Chapters One to Three of autobiography, “Silent Screams,” are available in Audio, along with Additional Chapters not included in print or e-book. Articles too, related to book and psychology are available at http://soundcloud.com/dcrossauthor.
What I Learned From Psychotherapy
The first thing I noticed about Dr. Stevens as he walked toward me down the hallway was his medical uniform, the standard white lab coat. The second was that he was older than I was, which seemed initially comforting in a way. I suppose I had equated age with knowledge and maturity, but when I first came to the mental health center, I’d been assigned to a rotating list of interns who were learning what psychotherapy was all about–just as I was.
I had chosen therapy after reading Clifford Beers, “A Mind That Found Itself,” in which he described how his psychiatrist helped him through a severe mental illness. His book then led to reading about others who’d been helped in much the same way.
There had always been a stigma attached to mental illness, and mystery attached to psychotherapy, but by my early twenties, my own mental/emotional pain had reached the point at which I had to ignore any misgivings I may’ve had about seeking help. And whether what I was experiencing at the time was termed mental illness or not mattered very little.
On meeting Dr. Stevens, I wasn’t aware of his background, or his preferred method of treatment. I only knew that he was a physician with a specialty in psychiatry, and knowing that had seemed enough. I was also unaware, until much later, how important what had been clinically deemed the doctor/patient relationship could become.
After many beginning and expected information-gathering (on the doctor’s part) sessions, I waited patiently for the therapy to begin; although I wasn’t quite sure how this was to occur. In fact, I never knew when, or even if, it would occur. So for awhile, with nothing left to lose, anticipating my appointments with Dr. Stevens was all that kept me going; then, as time dragged by, and after growing steadily frustrated, I began to feel that mine was just another hour on the doctor’s weekly schedule.
I suppose, in retrospect, that I had been expecting too-much-too-soon to occur, both from him and the medications he prescribed, but I could find no relief from the pain that seemed to be growing steadily worse. What I had failed to realize then, however, was how much worse the pain could become.
When it continued to grow worse, I was at last overcome, and began withdrawing behind a wall of silence that no one, not even Dr. Stevens, might be able to shatter. Such pain, I decided, had to end. When the doctor hospitalized and then all but ignored me, I was even more devastated–until it happened that I grew angry about our lack of communication and determined enough to seek the knowledge and understanding I knew that I needed on my own.
My anger may have had a curative and catalytic effect, however, by getting to one crux of the matter, in addition to having been sequestered during the worst of the pain; because it was then that I embarked on a journey of self-discovery, one I knew would be necessary in order to survive.
My therapy sessions with Dr. Stevens lasted approximately five arduous years–arduous for me, that was, because Dr. Stevens often seemed irritatingly self-satisfied and aloof from the ordeal I was going through. I considered, only later, that his role of self-detachment might have been a needed one, and that–as I like to think now–Dr. Stevens knew his primary role was to be there as someone to trust.
I hadn’t learned to trust, and perhaps, he knew that. In addition to which, he perhaps also knew that since my personal tendencies were to figure things out on my own, he could not act as a teacher. No, if I was to gain understanding, the insight would have to come from me.
I finally ended our sessions with much insight left to be gained, but knowing I’d seen the worst of what Hades had to offer. And I later wondered if Dr. Stevens had foreseen many of the stepping stones I’d had to tread. I would never know. But I was sure he knew there would be more obstacles to be surmounted because he’d remarked, when I’d become disappointed with my progress, that, “I never promised you a rose garden” (referring to the title of a book by Hannah Green).
I would always acknowledge my time with Dr. Stevens as a critical one, and continue to wonder about his thoughts and beliefs because he hadn’t shared them. Perhaps he didn’t think it was appropriate to do so. But I never got to know him as a person, or know if, in other circumstances, we might have become friends.
Later on, as I studied, worked and trained with other counselors and therapists, and the shoe was on the other foot, so to speak, it became clear that the therapeutic relationship was not meant to be a simple sharing of information, collaboration, or friendship. And while the doctor/patient, or counselor/client, relationship can be a sensitive one, it does not have to be a critical one. It usually does, however, have to be one of trust.
The responsibility of the counselor/therapist is not to have hard-and-fast rules or preconceptions about what might work for his patient/client. His responsibility is to know and learn what will work. And, as with any other relationship, he must be aware of the expectations brought into therapy both by the patient/client and himself.
Many years have gone by since my experience as a psychiatric patient, but the stigma of mental illness still exists, primarily because of a general lack of understanding about its nature and effects.
But there is no such stigma regarding physical illness. Individuals are usually more than willing to admit and talk about it. They are also often praised for taking steps to overcome illness and disease. The same is not true for those suffering with mental/emotional problems, however, or for those seeking help through counseling and therapy. And one should never have to keep silent about illness of any kind, or feel awkward or compromised about seeking help.
The information explosion has been diligent in providing enormous amounts of facts, figures, statistics, and explanations, regarding mental illness. One can only hope that as time passes, understanding will also be gained.
