This is the eighth post in this series. The last part can be found here.
Julia and Robert have come to my office. We are discussing their desire to elope.
I've just asked Julia if there is any way that her parents would agree to delay her return to their home island in Portugal.
Julia: I tried to get my father to delay my trip. He went crazy on me. This is exactly what he said: "You're going to São Miguel. And if you don't go on your own, I'll drag you there. You disgust me, you little bug! You worthless girl!"
I cried and cried. I said, "Father, I'm begging you on my knees, be patient and listen to me say just one thing."
He just wouldn't listen. He went on and on. "Forget about you, you worthless girl! You disobedient wretch! I'll tell you what. Go to the airport on Thursday or never look me in the face again. Don't say anything. Don't reply. Don't talk back to me.
"I feel like slapping you. Wife, we were cursed when we had her. She disgusts me!"
My mother and my assistant tried to help me. It was useless. The longer he yelled, the angrier he got. His last words to me were:
"If you don't act like my daughter, you can beg, starve, and die in the streets. I swear on my soul, I will never take you back or do anything for you. Believe me. Think about it. I won't break this promise."
Then my father stormed out of the room.
Me: What did you do then?
Julia: I begged my mother and my assistant for help. I said, "Mother, don't throw me out! Delay this trip for a month. Or, if you don't delay, make my travel plans to my grave."
Me: Did you mean that? Do you want to die instead of returning to São Miguel?
Julia: Yes, of course I mean it! How can I marry Robert if that happens? I'd rather die than live without him! If everything else fails, at least I have the power to take my own life.
Me: But what if they insist that you leave on Thursday or get thrown out of the house?
Julia: I have a plan for that.
Me: Can you share your plan with me?
Julia: Well, it's not really my plan. I went to the parish priest after the fight with my parents. He's from the islands and I thought he might have a solution for me.
Me: What did you say to him?
Julia: I said, if you who are so wise can't help, please be kind enough to call my solution wise. Then, I showed him my knife. I told him, I'll solve the problem now with this knife. Love joined my heart to Robert's. Before I go to São Miguel and am married to another man, I'll kill myself. You are wise and you have so much experience. Give me some advice. I want to die if what you say isn't the solution to how I can be with Robert.
Me: What was his plan?
Julia: This is what he told me to do. He said:
"Tomorrow night make sure that you are alone. When you're in bed, take this vial, mix its contents with liquor, and drink. Then a cold, sleep-inducing drug will run through your veins, and your pulse will stop. Your flesh will be cold, and you'll stop breathing. The red in your lips and your cheeks will turn pale, and your eyes will shut. It will seem like you're dead. You won't be able to move, and your body will be stiff like a corpse. You'll remain in this deathlike state for forty-two hours, and then you'll wake up as if from a pleasant sleep.
"Now, when your father comes to get you out of bed on Thursday morning, you'll seem dead. Then, as tradition demands, you'll be dressed up in your best clothes, put in an open coffin, and carried to the church. Meanwhile, Robert will come here, and we'll keep a watch for when you wake up. Then we'll seal the coffin and nobody will know that you're not in it. That night, Robert will take you away to New York City. This plan will free you from your shameful situation as long as you don't change your mind, or become scared like a silly woman and ruin your brave effort."
Me: (I look at Robert.) You know about this plan? What do you think?
Robert: I trust the priest. We've both known him forever. If this is what he thinks is best, then I'm willing to try.
Me: But suppose the medicine is too strong? Suppose Julia doesn't wake up from the coma or suppose that she dies instead?
Robert and Julia together: It will work.
Me: But the priest is not a doctor. Suppose something goes wrong. Robert, how would you feel if something bad happened to Julia?
Robert: Well, I'd be the one to find her. So I'd just drink the same poison, and kiss Julia good-bye. That way I'd die with a kiss.
There's no other way. Either we do what the priest suggests or she leaves the country next Thursday.
Me: (to Julia) You know about his plan to suicide if you die? Do you approve of it?
Julia: I wouldn't say that I "approve" but I can understand it. I'm not worried, I'm not going to die so he won't have to either.
Me: Suppose we try to come up with a different plan. If we could find one, would you agree not to take the priest's advice?
Robert: For me, I'm in favor of our plan. We've already discussed it. We both think it's our only option and that it will work. No offense, but I trust my priest more than I trust you.
