Starting Line: A Story and Response

What Can Go Right as Well as Wrong in Therapy

A collaboration and conversation with PreetamDas

f-bomb-psalms

about the challenges of just reaching out and finding therapy.

Starting Line is written by Preetam. Followed by my response. The audio version of Starting Line is on Preetam’s site for those who want to listen.

Note from Dr Sherry: My critiques of the therapists in this series are harsh. I know that. I’m trying to balance that by suggesting more of what we CAN do to help. The aim here is not to make people afraid of seeking therapy, just more alert ;). At Preetam’s suggestion, I’ll keep suggesting the “Green Flags” as well as the red ones, so people know what TO look for! We hope that this shared project will lead to a better understanding and better conversations about mental health and wholeness.

Starting Line

I had arrived at the counseling office technically a few minutes late to see a new therapist, the previous one still being “on leave” now since the first of the year. The therapist was still with a previous client. I can definitely appreciate that happening so I waited patiently and busied myself trying to mind the adult in my brain who was insisting I not move the furniture in the waiting area, as I was trying to work out how I could do exactly that without the receptionist noticing. There was a quarter inch of brown colored something sticking out from under the short cube shelf that held magazines and brochures. Once I noticed it, my mind became obsessed with it.

“It could be an air vent. It shouldn't be covered anyway and I can barely breathe, it's so humid”, my mind reasoned.

“I want you to leave the furniture alone,” insisted my adult.

My spouse has sometimes been surprised, by which I mean exhausted, by my rearranging the furniture so often at home. If he had any idea of the actual struggle it is sometimes to not do that in other places, keeping it at home would likely be a relief.

We, the adult, when available, and I, go through this in public. I’ll try to make it through my entire meal and exit the restaurant without balancing the crooked hanging picture on the wall opposite our table.

I will. I will try.

I will struggle and I will most often, fail that test.

We can't take us anywhere.

“If I just slide it slowly toward me,I bet she won't even look out from behind her computer screen,”

My OCD chattered on like this until the therapist was a half hour late for our appointment and I expressed my concern to the young receptionist. Finally, Terri, the counselor appeared, trailing the clients as they left the office. She was a weathered, older woman but that was all I or anyone was going to notice easily for awhile, as she wore a kind of colorful tribal top and tribal leggings but they were different tribes and the tribes were at war. Maybe she's trained in treating OCD and is, you know, really holistic about it, like I imagine I’d be. I mean, it was almost like it was meant to be an intentional OCD diversion tactic.

In my imagination, the OCD goblin is greenish and looks up from the protruding brown strip of fabric under the shelf to declare with wide eyes, “Wtf?”

The busy jaguar-like print leggings stopped just above her ankles where they gave way to worn, dull colored suede demi boots. That's right, I said ‘demi boots’. It was in the first several minutes of our first conversation that it all instantly came together when she shared she had been in the “biker life”. My roots include adults who scared kids like me with these words put together, roots where this image was basically an Evangelical nightmare, this counselor's roots included actual members of “Hell’s Angels”.

The more I listen and learn, the less I know for sure about God or “the Universe”. The only thing I’m convinced of is: a sense of humor must be key,

I cut my eyes at That I Cannot See, and look back at the counselor, visibly missing a few essential teeth, with her Hell’s Angel's biker background and effusively “gay-welcoming” self, whose help I need so much and I reach into my backpack for previous evaluation results I had brought to share and here, we begin, blurring lines unseen.

-pdk

Dr. Sherry responds:

We all need and yearn for order. Even the most fluently-creative individuals I know need some sense of order in their lives. How can you create from a place of continual danger?

Because that’s what disorder can feel like: danger. It can be freeing, but it can also be frightening.

Especially so for people who grew up in the most chaotic, unpredictable homes. Which, for you, Preetam, we know to be true, thanks to your generous sharing.

The term or diagnosis of OCD is thrown around a lot lately. A former client of mine who was tormented by intrusive sexual thoughts once said that she laughs when some people talk about their “OCD” if they’re describing a relatively-minor, common quirk.

From her perspective, I get it. Especially if they’re describing fleeting experiences that are quickly and easily taken care of and put out of mind.

But of course, there are so many variants of both obsessive thinking AND compulsive behaviors, that the toll taken can be just as varied.

(BTW, I know at least one other person, a friend of mine who used to babysit for Simba, who needs to do the picture-straightening thing; our apartment was a bit of a challenge for her, but she usually resisted ;).

On top of what I imagine is your ongoing search for safety and predictability, it’s not at all surprising that the OCD Goblin was particularly aggressive as you were waiting to meet your new therapist. You had been finally settling in to your sessions with the pen-stabbing, voodoo-casting guy, and he was unpredictably taken away from you! More adaptation ahead. Danger, Will Robinson. Danger.

Her unacknowledged 30-minute lateness must have been excruciating. I imagine that as painful as it was to feel tortured by the furniture, it would have felt doubly difficult to feel as frightened and angry as you probably were already feeling toward her.

I know all about biological/chemical predispositions. I also know that early environments shape how those genetics become expressed by each of us.

For people with OCD, whether the capital or lower-case version, the obsessions/compulsions are learned survival mechanisms.

Think about something, anything other than what’s actually going on right now.

Or for some people, they’re compelled to think ONLY about what they fear.

Or to take action to correct something concrete because nothing else is fixable.

That might be true in general, like you say, even at a local restaurant with your husband who loves you. And it becomes even more of a needed mechanism in a situation with warning signs all around it.

The part that’s so tragic is that the repetition of your mind working this way, on so many occasions over the years, has become so automatic, or near-automatic, that the struggle to regain control is really a battle.

For my client, her obsessive thoughts were trying to help her work out her own feelings about sexuality. But they also became hardened to a point where it was hard to tell what her genuine self was trying to say.

In your case here, you were trying to cope with your first meeting with someone you’d hope to depend upon. Like your family. But who was looking less and less dependable as the minute hand kept ticking. Like your family.

I too can appreciate therapists sometimes running a little overtime. Not 30 minutes without a true emergency. And certainly not unacknowledged.

What you needed by the point you got into the office was an apology or at least acknowledgment, and a conversation about what it was like for you to be kept waiting.

On your own out there in the waiting room, your old coping mechanisms had to work on overdrive because it must’ve felt too scary to feel so scared and angry at someone you haven’t even met yet. Someone you were hoping to count on.

But once in the office, if those feelings had been given room to breathe, it might’ve led to more insight, more working through of old feelings of chaos, and it might’ve been a genuine way for you to start bonding with “Terry”.

She might’ve planted enough of a seed for you to be able to be more compassionate with yourself. Rather than continue to split yourself into the rational adult who just can’t take this kid anywhere with him and the frightened child who just can’t get things in order.

If she’d given you a genuine welcome, inquiring about who you are and what hurts you rather than the list of all the queer people she knew (I know that from another audio; in this one it’s what you refer to as the “effusive gay welcoming”), perhaps with a real conversation about you, not about her, your attention might’ve been drawn back to your own actual feelings of pain.

Instead, you were left with the same self-shaming you’ve internalized over the years. Who am I? Am I worth knowing? Worth seeing as an individual?

Faced with those feelings, it’s no wonder your focus held on to the tribal warring factions of her outfit and the misplaced bookcase.

As one of my colleagues commented on our earlier piece, what a missed opportunity. Out of her imperfections and yours, something more useful might have been built.