by A. F. Brady
Rachel pulls me aside and thanks me for playing along. I rejoice in being her golden girl, and whenever she has faith in me, it helps me to have faith in myself. She reminds me again that Richard specifically said he wanted to work with me, Samantha James.
Julie is waiting for me outside the conference-room doors. “No wonder Gary couldn’t handle that guy, I’m sure you’re going to do a much better job. I can’t believe Rachel even wasted our time assigning him to someone so incompetent.” Julie, always looking for someone to tell her she isn’t incompetent. She is huddling next to me like we’re girlfriends of twenty years, holding my arm and whispering her hot-coffee whisper into my hair.
“I just think it’s stupid to have these meetings at the ass crack of dawn when everyone is still hungover and can’t even read yet,” I say, trying to lose her.
“You’re hungover?”
“It’s a figure of speech, Julie. I am not literally hungover.” Lies. Lies. Lies. I would be much better off wrapped around a toilet right now, but Julie will offer me no solace.
“Oh—I know—I guess I just thought maybe you went out last night again. When are we going to go out together? Are you doing anything tonight?”
Julie likes me and wants to be my friend, but I find it impossible to like her. As much as I appreciate her for being an idiot who can’t get over high school, I still can’t tolerate listening to her inane musings and cotton-candy problems with her debutante friends and country-club life. David walks past us and gives me a knowing smile and chuckle.
“I never make plans this early in the day. I will let you know, though; we should definitely grab a drink sometime.” I smile broadly and disengage from her grasp as we are getting close to my office. I juggle my coffee and my case files to try to get the keys out of my pocket when I see that my door was left open anyway.
Nothing is amiss. I must have just left it unlocked. Maybe I’m still drunk. My iPod is still sitting tangled in the headphones on top of a stack of books on my desk. That wouldn’t be there if anyone had come into my office. My sneakers are in the corner where I leave them every morning. A couple of months ago, Shirley left her door open during one of her group sessions and the batteries got stolen out of all her electronics.
OCTOBER 28TH, 11:00 A.M.
My initial meeting with Richard is already happening today, and I have been fixing my desk and my hair and my face and my office for the past hour to prepare for it. I am afraid of him, and I haven’t had this feeling since I started on my first psych unit nearly fifteen years ago. I was barely twenty-two. I never feel like this anymore. I’ve sat across from lunatics and psychopaths, diplomats and dignitaries; it’s all the same to me now. I haven’t been scared like this in ages.
My office is configured the way it’s supposed to be, with the desk chair closer to the front door than the patient’s chair. This is done just in case the patient gets violent and the therapist needs to escape, but we say it’s done so the clinician can obtain emergency services more quickly should the patient need it. I’ve never had a patient get violent in my office; it usually happens out in common areas. I realize I have the scissors closer to the patient’s chair and I move them to the drawer. Sometimes I sit on my desk so I can gaze out the window and pretend I have a different life.
The door knock is so loud and jarring that my already frazzled nerves just explode and lodge themselves in my throat, making it hard to speak. I have to appear calm no matter how scared I am.
“Hi, Richard. Come on in, have a seat.” I remain standing, holding the door open for him. I’m waiting for him to sit, then I close the door and begin to get dizzy. He sits in my patient chair and places a large stack of newspapers at the corner of my desk. “I am going to be your counselor. I wanted to set up this initial meeting so we could get to know each other a little bit, and maybe get started on some of the clinical documentation we need to do.” I sit down as I say this.
Richard doesn’t say anything in response. Instead, he lifts the top paper from the pile and makes a show of opening it up and finding his intended section. He slips off his hat. It’s a brown herringbone newsboy cap. He places it gently on top of the newspapers. As he turns his neck, I notice two small, round scars under his collar.
I rustle the papers of his blank file and begin again. “Why don’t we start with the family history section? This way you can tell me about your family, and we don’t have to dive right into talking about you personally.”
