Psychiatric Shoes

I’ve known my share of mental health professionals in my time: psychiatrists, licensed marriage and family therapists, social workers and substance abuse treatment counselors, not to mention the various vintages of students, trainees and interns in each of these fields. Many of us have relationships with people like this, and it’s important for us to learn how to get the most out of these relationships and deal with the feelings they bring up. Let me tell you a story about my very first one.

I met her when I had just turned 25 years old. Back then you had to be a pretty big troublemaker to be sent to therapy as a child or teen, and I had been the quiet type. I didn’t really have any idea about what psychotherapy was, or the difference between the types of professionals, or even what the goals of treatment were supposed to be. I only knew I was there because I’d talked a little too loudly about my suicidal thoughts and been admitted to the “Hotel 5150” for a few days that turned into a few weeks.

My room did not look like this.

The staff at psychiatric wards deal with so many frequent flyers that I think it’s sometimes easy to forget how frightening the whole process can be for a first-timer. I wish they’d had a little brochure to hand out; “Introduction to the Psych Unit.” Not just the rules they lay out, but the little things they don’t think are necessary to say. I seized up in complete terror the first time I heard the door to my room creak open in the middle of the night, not realizing it was the hourly safety check. I got reprimanded for opening a window, because nobody had ever told me not to. I felt shamed by so many small things…the plastic spoon with my dinner, the crayons instead of pens, being told when I could take a shower.

The staff’s name badges had first names only on them, except for the psychiatrists. I guess they figured that the anonymity ship had sailed for them, because their full names were on our prescriptions anyway. It also set them apart from the other staff as the ones who controlled our meds and our potential release.

See this? I can write anything I want on it.

See this? I can write anything I want on it.

So that’s how we met. She was “Doctor ______” and I was a mental patient. I’d been a graduate student in molecular biology three days ago. Now I was nothing, and she held all of the power. Her manner was detached and methodical, as if she were going down a checklist (which, knowing what I know now, she probably was.) I found myself fascinated by every detail of her appearance, as if observing her thoroughly enough could restore some of my own power.

She was probably in her late twenties, gorgeous and impeccably dressed. Tall and slender, with lustrous brown hair hanging nearly to her waist, she arrived every day in a different suit worth more than my monthly stipend. Her makeup and jewelry were tasteful and conservative, adding to my impression of an “old money” background. Everything about the way she looked seemed to highlight my own failures, and her controlled manner denied any similarity between us.

I felt so lonely and so judged that I needed to find some mundane quality in her; some way I could see her as a person with human foibles. I found it in an unlikely place: her shoes. Every other piece of her expensive apparel was basic in its color and design, but her shoes betrayed her. There were the black-and-white checkered heels, the beige diamond-patterned sandals, even a pair of orange leather near-stilettos one day. I ran with it…I imagined her pondering which pair to wear in the morning. I imagined her laughing with girlfriends on a shopping trip. I imagined her flirting with a salesclerk and agonizing about whether to indulge herself with a new pair.

Or what kind of shoes she wore after work.

Or what kind of shoes she wore after work.

I’ve learned and done a lot since that time, including some experience and study in the field of counseling. Though I’m not licensed or currently practicing, I now know something of what it must have been like to be in her chair. I realize that she was almost certainly an intern on her first clinical rotation, reporting to a training supervisor. I’m able to wonder if part of her was as scared in that place as I was, and had been trained or advised to adopt a detached manner to maintain her authority. I sometimes wonder what she’s doing now; whether she stayed in the field and how her philosophy has evolved over time.

I deal with professionals very differently now. I know how to test and evaluate the degrees of honesty it’s safe to have with someone, and how to accept the unsafe ones for the imperfect people they are and stick to practical matters with them. Most of all I know that these professionals are no less wounded than I am: they struggle with addictions or childhood wounds or abusive relationships or a hundred other issues just as we do. They close the door after a difficult session and shake for five minutes before placing a frantic call to a supervisor or peer because they don’t know what to do.

Never forget this. Sometimes it’s important for us to be humble and admit that we aren’t in a place to have good judgment; that we need the help of people with some training and objectivity. But these people are not “other.” They’re us, and we’re them.

One response to “Psychiatric Shoes

  1. I am really enjoying your blog!

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