Wednesday, March 03, 2004

Group Therapy: March 3, 2004


Hey, buddy. What’s up today, March 3, 2004?

I think tomorrow, March 4, is the anniversary of the “Catastrophe.” The day I started waltzing
to that unending melody in three-four time. The beginning of my association with Strauss and his band.

But I’m still caught up with the group therapy situation. I telephoned Nicole this morning and left a lengthy and distressed message on her machine. I told her I believe that what I have experienced in group is a violation of my civil rights and my “Consumer Rights Statement” issued by the D.C. Department of Mental Health. I said I plan to file a complaint with the U.S. Department of Justice (U.S. Attorney, Roscoe Howard, District of Columbia) and possibly to the Office of the Attorney General of the United States.

I find it unbelievable and offensive that group members, week after week, make allegations that I’m fabricating evidence of mental illness to maintain my social security benefits, which amounts to an allegation that I’m committing a crime. I don’t think the group members or group leaders recognize that they are, in fact—for all practical purposes—accusing me of engaging in a continuing course of criminal conduct, punishable by imprisonment. Not only do Debra and Nicole say nothing, like perhaps: “Gary’s relationship with the Social Security Administration is out of bounds for discussion,” which I think it is. But on one occasion, Debra actually solicited comments from the female group member about how the group member thought I was malingering—which amounts to her speculating about how I’m committing fraud against a federal agency. Outrageous!

Under the “Consumer Rights Statement” I have a right “to be treated at all times with dignity and respect.” Repeated and unfounded accusations of criminal misconduct are not consistent with my rights.

Under the Statement I have a right to be free of discrimination. Arguably I am being discriminated against because I am the only person receiving disability benefits. None of the other group members have been subjected to accusations of misconduct amounting to a prosecutable offense under federal law. That’s discrimination—abetted by the group leaders, both representatives of the D.C. government.

Also, under the Statement I have a right to “request an exam of my mental condition.” I have repeatedly requested that I be assessed for suitability for group therapy. Debra and Nicole assert that I was in fact assessed for group—that their 30-minute discussion with me prior to my commencement of group constituted an assessment. I don’t think that constituted an appropriate assessment in view of my “long-history of mental illness,” see Letter from Albert M. Taub, M.D. dated February 22, 1999 to the D.C. Board of Medicine, namely “paranoid schizophrenia.”

My illness features the following issues that are pertinent, I believe, to an assessment of my suitability for group:

A history of psychotic ideation of 16 years duration.

The statement made by the late Jerry M. Wiener, M.D. that my paranoia had “crippled my life.” Dr. Wiener was a past President of the American Psychiatric Association and the American Psychoanalytical Association. Dr. Wiener commended my action in filing for Social Security Disability Benefits during a meeting I had with him in August 1993.

The diagnosis of paranoid schizophrenia by two different psychiatrists at two different institutions. Regardless of the correctness of the diagnosis, the import is ineluctable. My style of thinking was deemed by two different psychiatrists to be similar to that found in the most severely disturbed patients. It is useful to bear in mind: If it walks like a duck, and talks like a duck—and it’s not a duck—the fact remains: two experts believed, based on the evidence before them, that it resembled a duck, with all that implies about the animal’s functioning. Even low-functioning persons are not mistaken for schizophrenics.

The diagnosis of bi-polar disorder by a psychiatrist affiliated with St. Elizabeths.

A history of 12 years of complete social isolation. A life-long history of social isolation.

A history of no communication or contact of any kind with any family member since the year 1996.

Allegations by my last employer that I was unable to function in a group setting. Allegations by that employer that I had engaged in violent and disruptive conduct when I was placed in a group employment situation.

A diagnosis of delusional disorder (a psychotic mental illness) following an extensive battery of psychological testing performed by GW in 1994. See Report of Psychological Testing, prepared under the supervision of William Fabian, Ph.D. (GW, May 1994).

The fact that my delusional thinking has been refractory to three different anti-psychotic medications. And, importantly, that my current treating psychiatrist, Betsy Jane Cooper, M.D., recommends that I try a course of a neuroleptic that is considered a medication of last-resort for psychotic patients.

My involvement with three federal law enforcement agencies (during the period 1994-1998) with respect to concerns that I pose a risk of violence.

Well, I think these are a few issues that Debra and Nicole should educate themselves about.

Some expert in group therapy out there must have come up with some objective criteria that can be used to assess a person’s suitability for group. Perhaps someone like Irvin Yalom, M.D., at Stanford. He’s one of the country’s leading experts on group therapy. Yalom used to serve (along with my former treating psychiatrist, Stanley R. Palombo, M.D.) on the editorial board of the journal Psychiatry.

Also, one of my own former psychiatrists, here in D.C., Lewis Winkler, M.D. is an expert in group therapy. I saw Dr. Winkler for three sessions back in the spring of 1991. I stopped seeing him because I believed he was sharing confidential mental health information about me with Bob Strauss and his partners. And doesn’t that in itself speak volumes about my mental status!

Anyway, Dr. Winkler is routinely listed in Washingtonian Magazine as one of the top psychiatrists in the region. So is Dr. Taub, for that matter (who diagnosed me with paranoid schizophrenia.)

In any event, I think my telephone call to Nicole this morning will get some kind of ball rolling. “They’re off and running,” as Bob Strauss would say at Pimlico.

I just can’t get over some of the things in group. Not only did Nicole use the word “dialectic,” but yesterday she spontaneously mentioned Margaret Mahler. A few weeks ago she started to talk about Alfred Adler. And they say I intellectualize too much in therapy! Nicole acts like this is her Ph.D. orals.

Funny thing. I still remember when I was seeing Dr. Winkler, I happened to mention the psychoanalyst Melanie Klein, who died years ago. Dr. Winkler said to me: “You know, in the twenty years I’ve been practicing psychiatry, this is the first time a patient has mentioned Melanie Klein in therapy.” Yes, I still remember that.

I think Debra and Nicole need to look at the psychodynamics of what’s going on. What does it mean that I’m very unhappy with things that, arguably I have a right to be unhappy about, but I feel I can’t talk about my dissatisfactions in group and feel I have to go to the U.S. Department of Justice? How many mental patients complain about group therapy to John Ashcroft? I wonder.

But I have a right to complain. My Statement of Rights says I have a right “to say how I feel about the services I receive.” I didn’t agree not to write to the Attorney General. In my superego functioning the following precept applies: “What is not forbidden is permitted.”

Well, Debra and Nicole can’t say I didn’t warn them. I’m a moral narcissist. A whistle blower. I will not be sullied by others’ impurities.

Come, come, Brian, you well know, Goethe was quite right: “Es bleibt ein Erdenrest zu tragen peinlich. Und w¬r Er von Asbest, Er ist nicht reinlich!”

Check you out later buddy. I hope our trip to L.A. will put me in a better mental state. Can’t wait to meet Will. Great guy.

One other thing I forgot to mention. A few years back I suggested to a psychiatrist that perhaps group therapy would be good for me. His reply was: “I agree that you’d derive benefit from group therapy. But finding the right group would be a problem in your case. You wouldn’t fit into most groups.” I find that significant. What did he mean: “You wouldn’t fit into most groups?” Also, that was before the onset of my psychotic illness. If anything, I’m arguably even less suitable for group now.

Also, Brian. Thanks again for being here (or there) for me. I don’t know what I would do without you and your empathic ear. Thanks, buddy.

No comments: