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The Conversation

Authors Andrew Solomon and Abraham Verghese discuss intimate trust, earned and unearned, in friendship, family, love and sex.

The Conversation, by Pierre-August Renoir, 1878.

The Conversation, by Pierre-August Renoir, 1878.

Andrew Solomon: Falling in love, the love of ecstatic discovery — a state that I think American society has endlessly idealized, the happy ending of movies — seems to be predicated a lot of the time on illusion. It is based on a trust that has not been earned. The leap from that experience to the profound love of someone one really believes one can trust is enormously complex and difficult.

Abraham Verghese: In America we love fairly easily. But to trust someone is almost a higher art, a higher goal than to simply love someone. Love is used fairly freely as a word to describe our feelings for other people. But we can love them without necessarily trusting them, and I suspect that the most complete form of love is also to trust someone and risk all the pain that might ensue from having not just loved, but also trusted them, bared oneself to them.

AS: I think of two things: One is an old saying of my mother’s, that you can’t make a new old friend. There are some kinds of trust that have to develop over long spans of time, usually tested by traumas and disasters. Each time an old friend passes the test, demonstrating love and loyalty, that leads to a fresh understanding of the trust in the friendship. Old friends who endure have had their trustworthiness tried over and over again.

Though old friends are at the center of things for me, I also certainly think of myself as having newer friendships in which there’s a great deal of misplaced trust. There is a great deal of revealing of information, which is not actually the same as revealing of the self but which seems somehow to approximate intimacy. Reciprocal revealing of information — “this is who I am, this is what I’ve experienced, this is what I’ve done.” I think I put a premature trust, to some extent, in those people and so become awfully vulnerable to them.

AV: If you meet someone and fall in love and decide to marry and spend the rest of your life with them, or enter a domestic situation with them, you can’t really test the trust until time itself has tested the trust. There’s no way a priori to know that this is a trustworthy person. It has to be a leap of faith.

Without generalizing too much, I suspect that women are more willing to see the best in men. And men are not being deceitful in earning that kind of trust from a woman but perhaps don’t have a good sense of how well they can live up to these idealized images that they’ve created in order to win the women over.

AS: Now that’s interesting. I would have said that women’s perceptions of men tend to be more accurate and more informed — at least in the broad society out there — than men’s perceptions of women. The reason women experience more betrayals is because women are more inclined altogether toward the activity of trusting, and men experience fewer because they are more inclined toward a self-reliance which is ultimately isolating, in which trust is not so readily put forward or isn’t put forward as emphatically, and therefore is not as much available for betrayal or bruising.

AV: So you think that women are realistic about what men might do and can do, but they nonetheless have more faith in the institution of, say, marriage and put more trust in it than they should?

AS: “More trust than they should” is awfully prescriptive. But I think that women long to trust people and make an effort to find people whom they can trust — and make an effort to bring out the trustworthiness in the people they’re with by extending trust before the worthiness is fully manifest. While I think men are suspicious of the activity of trusting and withhold trust even when it’s been well-earned. Their suspicion is an effective defense against disillusionment. As you’ve suggested, women suffer more.

AV: Certainly from the perspective of an HIV clinic I see many more women who thought they were in trusting, intimate relationships who’d been betrayed than I see men who’ve been betrayed. It’s almost a cliché. One doesn’t know quite what to say to the woman in that setting. In a strange sort of way, the women are obviously surprised and devastated, but in some way manage still, most of them, to continue loving the person who brought this deadly virus into the marriage. It’s the most extraordinary thing. Almost as though at some level we understand this to be perhaps our nature, not something that we can take someone to task for, because it’s the very thing that makes us human.

AS: I’ve had sustained romantic and sexual involvements with men and with women; and when I’m first becoming involved with them, possibly before we’ve even fully progressed to the bedroom, the anxiety of gay men who I get involved with is that I will ultimately want a kind of settledness and permanence that they can’t offer, which is contingent on a conventional family and children. The concern of the women I become involved with is always that I have some powerful and uncontrollable secret erotic impulse and that I will ultimately run off and have sexual encounters with men. The men are very seldom worried that I might settle into a deeper emotional state with men. The areas of confidence and the areas of vulnerability are completely different. I don’t think that has to do with me per se. It’s simply that men and women fear differently. Gay love is different from straight love.

AV: I’ve seen many more women stand by their man through the most difficult circumstances; and I’ve always wondered, if the story was the other way around, if this wife had infected her husband because of her deceptions, would the husband stay around and three years later be nursing her on her deathbed and, even though he’s infected, stay by the children? And my feeling is perhaps not — or not as often.

