Tuesday, July 06, 2004

Love That Bob!


Brian--
Hey, buddy. How was your Fourth of July? I think I reached new depths of misery this weekend last.
Brian, Brian, Brian. What are we going to do? I just see nothing going on for me, occupationally or socially. I've been out of work now for almost 13 years. Who would hire me in any type of job worth doing? Socially, I just had a bad breakup with my girlfriend. She claims I threatened her, and called the cops on me. Women!
It just seems that, at age 50, I'm at that point in life--and in a life situation--where most normal people would give serious thought to committing suicide. Fortunately, I'm not normal.
Dr. Bash popped the question last session. I knew the question was coming--if you'll pardon the pun. "Do you have sexual feelings for Brian?" "No," I said. "I don't have any feelings for Brian below the neck."
I've decided to come clean. Fess up. Yes, I've had one homosexual experience. It happened years ago, in Pittsburgh. I've never mentioned it before -- to anyone. We were both crazy kids at the time. His name was Bob. His father was a German immigrant who came to the States to pursue a career as a solo flugelhorn player. The old man never made a go at that (big surprise!), and settled for a career in dry goods. Bob said his mother wanted him to grow up to be the first Jewish President of the United States. Obviously, that never happened, at least so far. I think about Bob now and then. I wonder if he ever made anything out of himself, whether he ever did anything with his life.
We slept together. He would get up in the morning and rush off to work, scrabbling through piles of our mingled trousers and briefs, running his head under the sink, slamming the front door in farewell, and after he was gone I would spend the luxury of my extra hour by bathing in the claw-foot tub and in the strangeness of it all. We lived well. Bob cooked elaborate dinners; in the refrigerator there was always pasta in the colors of the Texas flag, a variety of weird wines, capers, kiwis, unheard-of fish with Hawaiian names, and stacks of asparagus, Bob's favorite food, in the rubber-banded bundles that he never failed to refer to as fagots. We sent our dirty clothes out to be cleaned and they came back as gifts, tied up in blue paper. And, as often as possible we went to bed. I did not consider myself to be gay; I did not consider myself, as a rule. But all day long, from the white instant when I opened my eyes in the morning until my last black second of awareness of Bob's fading breath against my shoulder, I was always nervous, full of energy, afraid. The city was new again, and newly dangerous, and I would walk its streets quickly, eyes averted from those of passersby, like a spy in the employ of lust and happiness, carrying the secret deep within me but always on the tip of my tongue.
In any event, the fling with Bob didn't last. I woke up one morning and found a note on my bed stand. "Freedman. You rubbed me the wrong way -- literally and figuratively. I'm taking a trip to Russia; will be backpacking through the Urals. Bob." I never saw him again.
Be that as it may.
I find it absolutely impossible to talk to The Mad Monk. First, she simply invalidates everything I say. Her standard responses include: "No, that's not true." "No, I don't think so." "You need to get out and enjoy the beautiful weather." "Do you speak Hebrew?" "Do you eat out?" "Do you play chess?" Yes, that was the latest addition to her repertoire of recommendations: "Do you play chess?" I rely on you, Brian, or references to you, as a mantra--as a defense against the pain inflicted on me by her inanity. I just keep saying: "I want to see Brian. I want to talk to Brian. Couldn't you talk to Brian?" It's a never-ending cycle. She: "Do you speak Hebrew?" I: "I just want to talk to Brian." She: "Do you eat out?" I: "I just want to talk to Brian." She: "Do you play chess?" I: "I just want to be friends with Brian." I think she's getting sick of me. Good! She should understand that so long as she interacts with me as if I have no valid opinions, no unconscious wishes, conflicts or prohibitions--she, in turn, will suffer the consequences. Frankly, I see no end to this stalemate. Dr. Bash is not smart enough to comprehend how her behavior elicits the responses that she gets from me.
I badly need the support and corroboration of people whose opinion I respect, and when I don't get it, it's a terrible strain for me. Sound familiar?
Last session, she said to me: "I see by your chart that one of your previous psychiatrists, Dr. Taub (she proceeded to spell his name, "T-A-U-B"), recommended that you take the anti-psychotic medication Zyprexa in the year 1998. And that you refused to take it." My response: "Well, I in fact took Zyprexa in the year 2001 and it didn't do anything for me." The Mad Monk replied: "Well, if you had taken the medication when it was first recommended, it would have worked." I said: "But I took the medication eventually." She said: "But you took it three years after it was first recommended. If you had followed your psychiatrist's recommendation initially, the drug would have worked." As the sisters say in the 'hood, "Oy veh!"
