Hilly and I were in the middle of our fourth couples-therapy session; we’d been talking about whether or not I was controlling. Then Dr. Selman asked what we wanted to get out of the therapy ….
DR. SELMAN: It’s good to keep our eye on the goal. What do we hope to achieve?
George [to HILLY]: I think that you said that everything’s great 90 percent of the time? But stuff where we have … disagreements—it would just be nice to have a, you know, healthier relationship. Right?
DR. SELMAN: Interestingly enough, I don’t recall any specific disagreements that you’ve had. You pretty much agree on most things. There are complaints, but out-and-out disagreements, where one of you says, “Look, I don’t agree with that”—you haven’t said that!
HILLY: Well, I have to say something. There’s one we don’t necessarily agree on: When it comes to making plans of any sort, George really doesn’t like to. He likes to have control of his schedule. A couple of weeks ago, I was making holiday plans for this coming December with my parents. And they asked me on the telephone, “Well, why don’t you bring George?” Because if we book now, we’ll get a better fare. And my response was, “I can’t—he’ll have a coronary.” He doesn’t make plans, plus he hates holidays. So there’s no way I can ask him at least until November. And he doesn’t like to make plans such as, “What are you going to do tomorrow night?”—which is fine, because I like to keep that kind of stuff open, too. But sometimes I think grownups have to learn how to make certain plans for the future.
DR. SELMAN: What you’re saying again is that George is very controlling, and this is a complaint that you have.
HILLY: Only at certain times—for me. I do think that people need to plan for the future, whether it’s going to be on their own or with someone else, and just make plans and decisions in case … I don’t know ….
DR. SELMAN: Well, I think a disagreement would be more in line with, say, George saying, “You know something, I really don’t want to do that. I’d rather go somewhere else entirely.”
GEORGE: I complain about how I want to break the routine.
HILLY: Oh, yes—that happened the other night. When you got really, really upset when we tried to watch a couple of different movies? Finally you just screamed and stood up and said, “I’m NOT DOING THIS anymore!” And you walked over to the TV and turned it off and said, “I’m not going to sit around and watch movies!” And then you walked over and hid behind your computer. And I just read for a while and everything was fine.
GEORGE: Yes, I really liked us sitting around reading; that felt different. That was great!
DR. SELMAN: Well, is that a complaint? That he gets like that?
HILLY: Well, I do not like the fact that George gets irritable. I do not like the fact that George gets sad and depressed. Quite frankly, I’m sure that you of all people know it’s depressing to be around depressing people. And I’m already depressed. Everybody out there reading this knows that I take Prozac. And so it’s hard. When I see him depressed, it really starts to bring me down. I just think you have so many wonderful things to not be depressed about. It just seems like a waste of valuable Georgie time.
DR. SELMAN: How do you feel about her saying this?
GEORGE: Uhhh, I’m all right with it. Don’t worry. Can I ask something? The couples that you see … I’m just curious about …. Are they mostly married couples that you see?
DR. SELMAN: What is the relevance?
(GEORGE’s cell phone rings; he doesn’t answer it.)
GEORGE: I’m just wondering—all right, I am changing the subject. But I was just wondering, when you see, let’s say couples who are not married, how many years on average have they been together?
DR. SELMAN: There are all kinds of people.
GEORGE: Do you get couples after one year? Couples therapy after just one year of just going out?
DR. SELMAN: I’ve seen that.
GEORGE: What’s it like if it’s been an average of like three to five years?
DR. SELMAN: It depends on what your goal is. Usually, people who are in new relationships are not in couples therapy …. I think it’s important that we focus on what your goals are here.
HILLY: Are you married?
DR. SELMAN: [Silence] Am I? How is that relevant to this?
HILLY: Just curious.
DR. SELMAN: I’m separated. But I was married for 16 years.
GEORGE: Is that something that you wouldn’t want me to put in the paper?
DR. SELMAN: Put in whatever you want. If I didn’t want to say it, I wouldn’t say it.
GEORGE: Right, right.
DR. SELMAN: But I know what it’s like to be married. [Turns toward HILLY.] Did you say something?
HILLY: I dunno … I’m just kind of, uh ….
GEORGE: A person I interviewed last night, I mentioned to her that I was doing couples therapy, and she wondered if it was in our nature for men and women to be together for longer than three years. Or to be together without having problems, affairs.
