The contemporary Russian author and former dissident, Alexander Solzhenitsyn, wrote a book entitled, One Day in the Life of Ivan Denisovitch some years ago. The book was made into a movie of the same name. “One Day,” as it was called was a story of one day in the life of a man named Ivan (pronounced Ee-Vahn’ in Russian, by the way) as he survived a day in the Soviet gulag prison in Siberia. I had a day like this recently and thought it would be good to borrow Solzhenitsyn’s title for this blog. Actually, it was more like a week, no more like several weeks, but I will collapse some of this into a day “in the life of a therapist.”

Patient # 1: a man, late 30’s, now married for 15 years and together with his wife for nearly 20 years just heard from his wife that she is a lesbian and wants out of the marriage.  They have three young children; she has a very responsible professional job where her evident newly discovered sexual orientation may cost her the job and possibly her profession. My patient feels devastated, that he has “lost everything,” that he has “been lied too for 20 years,” that his wife may not really be lesbian, that his life is “ruined” and alternately that he is desperate to have his wife back and never wanting to see her again.

Patient # 2: another man, also late 30’s re-married for two years after a very painful divorce perpetrated by his wife who had an affair and claimed that she no longer loved the man. This new marriage, seemingly well founded, may not have been. He “dearly loves” his wife and thinks well of her, but they have such differences of how they go about life that he doesn’t know what to do. Secondary factors include his recent success in his profession along with his continued dissatisfaction with his career and profession.

Patient # 3: a young (19) man who got pushed into seeing me a year ago because his mother caught him smoking pot. Chris (of course, not his real name) got beyond the “push” from his mother and now enjoys talking to me, teases me as I tease him, has found a bit of direction in life aside from pot, and no longer has the suicidal thoughts and threats that concerned his mother.

Patient # 4: a girl, 6, whose mother brought her to me because, like so many other kids that I see in my office, she was been incorrigible. Oddly, I saw another girl, a bit older, right after this 6-year old, and they are both bright, attractive, fun, and…incorrigible. In a nutshell, this girl is 6 years old physically, about 8 or 9 years old intellectually, but about 3 emotionally. She is still selfish (we call it natural early childhood narcissism) like a 3-year old would be and demanding. And mother sees the worst of it, although the kid is not much better in school. Mothers always seem to get the worst of all things from kids. It’s a challenge to help Janey because she is so likable, and so my “play therapy” with her has a lot of fun and a lot of limitations. So she alternately loves me and hates me.

Patient # 5: a man, 45, now in his third marriage, that is struggling again. He wonders what seems to be wrong “picking the wrong woman”, or getting angry too easily, or something else that has prevented him from succeeding in his marriages. This same man has risen in the officer ranks of the Army at great speed. But he, like most men, has no real friends. Oh, he has a guy in NC whom he served with, a brother in Milwaukee, and he gets along with everybody in the Company, but he has no real friends…which is the case with most of the men I see.

Patient # 6: a man, 64, who is now off work on stress leave because, in my estimation, he was near death because of the stress he was experiencing where he worked. Everybody liked him at work, especially customers, who would always ask for James to help them, but he was falling apart. He had all kinds of psychosomatic problems that were caused by stress. He is now about 50% improved but can’t even go by his former employer’s store without cringing and increasing his blood pressure. He thinks I have done miracles.  All I have done is been his first friend in 30 years and helped him understand himself.

Patient # 7: a man, 66, who I see in a nursing home. He has multiple sclerosis. When I started seeing him 6 years ago, he had some use of his right hand so that he could manage his wheel chair and get around, and could change TV channels. He somehow fell out of his wheel chair a year or so ago and lost that ability. So now he can talk but cannot move any of his appendages. We talk about the Cubs (There’s always next year), his kids and grandkids, and much about his past. But the real task is to feel with him in this helpless life he has. He wishes he could fix his wife’s car or shovel the snow. He can’t. Oddly, I have to fight with his insurance company to cover my seeing Jack even though I am about the only person who understands what it is like to be a doer kind of person who can’t do anything.

Patient # 8: another man, also late 30’s, whose wife had an affair when she was at a conference in Atlanta. He is devastated, of course, but there are complications, like he is trained as an engineer but hates engineering and is not selling real estate, something he hates about as much as he hated engineering. Also, his wife and he have had some significant differences in their desire for frequency of sex, not unlike many couples. And, of course, they have a couple of young kids. So he is asking, who am I, who is she, who are we, and where should we go? I don’t have immediate answers.

 One day in the life of a therapist.