Counseling and Therapy

It is the middle of the night and I cannot sleep, so I thought I would take the time to write to you. Hope this letter finds you doing well.

I arrived early for my appointment with my psychiatrist, Dr Saba, last week, hoping he would call me into his office before the scheduled time, because there was a girl in the waiting room sobbing, and this was beginning to upset me. When Dr. Saba called my name and led me toward his desk and shut the door behind us, he immediately placed the scales in front of me, and I weighed in at 160.3 pounds. He became concerned about all the weight I was losing, and said he could look at me and tell I was getting too thin. I told him I thought the scales were wrong, because I had a bathroom scale at home and I weighed more on it than this. Becoming obsessed with weighing myself, I had noticed that when I ate a meal, I would gain two pounds; when I had a bowel movement, I would lose a pound; when I urinated, I would lose six-tenths of a pound; and I always weighed less in the morning, when I got out of bed, than I did at night before bed. Dr. Saba told me that this was natural for a person, and I replied that whenever I stepped on his scales during an appointment, I felt like I was taking a test, fearing that I would fail. “It isn’t like that,” Dr. Saba said, attempting to comfort me. I told him I wasn’t fasting anymore, and he responded by thanking me. “What kinds of foods do you like?” he asked. I told him I liked lintels and rice, I liked bagels, and I liked cheese, among some other things that were not on my diet. “You can have these things twice a week and it won’t hurt you,” Dr Saba said. I told him again that I thought his scales were wrong, so I stepped on them once more. I weighed in this time at 166.4, which was closer to what I weighted on my scales at home.

I told Dr. Saba that I was seeking out more mental health support. I had an appointment scheduled with a psychotherapist, and I was hoping for a great improvement in how I had been feeling. I had gotten involved with an establishment called Navigate, which was part of the East Carolina University medical school. These were the type of therapists I was looking for — people who were good students, who were young and idealistic, who may be inexperienced but didn’t feel jaded or arrogant. Dr. Saba seemed irritated at my descriptions, as if they were a reflection on him, but I didn’t mean it that way. He told me to stay in counseling and to consider the turnover, as the students there would eventually graduate.

When the day to meet my student counselor finally arrived, I rode my mountain bike to Greenville with a great sense of anticipation. I entered the campus of the medical school hours before my appointment, walking into the School of Human Services building, knowing there was a library in there — filled with classic medical texts — where I could sit down, cool off, and read some as I was waiting. I went up into the stacks for a couple of hours, looking through old books on anatomy, physiology, cancer, and personality disorders. I left the library later on and walked past a woman on the housekeeping staff, who was pushing a large broom along a perfectly clean floor in the hallway trying to look busy. I stepped into an elevator, reaching the fourth floor, and I entered the waiting area for Navigate clients, where a college student gave me some paperwork to fill out and sign. She also gave me a handbook. My new counselor was a young woman with short curly hair, who introduced herself as Dana. We found out that we were both “morning people” who enjoyed the aesthetics of the sunrise. Dana said she liked walking her dogs every morning while it was still quiet outside.

We entered an office with a desk and three chairs; I took a seat and placed my bicycle helmet upon the empty one in the corner. Dana closed the door, allowing me to speak my mind — a flood of complaints came out of my mouth. I told her that I was living with stigma, with disrepute affecting almost every aspect of my life. I had only Social Security to live on, being disabled because of mental illness, and I couldn’t afford to buy a car, so I was seen throughout Robersonville riding a bike to get from place to place. Whenever I would go to a store, I had to use a backpack to carry the items I had bought there, or hook the bags on my handlebars, and the people in town could notice this. I couldn’t afford to buy my food at the local Food Lion, so I had to ride my bike to the housing projects to receive my weekly supply from the food bank, using a large backpack I had bought from a sporting goods store that was meant for mountain climbing and hiking. I also lived in subsidized housing, in an apartment complex that everyone in town knew was housing for the handicapped and the indigent.

Dana thought it was interesting that when I rode my street bike in Robersonville, I felt the obloquy of normal people, but when I left town on my mountain bike, I felt that the stigma had melted away. This was because out on the open road I had become anonymous — nobody out there knew me — and passing motorists didn’t realize that I was attempting to transport myself to an appointment, but thought that I was merely an athletic person out for a morning ride. In Robersonville, everyone sees and knows everyone else. The local librarian, Sallie, greets me sometimes when I go in there, saying “I haven’t seen you in a while,” always encouraging me to come in as if she is glad to see me, but addresses me in a maternalistic fashion, as if I were a child who cannot take care of himself, instead of a fully grown adult who is the same age as she. My girlfriend Laura has a friend from church who addresses me as if I were an eight year old. I didn’t think much of it at first, then I began to notice how she would size people up according to the money they had and the property they owned. She was a member of the Robersonville Country Club.

“She’s at the top,” Dana observed.

I told her that there wasn’t much money in Robersonville, and the majority of the people — those who felt they were at the top — weren’t really as wealthy as they seemed to think they were. This was because they had lived in Robersonville all their lives, having no liberal arts education (if they had an education at all), knowing very little about the world outside of Martin County. I told Dana that I won a settlement from a class action lawsuit seven years ago, placing the money in a savings account, adding to it every month. I have low-income with high savings and low debt, while my rent and food subsidies are based upon my income alone. As I continue to save thousands of dollars as the years go by, some of the working people in town, who would pass by me in pickup trucks while I’m on my bike — those who would look down upon me with disrespect, hating me because they resented paying taxes to support me — they didn’t realize that my net worth is probably greater than their own, and this realization is my only way of exposing their ignorance, of giving them all the finger.

