Oct. 17, 2015 - The 'talking cure' doesn't work without action

The ‘talking cure’ doesn’t work without action

By Christopher MacNeil

Two to three hours of sleep every night for months, a daily diet of mostly coffee and cigarettes, a steady loss in weight and the idea that being dead - inexplicably comforting - would be a welcome break. And at 24 years of age.

So were the symptoms that drove me to make an appointment with my family’s doctor. I had not been part of my family for years, however, and was not sure I would get an appointment. I did, though, and went to the appointment assuming the doctor would prescribe vitamins and a sleeping pill to get me built up physically - and that would be it. Instead, the doctor subjected me to a battery of tests in his office and at a hospital, from weight and blood pressure readings to x-rays and a CAT scan.

Then, the diagnosis: medically sound but I “showed up looking like death” and was “a pressure cooker ready to blow,” the doctor said. His treatment plan: “It’s time for a psychiatrist.”

Throttled by the confirmation that I was crazy, one of the words my father had hurled at me for years, I sat dazed and scared in the doctor’s office as he called a shrink a third of a state away to set up my first talking session. “Goddamn,” I thought to myself driving home from the doctor’s office, “he (my father) was right! I’m f**king crazy.”

My dad would have loved being proven right, and he would have loved what it had done to me. Barely into legal adulthood, I felt like a loser as a man and raped of whatever masculinity and concept of manhood I was raised to believe. A “real” man didn’t need “a goddamn shrink” and the man who did was a not a man, my father told me once. Defeated and emasculated, I conceded to my father. He’d been right all along. The medical doctor made it official. I was a basket of eggs to be “handled with care” or get completely broken - forever shattered, never again whole.

So was my attitude heading into my first session with a doctor whose specialty I always believed was reserved for people who were not only crazy but weak as well. And I was about to join their elite company. I was somewhat disappointed that my first session with the psychiatrist consisted mostly of questions about my health but was consoled when I left with a handful of prescriptions for anti-depressants, sleeping pills and dietary supplements.  With all those medicines, I had been certified as crazy and finally I had a clue to what the rest of my life would be like: a permanent regimen of “anti-crazy” medications and caution not to hit a bump on life’s road that would shatter me.

The self-exploration and introspection that is the meat of the “talking cure” came quickly enough after I was properly medicated and, at one point, I informed the doctor I had concluded that I was manic-depressive, the predecessor to the current term – bipolar. He suggested I leave the diagnosing to him and subsequently concluded I had suffered for years with “depressive neurosis.” I knew what neurotic meant - but depression?

The next five years were dotted with countless psychiatric sessions and a couple of in-patient stays in the psych ward of a hospital in Indianapolis, the second that lasted three months and included some two dozen electroconvulsive or ECT sessions - “shock” treatment that then was used routinely to treat severe depression.

In time, I was gradually weaned from all the medications, and sessions with the psychiatrist gradually tapered off and eventually ended altogether. But while I was discharged as “sane” again, I had a lingering sense that I had been treated only with drugs and had not delved into myself deeply enough to understand where and why I went wrong years earlier. That deeper introspection came years later in another city where I had moved and resumed therapy with another psychiatrist after an alcoholic relapse and, later, as a trauma victim of a home invasion in which I shot one of two assailants with his own gun.

Through my second psychiatrist, I understood that I had started therapy for the first time with the incorrect assumption that simply talking would “cure” whatever was wrong. I failed to see that the talk had to come with action to confront and deal with the reason for whatever was broken in my emotional and mental psyche. To that end, my second psychiatrist was literally my life-saver.

Not surprisingly, my relationship to my father and his to me consumed a hefty chunk of my second round in therapy. By then, I was ready to give up and was literally sick of the “victim” role that I assumed in that uneasy, even destructive, relationship. Instead I took on the paternal perspective of our father-son relationship and came to understand that my father parented me as he had been by his father. The reasons my grandfather raised my father as he did helped me to develop empathy for my dad and, with that, my “forgiveness” of him came.  I also understood I had to simply reconcile myself to the truth that I had been a failure as a son and could only hope my father had forgiven me although we had not seen each other or even talked for some 17 years before he died.

But a dream, and the psychiatrist’s interpretation of it, gave me closure with my father - to the extent there is closure. In my dream, I was a child again and on a swing when a grown man who was not my father came up to me and asked if he could adopt me. Recounting the dream to the psychiatrist, I chuckled in frustration and asked why I was “doing this to myself again.” My doctor quickly answered with his interpretation of my dream: I was the man returning to myself as a child to tell the broken boy inside me that he was worthy of love, that he had healed, that it was “okay” to become a man. I was dumbfounded, at a total loss of words: in that split moment, both my father and I were free.

As for drinking, my psychiatrist was a hard-liner. Drinking is a choice that comes with consequences, and there is personal responsibility to those consequences, he said. If the consequences of my choice to drink are worth the risk, go ahead; if the consequences of getting caught are too heavy, then don’t. While I internalized that rationale and still apply it, I also understood that my own drinking was rooted in a “need” to escape whatever reality I either could not or did not want to face. In short, I did not trust myself to be strong enough to get through something difficult or painful without getting drunk.

The invasion of my home in which I shot a man should have been one of the strongest threats to my sobriety but, ironically, strengthened it. Within days of it, I called my doctor after nights of no more than 45 minutes of sleep, days of not eating, literally jumping in panic at the slightest of sounds and worrying about being criminally charged. I decided again I had gone “crazy” but, this time, I needed to be locked up in a psychiatric hospital.

The doctor assured me I wasn’t crazy and that I was dealing with trauma. As I sat in a chair next to the reception area while the doctor dictated prescriptions for medication, he asked me if I thought I needed Antabuse. Although fully aware that Antabuse is a prescribed drug that makes problem drinkers sick if they drink on it and is used to deter drinking, I was caught off guard and fumbled for words to answer the doctor’s question. “Do you think you need a drink?” he asked quickly as if to clarify. I answered - honestly - “It hasn’t even crossed my mind. Why’d ya’ ask?” The doctor answered, “Maybe you’re strong enough not to need it anymore.”

At a loss for words for my doctor again, I stared unblinkingly at him or maybe at something not there but nonetheless real, aware only of the track of a single teardrop on my cheek and the power of the moment: for the first time in my life - the first time - someone had empowered me with the strength to survive something horrible. I knew then that whatever happened to me from then on I would be alright.

And I have been.

My days of therapy are long passed, and my sobriety now has mounted to years. But I fall back onto my years on the couch to pick up and put to work the tools that therapy gave me. As my second psychiatrist said, counseling can give us the tools to work with but are of no use if we don’t pick them up and apply them. For me that means taking care of myself first but not to the extent that I am the center of the universe, removing myself from myself when I begin to think that no one bears a heavier load, letting go when hanging on is unhealthier, and avoiding malignant feelings such as self-pity, anger and resentment. Doing that, I understand a vintage promise of 12-step recover: life’s toughest day sober is still better than the best day drunk.

To the men from the era that bred my father and grandfather, when a man needing help to survive his lot in life was seen as less than a man, I can only say that your world was probably simpler and less stressful and that you are to be commended for the happiness and success of your life. If anyone wants to say I am less a man because I tripped along the way, I can say with honesty that the help I needed so desperately has made me more a man today than I was yesterday.