But when I see a fat lady, I move down a couple of rungs on the ladder of human Her New York therapist had referred her to Dr. Yalom. She’d. Section 2 > Exercise 4 > Obesity: body image and culture. The following passage opens Irving Yalom’s story, “Fat Lady.” In this story, Yalom, a psychiatrist, tells. Fat Lady. Yalom, Irvin. Primary Category: Literature / Nonfiction and “disgusted” by fat women, that his “contempt surpasses all cultural norms.

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So I then attempted to help her work on her life situation, but I could make little headway. I can see, I c? The closer we looked, the more apparent it was that everything led back to him, to his death, and to the one hundred fifty pounds Betty weighed at that time.

Farber’s falling asleep on her and added that I seemed much more interested than he.

During the first few sessions, Betty described, in endless detail, prob- lems she encountered at work with customers, co-workers, and bosses. But my contempt surpasses all cultural norms. Our exchange had taken my breath away, and I hated to end.

The real reason is that I can’t stand fat people.


This is raw and ugly stuff. But I’m changed as a result of knowing you She had been crying, her eyes downcast, but at my words she stopped sobbing and looked toward me, expectantly. Why is it so necessary for you to entertain me?

I needed someone to hate, too. I saw I had no choice but to own up. I’m going to have to leave California in a year, remember. Maybe that’s part of the reason you feel empty inside. Now committed to being entirely “present” with Betty, I tried not to flinch from any of her questions. Though she continued to take it, it had not helped her: And in her rebuke, she points out that in fact he has changed far less than he imagines. In the course of her abbreviated treatment-Yalom was about to start a sabbatical and could only offer 12 sessions-Penny resolutely faced the major issues of her life.


How dare they impose that body on the rest of us? The closer she approached that weight, the more depressed she grew and the more her mind swarmed with feelings and recollections of her father.

Interacting with the Medical Humanities

She got the point quickly. Nothing was going right in her life. It was also not difficult to argue that it was within her power to change these patterns — in fact she had already begun: Betty was a good student, attended the state university, went to work for a department store in Texas, and after two years was transferred to the central office in New York.

How would I respond when she asked about my feelings toward her? My negative feelings slowed me down. Where transference refers to feelings that the patient erroneously attaches “transfers” to the therapist but that in fact originated out of cat relationships, countertransference is the reverse — similar irrational feelings the therapist has toward the patient.

Can you believe a Texan who can’t drive? There was no way that she could deal with my revelation of negative feelings. It came about in this way. When she had been in therapy for a few months, I decided that her progress would be accelerated if she worked in a therapy group as well as in individual therapy.

What would happen if you stopped trying to entertain me? I had to be clear about how much of the boredom was my problem, about how bored I would be with any fat woman. I have never touched her. Aside from two or three brief periods fwt she lost forty to fifty pounds on crash diets, she had hovered between two hundred and two hundred fifty since she was twenty-one.


Second, there was her damned giggling, her forced gaiety, her reluctance to be appropriately serious.

It was an effort for me to locate her face, so layered and swathed in flesh as it was. It struck me that she was always revealing some- thing that occurred elsewhere — another time, another place. Betty tells him she knew this, but she kept seeing him because, despite his aversion, he was willing to listen to her and try to help.

But she inter- rupted and told me I had misunderstood: You might not like Yalom’s attitude toward his patient, but at least he is frank. Living on a ranch, she was no stranger to death. I was now permitted to inter- rupt her instantaneously reminding her, of course, of our new agree- ment whenever she giggled, adopted a silly accent, or attempted to amuse me or to make light of things in any distracting way.

A good working formula is: They were painting the whole outside of the house. So I know what it is like to sit in Betty’s place and I also know, as a therapist, what it is like to be confronted by one’s shadow in the person of the patient who has come to see me.

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