“Seek professional help.” Yeah, Ken, you’re a bana: that’s 2/3 bananas. Well, I had indeed sought help over the years. Starting with Junior High School, I’d been on and off under some therapist’s care. Some of them were boot-clicking fascists who couldn’t get jobs as concentration camp guards because they were Jews. And some were godsends. The care? it was sometimes great, sometimes less than helpful, and sometimes was more like psychological bullying. And occasionally, it was just stupid.
I had family members who thought I was part of the worldwide cracker barrel. At times I thought so too. I still do at times, but I’m just a bit smarter about how I handle “interactions” with shrinks, even, unfortunately, if it takes me some time to collect the necessary level of outrage to hit back.
For someone with chronic emotional or mental illness, an effective talk therapist is as important as a psychiatrist who can write prescriptions, once he or she figures out what might be going on. I didn’t self-diagnose as bipolar, after all. I wasn’t Lord Byron, taking hits from the laudanum bottle while screwing my sister. I needed a professional to make that diagnosis, the same way I needed a talk therapist to work with me and the psychiatrist. Very few psychiatrists perform psychotherapy or analysis anymore. Either they’re not trained for it, or the all-powerful insurance companies demand a certain rate of “throughput” based on allowable patient contact hours. Fair? What’s fair? This is insurance we’re talking about.
The story of the varied years of therapies will need to wait for another time. Let’s just fast-forward to the last one.
Last September I was in a sorry state. I was homeless. I was taking psychiatric meds prescribed by a GP, but I was still miserably lonely and feeling very little hope. I was no longer on speaking terms with my family. I saw no way out of the situation I was in short of therapy or suicide. The latter was no longer an option. So I tried to find a local therapist in North Jersey who would (1) see a new patient, and (2) accept my insurance. I thought I had found just the guy. He was Jewish (you have no idea) and on my then-health plan. He was seeing new patients. So I made an appointment with Dr. Dan, Ph.D.
And he asked me why I was there. The standard opening gambit, right? P-E4. So I told him a condensed and honest version. Sixty-nine years old, diagnosed bipolar II, recovering alcoholic, divorced, two grown children, now homeless. I really got to unload a stored up bag of grief.
And then, after listening meditatively, Dr. Dan responded.
“Mr. Wolman, I want to congratulate you [pause] on having completely fucked up your life.”
You didn’t misread that. He actually said it. If this were a Court of Law, my hand would be on the Bible. The same court might not convict me of manslaughter.
I was shocked, but tried to laugh it off. I even took the man’s card. I said I’d make a follow-up appointment. But when I got outside I tore up the card. See you again? Fuck, no. Why I didn’t jump ugly with this man at the time, I’m not sure. Except that as an inveterate people-pleaser, I often cannot tell people the truth unless I’ve stored it up as a grudge. And that is what I did. It got down in me and fermented for quite a few months.
The definition of Jewish Alzheimer’s: where you forget everything but a grudge.
When I’d been in Massachusetts for a month or two, the bills started getting forwarded from the shelter. My insurance company, Aetna, required a $40 co-pay. So I got Dr. Dan’s bill. I tore it up. I got another. I tore it up. I got a third. And then I was in a sufficiently crappy and truth-telling mood to dump the crap back on him and tell him the truth. I’d decided enough was enough. I didn’t care if it was $40 or four cents (one cent short of Lucy’s charges for psychiatry). I called Dr. Dan’s office in Wayne, NJ and asked his receptionist for his email. I sweet-talked her into giving it to me.
And then I wrote him an email note. It’s since been lost in an email crash, but this is the gist:
You “took my inventory” based on not even a full conversation. You made an unprofessional and snotty judgment of me based on no prior relationship of any kind, neither personal nor professional. You were deeply discourteous and took liberties with my confidence that even previous therapists with far more knowledge of me would never have taken. You attempted to effect a counter-transference with me when no transference had ever taken place. Needless to say, I will not pay you. You may turn this note over to your lawyer or collection agency. Forty dollars is not the point. Taking advantage of my vulnerability, however, is unconscionable. I will also make sure the licensing authorities in New Jersey are apprised of your conduct.
Und so weiter. I don’t know if Dr. Dan underwent some form of behavior modification, but I’ve never again heard from him, or from his lawyer or collection agent. Maybe he just went “whoops” or maybe he figured $40 wasn’t worth chasing me for.
Such is the risk of going to any therapist who is human and isn’t a “bot.” You can be hurt and mishandled by a rank amateur, even one with the initials “Ph.D.” after his name. I engaged for one hour with a so-called “professional” who misjudged me, who exhibited totally unintegrous behavior, and who sought to make up it for with snarkiness what he lacked in compassion or empathy. Thank God the profession is filled with better people than Dr. Dan. And thank God I had the resilience to overcome the wound he inflicted, and to turn him into the State of New Jersey Department of Consumer Affairs. That’s the body that oversees the licensing of all sorts of medical and quasi-medical specialties, ranging from surgeons to massage therapists.
I hope they dealt with him with some degree of harshness.
Do not be deterred. Psychotherapy is a critical component of dealing with chronic mental health issues. Bipolar and unipolar depression do not respond to two aspirin and call yourself in the morning. But just be real careful about who you talk to. Interview the therapist. A very fine practitioner may have saved my life in the years between 1996 and 2002. But the crappy ones can drive an ice-pick into your head.