience, and I have no doubt Sarah will “pay it forward" when it comes to passing on this lesson.