It’s clearly not fair to look at life from the perspective of a clinic, yet I’m in a unique role because people tell their physicians things that they wouldn’t tell anybody else. Not even their ministers. They go to their graves carrying sexual secrets that their spouse doesn’t know, their minister doesn’t know, and so one has this unique opportunity to see human nature from that perspective. But it’s a very skewed perspective. It leads me to certain generalities that may not hold true for the people who don’t show up in clinic, who are living very happy and comfortable lives.

AS: I don’t know that I can say that that’s in keeping with my experience. I haven’t been in the clinical situations that you’re describing. I suppose I was so close to my parents’ marriage and to the ways in which my father stood by my mother during her terminal illness and suicide, a situation in which there hadn’t been a betrayal; and then none of our family friends or relatives ever divorced or separated, and my own relationships of two or three years during my dating twenties ended when trust failed. So I don’t feel particularly in touch with situations in which there has been betrayal and somebody has stuck it out.

There was someone I knew when I was young who my friends and I thought of as being perfect. It was a kind of running joke that she was perfect. She was beautiful and she was brilliant. And she was much loved. She had wonderful parents who adored her, and she was incredibly sweet and nice and good-natured. She ended up marrying a man almost all of her friends disliked and whom we all tried to come around to because she had married him. He then treated her very badly. They’ve since got divorced, and I think it’s almost destroyed her. She’s withdrawn from the world. She lives back at home with her family.

I think that her marrying him in the first place came out of a naïveté in which she had not recognized that people could be of ill intention. Her trust, as it were, was so broad and so general that there were no boundaries to it. There were no edges where there needed to be edges. Once that total innocence was shattered, there was no way to accommodate the problems that she’d had to endure, except to go back as much as she could to an approximation of her early childhood situation.

AV: I guess it begs the question, “Is trust, is intimate trust, really a form of naïveté in our present society?” In other words, as someone said: “You know how they say ‘Screw you’ in Hollywood? They say, ‘Trust me.'” Has it come to the point where intimate trust is really a form of naïveté?

AS: Gee, I hope not. One of the things I’ve noticed in working with the depressed population that I’ve been with, one of the things that’s so striking to me about many of these people is that they don’t trust anyone; they haven’t trusted anyone. Sometimes they’ve been surrounded at a very early stage by untrustworthy people, and that’s been the origin of the depression. But sometimes the consequence of the depression is that they cease to trust perfectly trustworthy people who are close to them, and that causes an isolation that is the most devastating of all of the symptoms or all of the manifestations of depressive illness.

AV: I think a lot of trust is about being willing to be needy for someone, to let them see your neediness, your desire, not just for them, but for a ministering to, a sort of being taken care of. And when someone betrays your trust, the counterpoint of trust to me is shame. I think shame and trust go hand in hand.

AS: Well I think it’s a sham that we’re so ashamed of neediness. There’s almost a cliché now of romantic pursuit, that the person in pursuit should never manifest any neediness or vulnerability. There are lots of people who in some bygone era would have written troubadour poems and played the harp under their lady’s window and gone off to war with her mascot, who now make a point of not really returning telephone calls and not returning them too quickly, and not seeming too committed too soon. Flirtation is almost entirely based on that unavailability, and “unavailable” is seen as the desirable and the “available” is someone undesirable.

AV: I think it’s very American and English. I’m struck, living in El Paso in a very strong Hispanic culture, how the troubadour is alive and well. You send mariachis to sing under the window of the woman you’re courting.

AS: Our issues in America are very different from the experience that I’ve witnessed in Russia, where I’ve spent a lot of time. It is the tradition in Russia that if someone is needy, one ought to give, and that everyone should be, I suppose, in some sense, as trustworthy as possible. Not with strangers — to whom one is unbelievably, unspeakably rude — but with people one knows, who are part of one’s circle. Here there is definitely a measuring and a doling out that goes on. “I’ve come through for you three times in the past six months, and that’s enough. Don’t ask me to do it again.” One feels that a lot of one’s trust — except perhaps for certain kinds of familial trust — is conditional, and that one doesn’t want to upset the balance too much. That sense of not occupying too much of someone else’s energy or space, of constantly defending one’s own turf or territory, is very isolating and is very Western.

AV: India is suffering from the biggest explosion of AIDS almost anywhere in the world, and an amazing number of the people being infected are housewives who are being infected by their roving husbands. So I’m not sure that the paradigm is that different in terms of betrayal and intimate trust. But the expression of neediness — the strength of one’s society, of one’s connectedness to one’s neighbor, one’s parents, one’s relatives — I think is so much stronger elsewhere than it is here.

AS: I feel extremely fortunate in having a very trustworthy family, which has perhaps made it easier for me to trust people out in the world. I have many neuroses that were caused by complex dynamics in the family, and I have elaborate and mixed feelings about family in many ways. But the whole time that I was growing up, I don’t remember my mother ever not being someplace she’d said she would be, not being on time when she was picking me up. At that actual, basic level she never said that she was going to do anything that didn’t happen.

