What the hell does the Brownell Center for Behavioral Health think you want psychotherapy for? For all this stuff—the yelling and hitting and fucking and drunkenness and drugging! That’s what’s hurting you! And they are ripping through the most painful, God-awful list of torture and torment in your life as if it’s—well, I can’t think of anything that compares to this. Brownell Center treats you and your most private painful problems as if you’re at the counter at Burger King—you want fries with that?
It is absolutely unconscionable. The message it sends is that you have no feelings, i.e., that you are not human, not a person—particularly not a person in pain. You are an object and they are an assembly line that deals with such objects. Somebody in the front office—somebody like Dr. Robert Feldman—decided that the agency needed a whole lot of information about you, and they needed it fast, and they matter and you don’t.
What do they need all this information for? Who’s going to see it? Who’s going to review it, copy it, file it, and go home and tell their friends about it? Don’t talk to me about HIPAA—I’m 65 years old, I used to work for agencies, and I’m a realist. People talk.
So the kid and I sit down to talk and he asks me all these questions and I get upset. He’s a second-year master’s candidate at Syracuse University—they have three different programs that produce therapists and I forget which one he’s in. He’s a nice guy. He can see I’m in pain and he doesn’t want to hurt me any more: he wants to help. The problem is that he’s been told to fill out the paperwork. Now, what’s he supposed to do? His gut tells him not to do what he’s doing. Likewise, some of his training tells him not to treat me this way. The problem is that some of the rest of his training has told him to treat me exactly this way. And it was his trainer that put him in this job to treat me exactly this way.
So now we need to talk about what we’re training our kids. He, Mom and Dad are paying to send him to graduate school to become a therapist because helping people is a good thing. But what’s “help?” Who decides? People who read books? People who do studies? Nice people or cold, pedantic people? They’re all so sweet and helpful and hopeful when they’re young—but they have no decision-making power. And by the time these students have decision-making power, what have they become? How have they grown? Have they become drudges who just want to fill out paperwork and pick up their paychecks? Have they become bitter and cynical, not really caring about anything? Have they learned that pleasing the boss comes first? Have they become driven by money and prestige? Have they developed a need to have power and control?
Have they learned that it feels incredibly good to listen, and work with a person so that the darkness in her eyes is replaced with light, and her anger turns to quirky humor? Have they learned to put the patient first—if it doesn’t feel good to the patient then they shouldn’t do it?
The young man and I go up, down and sideways in trying to meet his needs and my needs, which are not the same needs. We are not both focused on the goal of helping me. He is trying to please his boss, who wants tons of paperwork filled out. Why? Why paperwork at the cost of further hurting the patient? Somebody should ask Dr. Robert Feldman that; somebody should ask the student’s professor that.
Then the young fellow says something about the next appointment, which is not with “my” therapist—it’s with another intake person who will assign me to a therapist. I will, again, have to go over all my stuff with another stranger whom I will never see again. It is at this point that I say no, I won’t do it.
I was a research subject at the National Institute of Mental Health, where the psychiatrists all had to do their own blood draws. My psychiatrist was no good at it. He kept me pinned to the bed for an hour while he stuck needles in my arms and legs, trying to get a vein. I couldn’t say no to him; now I say no to the kid. No more. Nobody should ever be treated this way.
You know how you should be treated? The therapist should walk into the room with a blank pad and ask you what’s wrong. The therapist should say, “Tell me your story. Tell me where it hurts.” And then you and the therapist should slowly pick your way through the mire of your life and figure things out.
No ridiculous one-page intake form, no intaker who fails to keep her word, no boss who ignores the American’s with Disabilities Act, no director with a heart of ice and a mind of muck. No reducing the patient to fifteen pages of boxes to be filled out. No kid who is forced to abuse you with a direct recitation of abuse. No more strangers, who have no commitment to you, asking invasive questions.
I tell the kid that all I want is out. He offers to shred all my paperwork, and I accept. Then he starts to lead me back through the labyrinth toward the front door, but stops, turns, and opens the back door that lets me out into the parking lot and the sunshine.
I wheel home, crying in the sunshine. This is what therapy has come to in America.