Tuesday, May 22, 2007

Psycho-the-rapists

My psychiatrist likes to remind me that no treatment is risk-free, including talk therapy. She can be rather snotty like that, but that's another story.

Another story still was told on a website, that has now been taken down as far as I can tell, so I'm relying on my less than perfect recall here. The story was that of a woman, whom I'll call Jane, who was referred to an eminent psychiatrist, whom I'll call Dr X, after experiencing some difficulty sleeping. Dr X provided psychoanalytically-oriented psychotherapy, and by Jane's account, chose to ignore her presenting problems and instead focus exclusively and obsessively on the developing transference. In particular, Jane accused Dr X of deliberately fostering her dependence on him by forcing the transference - putting it to her that she had sexual fantasies about him, encouraging her to talk about them, assuring her it was appropriate, and so forth. This, according to Jane, had the effect of producing such sexual thoughts and feelings where none had existed before, culminating in her own obsession with Dr X and the therapy, and driving her to the brink of an emotional breakdown. Jane did not, however, allege that any sexual contact had actually taken place.

Such was the gist of Jane's complaint to her state medical board. Predictably, it did not find in her favour - Dr X received a slap over the wrist for not adequately documenting his sessions with Jane, but no further action was taken. (Psychiatrists, take note... take notes, preferably accurate ones. If you even suspect you are within a fifty metre radius of one of them darn borderlines, whip out that pen and paper and note down the fruits of their futile efforts to seduce you.) This sent Jane into a frenzy of righteous indignation, enough for her to decide to make her complaints public, setting up a website onto which she uploaded copies of her email and other correspondence with Dr X's lawyers, and otherwise exhibiting the kind of behaviour that tends to prompt reactions like hard luck, but isn't it time to move on or, more crudely, just get a fucking life.

Some psychiatrists will do their best to force the transference, which is both pointless and inappropriate. At the more benign end of the spectrum, you have shrinks who do a big song and dance just before they go on holiday, in grandiose anticipation of you doing likewise while they are away. Any arguments or other unpleasant moments that might occur in the periods immediately before and after the shrink's time off are are automatically and relentlessly interpreted as expressions of the patient's resentment of the shrink having a life of his or her own.

Then you have the shrinks who will quite openly suggest that you want to sleep with them, and who will do their best to cajole you into believing it. These guys will really fuck you in the head, insisting that you're fucking them in your head until you're fucked in the head. They may justify their behaviour to themselves and others by reference to some theoretical underpinning - the it's just part of your treatment excuse - but it is nevertheless clearly predatory, narcissistic and self-serving. By Jane's account, this is what Dr X was doing. It seems likely that at the very least he mismanaged the transference, and when the situation became too intense and he had to refer her to someone else, she was left feeling blamed for the unfolding of a dynamic that she had not even anticipated, hence her subsequent outrage.

But let's not talk about sex for a moment, and just talk about talking, and the risks that go with just talking.

For confession or disclosure can be so much more intimate than sex. When you tell somebody something you can't take it back once you’ve done it, like you can with a part of your body, leaving the other person with nothing more concrete than the memory of some diffuse physical sensations that do not vary too much from one encounter to the other. Confession is specific, and the range of conclusions that the confidante may draw about the confessor extend well beyond that allowed by the usual insulting sobriquets.

You are always bound to your confessor; even if he abandons you, or disbelieves you, the larva of confidence he once inspired grows into a tapeworm that eats away at your insides until your outsides cave in and what is hidden has prolapsed for all to see. Or the binding might be, in essence, an intersection: you become Siamese twins. You share his heart, liver, lungs, kidney; he shares you with the footpath, you’re a piece of gum stuck to the bottom of his shoe. Only he will survive the separation, which is why you know, deep down, that some things must never be revealed. On pain of death. Confession is, in a sense, losing one’s marbles; like a kid on the first day of school you don’t know that you’re supposed to exchange them, not just give them away. Or else they roll into drains, cats-eyes following their namesakes, iridescent meteors meeting their liquid selves in puddles of petrol; galaxies disguising themselves as birds’ eggs, clownfish masquerading as candy, blue jays as lost to you as NASA’s Big Blue Marble. You barely have time to grasp the entropy of the spheres, the distortion of your narrative, as a sharp shooter is catapulted into your forehead. Confession becomes indiscriminate, indistinguishable from small talk. Needless to say, friendships dry up, as do invitations to parties, as the marbles are picked over by filthy hands and the tapeworm eats through your brief career as a risky raconteur and leaves you wallowing in a state of total self-absorption.