I know that I don’t myself come up to that standard. But I think the ways in which one trusts and the kinds of trust one expects are very much contingent on family and on early experience. And to some extent, I think that later in life people get the kinds of trust that they have learned to anticipate. People who have an underlying sense that they’re going to be betrayed usually find people who will betray them.

AV: I think the best form of trust and intimacy that one ever sees is in the parent-child relationship. The love one has for one’s child comes out of a wellspring that one didn’t quite know existed. I think there’s nothing better for a child than to be able to look up to his parents and feel like they’re there for him.

Yet I think so much of the love we see around is a possessive sort of love. It says, “I’ll love you as long as you conform to the kind of behavior that I find acceptable.” This is true also of parental love, which is often conditional.

AS: Parental approbation is conditional and is something that children long for, but I think parental love is the least conditional love that there is.

AV: But the child may not understand that. The child might mistake any form of parental disapproval as rejection, and it can easily elicit shame. These can be, I think, the biggest wounds that linger for the longest time.

What makes divorce extraordinarily difficult is to somehow convince the child that this act doesn’t involve some distancing from him. It’s very, very difficult to do. And very painful because your overwhelming feeling is one of having let down the trust of the child who trusted that what he or she saw from the moment they were first aware would always remain that way. And to betray that, to me, creates a much greater sense of betrayal than betraying one’s spouse.

AS: I think the story of Anna Karenina reduced to a sentence is that she was overcome by a passion so powerful that it caused her to abandon her son — oh, and by the way, her husband and the whole life that she lived. And that once she had abandoned him and understood that there was no way that she could keep him and keep the passion, which happened after she had allowed herself to run with the passion, there was no possibility of happiness for her. There was nothing she could do except to kill herself, because all of the available scenarios were equally dismal and bleak.

AV: In gay relationships, do you think that quality of trust is more elusive? I know we’re coming back to this again, but I think there’s a tremendous longing on the part of many gay men I know to find something that resembles the traditional American marriage and all its qualities. Lacking that institution, how do you define and get and guarantee all those attributes?

AS: I’ve never found it so difficult or elusive; but I know many, many people who have.

It was quite startling to me, having been gay and fairly openly gay for a while before I got involved in the first heterosexual relationship that I was in. I felt that I was very much at ease being gay, living in New York in the world that I was in. Then I got involved with a woman, and I was amazed by how much reinforcement there was from the outside world and by how different that experience was. How enabling it was, and how much easier it made some parts of our lives. Suddenly I was brought face to face with the fact that there were mechanisms of — almost legislated ways of — representing trust and love and all of the internal matters that we’ve been discussing. There was an unself-consciousness to the whole thing that I’d never had before. It was a sense somehow of people cheering one on.

The social support for heterosexual union is surprisingly strong and surprisingly different from the community support there is for gay union, and the assumptions of permanence are very different. And I think permanence is one of the absolutely crucial components of trust. I think temporary trust is a bit of an oxymoron.

AV: As you were talking, I was thinking of other circumstances where our society sets boundaries or facilitates your relationship or not. The patient-physician relationship is an interesting area of intimate trust. I think it’s interesting how we’re always better at fulfilling our societal or professional roles where we’re supposed to be trustworthy than we are in our personal roles. When physicians get into trouble, the first thing that suffers is their marriage, then their partnership with other physicians, then with their office staff. The last thing to go is the physician-patient connection. Physicians manage to keep that going to the very end.

I think the most intimate and trusting encounters I’ve had have in many ways come about from my role as a physician. They forced me to really define who I was and what I was feeling. I remember the novelty and the education that came about when I began to treat lots of gay men. That was a very interesting phase in my life. But I found it especially poignant when a woman came to the clinic. It immediately made me aware of how different the possibilities are when the patient is a woman. This was manifested most recently with a patient who had been infected by a lover who had also impregnated her.

AS: This is the woman who’s mentioned in The Tennis Partner?

AV: She’s mentioned in The Tennis Partner, and I’ve written about her in more detail since then. I remember being very self-conscious of the patient-doctor relationship in a way that I wan’t necessarily among gay men. I’m often teased by my gay patients about, “Well, such and such a guy finds you really sexy,” and you can just sort of laugh it off; but in the context of a woman one has to be more careful. You become very conscious about what those boundaries are. I remember that I found myself immensely drawn to her and to her son, a very young boy. I’m sure she was projecting on me all the qualities that, in a sense, were missing with this guy who had disappeared. If he was unreliable and untrustworthy, I was — at least in my role I appeared to be — the opposite. I began to see her for several years in the clinic, always in the clinic setting.