Me: Julia, what do you think?
Julia: I agree with Robert.
Me: Julia, you mentioned your assistant. She seems to know about your situation. What does she say?
Julia: Well, she was helpful in the beginning. But then she agreed with my parents. She said, "Since things are the way they are, I think the best thing to do is leave for São Miguel."
Me: So you don't think that she could help us come up with an alternative to your plan?
Me: There's nothing, then, that can replace your current plan?
Robert: Can't think of anything.
Me: Well, to be honest, this plan makes me nervous. It sounds too close to a suicide pact. Or that's what could happen, anyway, if even the smallest thing goes wrong.
Robert: (talking over me) Well, it's our only way to be together and we're both willing to take the risk.
Me: Oh, gee, I forgot to tell my receptionist something. I'm really sorry but I need to step out for a second. I'll be right back.
I go to the receptionist and ask her to call 911 for me. I tell her that the couple has a suicide pact and needs to go to the hospital for evaluation.
When I go back into the room, I explain what I've just done. Both of them are angry. They threaten to bolt from the office. I explain that the police will be here before they get to the street. I also explain my rationale for calling the police and rescue. Their pact was too dangerous. My duty is to preserve their health and well-being. Therefore, I had to call the police. I offer to continue treatment after they are safe and stabilized.
Julia breaks into uncontrollable sobs. They make all sorts of objections and threaten to sue me for violating their confidentiality.
After a few more minutes, there is a knock on my door and the rescue team comes into my office.
It will surprise no one that I am not as bright as Shakespeare. Try as I would, I could not resolve Romeo and Juliet's dilemma with a smooth therapeutic move. Just as in the play, the resolution could only come from drastic measures.
The Chorus tells us this in the opening Prologue: "For the next two hours, we will watch the story of their doomed love and their parents' anger, which nothing but the children's deaths could stop." This was not my intended treatment outcome. However, I have no realistic alternative. I tried several versions of this post. I used every way that I could think of to solve their dilemma without involuntary hospitalization. None of it, though, rang true to the situation or the dialogue from Romeo and Juliet.
Their circumstances are too acute and progressed. Neither of them, in my opinion, can be trusted not to act on their plan. They might even devise a more risky, impulsive course.
As Robert says, they trust the priest more than me. Our therapeutic alliance is in its nascent stage and still weak. Their thinking is concrete and action-oriented. Interpretations of their situation and plan do no good in this case. For instance, I might try to point out to Julia that her plan has at least as much to do with parental rejection as it does with love for Robert. She plans to do to herself what her father threatened. Instead of his threat that she "beg, starve, and die in the streets," she was planning a death in her own bed. Julia would laugh at me for that interpretation. The therapy has not progressed to the point where she could use such an explanation. Furthermore, even on a more concrete plane, they reject my offer to help problem-solve and find other options.
Neither of them can identify a trustworthy external support. That is, of course, except for their parish priest. And he designed the plan to enter a drug-induced coma.
I have found few internal resources that either of them has to self-sooth or to improve their judgement and insight. They are both overwhelmed.
Their anxiety is fueled by a fear of losing one another. Additionally, for Robert, the fear of a return to deep depression is intense. The anxiety is propelling them toward ever more dangerous and hastily conceived actions.
Even though their plan stems from anxiety and is in itself intensely anxiety provoking, it keeps their hope alive. Seeing their plan as foolhardy would leave them without hope. And that would place them on the threshold of depression. So, rather than see the reality of their situation and cope with it accordingly, they lunge into anxiety and near irrationality.
I do not want to give the impression that all cases of anxiety guarding against depression lead to such an outcome. Recall Donovan Campbell; he certainly did not meet the criteria for psychiatric hospitalization.
Hospitalization could go either way for Robert and Julia. It might make them more emotionally and cognitively available for treatment. Or, they may lose their trust in therapists and shun any further therapy. At the least, the families will find out about their plans to wed. Any immediate repercussions of that can be handled in the safety of the hospital.
If any readers can suggest a viable alternative to involuntary hospitalization, I'd be appreciative. I want again to acknowledge that the overwhelming majority of the dialogue for Robert and Julia comes verbatim from No Fear Shakespeare's modern translation of Romeo and Juliet.