The Black Swan

First Patient

By Gerald Alper

A black swan is a totally unpredictable event that has dire consequences. My black swan, as a would-be psychotherapist, was my first real patient. My initiation was as a volunteer counselor working for a social service agency that functioned as an auxiliary to the family court. We were the last line of defense before a judge would assign a given case (usually, a husband who had been accused by his wife of violently beating her) to the criminal court. In effect, husband-and-wife, defendant and plaintiff, were told by the judge that if they wished to keep what had happened within the confines of the family court, they had better show good faith by immediately seeking the assistance of family counseling. Invariably, the husband, with no interest whatsoever in counseling but willing to do whatever was necessary to appease the judge, would dutifully proceed with his wife (generally intent upon revenge and finding someone who would collude by acting as a biased jury) to the nearest counselor.

It was my first job; Mrs. Miller (as I'll call her), a jovial, good-humored woman who took a friendly interest in cultivating my nascent skills, was my first supervisor. Raymond and Lucy were my first couple.

They were also the couple representing the greatest study in contrasts I was ever going to see. Raymond, a towering six-feet-five inches tall, was a militant black man who had migrated from Jamaica as a teenager and who worked as an auto mechanic. Lucy, five feet tall, was a petite Hispanic whose main dream, after she finished nursing her baby, was to matriculate full-time at the city college.

While sessions were joint, they might as well have been individual, for they were used primarily as a platform for Raymond's rage, with Lucy, cringing in her chair, as audience. Sonorous, sermonical rage was often how I thought of it. Counting himself as a member in good standing with the rising generation of angry black poets whose workshops he faithfully attended, Raymond sounded more like he was wailing away at some biblical turpitude, instead of venting his overblown disgust at what he perceived as domestic and marital injustices.

What did my instincts, unschooled as they were in family counseling, tell me about this couple? They told me that Raymond was dangerous — not to me (“I don't know if I agree with what you're doing but I trust you man”) — but to Lucy. When Mrs. Miller, clearly concerned, pressed me to be more articulate concerning the determinants of my alarm I was unable to do so. I didn't know whether it was the scary sense of the lack of boundaries to his crescendo–like rage, his fondness for purchasing illegal weapons at martial arts supply stores and then brandishing them in the face of his terrified wife, or his habit of barging in unannounced at his mother-in-law's apartment where Lucy was staying, rattling the bars of the baby’s crib while laughing devilishly and promising dire consequences if his wife didn't move back in with him immediately.

But Mrs. Miller took me seriously. Feeling that Raymond’s flights of global rage were as overwhelming for Lucy as they were for me, she recommended individual counseling for both to replace couple counseling. The idea, which made sense to me and won my immediate support, was to prevent Raymond from using counseling as a forum to discharge his rage, while thereby gaining precious breathing room for Lucy, and with it at least the hope of helping her to shore up her fragile defenses. And for the next month that is what I did, trying my best to function as a container and cathartic outlet for Raymond, while endeavoring to find a way to summon in Lucy a spark of resolve to take some initiative. I saw each of them alone, as Mrs. Miller had suggested, and although I thought I noticed some abatement of the previous pathological intensity of their conflicts, I continued to experience (with if, anything, even greater force) an unshakable dread that Raymond was on the verge of exploding. It was a premonition my supervisor shared, although she seemed as confused as to what to do about it as I was.

Then, about three months after they had originally been referred to me, they both failed to keep their appointment. When neither called, I did, finally reaching Raymond in his brother's apartment, where he was temporarily staying. On the telephone, he was surprisingly casual (“Something came up, I'll tell you about it next week”), and when there was a trace of a cough in my voice, he went out of his way to advise me, "Hey, take care of that cold."