She began to get more and more ill, and I remember when she died I happened to be out of town, and my physician assistant had gone to her house a few days before she died and ministered to her and helped her and another woman. And before she died she told my assistant, she said, “Tell Dr. Verghese thank you for everything he did. I had such a crush on him.” When I heard that later I just broke down, because I felt, “Why did I not do for her what I have done for many gay men?” — which is go to their house when they were dying, have dinner with them when they were well, cross the threshold of our medical-industrial complex and engage with them on their turf. The very thing I had to offer her, which I could offer my gay patients, I held back because of propriety.

AS: Yet at the same time, since there was the real possibility of the crossing of boundaries, if you had allowed her to indulge to any extent the fantasy that her crush was going to result in an actual romance, that might have been much more damaging to her.

AV: Absolutely. I clearly didn’t intend to lead her on or anything like that, but I think I could’ve used my role more therapeutically. I have no doubt in my mind about what is sacred in the physician-patient relationship and what’s criminal, and what’s not even debatable. But the point is that intimate trust — even in a professional setting — can be such a powerful therapeutic tool. If I’m willing to be in the home at the bedside of my best friend James, who was my patient, and weep as he dies, why should I restrain myself when I have that same urge to be as helpful as I can because my patient’s a woman?

I’m always struck by letters that I get that credit me with being much more altruistic than I think I really am. Almost as though they’ve overlooked the real truths in my book about my own sense of inadequacy. I think I’ve failed my ex-wife and children and so on. They manage to gloss over that and create something that perhaps suits them and their sense of need for someone to play a certain role for them. I have people tell me, “Well, you reveal so much about your life,” and I always think: Well, if you only knew how much I’ve held back.

AS: All relationships with readers have got some aspect of the romantic about them, you know, romantic in the most abstract sense of the word. I found myself very seriously thinking at one stage when a reader had written me a sequence of extremely moving, intelligent letters that maybe she was the gal for me. There was something very compelling and appealing about her.

She was an appealing person and I was seduced by her — but I didn’t know her. She had gotten in touch with me because she was someone who had an enormous number of problems. She still had most of those problems. Her trust and her faith were exciting to me, but my benevolence was not going to solve her problems. In the end, I felt that I had allowed a very dangerous situation to develop in that she had more trust in me than I warranted, so that I felt compelled to try to live up to ideas she had of me that were not who I was. A kind of fictional persona had developed out of our correspondence. An attractive fictional persona — it would have been kind of delightful if that were who I really am — but fictional nonetheless, and when I protested, she seemed not to be able to understand. She’d say, “Don’t be ridiculous. I have a real sense of you. We’ve been exchanging all of these e-mails.”

AV: Did she get angry?

AS: She got very angry. And I was left feeling very sorry about the whole thing.

I think that there’s a very misguided notion that the only kind of trust that’s authentic is one in which people are entirely honest with each other, and I don’t know that that’s always the case. There was one of those witty little Judith Viorst poems I remember from years ago:

“I told him always to tell the truth. I never would resent it. I told him always to tell the truth. What made him think I meant it?”

It seems to me that frequently what one can be trusted for is to act in certain ways and to be present in certain ways no matter what one is feeling, and that the actions count whether the details behind them are given full voice or not.

AV: Intimate trust doesn’t necessarily mean the absence of all secrets, but I think not to have to live a double life is important to the long-term relationship. You invest a lot of energy if you’re hiding certain things from certain people and only other people are aware of this. On the other hand, I think there are parts of your life that your spouse may not even care to know about.

AS: There’s a difference I think also between having secrets and having things within a relationship that you’ve more or less agreed not to dwell on. I think it is a very Western notion that you should be able to find one person in whom every conceivable kind of trust will reside. I think that being isolated as a couple, though preferable to being isolated all by yourself as a person, is still a kind of isolation.

AV: I agree. A lot of trust is forced to manifest itself in a certain kind of financial vulnerability. I’ve always found prenuptial agreements to be distasteful, because it seems to me — and again maybe this is my idealism — that if you love, and if it’s true love, then you don’t set up all these qualifiers. I know they make good sense, and I know the reasons for them. But in my second marriage I just consciously didn’t want to do that because I felt it was saying, “I love you, but…” “I have faith in you, but….”

AS: It would be so nice if one could trust people as readily as one can love them. I think that may be the essence of the loss of innocence.

AV: The child is taught not to trust, and then you start to qualify all your innocent, childish trust. The wonderful thing about falling in love and having someone reciprocate is that when they give you all their trust they seem to see in you some possibilities that you had forgotten. It’s the same experience in having a great mentor, someone who takes you under their wing and sees in you and trusts you to reach the kind of heights you really didn’t think you could. It’s very invigorating to be trusted in that sense. There’s a saying by H.L. Mencken that I wrote down: “No man ever quite believes in any other man. One may believe in an idea absolutely, but not in a man.” So maybe what we believe in is the idea of intimate trust, not necessarily a person who can be the object of it.

AS: Yes, and still we go on seeking. And sometimes finding, too.