by The Naked Lady Who Stood on Her Head: A Psychiatrist's Stories of His Most Bizarre Cases
Thursday afternoon finally rolled around, and Brenda arrived looking professional and calm. We exchanged our usual greetings, and I began, “Brenda, I don’t think you’ve been completely honest with me.”
“What are you talking about, Dr. Small? I thought we were making progress. Oh, and I need a new prescription for Wellbutrin.”
I smiled. “Is Dr. Simon prescribing that for you also?”
She looked at me, surprised. “What? Who?”
“Brenda, I know you’re seeing Charlie Simon as well as me. Please don’t deny it.”
She laughed. “So you think you know everything about me, right?”
“I only know that you’re seeing my colleague Charlie Simon for psychotherapy and you never mentioned it to me.”
“What, do you have a little shrink club where you all get together and gossip about your patients? I have a right to see whoever I want. Charlie Simon. Dr. Wells—”
“Malcolm Wells?!” I exclaimed.
“That’s right. And he’s very good.”
“Well, who else are you seeing?” I asked in disbelief.
“Jeffrey Sanderson. But he’s only an M.F.C.C., so that doesn’t really count.”
As I sat there trying to regain my composure, Brenda continued, “You know, Dr. Small, when I had that breakthrough with you about my shopping addiction, it felt so good that I craved those flashes of insight all the time. I tried to be a good therapy patient, but those magic moments weren’t always there with you. And I got kind of bored with those twelve-step meetings.”
“Why didn’t you tell me?” I asked.
“I didn’t want to disappoint you. Once I started seeing Dr. Simon, the excitement returned. I loved relating my insights about my eating addiction turning into a shopping addiction. I may have embellished things a little about Richard and my mother. Keeping it from you was part of the rush. You know what I mean?”
Just as she had always tried to get her mother’s approval, now she wanted mine. But this multiple-therapist quest just seemed like another addiction.
Still shaken, I prompted her. “I’m not sure what you mean.”
“Now that I added Dr. Wells and Dr. Sanderson, I have someone to talk to almost every day. It’s so great. Besides, it keeps me out of the department stores. That’s a good thing, right?”
“Look, Brenda, sneaking therapy on the side is not in the spirit of the two of us working together. It just confuses and diffuses our efforts.”
“I don’t see how it affects it at all,” she said.
“That may be, but I can’t see you if you’re going to continue with the other therapists. Besides, it appears you’ve replaced your shopping addiction with a therapist addiction.”
“Oh, that’s absurd. What do you think I am, a serial addict?”
“Well, it appears so,” I said. “This is the first time I’ve seen someone whose addiction has shifted to multiple psychotherapists, but the same behavior patterns we’ve discussed before apply here.”
She paused for a moment and then said, “Dr. Small, you were the one who helped me face my addictions. I swear I’ll stop seeing those other doctors. Maybe we should start meeting more often.”
I treated Brenda for a few more years. She was able to work on her need for my approval, which helped her get perspective on her need for her mother’s approval. Her relationship with Richard also improved.
I knew from my regular coffee shop meetings with Charlie Simon that at least he was no longer treating her, but unfortunately there was no little shrink club to check for multiple-therapist disorder. Even though I took Brenda at her word that she had supposedly kicked her therapist addiction, I admit that my relationship with her was tinged with uncertainty and I felt distrust—as most people do with ex-addicts. As far as I could tell, she was getting better. I noted that she would wear the same outfit more than once, which I took as a sign of her improved mental health.
CHAPTER FOURTEEN
Mountain Heir
Winter 2007
“SLOW DOWN! HE’S BRAKING IN FRONT of you,” I said with terror.
“I see that, Daddy, and I was slowing down,” my fifteen-and-a-half-year-old daughter said in frustration. “Why are you always telling me what to do?”
I shook my head in disbelief. “Because I’m teaching you to drive, and I’d like us both to survive it.” I really didn’t understand why the driving age wasn’t raised to twenty-five, when a young person’s brain finally has a fully developed frontal lobe. In the six months that I spent teaching Rachel to drive, she became fairly good at it, although my hair turned noticeably grayer.
After nearly sideswiping a parked minivan, she finally pulled up in front of our house to practice her parallel parking. She completed the maneuver and asked, “How’s that?”
She was almost a yard from the curb, but I needed to get to the office—with my sanity—so I said, “Good job, honey. Mom can practice with you later.”
When I got to work, my first meeting was with a brother and sister, Carolyn and William Dunlop. I knew them from years earlier when I had consulted on an older relative of theirs with Alzheimer’s disease. They were extremely wealthy—their grandfather had invested in real estate during the Depression, and now the family business was diversified among several large companies. The Dunlop siblings were in their mid-fifties and had an East Coast, old-money attitude.
My assistant escorted Carolyn and William into my office, which was now part of a suite I kept for my research and administrative staff. It was on the top floor of the Semel Institute and had an impressive view of the ocean and mountains surrounding UCLA. I vacillated between calling it my penthouse and my attic, depending on whether I was trying to impress people or protect my space from academic poachers.
William began, “I’m glad you could see us so quickly, Dr. Small. Thank you again for your efforts on behalf of Uncle Ernest.”
