chance that she might once again revive her relationship with her lover, renunciation of that possibility signifying diminishment and death.
Existential isolation, a third given, refers to the unbridgeable gap between self and others, a gap that exists even in the presence of deeply gratifying interpersonal relationships. One is isolated not only from other beings but, to the extent that one constitutes one’s world, from world as well. Such isolation is to be distinguished from two other types of isolation: interpersonal and intrapersonal isolation.
One experiences interpersonal isolation, or loneliness, if one lacks the social skills or personality style that permit intimate social interactions. Intrapersonal isolation occurs when parts of the self are split off, as when one splits off emotion from the memory of an event. The most extreme, and dramatic, form of splitting, the multiple personality, is relatively rare (though growing more widely recognized); when it does occur, the therapist may be faced, as was I in the treatment of Marge (“Therapeutic Monogamy”), with the bewildering dilemma of which personality to cherish.
While there is no solution to existential isolation, therapists must discourage false solutions. One’s efforts to escape isolation can sabotage one’s relationships with other people. Many a friendship or marriage has failed because, instead of relating to, and caring for, one another, one person uses another as a shield against isolation.
A common, and vigorous, attempt to solve existential isolation, which occurs in several of these stories, is fusion—the softening of one’s boundaries, the melting into another. The power of fusion has been demonstrated in subliminal perception experiments in which the message “Mommy and I are one,” flashed on a screen so quickly that the subjects cannot consciously see it, results in their reporting that they feel better, stronger, more optimistic—and even in their responding better than other people to treatment (with behavioral modification) for such problems as smoking, obesity, or disturbed adolescent behavior.
One of the great paradoxes of life is that self-awareness breeds anxiety. Fusion eradicates anxiety in a radical fashion—by eliminating self-awareness. The person who has fallen in love, and entered a blissful state of merger, is not self-reflective because the questioning lonely I (and the attendant anxiety of isolation) dissolve into the we. Thus one sheds anxiety but loses oneself.
This is precisely why therapists do not like to treat a patient who has fallen in love. Therapy and a state of love-merger are incompatible because therapeutic work requires a questioning self-awareness and an anxiety that will ultimately serve as guide to internal conflicts.
Furthermore, it is difficult for me, as for most therapists, to form a relationship with a patient who has fallen in love. In the story “Love’s Executioner,” Thelma would not, for example, relate to me: her energy was completely consumed in her love obsession. Beware the powerful exclusive attachment to another; it is not, as people sometimes think, evidence of the purity of the love. Such encapsulated, exclusive love—feeding on itself, neither giving to nor caring about others—is destined to cave in on itself. Love is not just a passion spark between two people; there is infinite difference between falling in love and standing in love. Rather, love is a way of being, a “giving to,” not a “falling for”; a mode of relating at large, not an act limited to a single person.
Though we try hard to go through life two by two or in groups, there are times, especially when death approaches, that the truth—that we are born alone and must die alone—breaks through with chilling clarity. I have heard many dying patients remark that the most awful thing about dying is that it must be done alone. Yet, even at the point of death, the willingness of another to be fully