Post by Admin on May 5, 2022 11:05:32 GMT
What my patient with paranoia taught me about fear and humanity
psyche.co/ideas/what-my-patient-with-paranoia-taught-me-about-fear-and-humanity
He was scruffy-looking, unshaven, eyeglasses taped and barely holding together. In rumpled pants and tired tennis shoes, he shuffled his feet in that Frankenstein’s monster-like gait that I hadn’t seen since my municipal hospital days in the Bronx – back when patients were locked in psychiatric wards accessible only with lunatic asylum keys, artefacts of the Victorian era.
John (not his real name), a newly referred patient, plopped down on my sofa. ‘You know,’ he began, ‘that psychiatrist, Dr G, who made me come to you, has weird sexual stuff going on right under his desk.’ John continued: ‘Also, Dr G and my wife tricked me into quitting my last psychotherapist. I am not happy about it!’
Seated opposite John, I felt frightened by his paranoia and resentment. My office sits at the end of a long corridor in a medical suite in suburban New Jersey. Private patients in my practice rarely looked unkempt, nor did they spout sexualised paranoid distortions.
I worried that John would soon weave me into his delusions, a bumpy ride for which I felt unprepared. He was not happy to be with me. Nor I with him.
My office felt invaded, no longer an oasis with plush oyster-hued loveseats, Henri Matisse and David Hockney posters, and soothing whispers from a white noise machine. For decades, this was a place for quiet conversations, confidential sharing and serious collaborations. Now my space felt precarious, like an exposed wire threatening to shock. Could I help John? Did I want to?
My back stiffened. My stomach began to knot. Gripped by anxiety for my safety, I doubted my competence to treat this delusional patient. But I soldiered on, hiding behind a list of standard intake questions for a semblance of composure.
John was in his mid-50s, married with two adult sons. He lived in an affluent town and was unemployed. Jobs as a business writer had crumpled under the paranoid contortions that cast co-workers as threats to him and undermined his focus. His wife headed a major human resources department. The couple had met as undergraduates at an elite Mid-Atlantic college before paranoia invaded John’s psyche.
Begrudgingly, at the end of our first session, and after John had mouthed a litany of complaints about therapy with me, he agreed to come back. At each session, he’d bemoan the loss of Dr AJ, his prior female psychotherapist. John rarely made eye contact. Miserable and annoyed, he dutifully attended sessions while I, dutifully but warily, tried to engage him.
psyche.co/ideas/what-my-patient-with-paranoia-taught-me-about-fear-and-humanity
He was scruffy-looking, unshaven, eyeglasses taped and barely holding together. In rumpled pants and tired tennis shoes, he shuffled his feet in that Frankenstein’s monster-like gait that I hadn’t seen since my municipal hospital days in the Bronx – back when patients were locked in psychiatric wards accessible only with lunatic asylum keys, artefacts of the Victorian era.
John (not his real name), a newly referred patient, plopped down on my sofa. ‘You know,’ he began, ‘that psychiatrist, Dr G, who made me come to you, has weird sexual stuff going on right under his desk.’ John continued: ‘Also, Dr G and my wife tricked me into quitting my last psychotherapist. I am not happy about it!’
Seated opposite John, I felt frightened by his paranoia and resentment. My office sits at the end of a long corridor in a medical suite in suburban New Jersey. Private patients in my practice rarely looked unkempt, nor did they spout sexualised paranoid distortions.
I worried that John would soon weave me into his delusions, a bumpy ride for which I felt unprepared. He was not happy to be with me. Nor I with him.
My office felt invaded, no longer an oasis with plush oyster-hued loveseats, Henri Matisse and David Hockney posters, and soothing whispers from a white noise machine. For decades, this was a place for quiet conversations, confidential sharing and serious collaborations. Now my space felt precarious, like an exposed wire threatening to shock. Could I help John? Did I want to?
My back stiffened. My stomach began to knot. Gripped by anxiety for my safety, I doubted my competence to treat this delusional patient. But I soldiered on, hiding behind a list of standard intake questions for a semblance of composure.
John was in his mid-50s, married with two adult sons. He lived in an affluent town and was unemployed. Jobs as a business writer had crumpled under the paranoid contortions that cast co-workers as threats to him and undermined his focus. His wife headed a major human resources department. The couple had met as undergraduates at an elite Mid-Atlantic college before paranoia invaded John’s psyche.
Begrudgingly, at the end of our first session, and after John had mouthed a litany of complaints about therapy with me, he agreed to come back. At each session, he’d bemoan the loss of Dr AJ, his prior female psychotherapist. John rarely made eye contact. Miserable and annoyed, he dutifully attended sessions while I, dutifully but warily, tried to engage him.