PSYCHO Shrink Speaks

Obsession

by Gary S. and Morris E. Chafets

Crown Publishers, $25

Breakdown

by Eileen McNamara

Pocket Books, $22

The story of Paul Lozano and Margaret Bean-Bayog is a remarkable one, so it remarkable literary event. Two books have just been published that both purport to tell the story of what happened between this and his distinguished psychiatrist. Both books are written by journalists associated with the Boston Globe--Eileen McNamara, who writes for the Globe's Sunday Magazine, and Gary Chafetz, a freelance investigative reporter who covered the story for the Globe when it first broke (Chafetz, as a co-author) although the preface indicates that his role was mainly one of consultant and adviser).

The two books draw diametrically opposed conclusions, McNamara advocating Paul Lozano's family's story and Chafetz taking Bean-Bayog's side. When I heard that these two books had been (almost simultaneously) published, I very much looked forward to reading them -- how often does one have the opportunity to hear both sides of the story? Surely, we would finally know what really happened in this sordid case.

A summary: according to McNamara's book, breakdown, Lozano entered Harvard Medical School in 1984 and soon entered therapy with Dr. Margaret Bean-Bayog, a psychiatrist and teacher at the school. She pursued a strange course of regression theraphy, making Lozano believe that she was his mother and implanting false memories of childhood abuse. It is almost certain that she had an affair with him or at least masturbated in his presence, but she abandoned him when she successfully adopted a child, leaving him helpless and depressed. He killed himself nine months later.

According to Chafetz's book, obsession, Bean-Bayog's therapy was innovative and difficult to understand , but not irresponsible or beyond the psychiatric pale. The sexual fantasies that Bean-Bayog wrote (and which Lozano Subsequently stole from her office) were a case of countertransference, in which a therapist attempts to deal with her emotional and psychological reactions to her patient. Lozano was psychotic suicidal, pathological liar whose inevitable suicide was delayed by Bean-Bayog's therapy.

Geoffrey stokes, who reviewed these books for the Globe, admitted this: "Though I am somewhat more sympathetic toward Bean-Bayog as a result of these books, I'm not that much more certain about what 'really' happened during Lozano's therapy and life than I was when his vexed case was playing itself out on the front pages." I find myself in exactly the same situation, as if I am watching one of those optical illusions that consists of a vase, depending on the Organizational whimsy of one's brain. Stokes continues: "But I am sure of this: One of these books --McNamara's -- is pervaded by a bias that fatally cripples its argument."

This is a rather strange assertion to make, especially after he has admitted that both of these books paint rather murky pictures of the story. Why does he resort to accusing one of the authors of bias, even as he is unconvinced by the other author's argument? After all, the Chafetz book is not without its own likely bias; in his preface, Morris Chafetz notes that he was (like Bean-Bayog) a member of the Harvard Medical School department of psychiatry and (like Bean-Bayog) a specialist on alcohol abuse and alcoholism.

Stokes does point out that the Chafetz book is curiously self-indulgent, written as a first-person narrative of one man's odyssey in search of the truth, whereas McNamara strikes a strong pose of journalistic objectivity, with her crisp prose and confident tone. But Stokes is correct--even if both of these books are "biased," only one of them could be said to be "croppled" by it, and that book is McNamara's. And it is croppled largely because of its posture of objectivity.

This is a story that confounds objectivity, partly because of its sheer complexity and partly because of the impossibility of knowing all the facts. One is convinced that Chafetz's story was, at least, pursued in good faith, that he was honestly searching for the truth of the matter. He is forthright about his sympathy for psychiatry, and he liberally admits uncertainty and ignorance when uncertainty and ignorance are warranted. McNamara, on the other hand, is far too certain. She never spoke to Bean-Beyog (whereas Chafetz did) and almost never admits the possibility of her innocence.

Innocence is, of course, the rub. We will probably never know exactly what happened in Margaret Bean-Bayog's office, and it is probably impossible to determine whether her therapy (or malpractice) actually caused his suicide. But we can ask at least two questions. If she is innocent, of what is she innocent, exactly? If she is guilty, of what is she guilty, exactly? Even if this case remains essentially unresolved, we must hope that it will initiate serious conversation about the practices of psychiatry and psychotherapy.

After reading these books, I am, like Stokes, somewhat more sympathetic toward Margaret Bean-Bayog. I believe that she wanted the best for her patient, and that she did not believe her therapy was irresponsible or bizarre. But this does not mean that her therapy was responsible or beneficial, which is an issue that would require at least tow more books to resolve. If nothing else good comes of this case, perhaps, at least, a hard look will be directed at one of the least regulated or established branches of medicine.