He turns away from me, folds his paper in his lap and focuses his attention on the men climbing the scaffold across the street.
“Okay, no family history. What about goals for treatment? Would you be willing to talk about what you’d like to achieve while you’re here at Typhlos?”
He raises his eyebrows, releases a breath and adjusts his seat to get a better view of the construction workers.
“Okay, that’s a pretty obvious no. How about telling me a little bit about yourself, informally, and I will gather whatever information I need. How’s that?”
Richard glares disapprovingly. “You want me to sit here and tell you all about me? Like a job interview?”
“If that’s how you want to look at it, yes. A job interview would be great.”
“No.” Blunt. Decisive.
I’m barely making more progress than Gary did. It looks like I’m going to have to work on this guy a bit more than I’d anticipated. I feel exhausted just thinking about it.
I sigh an enormous, frustrated sigh, and I intentionally blow it in Richard’s direction. I hope it stinks of booze and vomit and coffee so he knows how much his resistance is pissing me off.
OCTOBER 28TH, 10:01 P.M.
I’m on the train, watching the people in front of me arguing. It’s packed, and it’s cold outside, but the body heat from the rest of the riders is making me sweat into my scarf. The sways and jolts of the train are lulling me into a trance, and all I can hear is the woman in front of me telling her boyfriend that she has had enough.
I am currently seeing someone. I don’t know why that is the terminology we use—“seeing” someone; usually, I say “seeing someone” in reference to a therapist, but this is how I describe my relationship because I don’t want to say “relationship.” We have been involved for a while.
His name is Lucas. On paper, he is the type of guy you’re supposed to marry. He does something in finance, and he calls it “finance,” which makes me want to punch him. He knows the difference between Cabernet and merlot and wants me to taste the tannins. He has a King Charles spaniel named Maverick, which of course just makes him wildly out of my league. He went to Cornell, and he actively parts his hair. In the morning, he uses a fine-tooth comb and creates a straight line down the left side of his head, and he tucks stray hairs behind the line. I am anal, but he is crazy. He wears shoes that he keeps shoe trees in. He finds it very important that when he gets home from work and he takes off his shoes he immediately puts the shoe trees into the shoes because they are warm from wear and more susceptible to morphing into an undesirable shape. I care less about shoes than he does. He has dirty-blond hair, is tall and wears suits with pocket squares that he has to have folded just so. He’s prettier than I am.
He talks to me about getting married. I find this completely ridiculous. I am not the girl you marry. The only reason I have stayed with him for such a long time is because I am trying to rescue him. This is a well-known pattern in my life, and I have only recently become aware of it and okay with the fact that this is what I do.
He has all the things that girls are looking for: the stability, the money, the good looks, the education. But underneath it all lies a very damaged, very insecure little man, and that is who I am dating.
I do not want this picture of perfection; I do not want this combed, shoe-treed, elitist, country-club gentleman. I want the broken-down little puppy inside of him who is desperately trying to play pretend. I want to find that puppy, I want to rub his belly and give him a good home
, and then, when he’s better, I will leave. This is a project. This is a way of making sure that I don’t get hurt, and making sure that someone values me.
I have no way of getting value from within, so I get value from without. As soon as I see the reserves beginning to dry up, I will walk out of his life and move on to the next well of validity. The truth is, this plan isn’t working, and hasn’t been working, but I’m not ready to give up just yet.
OCTOBER 31ST, 10:25 A.M.
Richard is in my group this morning, and I suddenly feel like I am performing more than facilitating a therapy session. He’s sitting next to a relatively new kid named Devon. Devon is my age and surprisingly stylish. Today he’s wearing designer jeans, distressed black leather shoes that extend too far out and look like cartoon cowboy boots, a gray athletic T-shirt and a pretty badass leather motorcycle jacket. Not the kind you pick up at a department store for nine hundred dollars; the kind guys who actually ride motorcycles wear. His long dreads are twisted into a thick ponytail. If I had seen him under different circumstances, I might have said he was hot. Except for the shoes.
