A Song of Ice and EAP

Ice Cubes as a Metaphor

Dr: "How have you changed since you've been released?"

Me: "Well. I always have ice cubes in the freezer now."

Dr: "Uh... Is that a euphemism?"

Me: "No. But think about it. I'm stable. I'm home on a regular basis. I always have potable water and i'm always mindful of when i have to refill the ice cube trays."

Dr: "You could get a fridge with an automated ice maker."

Me: "That would be cheating. And besides, the ice gnomes who emerge from under my toe-nails at night would be offended."

Dr: "Um... Who signed off on your release again? oh! it was me."

Me: "No No. Just kidding. Ice gnomes? Under toe-nails? Kidding. I kid."

Dr: "whew"

Me: "Everyone knows ice gnomes come out of your navel."

Dr: "Now you're just fucking with me, arent' you?"

Me: "Only when my lips are moving, doc."

What Do I Care that Cause Precedes Effect?

Dr: "Go over that last bit again"

Me: "The part about the fever leading to an infection?"

Dr: "Yes, that."

Me: "Well i had a fever which propagated backwards in time to the point most likely where i would have developed the infection."

Dr: "Is that how you see the world working?"

Me: "Mostly. Sometimes events aren't correlated in time."

And this is how an undergraduate course in phenomenology led to an additional three weeks in the facility.

The Capgras Delusion

Dr: "So tell me more about the impostors around you."

Me: "Not so much impostors. More like THE impostor."

Dr: "Hmm. Your chart says you think people around you are impostors."

Me: "Oh, no. That's a mistake. I think metaphorically there is a 'person' who surrounds the 'real me' and sometimes blocks actions i want to take, sometimes does things I probably didn't really want to do. THAT is the impostor."

Dr: "Well... I'm already scheduled on Oprah to talk about the Capgras Delusion. You don't think you could maybe scream a few things about everyone around you being replicas, could you? It would make my presentation a lot more interesting."

Me: "Oh Doc. I would if i could. I just can't get up a full head of steam to talk about something that's really sort of a metaphor. You know. While i'm in a straight jacket."

Dr: "Hey. So. You wouldn't mind signing this waiver, would you?"

Me: "And all this time i thought you were a doctor."

Dr: "In the modern world, we are all insurance agents."

Me: "Is there a syndrome for that?"

Dr: "APA membership syndrome?"

subject. object. duality. meh.

Me: "So... Doctor... Tell me how you felt when you realized you had sexual feelings towards your mother."

Dr: "Wait a second... That's my line."

Me: "It's okay. It's all part of the process. We're building empathy. And wouldn't you agree that empathy has to go both ways in order for the trans-formative affects of cognitive based therapy to be effective?"

Dr: "Uh... Sure... Have you studied psychotherapy?"

Me: "Of course... How could i truly be crazy if i didn't understand the criteria by which i am judged insane?"

Dr: "That's usually not considered a requirement."

Me: "You would be amazed by the rational understanding held by most people commonly called 'insane.'"

Dr: "Oh no. I completely believe it. I've seen plenty of 'rational' processes that serve to reinforce the ego-dream."

Me: "But is it a rational process to repress distressing memories?"

Dr: "ORDERLY! It's time for me to leave."

Me: "Now we're getting somewhere. why do you want to leave?"

Dr: "This conversation is decidedly uncomfortable."

Me: "You're not going to get very far wearing that straight jacket."

Dr: "HOLY CRAP! HOW DID I GET INTO A STRAIGHT JACKET!?"

Me: "It's always been there."

(a more realistic vignette from the facility)

Dr: "Okay... And i think we'll put you on a moderate dose of Welbutrin and follow up with blood tests in a week. and if you experience any side effects, just press the red button and tell one of the staff."

Me: "Aren't we supposed to do 'talking therapy' too?"

Dr: "Hmm.. Don't think it's covered by your plan."

Me: "But if you look at the data, it shows that SSRIs work best in conjunction with cognitive based therapy."

Dr: "Yeah. I've seen that data. It's fascinating."

Me: "But no cogntive therapy?"

Dr: "Well. It's kind of expensive. But we have a great cafeteria here at the facility."

Me: "But the data..."

Dr: "Yeah. You're really going to have to talk to your plan administrator after you're released."

Me: "Uh oh."

Dr: "Do you have a problem with your plan administrator? Your notes say you're argumentative sometimes."

Me: "Uh... No.. I mean... I AM the plan administrator."

Dr: "Hold on! Let me look up what Carl Rogers wrote about irony."

Me: "Oh fuck me."

Dr: "No No. That's what Rogers wrote about the medical insurance industry."

GRUPPE

Me: "Wanna talk about it?"

Roommate: "Why i'm here?"

Me: "Yeah."

Roommate: "No"

Me: "Cool"

Roommate: "If you want to talk, I don't care. Might take my mind off my own problems to listen to someone else's"

Me: "Yeah. I guess I don't want to talk about it either."

Counselor: "TIME FOR GROUP! EVERYBODY! COME IN FOR GROUP!"

Me (to roommate): "You want to make some shit up? Just so we have something to talk about in group?"

Roommate: "Not so much. Making shit up is part of why i'm here."

Me: "Ooh. Good point."

Me (a second later): "Uh-Oh"

Roommate: "What?"

Me: "Just realized not talking about it is probably part of why i'm here."

Roommate (sarcastically): "I see we're making progress, today."

Me (a second later): "Sure you don't want to make shit up?"

Roommate: "You're not helping."

Counselor (cheerily): "HEY GUYS! COME IN FOR GROUP!"

Roommate: "Okay. I think i'm the king of france."

Me: "Really?"

Roommate: "No. Idiot. For group."

Me: "Cool! I yelled at a customer for changing into a cheese wheel without permission."

Roommate: "Oh! That's cool. Can i have that one!?"

Me: "Sure. You take that one."

Counselor (in the distance): "GROUP!"

Me: "Okay... I planned the escape from the last facility i was in."

Roommate: "No one escapes from Behavioural Health Stalag 13!"

Me: "Absolutely. But for the record... You're the enabler."

Voices

Dr: "Go on..."

Me: "And i kept hearing these voices saying horrible, horrible things."

Dr: "And do you still hear the voices?"

Me: "Oh heck no. They don't let me on twitter in here."

[*] It helps if you know that an "EAP" or "Employee Assistance Program" is a common "first response mental health plan" in corporate america.