Jane's story resonates with me tonight, her unshakeable belief in her own rectitude providing a stark contrast to my intuition that no one in the world could truly understand what happened to me when I was 'in the system'. I believe that if I try to describe it to a friend or professional or anyone, the feeling I will be left with is that they just don't get it; that they'll be waiting for some further violent denouement; that they will think that all I have endured is, as Maureen Dowd once put it, the "ordinary brutality" of love and life. I still have access to all the old feelings, rising and turning like seals in that hypnopompic state between dreaming and waking, but not the words that could adequately convey them, or the precipitating incidents; the original sins.

At first, there was just guilt, shame and more guilt, what ifs and why nots. It wasn't until I was 21 that I began to perceive, in the face of crippling agoraphobia, some (very ersatz) nobility in what I did, and some months later, I found myself in a dim bordello-style boardroom, discussing "some stuff that happened" with a sombre lawyer and a gung-ho social worker who had every free set of steak knives out, urging me to sue, sue, sue. The lawyer went through the options - civil action, conciliation, mediation, and warned me that I'd be dealing not with individuals but with institutions, with deep pockets and a legal policy of offense rather than defense. He also pointed out that any civil proceedings would possibly attract the attention of the tabloids and all their ilk. He was just doing his job, and no doubt his advice was sound. But the contrast between his demeanour and that of the rabid social worker was disconcerting, and at some point I said, "This is stupid, nothing really happened, let's just forget it." I was still shuttling between the extremes of experiencing a strange kind of gratitude towards one of the people involved, and even a (very hypothetical) yearning to see him again, and the understanding that something very inappropriate and damaging had taken place. Later, when I got a letter from the lawyer saying "Thank you for your courage in telling of your experiences", I felt like he was making fun of me.

It's so easy to be rational about these things on paper. The mediation of keyboard and chewed fingernails, coupled with the aesthetic impulse, leave bottles drunk dry and thrown only at the bin. Time destroys all things, as the paedophile butcher says at the beginning of Irreversible, but for the things that it leaves covered in ash and waiting to be excavated, I need a drink to destroy time. It renders everything fragmented, devoid of context. Psychiatrists want to know where I’ve come from, friends and intimates want to know where I’m going, and I don’t know how to make them understand that history has stopped, that all that’s left is an interminable present, and the only way to break time up, to prevent the accumulation of the crust of dead experience, is via the bottle.

12 comments:

Mark p.s.2 said...

thanks for shining light on the trip of "transference", whats good and bad? I don't know.

Monica Cassani said...

"all that’s left is an interminable present"

So much for all the advice about being "in the present" and it being the answer to everything.

I often get seduced by such ideas--thinking that if only I could apply the theory I'd be okay, but your experience of the presence is much more like mine than any romantic notion of "being here now."

Anonymous said...

Oh, the stories I could tell. I didn't think I would be believed, especially after I read my medical records and how my psychiatrist portrayed me. I was cluster A, then he decided I was Cluster B. I thought no way would a medical board would believe me over him. But, the investigator was very good. I sent her the emails and other info that proved I was telling the truth. Unfortunately, it seems there are quite a few predators in the field.

Ruth said...

"Oh, the stories I could tell." Feel free to tell them, either here on the blog or by email. (Also, feel free not to, of course!)

These days, people tend to focus on the damage done by medications. While such critiques are very important, the various other ways in which people can be hurt by psychiatry tend not to receive much attention.

If you haven't already seen it, Gianna at Bipolar Blast has posted in detail about her own disastrous encounters with psychoanalytically-oriented psychotherapy.

Monica Cassani said...

I don't know how to inbed a link so I hope you can see this whole link.

http://bipolarblast.blogspot.com/2007/05/isolated-history-of-psychotherapy.html

Ruth, the link you gave to the piece I wrote was to the main website..not the particular post.

The above link is to the particular post.

I was intensely struck by how many similarities to the potentially horrible nature of therapies you mentioned in your post and how they matched my experience. I didn't even understand the full extent of it until I had written the post. I've not liked to revisit that experience in general, but I think it ended up being a good thing.

And...like anonymous above....there is much more I could tell.

Anonymous said...

