Psychotherapy Off the Wall

Given this way of looking at the process of consolidation of new therapeutic learning, Felicity was not surprised to observe a periodic re-emergence of symptoms. And, in fact, it was even reassuring to him when it occurred. But it had been about two months – that is, more than six weeks – since George and Felicity had terminated their treatment work together. Didn’t that bother Felicity? Not really. Felicity had no idea at all about when to start counting off the 6-week intervals. With the benefit of 20/20 hind-sight, Felicity was ready to argue to himself that the treatment had really been completed when George, unbeknown to Felicity, had stopped exposing himself. And that had now been about three months ago, or an interval equal to two six-week long-term consolidation periods.
Although troubled by Felicity’s capricious nonchalance about his criminal behaviour, George accepted the reassurance that Felicity was not worried and went home. They completed their follow-up interviews together a little short of the planned two years. There were no further incidents reported during that time, and George remained out of court and out of jail.
As if to tell Felicity that the termination of the follow-up was premature, just after it was completed and almost exactly two years following the last incident, George phoned Felicity again in a panic. “It’s all over me again,” he moaned. Felicity invited him in for another interview.
George looked scared and despondent when he appeared for the session a couple of days later. Felicity asked him what had happened. He said his wife had stopped accompanying him everywhere about a year perviously, since he had not exposed himself for a long time. He was driving home from work on Friday. He saw a woman walking on the sidewalk. He parked in a lane way ahead of her and, when she passed the lane, he stepped out and exposed himself. But he was not sure that she had seen him as she did not react in any way. He drove on until he reached a shopping mall. He parked and got out of his car, found a couple of women and exposed himself again. He was sure they saw him this time. Then he felt overwhelmed by panic. He leaped into his car, drove home as fast as he could, ran in and hid under the bed.
Felicity wanted to laugh at the image this account painted in his mind, but the fact that he was still unsure about why this incident had occurred sobered him. He asked George whether he was suffering from any infectious illness – he was not. He could see that George had not aged appreciably. He asked if he had been imbibing alcoholic beverages in any unusual quantities – he had not. He asked if George was under any other acute source of stress – he was not. He asked if George had been particularly tired. That would have exhausted Felicity’s intelligence about the conditions under which old habits are inclined temporarily to re-emerge. George acknowledged that he had been particularly tired. The incident in question had occurred while he was driving home on the Friday evening having just completed a week of double over-time shifts at work. Fatigue, and the above other factors, can reduce usual conscious controls, and can reinstate old habits temporarily. Felicity breathed a sigh of relief and told George to go home and get some rest. George shook his head and stared at Felicity in disbelief. There was no doubt Felicity was mad. However, mad or sane, he felt he could trust Felicity, and he did as he was told.

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