I pointed out to Dr. Bash that it's a recognized fact that anti-psychotic medication rarely is effective in cases of delusional disorder. Its effective in schizophrenia, but not delusional disorder. "No," she said, "that's not true. Anti-psychotic medication is effective with delusions; it doesn't matter if the delusions are symptomatic of schizophrenia or delusional disorder." She doesn't know what she's talking about. Even Dr. Barbot said to me a few months ago, "anti-psychotic medication is frequently ineffective in delusional disorder."
In any event, the fact is I've taken three different anti-psychotic medications (in addition to lithium for my non-existent bi-polar disorder). None of the meds worked. So Dr. Bash's comment is somewhat moot. Even assuming anti-psychotic meds can be effective in delusional disorder, the fact is the three meds I've tried haven't been effective. And get this. Dr. Bash said: "So what medications did you take?" I said, "Zyprexa, Abilify, and Risperdal." Her response: "Oh, I don't think Abilify is the right medication for you." Like she knows. Where did she get her medical degree?
As I've pointed out to countless psychiatrists, I have very severe personality problems independent of what would be termed psychotic symptoms. Even if you removed the psychotic symptoms, I'd still be left with a debilitating (non-psychotic) personality disorder. Keep in mind, I've been seeing psychiatrists for 27 years now. It was only in 1992 that anti-psychotic medication was recommended for me. The fact is I've had a life-long history of social isolation that pre-dates the year 1992. I've had serious, debilitating personality problems before Bob Strauss started to spy on me in the fall of 1988!
At one point Dr. Bash asked me what it is that I'd like to do with you, Brian, if we were to get together. I said: "You know, I've thought about that. There's a park bench in front of the library. I'd be happy just to sit on the park bench with Brian and talk--shoot the breeze. Maybe for a half-hour or so, once in a while. We could just talk and eat lunch. Talk and have a sandwich or something. That would make me happy." And, of course, Dr. Bash proceeded to invalidate that with an absurd tangential response. "Well," she said, "that's not a friendship. That's something you do with an acquaintance. Do you know the difference between a friend and an acquaintance? Do you have a dictionary at home. Look up the word "friend" and look up the word "acquaintance." You need to that." ("You need to do that"--you just knew she would get that phrase in somehow, somewhere). "A friend is someone you do things with, go places with, share experiences with. An acquaintance is someone you just chat with. You're confusing an acquaintance with a friend." Does it matter? She missed the point. I feel comfortable with someone, namely you, buddy. I'd be happy just to talk to you, precisely because I feel a bond, a connection with you.
Based on what I said about you, she proceeded to offer her recommendation: "Well, if you're happy just to chat with an acquaintance, why don't you just go to a park and strike up a conversation with a stranger?" Yea. Right. Is that really what I'm talking about?
I can just imagine a conversation between Dr. Bash and Nancy Reagan:
NANCY REAGAN: I miss Ronnie so much, Doctor Bash. I feel I was robbed of my last ten years with him. I wish I could have some time with him. Just an hour. Just sit on a park bench and talk to him for an hour, the way he was before his illness. That would bring some closure to our relationship.
THE MAD MONK: Well, Mrs. Reagan, if that's all you're looking for, why don't you go to a park. Are there any parks in your neighborhood? Just go to a park and -- you'll see I'm right -- there are a lot of old men sitting on park benches who you could talk to. It's not hard to find old men sitting on park benches who'd be willing to chat with you for an hour. Really, Mrs. Reagan, you're making this more difficult for yourself than it needs to be.
Well, maybe that's what I need to do. Get myself a pair of double-knit slacks, some white shoes and find some old geezer on a park bench to chat with. And my problems will be solved!
With Dr. Bash, there's just no recognition of any internal psychological functioning: no recognition of internally-generated psychic pain. In her way of thinking, everything comes down to finding some soothing object in the outside world. It's all a matter of speaking Hebrew, finding a park bench, playing chess, or eating out.
Once again--as I've said countless times in the past--if it's so easy to make friends and if conventional social adjustment is the ultimate source of happiness, why are there so many lonely and miserable people in the world? Or even better: why are there so many miserable drug addicts who shoot up with their conventional friends? If dope-heads have friends, why do they need drugs to make them happy? Even more: why are there people who by any reasonable measure have enviable lives, but end up committing suicide--people like Vince Foster or Edgar Rosenberg (Joan Rivers' late husband). I guess these people never mastered the Hebrew language, the font -- or mikvah, as Fred Cohen would say -- of all joy!