The question of whether I can work or not has already been settled, I have amassed proof and evidence in the eyes of the law that I cannot, and I didn’t wish to revisit this in therapy. When I was in the state hospital the first time, I went to vocational rehabilitation and was placed in a job that wasn’t really a good one, but it was the best one I ever had, where the bosses were in the offices screaming at each other, where all the coworkers were nasty and hated one another. I thought that this was what work was all about. Then I got involved with a psychiatrist who was shooting me up full of lithium and other drugs. I didn’t know what his motivation could have been, except maybe to receive kickbacks from the pharmaceutical company, but at the time I trusted him. I would cup both my hands together, filling them with multicolored capsules and pills, filling my mouth with them, washing them down with a big glass of soda. One afternoon, I pulled my car over on the shoulder of the highway — to lean my seat back and rest my eyes for just a moment — when a Good Samaritan approached the side of my car, knocking on my window — I had been sitting there for hours and didn’t know it — and I slowly rolled the window down, and he asked, “Sir, are you all right? Do I need to call someone?”

I didn’t realize how sick my doctor was making me. I was at home seeing visions of disembodied skulls floating in my apartment; I could shut off the lights and watch glowing castles made of rubies and emeralds glistening upon the walls. A week later, I was driving and was pulled over by the police, who shined a flashlight into my eyes, noticing how dilated my pupils were, and I was lucky that I had my huge bag of medicine with me. The policeman told me to go straight back home. If I ever got into an accident while taking that stuff, he was telling me, I could be taken to civil court and be sued. This same week, my boss called me into his office, asking me what was wrong, because my job performance was marginal and my eyes were glassy. I was also experiencing tremors in my hands and my vision was failing. I was gaining weight as my health rapidly deteriorated.

I was a computer operator, and I always printed out memos concerning the other bosses and workers — then, suddenly, the memos were about me — and my boss would rush into the computer room and tear them off the printer so I couldn’t read them. My coworkers in my department soon became suspicious. “Where did you used to live before you came here to work?” they would ask me. I couldn’t tell them that I had lived in Cherry Hospital for two years and three months — where I lived among the lobotomized and the insane — treated by quacks who couldn’t keep a job anywhere else.

And I wasn’t employed much longer, either. After a couple more years of struggling to find work — changing doctors as often as I got fired by my bosses, getting evicted time after time, getting my car repossessed, and moving from town to town — finally, I realized I just couldn’t do it anymore. I ended up in Central State Hospital for sixteen months because I could no longer work and support myself, and I needed to be in a place where I could get my medication and take a bath. There was a forensic unit there, where most of the inmates in there had committed murder. The director of the hospital had created an open ward, to ease the overcrowding in forensic and to warehouse the other patients who were not placed in there by a judge — patients who could leave but had no home to go to — while the social workers would try to find them a place to live, forcing them out to most anywhere, and, while being trapped in the community placement building, we were all treated as criminals. And I got involved with a woman in there who killed her two teenaged sons with a shotgun as they were sleeping in their beds, then she turned the rifle on herself, but failed in the attempt, shooting herself in the thigh. She showed no remorse for her crime. She said she was only trying to send her children to heaven. She thought that if she followed all the rules to the letter, being always sweet with the staff, she would get discharged just like any other patient, living and working on the outside as if she had never done anything wrong.

“I don’t want to talk about this anymore,” I told Dana, interrupting my story. “I don’t know why I got on this subject. I just keep talking and talking while you remain silent. I guess it’s as if I was lying on a couch rambling to Sigmund Freud about my terrible childhood.”

“That’s the thing about therapy,” Dana replied, “Sometimes you begin discussing past trauma and you leave the session feeling awful.”

Dana asked me about my risk for suicide. I replied that I wouldn’t want to give my enemies the satisfaction. What I wanted was longevity, because the first half of my life was not really worth it, but now I wanted to live my best possible life.

Dana continued by asking how I found out about the Navigate project. I told her about Laura’s stay in the hospital at Vidant Medical Center, and they had these brochures for the National Alliance for the Mentally Ill in the waiting area. I took one, planning to go to a support group meeting, but when I called the contact number, they said the only meetings were at night, and, therefore, I couldn’t attend. What I was really looking for was a therapist, and they gave me the number for Navigate, and I made an appointment. It took a lot out of me to call and ask for help, knowing that a stranger was going to be at the other end of the line.

Dana began asking me what I wished to accomplish in therapy. I told her I no longer wished to be a recluse. I wanted to separate Laura’s problems from my own, and not allow her to monopolize my social life. I wanted to have a better outlook, and to deal with stigmatizing circumstances better. I also wanted to feel happier and to function in a more healthy fashion.

When the session was over, I almost left the office and forgot my helmet. I asked Dana where was a good place to secure a bike, and we looked out one of the windows, down upon the courtyard below, where my bike was locked by a cable to a tree. She said there were places on the grounds especially made to park a bike. If I should see one of the groundskeepers, he would be able to tell me where these places were. After we said goodbye until my next appointment, I turned my phone back on and called Laura as I was leaving the grounds of the medical school.

She was planning to have a yard sale this Saturday.

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