Two days later, Lucy, whom I had been unable to reach, telephoned me from St. Vincent's Hospital. She spoke in a barely audible whisper and seemed genuinely contrite that she had uncharacteristically missed her appointment with me. As a way of apology she recited the gruesome events of the past few days. Three days prior (the day before I had spoken on the telephone with Raymond), Lucy was standing on a street corner in front of her mother's house trying to find a taxi to take her to her sister’s. Unexpectedly, Raymond, who must have been waiting for her, walked up  and began amicably chatting about nothing in particular. He was smiling, and when she told him she was in a hurry to see her sister, who was ill, he immediately flagged down a cab for her. As it drove up he bent down close to his wife and said: “Take care of yourself.” For a few moments, perhaps half a minute, Lucy did not feel any different, did not sense anything was wrong as the cab pulled away. Then she began to notice that both her skirt and her blouse were slowly and increasingly being stained with some viscous fluid. She could not imagine what it was. Aware of no pain, she slipped her hand underneath her skirt and began to feel around and when she drew it out it was bathed in blood. As Lucy would later learn (through her brother-in-law), what had happened was this: prior to approaching his wife on the street corner Raymond had somehow procured a small stiletto, and as he had bent over (malevolently whispering, “Take care of yourself”) he had nimbly plunged the stiletto through the wall of her stomach and swiftly retracted it.

In a thin, sad voice, seemingly devoid of feelings of anger, hurt or betrayal, she recounted how she had been oblivious to the penetration of the stiletto. Immediately upon stabbing her (as she was later told) her husband had gone to his brother's house and enthusiastically described what he had just done. To embellish it and to bring it to life, he had sat down and drawn a cartoon depicting an unknowing, unsuspecting Lucy with a belly gushing blood.

Miraculously, the blade of the stiletto had missed all vital organs, and it had appeared Lucy might be getting out of the hospital in a week. Meanwhile, a guard had been posted outside her door. A detective had been assigned to the case and wanted to speak with me. Lucy gave me his telephone number, and after I had finished speaking with her I immediately called him, volunteering all the information and help I could supply.

I never saw Lucy again, nor Raymond. After being safely released from the hospital, she returned to her mother's home for an extended convalescence. I spoke with her several more times on the telephone, and made a point of leaving the door open for an eventual return to counseling. In retrospect, I felt she had been too traumatically demoralized by what had happened to muster the courage to try and continue with her life, and I often wondered what fate had befallen her.

Raymond was another story. A few days after he stabbed his wife he joined the army. By the time he was tracked down, his wife was completely out of danger and she had reached a decision not to press charges (perhaps fearing reprisal and thinking the army was the best watchdog available, anyhow). By a curious chain of circumstances, which I never understood, Raymond was allowed to continue unprosecuted, presumably deemed fit to serve his country.

What had I learned? I had learned that a therapist has little to go on, even if experienced, if he or she cannot rely on his or her instincts — especially in a situation that is utterly novel such as this one. I had trusted my instincts twice: first by continuing to believe in and act upon my intuition that Raymond was dangerous, and then by immediately realizing the necessity of revoking the contract of confidentiality between Raymond and me and switching my allegiance to the investigating detective.

What have I learned about the black swan? That no one can trust they’ll never encounter a black swan. All you can do is trust your best instincts.

For readers wishing to pursue these ideas further see my new book God and therapy: What we believe when no one is watching (iBooks, Alper).

Published April 9th, 2016

Gerald Alper is an internationally recognized psychotherapist who is the author of 20 books.  These include besides the celebrated Portrait Of The Artist As A Young Patient, The Paranoia Of Everyday Life, The Dark Side Of The Analytic Moon, The PuppeteersThe Elephant In The Room: The Denial of The Unconscious Mind, and more recently the just published God And Therapy: What We Believe When No One Is Watching (I Books, Alper). He's been a Fellow of The American Institute of Psychotherapy and Psychoanalysis since 1985, a reviewer for The Journal of Contemporary Psychology, a contributor of articles and essays to leading professional journals, a frequent guest author appearing on public access radio programs throughout the United States and Canada.  His classic paper, A Psychoanalyist Takes the Turing Test, was included in the 2004 pioneering interdisciplinary anthology by Italian neuroscientist Franco Salzone who brought together seminal papers from both psychoanalysis and neuroscience. He lives with his wife in New York, stays in close contact with his two grown sons who remain hunkered down in Los Angeles and has been a practicing psychotherapist in Manhattan for the past 25 years.