I was struck by something I read about Suze Orman. You know her? The money guru? She appears on public television stations from time to time, giving advise on managing money and investing. She's Jewish. She said that when she was young, she moved to Israel to find spiritual fulfillment. One day she was riding on a bus in Israel, and she struck up a conversation with the person sitting next to her. She explained her whole story: how she grew up in the States and moved to Israel to find spirituality. Her companion mocked her. "You're looking for spirituality? So you moved to Israel? You won't find spirituality here or anywhere else. Spirituality comes from yourself. From inside yourself. It doesn't come from outside. Spirituality comes from inside. You don't need to live in Israel to find spirituality." Of course, if Suze Orman had been sitting next to Dr. Bash, she'd probably still be looking for spirituality in Israel. "Do you have a synagogue in your neighborhood?" "You need to master Hebrew. Right now your Hebrew needs improvement. That's your problem, Miss Orman."
By the way, Brian, did you know that there are no lonely, unhappy people in Israel? It's the only country in the world where nobody's unhappy. You know why? Everybody speaks Hebrew! That's why Dr. Bash moved to the U.S. to practice psychology. There's just no client pool in Israel. So she learned English (the perfect language to be miserable in), got a psychology degree at N.Y.U., and the rest, as they say, is hysteria. "People, people who speak Hebrew, are the luckiest people in the world!"
I just don't know what to do. I gotta get out of this relationship. I keep thinking about Dr. Caesar, the psychoanalyst in my building. You know, I really think one dollar per session's not a bad deal for him--at least that's what I thought before I learned that he drives a Porsche and subscribes to "The Wall Street Journal." My current thinking is that any psychoanalyst who drives a Porsche and reads "The Journal" everyday is not going to be too keen on a patient who pays one dollar per session.
So where does that leave me? Maybe Dr. Akman would take me on. Jeffrey Akman. I think I told you about him before. He's the head of psychiatry at GW. He's homosexual. He's in a long-term relationship with another guy. Maybe he'd find my case interesting. Maybe he'd see some research interest in a gender-confused, obsessive letter writer who's been looking for love in all the wrong libraries. Jeff Akman is a cool guy. He specializes in gay male patients. His patients all love him--literally, I suppose.
I don't know. As far as I can see, I'm ready to go to work in therapy. Do some hard, in-depth therapeutic work -- without the Hebrew, the chess, the park benches, the synagogues (Reform or Conservative) or the "all you can eat" breakfasts at Denny's. It seems to me that Dr. Bash can't meet my needs. She just perpetuates my role as the "professional patient." That specific phrase she used: "I see by your chart . . . " That's so typical of the mental outlook of therapists who perpetuate the professional patient syndrome.
It reminds me so much of what Erik Erikson wrote about the professional patient: "Hospitalized patients, having been committed, are often ready to commit themselves. They expect 'to go to work,' both on themselves and on whatever task they may be asked to do. But too often they are met by a laborious process of diagnosis and initiation which emphasizes the absolute distance of patienthood from active life. Thus literally 'insult is added to injury' in the uprooted one, already considered expendable or abnormal by his previous group of affiliation, who finds himself categorized and judged by those who were expected to show him the way through a meaningful moratorium. Many a man acquires the irreversible identity of being a lifelong patient and client not on the basis of what he 'is,' but on the basis of what is first done about him [as described in his medical records]. "Insight and Responsibility" at 97. Incidentally, Dr. Bash's motto is: "I have no insight and I take no responsibility."
Everything The Mad Monk recommends doesn't pan out. So how can I take her seriously? When I first saw her, she said I was employable. She would harp on that endlessly. "You can work. I don't understand why you don't work. It's sinful in the Jewish religion for a person not to work." Apparently, she subsequently got her marching orders. "Don't tell him he's employable." She no longer talks about my getting a job.
You should ask Brian if he would go to lunch with you. -- Yea. Right.
You should do group therapy. -- And that turned out to be a dream come true, didn't it?
When I asked Dr. Bash last week why I had problems in group, her answer was "you have no social skills." In fact, nobody in group even alluded to my lacking social skills. They said they found me personable, charismatic and outgoing. The Mad Monk is giving me symptoms I don't even have; that's great for my self-esteem!
Months ago, Dr. Bash said I was fabricating evidence of delusions. She said I really didn't believe that the Pope and The Prime Minister of Israel were involved in my case. Now, she's dropped that idea, and chastises me for not taking anti-psychotic medication to rid me of my ideas about the Pope and the Prime Minister!
She asked me to tell her why I'm obsessed with you, buddy. I said: "Would you accept a written explanation?" "Sure," said the Mad Monk. The following week I told her I'd written a ten-page letter about you, Brian. "Ten pages!" she said. "That's awfully long. You just keep repeating the same things over and over again in your letters. And you think people are interested in reading what you write? Nobody's interested in reading the same thing over and over."
I've had it. Really, Brian. Dr. Bash is the last straw in a lifetime of disappointments. Lock me up for saying this, but "Somebody's going to pay for my pain."
Check you out later, my Faustian friend. Write to you again on the 12th, buddy.

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