On A Scale of One to Ten, How Much Excruciating Emotional Agony Are You In?

“On a scale of one to ten,” the psychiatrist asked me, “how much emotional pain would you say you are in?”

I considered the question carefully. It was our first session, and I’d been having a difficult time finding a therapist I felt comfortable with. I didn’t want to get off on the wrong foot.

“On a scale of one to ten?” I asked.

“Yes.”

I thought about it a moment, but to be honest, a simple number scale seemed an inadequate system for defining something as complex as emotional suffering.

“One to ten?” I asked.

He smiled and nodded.

I stared up at the ceiling above his couch and thought about it some more. I could hear his nose hair whistling as he waited. I wasn’t trying to be difficult - I could easily enough respond with Number One if I was feeling, say, mildly uneasy, Number Ten if I was about to run screaming out the window of his tenth-floor office, and Number Five if I was feeling somewhere roughly in the middle. But that seemed to cover a large emotional range for just three numbers; surely the human mind deserved more than a simple “Small, medium or large?” when it came to identifying one’s least emotional agony to one’s worst emotional agony.

On principle alone I refused to pick Number One, Number Five or Number Ten. I would not reduce my pain to grande or venti. That left seven other numbers, but the decision was still a complicated one. If I said Number Three, for example, he might take my whole case somewhat lightly, as little more than a passing cloud; then again, if I said Number Eight, he might think I was on the verge of jumping in front of a crosstown bus and come out guns blazing, sending me home with a prescription that read “Lithium. All of them/3X a day.”

He crossed his legs.

“Don’t think too much about it,” he said. “It’s not a test.”

I knew it wasn’t a test, but it was an evaluation. If I said I was feeling Number Seven, and we spoke for a while and he realized I was in more of a Number Three, he might decide I was a hypochondriac and dismiss my future sorrows as mere melodrama; conversely, if I answered Number Three and after some discussion I turned out to be in more of a Number Seven, he would forever think I didn’t honor the degree of my own suffering, and suspect evermore that I was worse off than I claimed to be. Most troubling of all, though, was the dark realization that my Number One might be his Number Four, that his Number Three might be my Number Ten. The sad truth of the matter, I realized, was that we had no shared context with which I could answer his question.

“We have no shared context with which I can answer your question,” I said.

“That’s true,” he said, with noticeably less patience than before. “But we do have shared experiences, and through those shared experiences we can come to understand one another’s pain. What’s your Number One?”

I thought about it a moment.

“My Number One,” I said, “is the dread I feel I feel in the darkest of night, waiting for sleep that never comes, assailed by thoughts of worry and doom, no thought so painful as the knowledge that I myself am my own ceaseless torturer.”

“Hmm,” he said with a frown, “that’s my Number Eight. What’s your Number Five?”

I’ll say right now that I’m not proud about how this whole unfortunate episode ended; in hindsight, this was the moment it began to unravel. It troubled me that my Number One was his Number Eight, that the shallow end of my agony pool was just outside the rope marking the beginning of his deep end. After all, if the depth of my sorrow was so much greater than his, could he ever truly understand me? Could we humans ever understand the pain of others? I’m drowning in the Sea of Distress, and he’s splashing around in the emotional Kiddie Pool. I sighed. We are each of us prisoners in the dark, solitary confinement of our isolated selves, I realized, and however dark I was feeling when I came into his office, I was now feeling considerably worse.

“My Number Five,” I said, with growing impatience myself, “is that love is both our reason to be and our reason not to be, that when it blooms it is the blessing that gives us reason to live and the curse, when it withers and dies, that makes us want to die with it.”

He scratched his head.

“That’s my Number Three,” he said.

His Number Three? That’s his Number Three?

I felt a surge of anger flash through me, not just because this was further evidence of our unbridgeable incompatibility, but because the double-edged nature of human love was barely making his list! Was he some sort of monster? Was he dead inside? He seemed equally troubled by me.

“What’s your Number Ten?” he asked with some caution, but I had already decided this was not the man for me. I rose from my seat and buttoned my coat.

“My Number Ten?” I said, with barely contained rage. “My Number Ten? I will tell you my Number Ten, Doctor. My Number Ten concerns not illness nor ruin nor death itself. My Number Ten, my worst emotional anguish is the knowledge, confirmed here today in this very office, that human beings will never fully understand one another for the simple fact, Sir, that some are born evil, some of us are born with a heart that beats and a mind that reasons but no soul that feels, and so we are doomed to forever see one another as the dark strangers we are!”

He rose from his seat, and anger flashed across his face, too.

“That’s my Number One,” he said through clenched teeth.

I don’t recall much of what happened then, or who did what to whom first, but the next thing I knew we were on the floor, trying quite literally to kill each other. We punched and kicked and shouted… he scratched at my face, I tore at his hair… he smashed me over the head with his framed diploma, I bashed him in the face with a bronze bust of Sigmund Freud. Never have I fought with such fury, such rage. We might have killed one another, too, if not for the fact that as I was choking him with his own necktie, I yanked his face close to mine and growled, “That’s your Number One? Our inability to understand each other’s pain, that’s your least agony???”

“Least?” he gasped as his face turned blue. “That’s… my… worst…”

“Hang on,” I said. “Number One is your worst?”

He nodded as his eyes rolled back into his head, and I began to laugh.

“I thought Number Ten was the worst!” I said.

I loosened his tie, and he pulled his thumb from my eye socket, and we had a good laugh about it all. We were both a bit embarrassed by what had occurred, of course, but we were relieved to know that ultimately we humans can relate to one another, we can appreciate each other’s pain. Sadly, whatever comfort that offered me was quickly negated by the sobering realization that even though we can appreciate each other’s pain, we can also get to the point where we want to murder one other over a simple difference of opinion. This made me feel worse than before, and I changed my previous Number Ten to Number Nine, and made the whole opinion/murder thing my new Number Ten.

He understood, and gave me a pill for Number One, a capsule for Number Two, a suppository for Number Three, an injection for Number Four, a tablet for Number Five, a transdermal patch for Number Six, a lozenge for Number Seven, a gummy for Number Eight, and drops to place under my tongue for Number Nine.

“What about Number Ten,” I asked. “Can you give me something for that?”

He shook his head.

“I’m afraid not,” he said. “We have something for Number Tens, but they can only be prescribed for Number Tens, and now that you have no other pains, your Number Ten is now your Number One, and the pill we have for Number Ones won’t be very effective at all since your Number One is actually a Number Ten.”

I don’t fully understand pharmacology, that’s true, but I’m sure someday there’ll be a pill that takes care of all our pains and sufferings, even Number Ones that are really Number Tens. Until there is, perhaps the best we can do is to simply acknowledge the pain we all feel, so that a mere difference of opinion doesn’t bring us to blows. It won’t be easy, but it beats rolling around on the floor, trying to bash each others head’s in.

Yours in the fetal position,

S.

(Hat tip here to the incomparable poet Tony Hoagland, whose books you should read. Buy them, download them, steal them from the library. Just read them.)

Quick note: An earlier Substack post of mine, “Comedy: A Tragedy,” has been reprinted with an additional introduction in INDEX ON CENSORSHIP, one of the oldest, most important magazines fighting censorship around the world, and they can use the clicks. It is a special issue on “Comedians Who Won’t Be Silenced,” and well worth reading. There’s a paywall, but they’ve taken it down for a couple of weeks here in case you want to read it.

illustrations by orli auslander