On October 14, 20–, I took on the case of Dr. Bavaria, a psychiatrist in his fifties who practiced in the Noe Valley neighborhood of San Francisco. His symptoms and prescription pad so fascinated me that I committed myself to his analysis and cure. The resultant failures are my own, mostly due to my hypnosis technique still being in its infancy. But I am happy to say that I myself came out of the enterprise all the fitter.

“Dr. Bavaria” is, of course, a pseudonym, inspired by the man’s Teutonic mass. His teeth appeared too large for his mouth and his hair still swelled gloriously above his head. When I saw him for the first time, he was holding the door open as he ushered me into his office. He then perched on an expensive-looking leather chair and informed me dreamily that he did not accept health insurance. I couldn’t help but notice a queer disassociation between speech and body, as if he were barely aware that he was speaking to someone else.

He was reticent about his past and private life, so it was challenging for me to piece together a personal history. Luckily, today’s analysts can rely on social media to fill in some of the gaps. While waiting for my appointment one day, I saw a well-preserved, honey-haired woman emerge from Dr. Bavaria’s office. The psychiatrist was on the phone, so he could hardly prevent me from introducing myself to the woman intuition told me was his wife. “Augusta,” she said as she inclined her head (obviously, I have changed her name). Peeping out of her Salvatore Ferragamo bag was an art history textbook. With these clues I sacked the Internet and determined that Dr. Bavaria’s wife was indeed named Augusta. Born in Des Moines, she had been crowned “Miss Teen Iowa” decades back. After raising two children, she appeared to have gone back to school to pursue a degree in art history. Although I dug a little deeper, the only hints of perversity I could find were a penchant for knee-length leather skirts and a tendency to kiss the cheeks of female friends in photographs. What these behaviors may indicate about her sexual relationship with Dr. Bavaria, and his satisfaction or lack thereof, I cannot say.

***

The patient and I met once a week for fifty minutes. He said very little, and while I talked his face bore a strained expression, as if he were constipated. However, I speculated that he wore it because he was listening to me so intently. I have always enjoyed talking about myself, and thus I find this part of the analysis most pleasant. While I ramble on about my interpersonal problems, which I have recited many times before, I am free to observe my subjects.

This one was even more laconic than usual. His reticence amplified his glowering physical presence, which might have intimidated another analyst. But I thought of him as a wounded bear, trapped in his large body. Certainly, he always looked, when I met with him, like he wanted to be anywhere but where he was.

Near the end of each appointment, he would take out his prescription pad. Usually he adjusted my medications slightly but added nothing exciting. When I voiced a desire for a painkiller to soothe my migraines, he refused, citing the potential for dependency.

The patient suffered from a profound narcissism, as evidenced by the fact that, when I called him one week in between sessions, he charged me for returning my call. “I charge in fifteen-minute blocks,” he explained at the next session. As only a narcissist could imagine that one fifteen-minute block of his conversation was worth a hundred and twenty-five dollars, I added this diagnosis to my developing picture of him.

***

After about a half dozen sessions with the patient, I decided to try hypnosis. I have always been fascinated by Freud’s claims that he could revise a patient’s painful memories while he held her in a hypnotic state. While it may sound implausible that I could have induced hypnosis in a subject unaware of what was happening, please remember that the repetitive recitations of a neurotic are nothing if not sedative, and I can expertly mimic such a patient. Thirty minutes into my monologue, I only had to make a few passes of my hand to achieve my goal.

First I asked him some questions about his day and his dreams. Suddenly, Dr. Bavaria whispered breathlessly, “I am the captive of a madwoman.”

Taken aback, I thought of one of Freud’s case histories, specifically Frau Emmy’s somnambulistic assertion, “I am a woman dating from the last century.” In that case, a chance association with an antique cupboard birthed the bizarre announcement. What random thought collision had made this madwoman materialize in his mind? I decided to question him further.

“Where are you right now?”

“I’m in my office.”

“Where and when is your office?”

“Here, now, in San Francisco.”

“Who is holding you captive?”

“A deranged woman.”

“What is she doing?” If the woman was deranged, I deduced she must be doing something unusual.

“She is stealing my mind.”

Now this was interesting, as everyone knows that a mind, unlike a password or a bottle of pills, cannot be stolen. I pressed further.

“How is she doing this?”

“I don’t know.”

I could only conclude that some past trauma had emerged from his subconscious sufficient to cause him pain, but repression occluded its details. Freud went so far as to stroke or massage his patients in such moments of agitation, but I think boundaries are important. I decided to bring him back to the more important topic, in order to spare him the psychic affliction of past memories he was not ready to process.

“You are with a patient right now,” I prompted him.

“Yes, she is the madwoman!”

What anguish he must be suffering to confuse me with the madwoman of his fever dreams!

“This patient you are with,” I prompted. “She requires a higher dose of Klonopin.”

“Of course.”

“And Adderall.”

“Of course.”

“And Vicodin.”

“Vicodin?”

I decided not to push my luck—I mean, I decided not to allow any trace of unease into his relaxed state. I gradually brought him out of hypnosis, after making various suggestions concerning my likability and wiping clean all memories of this treatment.

Dr. Bavaria came back to his authority with a start. He looked sheepish; he must have suspected he’d fallen asleep listening to me. Still groggy, he reached for his prescription pad and tossed off directives for both the Adderall and additional Klonopin.

***

Three days later, there was a knock at my door. A letter from Dr. Bavaria—how old-fashioned!—had arrived by special delivery, requiring my signature. In it he broke off all relations with me, writing, “It is to my mind in the best interests of both of us that you find a doctor who has the time to monitor your progress and particularly your prescription drug abuse more closely.”

I felt a rush of sympathy for him later that evening when I realized his rejection of me was in fact a form of self-protection. Dr. Bavaria had probably grown subconsciously attached to me under hypnosis and experienced a great sense of abandonment when I left his office that day. Better, in his mind, to sever the connection before the intimacy and dependency deepened.

In conclusion, it is clear that Dr. Bavaria was stymied by several intractable behavioral patterns. Not surprisingly, given his narcissistic tendencies, his lack of empathy toward other human beings was striking. By the time I ended our analysis, I had even started to wonder if he might be a sociopath. I’m glad I ended his treatment when I did, lest his madness spread to me.