HILLY: Wait, isn’t she from a Muslim background? So she probably has a different perspective on relationships between men and women, I would imagine.
DR. SELMAN: What’s your perspective, Hilly?
HILLY: About Islam?
DR. SELMAN: No. Do you think men and women belong together in a relationship?
HILLY: Absolutely! I look at my parents’ marriage and it’s beautiful. They’ve been married for 35 years, they’re each other’s best friend, but also lead their own lives. I can’t imagine anyone wouldn’t want that. At the same time, I can see how people evolve. And so I would hope that George and I will always be together, but things happen. So you never know if one day … Heidi might come knocking on your door (snickering). I don’t know ….
DR. SELMAN: Heidi being the older woman?
DR. SELMAN: Or that other one?
HILLY: Yeah—Heidi’s the 6-year-old from George’s childhood, with the pigtails.
DR. SELMAN: Would you say that one of the goals here would be to maintain the integrity of your relationship?
HILLY: That’s a good way of putting it!
GEORGE: Maintain? What does that mean, to “maintain the integrity of the relationship”?
DR. SELMAN: So that you stay together?
GEORGE: Yeah … yeah.
DR. SELMAN: You both have to add that as a goal. You know, you asked for direction!
GEORGE: Right … right!
DR. SELMAN: I think we can achieve our goals; if we know what they are, we’re much more likely to get there. So if staying together is one of the goals of this treatment, then I think that we should be clear on that.
GEORGE: Has anyone ever come to see you with the intention of breaking up?
DR. SELMAN: Yes.
DR. SELMAN: Or they don’t know. I’ve heard a lot of stories over the years. But I think it’s helpful if we can at least understand what it is that you guys want out of this. So let me reframe this again: One is to maintain the integrity of the relationship; another is that you want somehow to enhance your communication. And in doing that, I suppose, to be able to be more open with one another as to complaints that you might have with each other.
GEORGE: And to sort of take an inventory, talk about our relationship and get feedback—right?
DR. SELMAN: Feedback from me?
GEORGE: Yeah, your interpretations—yeah!
DR. SELMAN: Well, simple feedback: I would have to say that for you to reduce your level of irritability vis-à-vis Hilly would be one positive step.
HILLY: That would be wonderful.
DR. SELMAN: And to be less controlling.
GEORGE: To kind of chill out?
DR. SELMAN: How about George getting less depressed?
HILLY: That would be … a wonderful gift.
DR. SELMAN: Have you ever considered maybe treating your depression, George?
GEORGE: I tried it once—Wellbutrin for a week—and that just made me feel so numb, and there were no highs. Then the doctor gave me BuSpar, and I felt like aliens had taken over my head. A horrible, nightmarish experience.
HILLY: But you know what a good anti-depressant for you is? Exercise!
HILLY: And a healthy lifestyle! When he’s healthy and he goes swimming, he’s in a good mood!
DR. SELMAN: There are medications aside from Wellbutrin.
GEORGE: O.K., like what?
DR. SELMAN: You want me to go into that? I do have some psychopharm experience.
GEORGE: I could try something else. What would you recommend?
DR. SELMAN: Try an antidepressant other than Wellbutrin.
GEORGE: Like what?
DR. SELMAN: Effexor?
GEORGE: Do these make you, like, really fat?
DR. SELMAN: People can tend to gain a little weight with that drug, but not a lot. (To HILLY) You’re on Prozac. Does that make you gain much weight?
HILLY: I actually lost weight when I started taking it.
GEORGE: Sex drive?
DR. SELMAN: That could be impacted. That’s probably one of the more common reasons that people don’t want to take that drug, because it can lower your sexual desire and make it harder to have an orgasm. Another common side effect of it is increased sweating. But it is a great anti-depressant.
GEORGE: But I could try it for a couple weeks, right?
DR. SELMAN: You could. I’d be willing to give you some of that.
GEORGE: O.K., ummmmmmmm ….
HILLY: Now is probably not a good time for you to try something like that.
GEORGE: Right. Maybe when I get back from my trip. [Silence] What else is on your mind, Hilly? Sorry.
Dr Selman: [Laughs] Why do you say “sorry”? Look, you said that one of the ways that you can help your relationship is for you to be less depressed and less irritable. And your irritability, short temper, results in depression.
DR. SELMAN: You even use the word, “depression.”
GEORGE: Right! O.K.—sign me up. I’ll take the stuff as soon as I get back.
DR. SELMAN: As I’ve said also in previous sessions, one can feel irritable, anxious, angry as a result of having a hangover.
GEORGE: Does this stuff help with hangovers? I know that’s the wrong question.
DR. SELMAN: It neither helps nor hinders. The only thing that helps hangovers is to drink less.
GEORGE: But wait—does Prozac ever help with the next day?
HILLY: No, but you know what does happen: You take Prozac, and the alcohol really hits you a lot harder.
GEORGE: In a good way?
HILLY: In a bad way!
DR. SELMAN: I really don’t think that there’s much interaction with the drinking, other than that if you’re a depressed person, alcohol is a depressant and can make you more depressed.
GEORGE: You know, one time—this is going to sound bad, but—I had a psychiatrist. I told him that once in a while, I had to go out, be at parties, cover events. And he prescribed me Vicodin—’cause I told him that I would not drink, that I would just take a Vicodin or two. Do you think that’s irresponsible? It really worked. I’m not asking for some now; I’m just saying that I had that one, one and a half, and I just felt great. And I didn’t become addicted.
DR. SELMAN: What do you think?
GEORGE: Bad idea?
HILLY and GEORGE: Ha ha ha ha ha ha ha ha ha haaaaah ….
GEORGE: But wouldn’t that be better, to take one or two Vicodins rather than to have like seven or eight drinks?
DR. SELMAN: My guess is that you’d have one or two Vicodins and seven or eight drinks.
HILLY and GEORGE: Ha ha ha ha ha ha ha ha ha haaaaah ….
DR. SELMAN: Well, there are obvious approaches here in terms of your mood, because you could take an anti-depressant. I don’t want to foist anything on you, really. And you could cut down on drinking. I think both of those things—or even one or the other—would probably make some improvements with some of the kinds of things that Hilly finds problematic as far as impacting adversely on the relationship. Do you agree with that?
HILLY: Yes, but I’m a little concerned about George taking an anti-depressant. I have a feeling it’s going to make him more depressed.
DR. SELMAN: Why?
HILLY: Because he’s been against the idea of anti-depressants since I first met him, as far as I know. And I think that the sexual side-effect thing would be equally as depressing, if that were a side effect. I mean, I think it would be great if it did work. But I don’t know.
DR. SELMAN: Not everyone gets the sexual side effects.
GEORGE: Don’t you think I’ve been going out less?
HILLY: I think we need to, in general, make plans and then stick to them. Last weekend, you got really, really irritable, remember? We sat around and read and stuff, but the plan was to go to the Bronx Zoo, and we never made it there. We have to force ourselves to get up and get dressed and get out into the world.
GEORGE: We should have said no to that dinner at Lotus.
DR. SELMAN: What did that dinner do?
GEORGE: It led to a late night.
DR. SELMAN: It’s almost as if all roads lead to Rome with the drinking.
GEORGE: Oh, I see what you mean.
DR. SELMAN: That seems to be a consistent theme: drink too much, then you can’t go to the Bronx Zoo the next day because you can’t out of bed early enough.
HILLY: I could have gone. I don’t think I ever have a hangover problem.
DR. SELMAN: I think one of the problems is that for you guys to make real progress, there needs to be some kind of behavioral change, and that’s not happening. I don’t know how motivated you are to actually do that.
HILLY: So we have to try it again, make it to the Bronx Zoo.
DR. SELMAN: Yes, you know, keep trying. If at first you don’t succeed …. This is only the what, the fourth session? You certainly have come up with a lot of stuff.
HILLY: So there’s hope for us?
DR. SELMAN: There’s hope. It depends—what are we hoping for?
GEORGE: Have we revealed more than your average couple that comes in?
DR. SELMAN: You guys are fabulous.
HILLY: That’s what we want to hear!
GEORGE: So it’s been harder to get other couples to open up as much, right?
DR. SELMAN: Right! Most couples would never open up.
GEORGE: Really? Is he being serious?
HILLY: He’s being facetious.
[to be continued]