“I hope I was helpful. I wish I could have done more. We’re still working on better treatments for Alzheimer’s, but no major breakthroughs yet.”
“I suppose you heard that Daddy passed last year,” Carolyn said.
“Yes, I read the obituary. I’m sorry for your loss.”
“Thank you,” she said. “When you met him, you may have noticed how…eccentric he was.”
“What do you mean?”
William jumped in. “I suppose that to be so successful, one has to be a bit obsessive, but Father took it to the extreme. It worked in real estate, but in his personal life it became a disaster.”
“How so?” I asked.
“Daddy would get up every morning at four-thirty to run six miles,” Carolyn said. “Not only did he have forty pairs of running shoes lined up around the walls of his bedroom, but he wrote the purchase date on the heel of each shoe so he could rotate them and make them last longer.”
“That does sound a bit obsessive,” I said.
“It’s not just that,” William said. “He was always argumentative and opinionated, and as he got older he became outright paranoid. If you didn’t agree with him, then you were out to get him.”
“It started escalating when Mother died five years ago,” Carolyn added.
I noticed that Carolyn and William spoke like a tag team, taking turns relaying the information and nodding in agreement when the other talked. I asked, “Did your father ever see a psychiatrist?”
“Heavens no,” Carolyn said. “We wanted him to come see you, but he was adamantly against it. The mere suggestion of it made him paranoid that we were trying to commit him or something.”
William interrupted impatiently. “But that’s not the reason we’re here today. Carolyn and I are concerned about our younger brother, Henry.”
“What’s your concern?” I asked.
“We’re concerned that Henry may have inherited Father’s obsessive-paranoid disorder or whatever it’s called.”
I didn’t know what, if any, disorder their father had, but their brief description sugges
ted several possibilities that could be inherited. No defined “obsessive-paranoid” disorder existed, but people who are obsessive-compulsive might display paranoid symptoms at times. And there are several forms of psychosis that run in families. Some people develop an isolated paranoid delusion later in life, which the English geriatric psychiatrist Sir Martin Roth termed “late paraphrenia.” It is more common in women than in men and is associated with declining vision or hearing or both. But their younger brother was probably in his late forties and too young for that condition.
“Hank was the baby of the family, and I adored him when we were little,” Carolyn said. “When William was off playing sports, Hank and I would bake chocolate-chip cookies with Daddy, and Daddy would let us lick the batter from the spoon. Hank was really sweet in those days. He would sneak extra cookies in his pockets, and we would share them before bedtime.”
“But then he became Father’s little favorite, didn’t he, Carolyn?” William prodded her. “And you didn’t like that too much.”
“Well, Daddy did always dote on him,” she said. “Here I was the only girl, yet Hank was the creative one, so he was special.”
“Never mind that Henry never spent a day using his law degree or helping in the family business,” William added. “He couldn’t waste his precious time doing real work. He was an artist, a photographer—I think that’s part of why Father favored him.”
“What do you mean?” I asked.
“Father was all business and exercise, but when he was young he had an artistic side that he stopped pursuing when it came time to take over the business. He studied classical piano in school and even gave recitals. I never heard him play, but apparently he had been quite good,” William said.
Carolyn added, “I think Daddy was living vicariously through Hank’s art. He built a darkroom for him when Hank was in high school and always supported his artistic pursuits.”
“But that’s all in the past, Carolyn,” William said. “Father’s gone now and we haven’t set eyes on Hank for over a year.”
“Why’s that?” I asked, intrigued.
“Because Henry is holed up in a secluded ski chalet in Colorado,” William answered. “He never leaves, and he didn’t even show up for Father’s funeral or the reading of the will. Sometimes he’ll take our phone calls, but whenever we invite him to visit or ask to come up there, he insists that he’s fine and doesn’t want to be disturbed.”
“What difference does it make, William?” Carolyn asked. “He probably already knew Daddy was going to make him sole executor of the estate.”
“Oh? Your father made him the executor?” I asked.
William turned to me. “Look, we’re not here about the money. Carolyn and I are genuinely concerned about our brother’s mental health. We know there is a family history of obsession, paranoia, and whatever else, and we want to help him—even if it means he has to be committed.”
That would be convenient, I thought. If the sole executor of their estate was in a mental hospital, financial control would revert to them. This plot was thickening like an old Hitchcock movie, and I half expected Janet Leigh to stumble into my office with a knife sticking out of her back.
“So you’re not concerned about the money, only your brother’s health. What makes you think Hank is paranoid?”
“He’s had a suspicious streak all his life,” Carolyn said. “He was always Mr. Perfect, and anytime something went wrong, it had to be the other guy’s fault. While he was at Dartmouth, he thought the dean had a personal vendetta against him. He went on and on about it for months and eventually ended up in the emergency room. It turned out he’d been high on cocaine for who knows how long. After rehab, he got back to his old self—suspicious but not insane.”
“For a while,” William added, “after Mother died, Henry cut himself off from the family and moved to the Colorado house. He stayed in touch with Father. But now that he’s gone, Henry has no one, and we’re concerned.”