My first experience in therapy was with Steve. Steve crippled me emotionally and financially. He would tell me if I skipped an appointment he would have the police come and pick me up and put me in the hospital because he was "worried." Once he did just that. The police do what the therapist says. My first hospitalization was a 24 hour hold. The psychiatrist there, the first psychiatrist I ever met, said - "You're a pretty girl what could you possibly have to be sad about?" The psychiatrist told me I could not go home until I showed some emotion. I showed some emotion. I cried. He said, "See, now you can cry can't you? I thought you could." Several weeks later my therapist called me at home. He did that often. I had taken a couple of Ambien, some ETOH, and a muscle relaxant. He gave me a choice. Either I could let him come check on me or he would call the police again. I pleaded with him not to come to my house. He said, "I'm giving you a choice." I chose him. The next morning I woke up with 1/2 my clothes off, and he was gone. I asked him what had happened. He told me I was "cute" when I was intoxicated. He said we hadn't had sex, just played around. I felt sick. He wore sensible shoes. He told me I could bring a stuffed animal to therapy next time, that it would help me. I wanted to throw up. I finally confided in a minister from the church who recommended this predator. They helped me get away from him. I refused to cooperate with an investigation. Steve continued to do therapy. He showed a teenage girl how to do a blow job. Steve lost his license for good this year. That was therapist # 1.

Anonymous said...

I wonder sometimes how I could have let myself be treated so badly. That's the part that I have the hardest time dealing with. How in the world could I have thought so little of myself that I so freely turned over my self respect to these fools? And then paid them for it. Never again.

Anonymous said...

I feel lucky that although I've had bad therapists and bad doctors, none of them tried to convince me I was sexually attracted to them or sexually abused me in any way.

Something the most recent anonymous commenter said about her first psychiatrist reminded me of something, though. I swear I am not making this up:

I tried to kill myself when I was seventeen, and the first person I saw at the hospital was a nurse, who asked, "Do you have a boyfriend?"

I said no.

"Did you break up with your boyfriend, then?" she asked.

I said no.

"Then why did you try to kill yourself?" she asked.

Aargh.

flawedplan said...

That's a graceful piece of work right there. Not many can do this material right, I'm glad to see your pages multiply.

Ruth said...

Polly: that reminds me of the first time I was in hospital. Not for attempting suicide though; just for skipping school and not keeping my room clean and that kind of thing.

A male nurse asked me if I smoked, and I said no, not any more. He then asked if I had a boyfriend, and I said no. He said "You're a pretty girl, why not?"

I walked away and but he followed. "I asked you a fucking question, didn't you hear me? Come on, how many boyfriends have you got?"

I rounded on him and pointed out that as questions went, it was a very loaded and shallow one. But then I was silly enough to follow through by claiming that I didn't treat the boys at school any differently than I did the girls.

He put his face close to mine and said "Well, boys are different to girls, you know."

"Well, how about that. You learn something new every day, don't you?"

"I could obtain an anatomical textbook that would demonstrate the differences. I could go over it with you."

"Cool."

"Another time maybe. Do you play any team sports?"

"No"

"Why not?"

And on and on it went. And the next day, it was the same fucking thing. "Do you have a boyfriend?"

"Yes," I said. "Do you?"

But of course I only succeeded in getting the first laugh.

Ruth said...

Apparently I was also "cute" when intoxicated. "It becomes you" was his way of putting it.

When I'd ask him what had happened the night before, he'd refuse to tell me, saying it was too tempting to have some fun at my expense.

Why did I let this happen to me? Youth, inexperience and alienation were the basic pre-requisites, although they don't explain everything, I guess. But what I do know is this: if you've never really been listened to or understood in your entire life ever, and then one person comes along who does listen and seem to understand (at least for a while), this can be so incredibly mind-blowing that you get completely hooked on them, and you may end up being prepared to wear any abuse or other bullshit that goes along with having a relationship ('therapeutic' or otherwise) with them. It can be hard to believe that you can have one without the other, and that there might be other people out there who who are able to listen and understand you just as well.

Kass said...

Ruth,

Great post. I've never experienced much of this stuff and, oh man, I just can't even imagine doing so. I'm sorry to hear such experiences with therapists and psychiatrists. I suppose this makes me feel fortunate that I haven't been in the med world so long to endure these experiences. It enlightens me as to why everyone is so skeptical of psychiatrists in general.

And guys at psych hospitals can be SUCH pervs.