Devon is diagnosed with schizophrenia, disorganized type. This isn’t particularly common here; most of the patients with schizophrenia are diagnosed with paranoid type. People outside these walls call it paranoid schizophrenia, but when I’m here I have to say it the right way.
He sits with his legs twisted around each other, at the edge of his seat, constantly wringing his hands together and twisting his arms around one another. At several points during today’s group, he looked like he was about to tip over. After a few groups, Devon began standing up in this position. He would perch on one bent leg with the other leg twisted around it, holding his arms out in front of him and eventually doing something that looked like martial arts. He would shadow box standing like that; he would move his arms in slow, concentrated motions like tai chi. This was both fascinating and distracting.
I’m seeing Devon twitch and perch now, and I’m inwardly terrified of how this is going to affect the other patients—particularly Richard. I’m watching him with one eye while keeping the other eye on the group. Richard is keeping to himself; he’s arranged it so there’s more than one chair between him and any other patient, but he is looking up from his papers over his glasses, and he is noticing Devon. The other patients start to become wary of Devon’s behavior, and some become obnoxious and say they don’t want to be around this weirdo and I should kick him out of the group.
“No one is getting kicked out, Barry. Take it easy.” I lean back on the desk.
“Nah, man, this dude is weird, I don’t want none of his weird getting on me, man. He distractin’ the group! He shouldn’t be in here!” Barry likes to be the peacekeeper while not keeping the peace at all. He frequently causes uproars in the name of justice and the betterment of the group process. I think Barry makes big scenes to distract himself from the voices in his head.
“Barry, since you’ve elected yourself to be the spokesman for this group, why don’t we follow your lead and talk about stigma.” Everyone hates when I do this.
“Aww, Miss Sam, can we not? I’m tired of talkin’ ’bout stigmata.”
“Stigma.”
“Whatever you call it. I’m tired of it.”
“Okay. First of all, what is stigma? What does it mean?”
“Stigma is like prejudice, right? Like when you an asshole to someone because of how they look, or being black or something, right?” This is Lucy. Lucy is seventeen. She wears sexy outfits and too much makeup. She has bipolar disorder. Some days she is so with it, I want to send her to Harvard, and some days she can’t tell you her name.
“That’s right, Lucy. Good job. Stigma is a lot like prejudice. It’s a negative belief that exists about a member of a group that is based solely on group membership. Anyone ever have experience with that?” Sometimes, I’m more of a teacher than anything else. When I get into a good discussion, I start kicking my heels against the front of the desk. We are not supposed to be sitting on the desks; it’s another one of the rules about making sure we keep a proper level of separation between “us” and “them.” The longer I’m here, the less I care about this separation.
Everyone raises their hands to indicate they have been stigmatized in the past. Even Richard has his hand up. Devon is the only one who doesn’t respond. I call him out.
“Devon, you see everyone else has their hands up? This has never happened to you?” I’m trying to involve him, not alienate him, but I fear I’ve made the wrong impression. He looks at me and seems to say something.
“I’m sorry, Devon, I can’t hear you from all the way up here. Can you say that one more time?” He responds again, this time unlocking his chin from his neck and seemingly trying to project.
“I’m sorry, still can’t hear you.”
“He says he stays away from people.” Stephan.
“Thank you, Stephan. Sometimes it’s hard to hear. So, Devon, you stay away from people? Is that to avoid being stigmatized?”
He nods.
“It hurts to be the victim of stigma, doesn’t it?”
He nods.
Everyone else nods.
“What kinds of things do you think other people believe about people with mental illnesses? What kind of stigma have you experienced?”
“People say we’re crazy.” As Stephan says this, I start writing the words on the blackboard behind me.
“Lazy. Uneducated. Stupid.” Barry.
“People say we a burden. Like we don’t do nothin’ to help America.” This is Lucy again.