At the mention of the cocaine-induced paranoid break, my differential-diagnostic wheels started spinning. Chronic amphetamine or cocaine abuse is a well-known cause of paranoia. It was possible that Hank’s reclusiveness meant that he was back on drugs. Perhaps his mother’s death triggered an initial relapse and then the loss of his father became too much for him to bear without self-medicating. However, someone with a predisposition to paranoia could start believing others were against him as a result of any stressful event or situation. Although drug abuse in college increases one’s risk for substance abuse later in life, it was not necessarily the current problem now that he was middle aged.
Carolyn and William had not completely convinced me that they wanted to help their brother rather than just gain control of the money. Having consulted with attorneys on forensic cases over the years, I was impressed by how powerful money could be at suddenly causing, as well as curing, alleged psychiatric illnesses. Maybe Henry was appropriately suspicious of his siblings’ motives, rather than paranoid or psychotic.
“So how do you envision me helping?” I asked.
“We want you to diagnose him and get him started on the right treatment, if there is one.” Carolyn paused and appeared sad. “Look, I know I’ve had my differences with Hank over the years, but he’s my baby brother and I love him. I’d like to be part of his life.”
“We understand you’ll need to examine him in person, but he’s certainly not going to come down here for a consultation,” William said. “You’ll need to go to him. We have a jet.”
“I’m willing to go there, but if Henry has refused your visits, why would he agree to see me?” I asked.
“We anticipated that issue and used a tough-love approach with him,” William said. “We got him on the phone and said that if he didn’t agree to see you, we would have to take more drastic measures.”
“He knew we were threatening an intervention or legal action,” Carolyn added.
“How did he respond?” I asked.
“Actually, he was quite agreeable, as long you came to him,” Carolyn said. “He even sounded a bit relieved.”
Two days later, I was packing my overnight bag for Colorado. As I hurried to get my things together, Gigi stomped around the bedroom putting away laundry. Could she be upset about my Colorado trip? I mean, here I was waiting for a limo to pick me up and take me to the Dunlops’ ski resort in their private jet, while she got to look forward to chores and carpooling.
“I just want you to know that it’s not fair if you do any skiing without me,” she finally blurted. Yep, she was pissed.
“Honey, you know I haven’t skied since I sprained my ankle in Vail.”
“Oh, yeah,” she said with a laugh. “You were going to loosen up in the gym before we hit the slopes, and two minutes later you limped back into the room after tripping on a stair.”
“Hey, skip the details. Everyone thinks I wiped out on a black-diamond run.”
An hour later I entered the Dunlop jet. A gorgeous flight attendant greeted me and took my coat, “Welcome, Dr. Small. Please, make yourself comfortable. I’ll be at your disposal.”
As I sat in what appeared to be a small flying living room, I had no problem getting comfortable. We took off and gained altitude quickly. The jet was smooth and silent. The flight attendant brought in a bowl of fruit and a cheese platter and offered me a cocktail. I declined and requested a soda. Now, this was flying—a guy could get spoiled.
As I enjoyed the view, my thoughts drifted to Henry Dunlop. I wondered what I would find when I met him. Would he be a drug-addled opium junkie, or perhaps a hyperactive amphetamine addict? Maybe he was suffering from extreme obsessive-compulsive disorder, constantly washing his hands like another wealthy and disturbed recluse, Howard Hughes. He could also be in a psychotic and paranoid state, and I experienced a moment of anxiety imagining myself entering a secluded fortress of some rich and possibly dangerous loner. But I knew I wouldn’t be alone there—his staff included a cook, maid, driver, personal
assistant, and bodyguards. I also wasn’t convinced that he was psychotic. A classic paranoid would not have been so willing to see me. Somebody in the Dunlop family didn’t have the facts straight, and I suspected it might be Carolyn and William.
When we landed, I was chauffeured in a town car, finally driving up a long, winding private road that ended at a large compound. The main building was an elegant marriage of Swiss chalet and modern architecture that I guessed must have been about ten thousand square feet. A half dozen luxury cars were parked in front on a large concrete-and-brick driveway recently cleared of snow.
The driver parked and opened the trunk to get my bag. I rang the bell, and Henry’s personal assistant, Ahmed, opened one of the huge, wooden, double-front doors and asked me to follow him as he took my bag from the driver. From the entry foyer, I noticed several stunning black-and-white photographs of what appeared to be the Colorado Rockies. I also got a glimpse of the impressive sprawling interior of the house with its exposed beams, spiral staircase, freestanding fireplaces, and floor-to-ceiling windows framing beautiful views of the mountains.
I followed Ahmed down a long hallway to meet Mr. Henry, as he called him. The hallway was lined with more framed photography, and as we headed toward the back of the house, I noticed that the images changed from lakes and snowcapped mountains to the compound grounds and landscaping and finally to interior shots of the house.
At the end of the hallway Ahmed knocked and then opened the door to an expansive bedroom suite. The sitting area was cluttered with books, magazines, cameras, and photographs. Henry was reading in an easy chair by the far window. He appeared tall and thin, with curly brown hair. He wore wire-rimmed glasses and had a stilted intellectual air about him. He looked up and smiled, “Dr. Small, how was your trip?”