“Most Men Lead Lives of Quiet Desperation…”
…Henry David Thoreau
This was not what I wanted! No, nothing like this! Waking in a hospital isolation room on a cold metal gurney when, earlier, I hadn’t wanted to wake at all!
As I looked up, I was surprised to see Dr. Stevens’ face filling my vision. What was he doing here peering down at me, I wondered? And where, exactly, were we?
I knew Dr. Stevens was on staff at St. Benedict’s, so assumed we were somewhere within the bowels of the old hospital; except I couldn’t remember arriving, or how I’d gotten here.
Not sure if it was day or nighttime, it occurred to me that if it was past the time of Dr. Stevens’ regular hours, he might have been called away from his home. And he was probably not accustomed to being called out after hours–especially for an unexpected encounter with a long-time patient.
As he continued peering down at me, I wondered what he was expecting–evidently not a fight-or-flight response because my body wasn’t restrained in any way; though I couldn’t have jumped up or run away if I tried, and I abhorred any form of aggression.
Undefined quiet having captured all the air in the room, was he waiting for me to break the silence suspended between us?
“This ain’t heaven,” I offered.
The doctor then surprised me, remarking in a low voice, “You must have been in agony.”
Was this empathy? Possibly. But there was no emotion in his voice. Not surprising because he was expert at showing no emotion. He had been able–even after three-plus years of therapy–to remain almost a stranger.
His remark was more likely inquisitive; though it must have been evident I had no desire to talk to him because he said nothing more. He just moved slightly away, seeming to ponder something.
Receiving no further response from me, he then proclaimed, “I’m going to admit you,” quickly turned and left the room.
I was glad he hadn’t asked “how I felt,” or “what I thought,” about being admitted to the hospital–assuming he’d meant St. Benedict’s–because I couldn’t have answered.
I not only had no answers, I was just too weak and weary to care about finding any. Because for a very long time, something I did not understand had dominated my life, suffered my body, tormented my mind, and undermined my soul, affecting every aspect of the world I knew; until, at twenty-something, I no longer wanted to live in that world.
I’d tried explaining this to Dr. Stevens during many therapy sessions, when it seemed the effort could still be worthwhile. It had seemed important, then, to find words to describe how painful my life had become; before I’d reached the point when all that mattered was to escape the hellishness that seemed to pervade it.
I considered it had been very early when a sense of misplacement in the world took hold and illness began its toll, making it difficult to do things others took for granted, and when, along with difficulty meeting the physical demands of life, a systematic mental and emotional turning inward had begun.
Not realizing, as a child, that my experiences might be out of the ordinary, I hadn’t questioned their portentous effect, nor understood, then, how the underpinnings of life had already begun to crumble.
Perhaps long-term physical weakness, reduced resistance to stress, and psychological trauma, had made life seem overwhelming; though something akin to sensory overload also seemed to occur during otherwise normal events: the skin-searing heat of Midwestern summers and chest-tightening coldness of winter had been especially painful, as well the bright lights, noisy crowds, and clamorous traffic of the city (I remembered, in particular, how mind-numbing going to large city departments stores had been: with their many products, overwhelming displays, bright lights, and rushing people).
It seemed, sometimes, as if the very air pressed in on me, and that oppression came from everywhere, like a weight overpowering my energy and will; until even the smallest effort became too taxing, everyday tasks too demanding, as day-by-day, week-by week, and year-by-year, ever more energy was required to merely function. And later on, with no relief from this dreadfulness, I began withdrawing further from what felt like life in a war zone.
It had been difficult even to begin describing these experiences to Dr. Stevens because, focused only on the present, he didn’t seem to understand how very long and deeply they’d been affecting me.
He’d appeared impatient when there was nothing I–or he–could point to as a precipitating cause for my withdrawal. And unable to formulate any boundaries around my description of an all-consuming pain, he’d remarked that, “It would be helpful to draw a line around the problem.”
Frustrated by my inability to pinpoint anything specific for him to conceptualize, my increasing unwillingness to continue explaining, and, finally, my withdrawal into silence, he allowed, simply, that he had “an intellectual understanding” of what I tried to communicate.
“It was like being only an observer of life,” I’d told him, “like watching everything on a movie screen,” not wanting to participate in a world I couldn’t relate to–though it was no less painful to be detached in such a way.
Now, words no longer mattered. I’d stopped trying to explain. Stopped even caring. No longer able to go through the motions of life, I only wanted to be rid of the awful oppression. And sometime before arriving at St. Benedict’s, I’d thought that sliding into a peaceful, non-wakeful sleep would accomplish that.
But it was not to be. Because after swallowing enough pills–I believed–to be rid of the pain that consciousness always brought, I awoke at the hospital and, unbeknownst to me, was about to be admitted to the mental health center across the street, where I could not have prepared for what was to follow. It would prove much too disturbing.