“Dangerous.” I’m surprised at who this is coming from. Adelle is about a hundred years old. She is as frail as they come, and I wouldn’t imagine she experiences the stigma of being dangerously mentally ill. Then I remember that while off her meds, Adelle once stabbed a man in the chest with a pair of scissors.
“Dirty. Disgusting. People don’t want to stand near us. Even we don’t want to stand near each other.” Darryl says this. Darryl is suffering from a traumatic brain injury that resulted from a self-inflicted gunshot wound to the head. He still struggles with major depression, but he swears he will never attempt suicide again. His wife left him after the incident because she couldn’t bear to look at him with the resulting disfigurement.
“Alright, I’ll say it: they say we’re weirdos.” This is Barry making amends. He looks at Devon. “Sorry, man, you don’t need me calling you a weirdo when everyone else already does.”
Devon nods.
“Thank you for that, Barry; that was very nice of you. What else, guys? What are some other stigmas you’ve experienced due to mental illness?” I see Richard looking at Barry, seemingly approving of his apology.
“People think they could catch it from you. Like if they have sex with you, they could get bipolar.” Lucy.
“Does anyone know if that’s true or not?” Me, I’m trying to teach without making the patients feel like they’re in school. I’m looking at Richard, but his head isn’t in the room.
“Nah, you could get AIDS and shit, but you don’t catch crazy.” Barry.
As I’m writing all the words on the board, I’m beginning to feel guilty because I’ve held every single one of these beliefs. I feel simultaneously sad and defensive.
As the group finishes, I wait for everyone to file into the hallway. I am walking around the room putting the chairs back into a semicircle, picking up the garbage left by the patients. As I walk past the chair that Devon squeezed into the corner, I notice little flakes, like paint chips or confetti, scattered at the base of his seat. I brush them onto the floor and keep walking.
I erase the board, making a mental note of all the words written, wondering how often I’ve felt stigmatized. Wondering how many of these things people think about me. Wondering, not for the first time, if I fit a profile.
NOVEMBER 1ST, 11:11 A.M.
I’ve given Richard a schedule with weekly one-on-one sessions with me, as well as se
veral group therapy sessions most days of the week. Patients often respond well to structure, and I want to keep him busy while I figure him out. We have our regularly scheduled Tuesday 11:00 a.m. session this morning, and he is shuffling and wiggling and trying to get comfortable in my patient chair. He is too large for my office. He looks like a doll two sizes too big for the dollhouse. He is holding that stack of newspapers under one arm while shifting his weight back and forth in the seat. When he finally finds a comfortable position, he drops his papers onto the corner of my desk and awkwardly bends his elbow on top of them. His left arm bows at a strange angle, and he holds his wrist rigid, so it looks like he has a prosthetic arm.
“So, now that we’re settled, I’m going to try to get going with your file again. Can you give me a few minutes of attention to get this ball rolling?” Hopeful, positive, maybe even energetic.
“What’s this? Another test?” he asks. He doesn’t take off his hat, which pisses me off because I think it would be polite if he did. I realize that the best way to suppress my fear might be to replace it with anger, so I momentarily dwell on being pissed that he is impolite. It’s still the tweed newsboy cap, like the ones R & B groups made popular in the ’90s.
“I’m not doin’ no more paperwork.” His voice is calm, masculine. He isn’t arguing with me, simply stating a fact.
“Any more…” I absentmindedly correct him while sifting through my files and avoiding eye contact.
“Look, I’m here because I chose to be here, and I know that I don’t have to fill out the forms, and I have confidentiality and privacy, and I don’t have to answer any of your questions, and if you want to kick me out then that’s fine. I know my rights. I heard you were the best counselor here and I didn’t think you’d give me trouble like that last dud they put me with.” He shifts farther away from me as he says this. He wrings each hand individually, as if he were wiping something off his thumbs. He is fidgety. He is nervous.