'Til death do you part?

Wrestling with matters of intimacy and autonomy

by Bill Rodriguezk

Peter D. Kramer

The author most widely known for writing Listening to Prozac doesn't believe in easy answers -- or easy questions. That's ironic, because Providence psychiatrist Peter D. Kramer is wrongly associated by many who didn't read the book -- and by some reviewers who read it carelessly -- with promoting the Panacea Pill school of mental hygiene. In fact, the 1993 best seller merely observed that anti-depressants are helpful for many people. The book, and Kramer, was far more interested in examining the ethics and likelihood that such drugs were changing the very nature of being a human being in our society.

And if it's tough to get across such a distinction clearly in a whole volume, how difficult must it be to communicate the right message to a person bristling with defense mechanisms in therapy?

Yet in his recently published Should You Leave?, Kramer has taken on an open-ended question that rarely has an absolute answer. It's also one of the most common themes in his clinical practice.

That he is humbled by the question is evident in the book's subtitle: "A Psychiatrist Explores Intimacy and Autonomy -- and the Nature of Advice."

Exploration indeed. Decide yes, decide no, each way leads into uncharted territory.

"You don't get the opportunity that you get in the stories of Borges, following two paths at once. You follow one path and you don't know what would have happened if you had done the other one," Kramer says of deciding to leave or not. "In reality you only get to follow one route."

Dressed in jeans and a black Provincetown sweatshirt, he is sitting in the living room of his East Side home, a leisurely walk to his classes and seminars as Clinical Professor of Psychiatry at Brown University. As a Harvard undergraduate his concentrations were history and literature. The latter interest is evident in his using fictional composites rather than case studies in Should You Leave? Kramer is 49, though he looks far younger, and despite a happy 17-year marriage that has produced three children, ages 7 to 16, he is anything but complaisant about the challenges to such unions today.

"We're in a culture where almost half the marriages end in divorce. You almost need as much reason to stay as to go. I don't think there's been any other civilization that's been balanced quite this way," he points out. "And that's marriages. Obviously, most relationships that are not marriages do end.

"This book is certainly not meant to solve the crisis of divorce. But I do think, often, that people give up too easily," he says. "Particularly, when people consult me I have a sense that they don't have a very good sense of what it is to try."

Trying hard to make a relationship succeed is hardly the kind of feel-good message that makes self-help book sales soar. Kramer doesn't think much of the run-of-the-drugstore-rack paperbacks that reduce the complexity of life to numbered lists and simple rules for living. A recurring character in Should You Leave? is the short story writing psychiatrist Lou Adler, a fictional assemblage of mentor figures in Kramer's life. After reading an early draft of the book, he impishly responds, "No maxims? No metaphors?"

"Almost anything you could say in self-help is right for some person and wrong for another person," Kramer says. "Really, living is a creative act. That's the problem with ordinary self-help, that if you went around applying the rules you might be more successful in terms of achieving the goods that the culture, but you might not live your own life."

And those values are problematical, as Kramer sees it. This is a very "consumerous" culture, he observes, where people's worth is largely assessed in terms of beauty, bank balance and other matters unrelated to character. "And there's a sense that you can trade up. That if the model you have doesn't give you sufficient dignity or reward, that you can trade up to a more valuable model. I think that is really more dangerous at the moment. The ease of divorce with the strength of this sort of hyper-capitalism makes relationships very difficult."

Perpetuating this attitude is the popular culture at large, which establishes and perpetuates behaviors and expectations through more than Oprah and Ricki Lake.

"The characters as they are depicted in sitcoms and hospital and police dramas and mass-market cinema are a lot like self-help," Kramer says. "They contain some message about what the cultural values are -- that you should be assertive, that you should leave and not try to reform an alcoholic. There are all these messages that are the bromides of the culture that are contained in non-literary storytelling."

Kramer contrasts that superficiality with literary storytelling, which he finds to be far closer to life as experienced. A New Yorker short story may not offer the comforting predictability of a Seinfeld episode, but it is far more honest in its characterizations -- ambiguous but honest.

"The message of literary fiction is that life and, parenthetically, your own situation, are as complex as you imagine them to be," Kramer suggests.

You won't get the final word about a perplexing relationship by skipping to the last chapter of Should You Leave?, as you might with a novel. But if Dr. Kramer succeeds in his book, his readers will have a greater respect for their own hard questions than they will for others' easy answers.

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What to do?

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